Week 4 & 5 Flashcards
1
Q
SGLT-2 Inhibitors - MOA
A
Inhibit sodium-glucose co-transporter 2 in the proximal renal tubule, reducing glucose and sodium reabsorption, leading to osmotic diuresis and improved cardiovascular and renal outcomes.
2
Q
SGLT-2 Inhibitors - Pharmacokinetics
A
Oral administration, renal excretion, minimal hepatic metabolism.
3
Q
SGLT-2 Inhibitors - Adverse Effects
A
Genitourinary infections, dehydration, hypotension, ketoacidosis (rare).
4
Q
SGLT-2 Inhibitors - Therapeutic Use
A
Heart failure with reduced ejection fraction (HFrEF), renal protection in chronic kidney disease (CKD).
5
Q
SGLT-2 Inhibitors - Contraindications
A
Severe renal impairment, type 1 diabetes (risk of ketoacidosis).
6
Q
SGLT-2 Inhibitors - Monitoring
A
Renal function, hydration status.
7
Q
Amiodarone - MOA
A
Prolongs the action potential duration and refractory period, primarily blocking potassium channels (Class III antiarrhythmic effects).
8
Q
Amiodarone - Pharmacokinetics
A
Extremely long half-life (weeks); hepatic metabolism via CYP3A4.
9
Q
Amiodarone - Adverse Effects
A
Thyroid dysfunction, pulmonary fibrosis, hepatotoxicity, corneal deposits, photosensitivity, QT prolongation.
10
Q
Amiodarone - Therapeutic Use
A
Atrial fibrillation, ventricular arrhythmias.
11
Q
Amiodarone - Contraindications
A
Severe sinus node dysfunction, second- or third-degree AV block (without pacemaker).
12
Q
Amiodarone - Monitoring
A
Liver function tests, thyroid function tests, chest X-ray, EKG, pulmonary function tests.
13
Q
Amiodarone - Black Box Warning
A
Pulmonary toxicity, hepatotoxicity, proarrhythmic effects; use only in life-threatening arrhythmias.
14
Q
Class I Antiarrhythmics - MOA
A
Block sodium channels, reducing conduction velocity and excitability. Subclassified into IA, IB, IC based on effects on action potential duration.
15
Q
Class I Antiarrhythmics - Pharmacokinetics
A
Varies by subclass: hepatic metabolism, renal excretion.
16
Q
Class I Antiarrhythmics - Adverse Effects
A
Proarrhythmic effects, QT prolongation (IA), CNS toxicity (IB), negative inotropy (IC).
17
Q
Class I Antiarrhythmics - Therapeutic Use
A
Atrial and ventricular arrhythmias (varies by subclass).
18
Q
Class I Antiarrhythmics - Contraindications
A
Severe heart failure, structural heart disease (IC agents).
19
Q
Class I Antiarrhythmics - Monitoring
A
EKG for QT interval, arrhythmia recurrence.
20
Q
Class I Antiarrhythmics - Black Box Warning
A
Proarrhythmia risk; reserve for life-threatening arrhythmias.
21
Q
Iron Therapy - MOA
A
Replenishes iron stores necessary for hemoglobin synthesis.
22
Q
Iron Therapy - Pharmacokinetics
A
Oral: absorbed in the duodenum and upper jejunum; Parenteral: bypasses absorption.
23
Q
Iron Therapy - Adverse Effects
A
Oral: GI upset, constipation, dark stools; Parenteral: hypersensitivity reactions, hypotension.
24
Q
Iron Therapy - Therapeutic Use
A
Iron deficiency anemia.
25
Iron Therapy - Contraindications
Iron overload disorders (e.g., hemochromatosis), active infections (parenteral).
26
Iron Therapy - Monitoring
Hemoglobin, ferritin, transferrin saturation.
27
Iron Therapy - Black Box Warning
Risk of anaphylaxis with parenteral iron preparations.
28
Vitamin B12 Therapy - MOA
Provides cobalamin required for DNA synthesis and red blood cell production.
29
Vitamin B12 Therapy - Pharmacokinetics
Absorbed in the ileum with intrinsic factor or via parenteral route; stored in the liver.
30
Vitamin B12 Therapy - Adverse Effects
Rare: injection site reactions, hypersensitivity.
31
Vitamin B12 Therapy - Therapeutic Use
Pernicious anemia, vitamin B12 deficiency.
32
Vitamin B12 Therapy - Contraindications
Hypersensitivity to cobalt or vitamin B12.
33
Vitamin B12 Therapy - Monitoring
Hemoglobin, mean corpuscular volume (MCV), vitamin B12 levels.
