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deck_990262 (1) Flashcards

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2
Q

Examples of Thiazide diuretics

A

HydrochlorothiazideChlorthalidoneChlorthiazideIndapamideMetolazone

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3
Q

MOA of Thiazide Diuretics

A

Inhibit Na/Cl transporter in the DCT and reduced excretion of calcium

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4
Q

Side effects of thiazide diuretics

A

Hypokalemic metabolic alkalosis; Sulfa allergyHyperglycemiaHyperlipidemiaHyperuricemiaHypercalcemia(HYPER-GLUC)

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5
Q

Examples of Loop Diuretics

A

Furosemide, Bumetanide, Torsemide, Ethracrynic acid

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6
Q

MOA of Loop Diuretics

A

Inhibit Na/K/2Cl transporter in the Thick ascending loop of Henle and increased Ca excretion

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7
Q

Side effects of loop diuretics

A

Hypokalemic metabolic alkalosisOtotoxicitySulfa allergy

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8
Q

Loop diuretic which does not trigger sulfa allergy

A

Ethracrynic Acid

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9
Q

Drugs that irreversibly blocks the vesicular monoamine transporter (VMAT)

A

Nerve terminal blocker: GUANETHIDINERESERPINE

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10
Q

Side effect of reserpine

A

Suicidal ideation

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11
Q

A vasodilator that alters intracellular calcium metabolism thus causing relaxation of the arteriolar smooth muscle, decreases afterload

A

Hydralazine

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12
Q

Drugs that induces Lupus

A

Hydralazine, Isoniazid, Procainamide, Penicillamine

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13
Q

Other use of hydralazine

A

when combined with ISDN, more effective in treating acute heart failure in Blacks

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14
Q

Side effect of hydralazine

A

reflex tachycardia

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15
Q

A hypertensive drug that is used in the treatment of alopecia

A

MinoxidilMOA for hypertension: opening of K+ Channels –> hyperpolarization –> vasodilation

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16
Q

Examples of Non-dihydropyridine calcium channel blocker (inhibits voltage-gated L type receptors)

A

verapamil, diltiazem(Cardiac>vascular)

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17
Q

Side effects of non-dihydropyridine receptors blockers

A

Constipation, Pretibial edema, gingival hyperplasia

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18
Q

Uses of nondihydropyridine receptors Ca channel blockers

A

Angina, SVT

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19
Q

Examples of dihydropyridine receptors Ca channel blockers

A

Amlodipine, felodipine, Nicardipine, Nisoldipine, IsradipineVascular>Cardiac

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20
Q

Side effect of dihydropyridine ca channel blockers

A

Pretibial edema, flushing, constipation

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21
Q

A parenteral vasodilator that relaxes venous and arteriolar smooth muscle (decreasing both preload and afterload)

A

Nitroprusside

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22
Q

Side effect of Nitroprusside

A

Cyanide ToxicityTx: Inhaled Amyl Nitrite, IV sodium nitrite, IV sodium thiosulfate

