First aid Pharm Flashcards
Which CCBs are dihydropyridines? Where do they work best?
Amlodipine, nifedipine “dipine”. Vascular smooth muscle
Mechanism of Calcium Channel Blockers
Block voltage dependent L type calcium channels to decrease contractibility
What are the non-dihydropyridine CCBs? Where do they work?
Diltiazem, verapamil. Heart.
Side effects of CCB?
Cardiac depression, AV block (non-dihydropyridines), hyperprolactinemia (verapamil),
Verapamil: constipation, gingival hyperplasia.
Amlodipine: flushing, ankle swelling
MOA of Hydralyzine?
Inc cGMP leads to muscle relaxation of arterioles > veins.
Toxicity of Hydralyzine?
Compensatory tachycardia (not used in angina/CAD), lupus-like syndrome.
Use, MOA, and toxicity of nitroprusside?
Hypertensive emergency; short acting inc in cGMP for direct release of NO, can cause cyanide toxicity.
MOA and use of fenoldopam?
Dopamine D1 receptor agonist: vasodilator coronary, peripheral, renal, splanchnic beds. Dec BP, and inc naturesis.
MOA of nitrates?
Vasodilates by inc NO in vascular smooth muscle, which inc cGMP, which dec Ca, leading to myosin de phosphorylation, and smooth muscle relaxation. Greater effect on veins.
Toxicity of nitrates?
Reflex tachycardia, hypotension, “Monday disease” loss of tolerance over the weekend (tachycardia, dizziness, headache)
Effect, MOA, side effects of HMG-CoA reductase inhibitors?
- Decreases LDL
- inhibits conversion of HMG-CoA to mevalonate (cholesterol precursor)
- hepatotoxicity, myopathy (elevated CK, worse when taken with fibrates)
Effect, MOA, side effects of bile acid resins?
Names: cholestyramine, colestipol, colesevelam
- prevent intestinal reabsorption of bile acids (making liver use cholesterol to reproduce)
- GI upset
Effect, MOA, toxicity of ezetimibe?
Dec LDL, prevents cholesterol absorption, rare side effects: inc LFTs and diarrhea
Fibrates (gemfibrozil, clofibrate, bezafibrate, fenofibrate)
Dec TG by up regulating LDL to inc TG clearance, also induces HDL synthesis through PPAR-alpha. Risk of myopathy, cholesterol gallstones
Niacin
Inhibits lipolysis, reduces hepatic VLDL
Can cause red flushed face, hyperglycemia and hyperuricemia
-Can also cause vasodilation