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OPT 541 > Quiz-AntiHTN and hyperlipidemia > Flashcards

Quiz-AntiHTN and hyperlipidemia Flashcards

1
Q

hydrochlorothiazide

A

Thiazide. Works on distal tubule. Increase Na and H20 excretion. First line drug for HTN.

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2
Q

Loop diuretics

A

inhibit reabsorption of Na and chloride in ascending loop.

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3
Q

Furosemide

A

Loop diuretics. Stops reabsorption of Na and Cli in ascending loop of henle

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4
Q

Eplerenone

A

K sparing diuretics. Stops aldosterone action in collecting duct. Helps pt. survive CHF. Doesn’t cause gyneomastia so preferred.

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5
Q

Beta 1 blockers

A

First line drug therapy for HTN with concomitant disease (MI) Beta 1 blockers mainly affect the heart.

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6
Q

Metaprolol

A

Beta 1 blocker. Used for HTN with concomitant dz (MI).

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7
Q

Beta 1 blockers SE

A

Decreased BP, Fatigue, sexual disfunction, bradycardia, insomnia.

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8
Q

ACE inhibitor

A

Used when diuretics or beta blockers are contradictor of ineffective (HF, renal dz). They decrease angiotenonsin II and increase bradykinin levels (cause persistent cough).

Drug names pril

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9
Q

Ace inhibitor SE

A

Dry cough, hyperkalemia, hypotension, skin rash, fever.

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10
Q

Angiotensin II-Receptor blocker

A

Alternative to AceI. Produse arteriorlar and venous dilation and block aldosterone secretion. Do not increase bradykinin levels so have reduced drug cough and angioedema.

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11
Q

Angiotensin II-receptor blocker drugs

A

All end in sartan!

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12
Q

Renin inhibitor

A

Acts earlier in the renin-angiotensin-aldosterone system. Used with other antihypertensives. A fixed dose combination with valsartan (Angiotensin II receptor blocker) or HCTZ (thiazide)

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13
Q

Aliskiren

A

Renin inhibitor. used with Valsartan or HCTZ.

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14
Q

Calcium channel blockers

A

Good for elderly and african americans. Have dipine suffix!!

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15
Q

Verpamil

A

CCB. Treats angina, tachyarrhythmias, and to prevent migraine and cluster HA

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16
Q

Nifedipine

A

CCB. First generation. Treats cardiovascular disease

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17
Q

CCB SE

A

Flushing, dizziness, fatigue, constipation, HA, hypotension

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18
Q

Alpha 1 blockers

A

Blocking alpha 1 relaxes the vessels. However alpha 1 tends to be used more often in the treatment of benign prosthetic hypertension. End in suffix odin. Can have first dose hypotension (rapidly decrease BP so the pt faints. Takes only at night) i.e. doxazosin and prazosin.

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19
Q

Alpha 2 agonist

A

Diminishes the central adrenergic outflow. Serves as a negative feedback mech. to slow down the heart and decrease BP. i.e. clonidine

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20
Q

Labetalol

A

Block alpha 1, beta1 and beta 2 blocker. Given as an IV in a hypertensive 911.

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21
Q

Minoxidil

A

Vasodilation. Often used with a BB and diuretic to treat severe malignant hypertension. Can use with ESRD.

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22
Q

Sodium nitroprusside

A

Used for a HTN emergency. Given as an IV.

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23
Q

Nitrates

A

Reduce peripheral resistance and pressure by dilation of vessels

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24
Q

What drugs should you use on young, white pt?

A

Start with an Acei or Beta blocker (AB)

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25
Q

What drugs should you use on older and black pt?

A

Start with an Calcium-channel blocker or diuretics (CD)

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26
Q

Which causes fetotoxicity

A

ACEi, ARBs, and aliskiren

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27
Q

Long term complications of HTN?

A

Cerebrovascular accidents, congestive HF, myocardial infarction, and renal damage.

28
Q

Coronary Heart disease

A

Cause of death in about half of all deaths in the US. Correlated with high levels of ldl and low levels of hdl. Other risk factors are smoking, hypertensives, obesity, and diabetes. Can also be due to genetics.

29
Q

Cholesterol

A

Found in cell membranes, vitamin D, and hormones

30
Q

Triglyceride

A

Used to store FA.

31
Q

Lipoproteins

A

Phospholipida and proteins that carry triacyglycerides and cholesterol in the body.

32
Q

Chylomicrons

A

A type of lipoprotein. Carry cholesterol and triaacylglcerides (lipids) absorbed in intestines. Can be turned into different densities.

33
Q

VLDL

A

Has smaller protein content. Transported to tissue and delivers triacyglycerides and becomes iDL and then LDL

34
Q

LDL

A

Has small protein content. BAD

35
Q

HDL

A

Has a high amount of protein. Can remove remnant lipoproteins and deliver them back to the liver to be re-used. This is the good cholesterol.

36
Q

Step 1: Serum triglycerides

A

Normal 500

37
Q

Step 2 of treatment

A

Figure out what patient risk is for CHD, carotid a. disease, peripheral arterial disease, or abdominal aortic aneurysm based on their numbers

38
Q

Step 3

A

Look at major risk fators. smoking, hypertension, family history of CHD, age (greater then 45 men and 55 for women)

39
Q

Type I inherited lipodemia.