34
Folic Acid Therapy - MOA
Provides folate required for DNA synthesis and red blood cell production.
35
Folic Acid Therapy - Pharmacokinetics
Oral absorption in the small intestine; widely distributed.
36
Folic Acid Therapy - Adverse Effects
Rare: hypersensitivity reactions.
37
Folic Acid Therapy - Therapeutic Use
Folate deficiency anemia, prevention of neural tube defects in pregnancy.
38
Folic Acid Therapy - Contraindications
Pernicious anemia (masks vitamin B12 deficiency symptoms).
39
Folic Acid Therapy - Monitoring
Hemoglobin, MCV, folate levels.
40
Statins - MOA
Inhibit HMG-CoA reductase, reducing cholesterol synthesis and increasing LDL receptor expression to lower LDL-C levels.
41
Statins - Pharmacokinetics
Hepatic metabolism, primarily via CYP3A4 or CYP2C9; extensive first-pass effect.
42
Statins - Adverse Effects
Myopathy, rhabdomyolysis, liver enzyme elevation, gastrointestinal upset.
43
Statins - Therapeutic Use
First-line for hyperlipidemia, prevention of atherosclerotic cardiovascular disease (ASCVD).
44
Statins - Contraindications
Pregnancy, active liver disease, unexplained persistent liver enzyme elevations.
45
Statins - Monitoring
Lipid panel, liver enzymes, CK if myopathy is suspected.
46
Nitrates - MOA
Convert to nitric oxide, causing vasodilation by increasing cyclic GMP in vascular smooth muscle.
47
Nitrates - Pharmacokinetics
Rapid onset with short half-life; hepatic metabolism.
48
Nitrates - Adverse Effects
Headache, hypotension, flushing, dizziness, reflex tachycardia.
49
Nitrates - Therapeutic Use
Acute angina, angina prophylaxis, heart failure.
50
Nitrates - Contraindications
Concurrent use with phosphodiesterase inhibitors (e.g., sildenafil), severe hypotension.
51
Nitrates - Monitoring
Blood pressure, frequency of angina episodes.
52
Heparin - MOA
Activates antithrombin III, inhibiting thrombin (factor IIa) and factor Xa, reducing clot formation.
53
Heparin - Pharmacokinetics
Rapid onset; parenteral administration; hepatic and reticuloendothelial metabolism.
54
Heparin - Adverse Effects
Bleeding, heparin-induced thrombocytopenia (HIT).
55
Heparin - Therapeutic Use
DVT, PE, ACS, anticoagulation during procedures.
56
Heparin - Contraindications
Active bleeding, severe thrombocytopenia, history of HIT.
57
Heparin - Monitoring
aPTT, platelets.
58
Heparin - Black Box Warning
Risk of spinal/epidural hematomas with neuraxial anesthesia or spinal puncture.
59
LMWH - MOA
Primarily inhibits factor Xa through antithrombin III activation.
60
LMWH - Pharmacokinetics
Subcutaneous administration; renal elimination.
61
LMWH - Adverse Effects
Bleeding, thrombocytopenia (less than heparin), injection site reactions.
62
LMWH - Therapeutic Use
DVT prophylaxis and treatment, unstable angina, non-ST-elevation MI.
63
LMWH - Contraindications
Active bleeding, severe renal impairment, history of HIT.
64
LMWH - Monitoring
Anti-Xa levels in select patients (renal impairment, pregnancy).
65
LMWH - Black Box Warning
Risk of spinal/epidural hematomas with neuraxial anesthesia or spinal puncture.
66
Warfarin - MOA
Inhibits vitamin K epoxide reductase, reducing synthesis of clotting factors II, VII, IX, and X.
67
Warfarin - Pharmacokinetics
Hepatic metabolism via CYP2C9; delayed onset due to preexisting clotting factor half-life.
68
Warfarin - Adverse Effects
Bleeding, skin necrosis, purple toe syndrome.
69
Warfarin - Therapeutic Use
Long-term anticoagulation for DVT, PE, AFib, prosthetic heart valves.
70
Warfarin - Contraindications
Pregnancy, active bleeding, noncompliance.
71
Warfarin - Monitoring
INR, aiming for target range based on indication.
72
Warfarin - Black Box Warning
Major bleeding risk; monitor INR closely.
73
DOACs - MOA
Inhibit factor Xa (e.g., rivaroxaban, apixaban) or thrombin (e.g., dabigatran).
74
DOACs - Pharmacokinetics
Rapid onset; hepatic metabolism (CYP3A4 for Xa inhibitors) and renal excretion.