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23
Q

What is the side effect for the treatment of the side effect of nitroprusside

A

MethemglobinemiaTx: oxygen supplement and methylene blueA

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24
Q

A dopamine agonist which is a parenteral vasodilator

A

FenoldopamUsed in hypertensive emergenciesMay cause hypokalemia

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25
Q

Anti-hypertensive which is a Renin antagonist

A

Aliskiren

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26
Treatment for malignant hypertension
Nitroprusside, fenoldopam, diazoxide (vasodilators) plus diuretics (furosemide) and beta-blockers
27
Ultrashort acting nitrite used in the treatment of cyanide poisoning (MOA: releases NO, increases cGMP and relaxes smooth muscle)
Amyl nitrite
28
Short-acting nitrite used in the treatment of angina and acute coronary syndromes
Isosorbide dinitrateIsosorbide mononitrate (maintenance)
29
Side effects
HeadacheTolerance (transdermal)dangerous hypotension when combined with phosphodiesterase (PDE) inhibitors (e.g. sildenafil, vardenafil and tadalafil)
30
DOC for Prinzmetal's angina
Diltiazem
31
Anti-angina drug that can be used in the treatment of raynaud's phenomenon
Diltiazem
32
drugs that can cause gingival hyperplasia
Nifedipine, Cyclosporin, Phenytoin, Verapamil(NapaCa Pangit ng gingiVa mo)
33
What drugs can be used in the treatment for migraine and performance anxiety
Beta-blockers
34
Excessive beta-block blockade will cause what problems?
Bronchospasm, AV block, Heart Failure, CNS sedationOther side effect: erectile dysfunction
35
What is the disadvantage in giving beta-blockers in patients with diabetes?
Masks hypoglycemia in Diabetic patients
36
What drug is a cardiac glycoside which inhibits Na/K ATPase?
Digoxin
37
Side effects of digoxin
Narrow therapeutic indexarrhythmias - increased by hypokalemia, hypomagnesemia, hypercalcemiavisual changes (remember Van Gogh)
38
Drugs with narrow therapeutic index
warfarinaminoglycosideslithiumamphotericin BcarbamazepinePhenobarbitalPhenytoinVancomycinTheophyllineDigoxin
39
treatment for digitalis toxicity
DOC: lidocaine (anti-arrhythmia)Digibind (digoxin anti-bodies
40
First line drugs for systolic and diastolic failure
diureticsfurosemide: immediate reduction of pulmonary congestion and edemaSpironolactone and eplerenone: has significant long-term benefits
41
First line drug for chronic heart failure
angiotensin antagonists
42
Drugs useful in acute heart failure
Beta-selective sympathomimetics (Dobutamine and Dopamine)
43
Should beta-blockers be used in treatment for acute heart failure?
NO. They have no value
44
What are the beta-blockers which have beta and alpha activity
Carvedilol and Labetalol
45
What are the phosphodiesterase inhibitors used in the treatment for acute heart failure
Inamirinone and Milrinone(Note: should not be used in chronic heart failure since they can increase morbidity and mortality
46
What are the vasodilators that can be used in acute severe failure with congestion
Nitroprusside or Nitroglycerin
47
What drugs are used in the treatment of CHF in African Americans
Hydralazine and Isosorbide Dinitirate
48
What is the ECG morphology in Torsade de Pointes
Polymorphic ventricular tachycardia, waxing and waning of QRS complex
49
What disease is associated with Torsade de Pointes
Long QT syndrome: mutations in the Ik or Ina Channel proteins
50
Group I antiarrythmics MOA
Sodium channel blockers- slow or block conduction in ischemic and depolarized cells and slow or abolish abnormal pacemakers wherever these processes depend on sodium channels- use dependent or state dependent (they selectively depress tissues that is frequently depolarizing or tissue that is relatively deporlarized during rest)
51
Group IA
Procainamide, Disopyramide, Quinidine(I am the Queen who Proclaimed Diso's Pyramid
52
Group IA effect
prolongs AP duration`
53
Group IB effect
shorten AP duration
54
Group IB drugs
Mexiletene, Tocainide, Lidocaine(I buy mexican tacos from Lily)
55
Group IC effect
no effect on AP duration
56
Group IC drugs
Fleicanide, Propafenone, Encainide, Moricizine
57
Use of IC drugs
Refractory arrhythmia
58
Side effects of IC drugs
increased proarrhythmic effect (contraindicated for post MI Arrythmia
59
Drugs that cause agranulocytosis
Colchicine, clozapine, co-trimoxzaole, aminopyrine, phenylbutazone, PTU/methimazole, indomethacin, tocainide
60
What drug causes cinchonism (headache, vertigo, tinnitus)
Quinidine
61
What is the beta blocker that is used as post-MI prophylaxis against sudden death and as treatment for thyrotoxicosis
Propranolol
62
what is the beta-blocker that has class 3 properties
Sotalol
63
