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Pharmacology III > PA Cardiac (Exam #3) > Flashcards

PA Cardiac (Exam #3) Flashcards

1
Q

What is the initial tx for HF, and why is this?

A

Loop Diuretics

- Very efficient in moving large volumes of fluid/edema

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2
Q

What are the three Loop Diuretics, and what is the CI/caution for each?

A
  • Furosemide (Lasix) = CI if Sulfa allergy
  • Torsemide = CI if Sulfa allergy
  • Bumetanide (Bumex) = caution ototoxicity
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3
Q

Which two Loop Diuretics are CI if Sulfa allergy?

A
  • Furosemide (Lasix)

- Torsemide

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4
Q

What are the two main AEs associated with ALL Diuretics? What other AE is also possible at high doses?

A
  • Hypokalemia
  • Hyponatremia

Also, hyperuricemia (Gout at high doses)

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5
Q

What is the major CI of all Diuretics?

A

Anuria

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6
Q

What are the three Thiazide Diuretics, and what is the CI/caution for each?

A
  • HCTZ (Microzide) = CI if Sulfa allergy
  • Chlorothiazide (Diuril) = CI if Sulfa allergy
  • Metolazone = caution if Sulfa allergy
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7
Q

Which two Thiazide Diuretics are CI if Sulfa allergy?

A
  • HCTZ (Microzide)

- Chlorothiazide (Diuril)

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8
Q

What are the two Aldosterone Antagonist meds?

A
  • Spironolactone

- Eplerenone

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9
Q

What are the two Direct Na+ Flux Inhibitors meds?

A
  • Triamterene

- Amiloride

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10
Q

What are the two CIs associated with Direct Na+ Flux Inhibitors?

A
  • Anuria

- Severe kidney disease

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11
Q

What is the primary use of Aldosterone Antagonists & Direct Na+ Flux Inhibitors?

A 
WEAK diuretic (HF)
- Used in combination with other diuretics
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12
Q

What is the primary AE of Aldosterone Antagonists & Direct Na+ Flux Inhibitors?

With what drugs should they be cautioned?

A

Hyperkalemia

- Caution in combination with ACE-Is/ARBs

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13
Q

What two classes of drugs are RAS Inhibitors?

A
  • ACE-Is

- ARBs

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14
Q

What do ACE-Is/ARBs decrease (2), and what are they used to improve?

A

Decrease preload AND afterload → improve sxs

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15
Q

What are the two uses of ACE-Is/ARBs?

A
  • HFrEF

- HTN

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16
Q

For which three co-conditions are ACE-Is/ARBs the 1st line treatment?

A
  • DM
  • CKD
  • HFrEF
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17
Q

What are the two primary AEs associated with ACE-Is/ARBs? What other AE is associated with ACE-Is too?

A
  • Orthostatic hypotension
  • Hyperkalemia

Dry cough with ACE-Is too

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18
Q

What are the two primary CIs associated with ACE-Is/ARBs?

A
  • Angioedema

- Pregnancy

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19
Q

What is the name hint for ACE-Is?

A

“-pril”

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20
Q

What is the name hint for ARBs?

A

“-sartan”

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21
Q

What do BBs decrease, and what are they used to improve?

A

Decrease mortality

- Improve sxs

22
Q

What are the four uses of BBs?

A
  • Angina
  • Status post-MI
  • HTN
  • Late HF
23
Q

What are the three CIs associated with BBs?

A
  • Severe bradycardia
  • 2nd/3rd degree block
  • Uncompensated HF
24
Q

With which two classes of meds is abrupt withdrawal NOT recommended?

A
  • BBs

- Centrally Acting Sympatholytics/Central Alpha-Agonists

25
Q

What are the two primary AEs associated with Non-Selective BBs? What is a med example?

A

Propranolol

  • Bronchospasm
  • Fatigue
26
Q

What is the name hint for BBs?

A

“-lol”

27
Q

What does Digoxin increase?

A

Increase inotropy

28
Q

What are the two uses of Digoxin? What is the primary AE?

A
  • Mild/moderate HFrEF
  • AFib

AE = arrhythmias

29
Q

When would Digoxin use be considered?

A

MUST be stable on diuretic, ACE-I/ARB and BB before considering

30
Q

What are the two cautions associated with Digoxin?

A
  • Poor renal function

- Hypokalemia

31
Q

What is always the 1st line tx for HTN?

A

Lifestyle modifications

- Smoking cessation, diet (low salt, DASH), exercise, etc.

32
Q

What are the four 1st line meds for HTN?

A
  • HCTZ
  • ACE-I
  • ARB
  • CCB
33
Q

Which two 1st line meds for HTN are more effective in AAs?

A
  • HCTZ

- CCB

34
Q

Which two 1st line meds for HTN are more effective in patients with CKD?

A
  • ACE-I

- ARB

35
Q

What are the two types of CCBs, and how do they differ?

A
  • Dihydropyridines = potent vasodilator

- Non-Dihydropyridines = less vasodilation

36
Q

What are the two major AEs associated with short-acting Dihydropyridine CCBs?

What is the major AE for Non-Dihydropyridine CCBs?

A
  • Peripheral edema
  • Mild/mod. reflex tachycardia

Edema only for Non-Dihydropyridine CCBs

37
Q

What is the name hint for Dihydropyridine CCBs?

A

“-dipine”

38
Q

Which two meds are Non-Dihydropyridine CCBs?

A
  • Verapamil

- Diltiazem

39
Q

What is the name hint for Alpha-Blockers/Alpha-Adrenergic Antagonists?

A

“-zosin”

40
Q

What is the primary use of Alpha-Blockers/Alpha-Adrenergic Antagonists?

A

HTN + BPH

41
Q

What is a specific AE associated with Alpha-Blockers/Alpha-Adrenergic Antagonists?

A

Orthostatic hypotension (“first dose phenomenon”)

42
Q

Which two meds are Centrally Acting Sympatholytics/Central Alpha-Agonists? What is a special use of one of these meds?

A
  • Clonidine

- Methyldopa = good for pregnancy

43
Q

What is the primary use of Centrally Acting Sympatholytics/Central Alpha-Agonists?

A

Refractory HTN

44
Q

Which class of meds is used for refractory HTN?

A

Centrally Acting Sympatholytics/Central Alpha-Agonists

45
Q

What is the primary AE associated with Centrally Acting Sympatholytics/Central Alpha-Agonists?

A

Orthostatic hypotension

46
Q

With use of Methyldopa, what three tests should be monitored?

A
  • CBC
  • LFTs
  • Coombs test
47
Q

What are the two primary uses of SHORT-acting antianginals? What is a med example?

A

NTG

  • Acute angina
  • Angina prophylaxis
48
Q

What is primary use of LONG-acting antianginals? What is a med example?

A

Isosorbide Dinitrate/Mononitrate

- Chronic stable angina (long-term tx)

49
Q

What is the major AE associated with LONG-acting antianginals, and what med can be considered as an alternative?

A

Tolerance

- If tolerance occurs, use BB

50
Q

What are the three CIs associated with use of antianginals?

A
  • Within 24 hours of Viagra use (Sildenafil)
  • Hypertrophic Cardiomyopathy (HCM)
  • RV infarction

Pharmacology III (25 decks)

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