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Pharm 3 > HTN, CHF, Angina, and Lipid Lowering > Flashcards

HTN, CHF, Angina, and Lipid Lowering Flashcards

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1
Q

Fiber

A

Decrease LDL via adsorbing cholesterol/bile acids and GI motility changes

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2
Q

Loraza

A

Polyunsaturated Fatty Acid

Increase clearance of TGs

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3
Q

Mechanism of statins

A

Inhibit HMG CoA reductase, decreases cholesterol synthesis in liver, increases hepatic LDL receptors, increased clearance of LDL/VLDL

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4
Q

Atorvastatin

A

Potent statin
Long half life (night time admin not necessary)
Metab by CYP3A4
Lipophilic, crosses BBB

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5
Q

Prevastatin

A

Night admin
Sulfation metabolism (not p450 dependent)
Hydrophilic, hepatoselective
Not used in renal impairment

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6
Q

Ezetimibe

A

Cholesterol absorption blocker
Reduction absorbed leads to upreg of receptors in liver
Not p450 metabolized
Well tolerated

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7
Q

Cholestyramine

A

Bile acid sequestrant/resin
Binds bile acids, promotes excretion, increase conversion of cholesterol to bile acids, upreg of LDL receptors
Can also lead to upreg of HMG CoA reductase (use w/ statin)
Binds other drugs

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8
Q

Niacin (B3)

A

Inc HDL

AE: flushing, hepatotoxicity, GI

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9
Q

Gemfibrozil

A 
Dec TG
Inc LPL synth which inc TG clearance
Renal/liver contraindicated
Myopathy w/ statins
Potentiates warfarin and OTC
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10
Q

Evolucumab

A 
PCSK9 inhibitor 
Binds to/inhibits LDL receptor
Injection, expensive 
Decrease in major CV events
AE: nasopharyngitis, URI
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11
Q

Nitroglycerin

A

Decreases contractile state of BV
Decreases preload
Reduces coronary steal

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12
Q

Isosorbide dinitrate

A

Organic nitrate

Chewable, half life 2-3 hr

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13
Q

Nifedipine

A

Ca channel blocker - dihydropyridine
Strong coronary and peripheral vasodilation
Reflex increase in HR and contractility

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14
Q

Verapamil

A

2+ coronary/peripheral vasodilation

Dec HR, contractility, and rate of recovery of Ca channels

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15
Q

Nimodipine

A

Ca channel blocker

High affinity for cerebral vessels

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16
Q

Diltiazem

A

Ca channel blocker

Inhibits central sympathetic activity

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17
Q

Ca channel blockers: use, contraindications, and AE

A

Use: best option for variant angina
AE: cardiac depression, cardiac arrest, bradycardia, constipation
Contra: heart failure

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18
Q

Propanolol

A

Beta adrenergic blocker
Decrease HR and contractility
AE: ED, depression, insomnia
Contra: respiratory problems

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19
Q

Ranexa

A

Tx for chronic angina
AE: prolonged QT
Only used in patients who have not responded to nitrates, CCB, or beta blockers

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20
Q

Fluticasone

A

ICS
Prevent asthma attacks by suppressing inflamm
AE: candidiasis, HPA suppression
Used in COPD if FEV < 50%

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21
Q

Methylprednisolone

A

Systemic glucocorticoids

Short term, for exacerbations (3-10 days)

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22
Q

Albuterol

A

SABA
Acts in 3-5 min, duration 3-6 h
AE: tremor, tachycardia, hypokalemia

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23
Q

Salmeterol

A

LABA
> 12 hr duration
Not prescribed w/o ICS

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24
Q

Ipratropium bromide

A

SAMA
Blocks ACh effects from vagus onto M3 receptors
Effective in COPD (less in asthma)
AE: dry mouth, caution in BPH