75
DOACs - Adverse Effects
Bleeding, GI upset.
76
DOACs - Therapeutic Use
Stroke prevention in AFib, DVT/PE prophylaxis and treatment.
77
DOACs - Contraindications
Severe renal impairment, active bleeding.
78
DOACs - Monitoring
Renal function, bleeding signs.
79
DOACs - Black Box Warning
Risk of spinal/epidural hematomas with neuraxial anesthesia or spinal puncture.
80
CCBs - MOA
Block calcium influx in vascular smooth muscle and myocardial cells, causing vasodilation and reduced myocardial contractility.
81
CCBs - Pharmacokinetics
Hepatically metabolized, primarily via CYP3A4; variable half-life depending on the drug.
82
CCBs - Adverse Effects
Dizziness, peripheral edema, flushing, constipation (especially with verapamil); hypotension, bradycardia (non-dihydropyridines).
83
CCBs - Therapeutic Use
Hypertension, angina, arrhythmias (non-dihydropyridines), Raynaud’s phenomenon.
84
CCBs - Contraindications
Severe hypotension, heart block, or recent MI (for non-dihydropyridines).
85
CCBs - Monitoring
Blood pressure, heart rate, signs of edema.
86
Beta Blockers - MOA
Block beta-adrenergic receptors, reducing heart rate, myocardial contractility, and renin release.
87
Beta Blockers - Pharmacokinetics
Extensive hepatic metabolism, renal excretion; half-life varies by drug.
88
Beta Blockers - Adverse Effects
Bradycardia, fatigue, depression, cold extremities; may mask hypoglycemia symptoms.
89
Beta Blockers - Therapeutic Use
Hypertension, angina, heart failure (specific agents), arrhythmias, post-MI, migraine prophylaxis, essential tremor.
90
Beta Blockers - Contraindications
Severe bradycardia, heart block, asthma (non-selective agents).
91
Beta Blockers - Monitoring
Heart rate, blood pressure, signs of heart failure.
92
Beta Blockers - Black Box Warning
Abrupt discontinuation may lead to severe cardiac events; taper gradually.
93
Diuretics (Loop) - MOA
Inhibit Na⁺/K⁺/2Cl⁻ cotransporter in the ascending loop of Henle, increasing sodium and water excretion.
94
Diuretics (Loop) - Pharmacokinetics
Rapid onset; renal excretion; dose adjustments needed in renal impairment.
95
Diuretics (Loop) - Adverse Effects
Hypokalemia, hyponatremia, dehydration, ototoxicity, hyperuricemia.
96
Diuretics (Loop) - Therapeutic Use
Edema due to heart failure, cirrhosis, or renal disease; hypertension (second-line).
97
Diuretics (Loop) - Contraindications
Anuria, severe electrolyte depletion.
98
Diuretics (Loop) - Monitoring
Electrolytes, renal function, fluid status.
99
Diuretics (Loop) - Black Box Warning
Profound diuresis with electrolyte and fluid depletion.
100
Diuretics (Thiazide) - MOA
Inhibit Na⁺/Cl⁻ cotransporter in the distal convoluted tubule, increasing sodium and water excretion.
101
Diuretics (Thiazide) - Pharmacokinetics
Moderate onset; renal excretion.
102
Diuretics (Thiazide) - Adverse Effects
Hypokalemia, hyperglycemia, hypercalcemia, hyperuricemia.
103
Diuretics (Thiazide) - Therapeutic Use
First-line for hypertension, mild edema.
104
Diuretics (Thiazide) - Contraindications
Anuria, hypersensitivity to sulfonamides.
105
Diuretics (Thiazide) - Monitoring
Electrolytes, renal function, blood glucose in diabetic patients.
106
Diuretics (Potassium-Sparing) - MOA
Block aldosterone receptors or inhibit sodium channels in the distal tubule and collecting duct, reducing potassium excretion.
107
Diuretics (Potassium-Sparing) - Pharmacokinetics
Hepatic metabolism, renal excretion; some drugs like eplerenone require CYP3A4.
108
Diuretics (Potassium-Sparing) - Adverse Effects
Hyperkalemia, gynecomastia (spironolactone).
109
Diuretics (Potassium-Sparing) - Therapeutic Use
Hypertension (adjunct), heart failure, hyperaldosteronism.
110
Diuretics (Potassium-Sparing) - Contraindications
Hyperkalemia, significant renal impairment.
111
Diuretics (Potassium-Sparing) - Monitoring
Potassium levels, renal function.
112
Diuretics (Potassium-Sparing) - Black Box Warning
Hyperkalemia risk.
