Brands/Generics; LD and Maint Dose

Question 1

Cardizem, Tiazac

Answer 1

Diltiazem

Question 2

Verelen, Calan, Isoptin

Answer 2

Verapamil

Question 3

Norvasc

Answer 3

Amlodipine

Question 4

Procardia-XL

Answer 4

nifedipine

Question 5

Toprol XL

Answer 5

metoprolol succinate/XL

Question 6

Zestril

Answer 6

Lisinopril

Question 7

Accupril

Answer 7

Quinapril

Question 8

Capoten

Answer 8

Captopril

Question 9

Avapro

Answer 9

Irbesartan

Question 10

Cozaar

Answer 10

Losartan

Question 11

Plavix

Answer 11

Clopidogrel

Question 12

Effient

Answer 12

Prasugrel

Question 13

Brilinta

Answer 13

Ticagrelor

Question 14

Lasix

Answer 14

Furosemide

Question 15

Lovenox

Answer 15

Enoxaparin

Question 16

Entresto

Answer 16

sacubitril/valsartan

Question 17

Coreg

Answer 17

Carvedilol

Question 18

Lovaza

Answer 18

omega-3 fatty acids

Question 19

Aspirin LD & Maint

Answer 19

LD: 162-325 mg
Maint: 75-162 mg

Question 20

Clopidogrel (Plavix) LD & Maint

Prodrug

Answer 20

LD: 300-600 mg
Maint: 75 mg daily
* 600 mg unless fibrinolytic
* over 75yo= no LD
* 75 or younger AND fibrinolytic= 300mg

Question 21

Prasugrel (Effient) LD & Maint

Prodrug

Answer 21

LD: 60mg
Maint: 10mg daily

Question 22

Ticagrelor (Brilinta) LD & Maint

Answer 22

LD: 180 mg
Maint: 90 mg BID

Question 23

Cangrelor (Kengral) LD & Maint

Answer 23

IV only

Question 24

Lopressor

Answer 24

Metoprolol tartrate

Question 25

Inderal

Answer 25

Propranolol

Question 26

Tenormin

Answer 26

Atenolol

Question 27

Metoprolol succinate (Toprol XL) dose

Answer 27

25-50mg starting dose 100-200mg daily

Question 28

Metoprolol tartrate (Lopressor) dose

Answer 28

50-100mg BID

Question 29

Nifedipine-XL (Procardia XL) dose

Answer 29

30-60mg daily

Question 30

Amlodipine (Norvasc) dose

Answer 30

5-10mg daily

Question 31

Verapamil (Calan, Isoptin) dose

Answer 31

60-90 mg TID-QID

Question 32

Diltiazem (Cardizem) dose

Answer 32

80-120mg TID

Question 33

ISDN dose

Answer 33

10mg TID

Question 34

ISMN dose

Answer 34

20mg BID

Question 35

ISMN SR dose

Answer 35

30mg daily

Question 36

ASA MOA

Answer 36

* MOA: acetylation & irreversible inactivation of platelet COX-1 * Normal Activity: COX-1 --> TXA2 (promotes clotting) * ASA Activity: inactivates COX-1, blocks thrombus formation, prolongs bleeding time * ASA targets COX-1>>>COX-2; low doses of ASA ok b/c mainly inhibits COX-1; high doses not ok b/c inhibits both COX-1 and COX-2 * Normal Activity: COX-2 --> prostacyclin PGI2 = inhibits platelet aggregation & causes vasodilation

Question 37

P2Y12 inhibitor MOA

Answer 37

* MOA: prevents ADP from binding to P2Y12; selectively inhibits ADP-induced PLT aggregation, no direct effecr on TXA2 * Normal Activity: ADP initially binds to P2Y12 (activates it), the active P2Y12 is coupled w/ Gi, Gi inhibits conversion of ADP to cAMP, thus decreasing cAMP; decr cAMP increases Ca++ which causes contraction & coagulation * P2Y12 inhbitor Activity: prevents ADP from activating P2Y12

Question 38

list BB cardioselective/Beta1-selective drugs

Answer 38

Atenolol, Metoprolol

Question 39

list BB nonselective drugs

Answer 39

Propranolol, Carvedilol, Labetalol ## Footnote if drug is beta & alpha blocker, it is also nonselective (targets B1 & B2)

Question 40

list BB beta/alpha blocker drugs

Answer 40

Labetalol, Carvedilol ## Footnote Targets B1, B2, and alpha-1

Question 41

Nitrate MOA

Answer 41

* MOA: nitroglycerin converts to nitric oxide (NO), NO then activates the enzyme guanylyl cyclase, which converts GTP to cGMP, causing relaxation * direct relaxant effect on vascular smooth muscles; * dilation of coronary vessels= improves oxygen supply to the myocardium * dilation of peripheral veins, and in higher doses peripheral arteries= reduces preload and afterload, and thereby lowers myocardial oxygen consumption

Question 42

DHP CCB MOA

Answer 42

* **Suffix**: -dipine * **MOA**: inhibits influx of Ca++ across blood vessels (only works on blood vessels) * **SE**: reflex tachycardia, peripheral edema (dose-related), gingival hyperplasia * **Extra**: use amlodipine if CCB is needed in HF; incr risk of angina/MI in pts w/ obstructive coronary disease (specifically immediate-release) ## Footnote * **MOA**: Ca++ contracts, so blocking calcium from entering arteries prevents contraction/vasoconstriction, leading to vasodilation (decr BP); more potent vasodilators than NonDHP; decr afterload * **Clinical use**: works w/ angina b/c reduces oxygen demand in the heart * **SE**: peripheral edema is dose-related; vasodilation leads to reflex tachycardia (amlodipine does not have relflex tachycardia) * **Extra**: risk of angina/MI increased due to reflex tachycardia

Question 43

nonDHP CCB MOA

Answer 43

* **Drugs**: diltiazem ER, verapamil ER (phenylalkylamine) * **MOA**: inhibits influx of Ca++ across blood vessels and heart (smooth and cardiac muscle); negative inotropic effects * **SE**: bradycardia, systolic HF, constipation ## Footnote * **MOA**: extracellular Ca++ triggers cardiac & vascular smooth muscles to contract, nonDHPs work on cardiac (heart) and smooth (arteries) muscles so less contraction occurs; HR and BP decreased; has ionotropic effects= slows HR and weakens heart's contraction; antiarrhythmic (blocking of cardiac) * **Clinical use**: works w/ angina b/c reduces oxygen demand in the heart * **SE**: bradycardia b/c MOA is to slow HR

Question 44

Cardicor, Congescor

Answer 44

Bisoprolol

Question 45

Carvedilol (Coreg) dose

Answer 45

starting dose: 6.25 mg bid target dose: 25mg bid

Question 46

Propranolol (Inderal) dose

Answer 46

starting dose: 40mg bid-tid target dose: 80mg qid