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25
Tiotropium
LAMA Blocks ACh from vagus onto M3 receptors More effective in COPD AE: dry mouth, beware in BPH
26
Theophylline
Phosphodiesterase inhibitor Taken orally COPD: increases diaphragm contractility AE: narrow TI, CV, CNS, GI effects
27
Montelukast
Leukotriene receptor antagonist Taken orally Add on tx, effective in aspirin sensitive asthma (no COPD) AE: hepatic dysfxn, neuropsychiatric
28
Omalizumab
Anti-IgE monoclonal antibody Binds and neutralizes at Fc position AE: expensive, may inc malignancies, wide variation in response
29
Substance use criteria 1-4: impaired control
1. Larger amounts, longer periods 2. Wants to quit (not able) 3. Time consuming 4. Craving
30
Substance use criteria 5-7: social impairment
5. Failure to fulfill social obligations 6. Continued use despite negative social consequences 7. Given up social/recreational/occupational activities
31
Substance abuse criteria 8-9: risk use
8. Uses in physical hazardous situations | 9. Continued use despite negative physical/psych consequences
32
Substance abuse criteria 10-11: pharmacological criteria
10. Appearance of tolerance | 11. Appearance of withdrawal sx
33
Effects of aldosterone
Causes cardiac fibrosis, decreases CO, which leads to Na+ reabsorption --> inc preload
34
Spironolactone
Aldosterone antagonist CHF drug Effects: inc Na excretion, dec fibrosis AE: hyperkalemia, gynecomastia
35
Eplerenone
Aldosterone antagonist CHF drug More selective for aldosterone inhibitors (less gynecomastia)
36
Function of diuretics in treating CHF?
Reduce preload and cardiac size by decreasing plasma volume
37
Function of ACE-i, ARBs and ARNIs in treating CHF?
Dec afterload by reducing peripheral resistance | Dec preload by reducing aldosterone secretion
38
Captopril
ACE inhibitor CHF drug Blocks conversion of Ang I to II AE: cough, angioedema, hyperkalemia (CAPTOPRIL)
39
AE C.A.P.T.O.P.R.I.L
``` Cough Angioedema Proteinuria/Potassium excess Taste change Orthostatic hypotension Pregnancy (C) Renal artery stenosis (C) Inc renin Leukopenia/liver toxicity ```
40
Enalapril
ACE-inhibitor CHF drug Blocks conversion of Ang I to II AE: cough, angioedema, hyperkalemia
41
Candesartan
ARB CHF drug Blocks Ang II receptor No cough
42
Valsartan
ARB CHF drug Blocks Ang II receptor No cough
43
What does neprilysin do?
Same effects as AT II Cross talk with AT II Targets ANP/BNP which usually decrease renin, inc Na excretion, and inc vasodilation
44
ARNIs
Angiotensin receptor-neprilysin inhibitor (ARB plus nep blocker) Inhibiting both pathways has greater effect and greater decrease in morbidity and mortality
45
Sacubitril/valsartan
ARNI Sacub blocks neprilysin, valsartan inhibits RAAS AE: more angioedema, less renal, hypokalemia, and cough
46
Beta blockers in CHF
Inhibits adverse remodeling Start and discontinue lowly AE: hypotension, bradycardia, bronchospasm
47
CHF beta blocker drugs
``` Carvedilol Metoprolol (selective) ```
48
Ivabradine
Dec HR Inhibits If channel to dec SA node firing AE: Afib, Bradyarrhythmias, visual disturbance
49
Isosorbide Dinitrate
Vasodilator, dec preload Mech: NO release, inc cGMP, less MLC phosphorylation (dec contraction) Veins>arteries Off time to prevent tolerance
50
BiDil
Isosorbide dinitrate + hydralazine Strong preload and afterload decrease Good for Af Am with CHF
51
Hydralazine
Dec afterload Dilates arterioles CHF drugs
52
How to treat diastolic HF (preserved EF)?
ACE, ARB, nitrates, diur Rate control w/ B blockers and Ca blockers Inc contractility with positive inotropes
53
Milrinone
Phosphodiesterase inhibitor Increases contractility and vasodilators Use: acute decompensated HF (not long term)
54
Digoxin
Cardiac glycoside, inc Ca Mech: inhibit Na/K ATPase Narrow TI Toxicity when combined w/ abx, diuretics
55
HTN diuretics
HCTZ (Na/Cl inhibitor) - dec preload and vascular resistance | Amiloride (K sparing)
56
HTN drugs that cause direct vasodilation
Hydralazine Minoxidil Sodium nitroprusside
57
Prazosin
a-1 blockers (vasodilator) HTN drug Beware of first dose phenomenon
58
Guanethidine
Adrenergic inhibitor HTN drug Replaces and depletes NE
59
Reserpine
Adrenergic inhibitor HTN drug Binds to storage vesicles and makes them dysfunctional, long term treatment depletes NE
60
Methyldopa, clonidine
a2 agonists HTN drugs Reduce activity of neurons in the brain responsible for maintaining sympathetic activity
61
Which HTN drug can you use in pregnancy?
Methyldopa

Pharm 3 (7 decks)

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