113
ACE Inhibitors - MOA
Inhibit ACE, decreasing the production of angiotensin II and aldosterone, leading to vasodilation and decreased blood pressure.
114
ACE Inhibitors - Pharmacokinetics
Primarily renal excretion; some liver metabolism.
115
ACE Inhibitors - Adverse Effects
Common: Dry cough, hyperkalemia, dizziness; Serious: Angioedema, renal impairment.
116
ACE Inhibitors - Therapeutic Use
Hypertension, heart failure, diabetic nephropathy, post-MI.
117
ACE Inhibitors - Contraindications
Pregnancy, bilateral renal artery stenosis, history of angioedema with ACE inhibitors.
118
ACE Inhibitors - Monitoring
Potassium levels, serum creatinine, blood pressure.
119
ACE Inhibitors - Black Box Warning
Fetal toxicity: Can cause injury or death to the developing fetus if used during pregnancy.
120
ARBs - MOA
Block angiotensin II receptors, preventing vasoconstriction and aldosterone secretion.
121
ARBs - Pharmacokinetics
Hepatic metabolism, excreted in urine and bile.
122
ARBs - Adverse Effects
Hyperkalemia, hypotension, dizziness; Rare: Angioedema.
123
ARBs - Therapeutic Use
Hypertension, heart failure, diabetic nephropathy, post-MI.
124
ARBs - Contraindications
Pregnancy, bilateral renal artery stenosis.
125
ARBs - Monitoring
Potassium levels, renal function, blood pressure.
126
ARBs - Black Box Warning
Fetal toxicity: Can cause injury or death to the developing fetus if used during pregnancy.
127
ACE Inhibitors
Lisinopril, Enalapril, Ramipril, Captopril
128
ARBs
Losartan, Valsartan, Irbesartan, Olmesartan
129
Calcium Channel Blockers (CCBs)
Dihydropyridines: Amlodipine, Nifedipine, Felodipine; Non-Dihydropyridines: Verapamil, Diltiazem
130
Beta Blockers
Metoprolol, Atenolol, Propranolol, Carvedilol, Labetalol
131
Loop Diuretics
Furosemide, Bumetanide, Torsemide
132
Thiazide Diuretics
Hydrochlorothiazide, Chlorthalidone
133
Potassium-Sparing Diuretics
Spironolactone, Eplerenone, Amiloride, Triamterene
134
Statins
Atorvastatin, Rosuvastatin, Simvastatin, Pravastatin
135
Nitrates
Nitroglycerin, Isosorbide Mononitrate, Isosorbide Dinitrate
136
Heparin
Unfractionated Heparin
137
Low Molecular Weight Heparin (LMWH)
Enoxaparin, Dalteparin
138
Warfarin
Warfarin
139
DOACs
Dabigatran, Rivaroxaban, Apixaban
140
SGLT-2 Inhibitors
Empagliflozin, Dapagliflozin
141
Amiodarone
Amiodarone
142
Class I Antiarrhythmics
IA: Quinidine, Procainamide; IB: Lidocaine, Mexiletine; IC: Flecainide, Propafenone
143
Iron Therapy
Oral: Ferrous Sulfate, Ferrous Gluconate; Parenteral: Iron Sucrose, Ferric Carboxymaltose
144
Vitamin B12 Therapy
Cyanocobalamin
145
Folic Acid Therapy
Folic Acid
146
Selective Factor Xa Inhibitors
Fondaparinux
147
Selective Factor Xa Inhibitors - MOA
Indirectly inhibits Factor Xa by enhancing antithrombin III activity, leading to reduced thrombin generation and clot formation.
148
Selective Factor Xa Inhibitors - Pharmacokinetics
Subcutaneous administration; renal elimination; no hepatic metabolism.
149
Selective Factor Xa Inhibitors - Adverse Effects
Bleeding (major and minor), injection site reactions, thrombocytopenia (rare).
150
Selective Factor Xa Inhibitors - Therapeutic Use
Prophylaxis of deep vein thrombosis (DVT) after surgery, treatment of DVT and pulmonary embolism (PE), acute coronary syndrome (off-label).
151
Selective Factor Xa Inhibitors - Contraindications
Active bleeding, severe renal impairment (CrCl <30 mL/min), bacterial endocarditis.
152
Selective Factor Xa Inhibitors - Monitoring
Signs of bleeding, renal function in at-risk populations.
153
Selective Factor Xa Inhibitors - Black Box Warning
Risk of spinal/epidural hematomas in patients undergoing neuraxial anesthesia or spinal puncture.
