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Flashcards in cardio pharm. Deck (57):
1

hypertension drugs that can be used in pregnancy

hypertensive moms love nifedipine

hydralazine
methyldopa
labetalol
nifedipine

2

hypertension drugs that cannot be used in pregnancy

ace inhibitor
arbs

3

what drugs must be used cautiously in decompensated HF

beta blockers

4

what drugs are contraindicated in cardiogenic shock

beta blockers

5

hypertension with heart failure

diuretics/ace inhibitors/arbs

6

minidoxil MOA

opens K+ channels, hyperpolarizing smooth muscle causing relaxation of vascular smooth muscle

7

hypertrichosis, hypotension, reflex tachycardia, fluid retention/edema

minidoxil side effects

8

orthostatic hypotension with first few doses

alpha 1 blockers (-zosin)

9

drug-induced lupus (Anti-histone ab)

hydralazine

10

minoxidil compensatory responses

marked salt/water retention and marked tachycardia (all others have less compensation)

11

sudden discontinuation of what drug can cause severe rebound hypertension?

clonidine

12

pt with second degree AV block + constipation

non-dihydropyridine toxicity (verapamil)

13

what calcium channel blocker is used in patients with subarachnoid hemorrhage and why

nimodipine to prevent cerebral vasospasm (rmr Nemo)

14

hyperprolactinemia

verapamil toxicity

15

gingival hyperplasia

calcium channel blocker toxicity

16

hydralazine MOA

increases cGMP --> smooth muscle relaxation

17

does hydralazine affect arterioles or veins

arterioles > veins thus causes decreased afterload

18

why is hydralazine administered with a beta blocker

to prevent reflex tachycardia

19

what is contraindicated in CAD and why

hydralazine because it causes compensatory tachycardia which would increased O2 stress on myocardium

20

what calcium channel blocker can be used in hypertensive emergency

clevidipine

21

nitroprusside moa

increases cGMP via direct release of NO
venodilator ~ arterioles ( decreases preload and afterloda)

22

what toxicity can nitroprusside cause

cyanide

23

fenoldopam MOA

dopamine D1 receptor agonist
coronary peripheral renal splanchnic vasodilation (good for renal failure)

24

does fendoldopam work on arterioles or veins

arterioles

25

common side effect of nitrates

headache (vc it vasodilates veins in meninges)

26

MOA nitrates

increases NO in smooth muscle, increases cGMP and smooth muscle relaxation
venodilator, so decreases preload and thus decreases cardiac work

27

how do you treat reflex tachycardia

propranolol - beta blockers

28

explain nitrate tolerance

patients on nitrates need to have a nitrate free period every day to avoid tolerance - usually done at night when patient is sleeping and cardiac work is the least

29

how do verapamil and diltiazem affect HR?

decrease (inhibit SA and AV nodes)

30

does minoxidil cause reflex tach?

yes so much so that it must be controlled with beta blockers
dose-dependent rise in HR

31

hypertension + diabetes drugs

ACE inhibitors or ARBs because they not only lower BP but also slow diabetic nephropathy

32

statins decrease what the most

LDL

33

statins upregulate what

LDL receptor

34

bile acid resins decerease what (cholestyramine)

LDL

35

what lipid lowering agent has a gritty unpleasant taste

bile acid resins / cholestyramine

36

what LLA causes decreased absorption of vitamins or other drugs from intestinal tract

bile acid resins/ cholestyramine

37

hepatotoxicity, rhabdomyolysis/myopathy

side effect of statins

38

bile acid resins MOA

prevent intestinal reabsorption of bile acids (decreased reabsorption of cholesterol)

39

statins MOA

competitively inhibit hmg coa reductase (rate limiting enzyme in cholesterol synth) - reduces hmg-coa converstion to malevonate

40

how do statins affect HDL

increase

41

how do bile acid resins affect HDL

slightly increase

42

how do bile acid resins affect triglycerides

slightly increase

43

how to statins affect triglycerides

decrease

44

what does ezetimbe reduce

LDL

45

how does ezetemibe affect HDL/Triglyerides?

no affect

46

if ezetimibe and statins are given together, what side effect risk is increased

hepatotoxicity

47

ezetimibe moa

prevent cholesterol reabsorption at small intestine brush border

48

cutaneous flushing is a common adverse affect of what lipid lowering agent

niacin

49

what drug do you give if someone has low HDL

niacin

50

how can you reduce cutaneous flushing due to niacin

pretreatment with aspirin/nsaid

51

if someone is on niacin, how do you need to adjust the rest of their drugs?

niacin causes hyperglycemia - increase diabetes drugs
niacin potentiates hypertension drugs so decrease dose

52

fibrates MOA

increases synthesis of lipoprotein lipase by adipocytes via interaction with ppar-alpha protein - increases triglyceride clearance

53

fibrates decrease what the most

triglycerides

54

fibrates increase the risk of developing what

choelsterol gallstones

55

what two lipid lowering agents shouldnt be used together because they both increase risk of choelsterol gallstones and increased risk for mypoathy

statins and fibrates

56

what lipid lowering agent will exacerbate gouty arthritis

niacin

57

what lipid lowering agents are teratogenic?

statins (hmg coa reductase inhibitors)