What is the beta blocker used in the treatment of supraventricular arrhythmias?
Esmolol
64
What is the beta-blocker used in acute perioperative and thyrotoxic arrythmias
esmolol
65
Class 3 anti-arrythmias
Dofetilide, Ibutilide, Sotalol, Amiodarone(AIDS)
66
What drug is used in the treatment and prophylaxis for atrial fibrillation which has a MOA of selective Ik block?
Dofetilide, Ibutilide
67
What is a class 3 anti-arrythmic drug that has group 1 activity?
AmiodaroneDronedarone
68
What is the mechanism of action of amiodarone
Strong Ik block produces marked prolongation of action potential and refractory periodGroup 1 activity slows conduction velocityGroups 2 and 4 activity confer additional antiarrythmic activity
69
What is the side effect of amiodarone?
microcrystalline deposits in cornea and skinpulmonary fibrosisparesthesiastremorsthyroid dysfunction
70
What is the MOA of class 4 antiarrythmic drugs
State and use dependent selective depression of calcium currents
71
What is the ECG findings in class 4 antiarrythmic drugs?
PR interval is consistently prolonged (AV conduction velocity is decreased and effective refractory period increased)
72
What is the major use of calcium channel blockers in arrythmias?
Convert nodal tachycardia (AV nodal reentry) to normal sinus rhythm
73
What is an antiarrythmic drug that increases the diastolic Ik of AV node that causes marked hyperpolarization and conduction block; and reduced Ica
Adenosine
74
What is the drug of choice for paroxysmal supraventricular tachycardia?
Adenosine
75
What should be checked in patients who will undergo treatment for arrythmia?
Serum potassiumpotassium ion depresses ectopic pacemakers including those caused by digitalis toxicity. Hypokalemia is associated with an increased incidence of arrythmia in digitalis toxicity while excessive hypokalemia will depress conduction and can cause reentry arrythmias
76
What drug can be used in the treatment of torsade de pointes
Magnesium. MOA is poorly understood but possibly it increases Na/K ATPase activity
77
What are the ECG changes in hyperkalemia? Hypokalemia
Hyperkalemia: Peak T waveHypokalemia: Depressed T wave
78
what is the drug that is used in the treatment of glaucoma, mountain sickness and edema with alkalosis which inhibits the Na-H antiport in the proximal tubule
ACETAZOLAMIDE, dorzolamide, brinzolamide, dichlorophenamide, methazolamide(carbonic anhydrase inhibitors)
79
what are the side effects associated with loop diuretics?
ototoxicityhypokalemiadehydrationallergy to sulfanephritisgout
80
what are examples of potassium sparing diuretics that inhibits cytoplasmic aldosterone receptor in the cortical collecting ducts?
spironolactoneeplerenone
81
what are the examples of potassium sparing diuretics that inhibits the epithelial sodium channel in cortical collecting duct?
amiloridetriamterene
82
what drugs that can cause gynecomastia
Spironolactonedigoxincimetidinealcoholketoconazole
83
give examples of diuretics that osmotically retains water in the tubules by reducing reabsorption?
mannitol, glycerin, isosorbide, urea
84
What are examples of ADH antagonist?
Conivaptan, LixivaptanDemeclocyclineLithium
85
A tetracycline-derived drug which can also be used as an ADH antagonist
DemeclocyclineSide effect: bone and teeth abnormalities (similar to that of the tetracyclines)
86
What are the adverse effects of giving fibrates with statins?
Rhabdomyolysis and myopathy
87
What are examples of lipid-lowering drugs that prevents reabsorption of bile acids by binding them
Cholestyramine, Colesevelam, Colestipol
88
Why bile acid binders are not given in patients with high triglycerides?
It increases triglycerides and VLDL in patients with high triglycerides?
89
what drug is used in hypercholesterolemia which inhibits NPC1L1 (a specific transporter in jejunal electrocyte), decreasing intestinal absorption of cholesterol and other phytosterols?
Ezetimibe
90
What drug is used in hypercholesterolemia which acts as a cholesterol analog, thus decreases absorption of cholesterol and phytosterols?
Sitosterol
91
Ezetimibe and statins have synergistic LDL-lowering effect, however, it also increases the risk of developing what abnormality?
Hepatotoxicity
92
What drug is the most effective agent in increasing HDL levels?
Niacin
93
What drug is given before giving niacin to prevent flushing?
Aspirin
94
What are the drugs that cause cutaneous flushing
VancomycinAdenosinNiacinCalcium channel blockers
95
What is the drug of choice in treating hypertriglyeridemia?
Gemfibrozil, Fenofibrate, BezafibrateMOA: activates PPAR alpha and increases expression of lipoprotein lipase and apolipoproteins

Pharma 1 (2 decks)

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