A

Famililal hyperchylomicronemia. Have high chlyomicrons in blood even with normal dietary fast intake resulting in elevated TG levels. Deficiency of lipoprotein lipase or normal apolioprotein CII (rare). Not associated with increased risk of CHD. Low fat diet. no drug therapy will work.

40
Q

Type IIA

A

Familial hypercholesterolemia. Increased LDL with normal VLDL levels due to block in LDL degradation. Have an increased cholesterol levels but normal TG levels. Caused by defect in the synthesis or processing of LDL receptors. Ischemic heart dz is accelerated.

41
Q

Type IV

A

Familial Hypertriglyceridemia. VLDL levels are increased, where LDL levels are normal or decreased resulting in normal to elevated cholesterol, and greatly elevated TG levels. Cause is overproduction and or decreased removal of VLDL in serum. This is a relatively common dz. Has accelerated ischemic HD. Frequently patients are obese, diabetic, and hyperuricemic.

42
Q

Treatment goals

A

Reduce ldl levels. CHD is positively associated with high cholesterol and with elevated LDL cholesterol in the blood.

43
Q

Treatment options for hypercholosterolemia

A

Diet, exercise, weight reduction, drug therapy if ldl levels high then 60

44
Q

Clinical signs of high cholesterol in the eye

A

Xanthalasthma-fat deposits in the lid

arcus-gray deposits along the limbal area.

45
Q

HMG CoA reductase inhibitors

A

Inhibits the first committed step of cholesterol synthesis. Improves coronary endothelial function. Inhibits platelet thrombi formation and are anti-inflam. The statins!

46
Q

Lovastatin

A

Statin. HMG CoA reductase inhibitor. PRODRUG!

47
Q

Simvastatin

A

Statin. HMG CoA reductase inhibitor. PRODRUG!

48
Q

Atorvastatin

A

Statin. HMG CoA reductase inhibitor. Very strong.

49
Q

When to use statins?

A

All types of hyperlipidemias. Often give in combo with with other anti-hyperlipidemic drugs. Use with diet, exercise, and additional agents.

50
Q

Statin SE

A

Liver failure, myopathy (muscle pain happens in 50-20) Severe cases can cause lysis of the liver). Cannot use in pregnancy.

51
Q

Niacin

A

Nicotinic acid. Vitamin B3 taken at a much high dose. Is most effective agent for increasing HDL. Reduces ldl levels by 10-20%. Lowers the level of plasma fibrinogen. Use in combo with other agents. Causes cutaneous flush and pruritus. Take aspirin prior to taken to relieve SE. Taken once daily at bedtime. Inhibit secretion of uric acid so may exacerbate gout.

52
Q

Fenofibrate

A

Fibrate. Peroxisome proliferator activated receptors (PPAR) that increases lipoprotein lipase. Lower serum triacylglycerols and increase HDL levels. Treat hypertriacyglycerolemias. SE: a predisposition to the formation of gallstone and myositis.

53
Q

Gemfibrozil

A

Fibrate. Peroxisome proliferator receptors (PPAR) that increase lipoprotein lipase. Lower serum triacylglcerols and increase HDL levels. Treat hypertriacylglycerolemias.

54
Q

Bile acid-binding resins

A

Bile acid is important in allowing the body to absorb the fatty food we eat. Bile acid is made in gall bladder and synthesized in the liver.. The drug will interfere with the recycling of bile acid and will increase the ant being secreted out of the body. Stops FA from being absorbed. This class of drugs is not absorbed by the body. It works in the intestine and then leaves.

55
Q

Bile acid being resins SE

A

Constipation, nausea, and flatulence. Impair absorption of fas soluble vitamins (ADKE). Take 1-2 hours before or 4-6 hours after meds to avoid drug interference.

56
Q

Cholestryamine

A

Bile acid binding resins

57
Q

Cholestrol absorption inhibitor

A

Inhibits absorption of dietary and biliary chorister. Lower LDL and TAG and increases HDL. If you get less chol from your diet then your liver will make more HDL. May not be as effective as sequestering we just talked about.

58
Q

Ezetimibe

A

Cholesterol absorption inhibitor

59
Q

Simcor

A

Combination of simvastatin and niacin. Must may close attention to muscle problems.

60
Q

What would you use to treat high cholesterol

A

A statin

61
Q

What would you use to treat low hdl

A

Niacin

62
Q

What would you use to treat high ldl

A

Fibrate.

63
Q

Important apopolipids

A

B-100: binds ldl CII: lipoprotein lipase E=uptake

64
Q

Desired chol levels

A

LDL: < 200TG <150

65
Q

Doxazosin

A

Used for HTN. Blocking alpha 1 relaxes the vessels. However alpha 1 tends to be used more often in the treatment of benign prosthetic hypertension. End in suffix odin. Can have first dose hypotension (rapidly decrease BP so the pt faints. Takes only at night) i.e. doxazosin and prazosin.

66
Q

Prazosin

A

Used for HTN. Blocking alpha 1 relaxes the vessels. However alpha 1 tends to be used more often in the treatment of benign prosthetic hypertension. End in suffix odin. Can have first dose hypotension (rapidly decrease BP so the pt faints. Takes only at night) i.e. doxazosin and prazosin.

OPT 541 (3 decks)

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