Mid 2

Question 1

Beta blockers suffix

Answer 1

Olol

Question 2

Beta blockers function

Answer 2

Block Beta 1 receptors:

Heart- increase HR, increase contractility

Kidney- release of renin

Some will be non selective and target both, some will be cardio selective

-In ACS patients, it reduces myocardial oxygen demand

Question 3

Why do you not wanna stop beta blockers abruptly

Answer 3

Can cause cardiac rebound excitation; tachycardia, angina, MI

Question 4

Ace inhibitors suffix

Answer 4

Pril

Question 5

Ace inhibitors function

Answer 5

Block conversion of angiotensin 1 to angiotensin 2

Gives vasodilation, decreased blood volume, decreased cardiac remodelling, potassium retention, can cause fetal injury

Question 6

What are considerations of ace inhibitors

Answer 6

Cause cough and hyperkalemia so if patient cannot tolerate then switch to ARBs

First dose hypotension
Monitor for angioedema

Question 7

Angiotensin 2 receptor blockers suffix

Answer 7

Sartan

Question 8

ARBs function

Answer 8

Blocks angiotensin 2 receptor access on adrenal glands to block release of aldosterone

Blocks receptors on BVs causing vasodilation

Question 9

Diuretics suffix

Answer 9

Ide or one

Question 10

Types of diuretics

Answer 10

Thiazide

Loop

Potassium sparing

Question 11

Thiazide function

Answer 11

Blocks reabsorption of Na and Cl in early segment of DCT
-adverse effect hypokalemia

Ex- hydrochlorothiazide

Question 12

Loop diuretic function

Answer 12

Blocks Na and Cl at ascending loop of Henle
-works earlier in the nephron and can thus act more effectively and blocking more water
-adverse effects are greater because of more blocking happening: hypokalemia, hyperglycemia, hyperuricemia

Ex Furosemide

Question 13

Potassium sparing function

Answer 13

Disrupts Na and K exchange at distal nephron- not as much diuresis happening
-conserves K loss

Ex spirinolactone

Question 14

Calcium channel blockers suffix

Answer 14

Ipine

Exception verapamil

Question 15

Calcium channel blockers function

Answer 15

Blocks calcium entry into cells

Calcium causes constriction so blocking is going to dilate
-decreases HR and strain on the heart reducing myocardial contractility

Question 16

Types of calcium channel blockers

Answer 16

Dihydropyridines

Non-dihydropyridines

Question 17

Difference between the two calcium channel blockers

Answer 17

Dihydropyridines are mainly vasodilation but minimal effect on HR
-ipine

Non…. Heart and blood vessels: used in arrhythmias
-azem and amil

Question 18

What should you avoid if using calcium channel blockers

Answer 18

Grapefruit juice- it takes away the enzymes that break down the drug so you end up with too high a dose

Question 19

Nitrates function

Answer 19

Nitrate uptake enduring nitric oxide and vasodilation: more dilation in veins than arteries

Ex nitroglycerin

-treating angina

Don’t wanna use continuously

Question 21

Ranolazine

Answer 21

Reduction in Na and Ca accumulation in myocardial cells- improved energy efficiency

-treats angina pain

-usually used with other drugs but has many drug interactions
-prolongs QT interval

Question 22

Angiotensin receptor neprilsyn inhibitor function

Answer 22

Combined sacubitril and valsartan

Sacubitril is a neprilsyn inhibitor- neprilsyn is blocked and cannot break down natriuretic peptides (ANP and BNP)- causing increased Na secretion and vasodilation

Superior to ACEi and ARBs

Question 23

Adverse effects of ARNI

Answer 23

Sacubitril/valsartan

Risk for hyperkalemia, hypotension

Cannot be used for severe kidney disease and pregnancy

Question 24

SGLT2i function

Answer 24

Increased natriuresis and thus reduces BP. Blocks reabsorption of glucose

Contraindicated in type 1 diabetes due to diabetic ketoacidosis

Adverse effects for UTIs and fungal infections

Question 25

SGLT2i suffix

Answer 25

Flozin

Question 26

Digoxin function

Answer 26

Irotropic agent- Increases contractility of heart, increasing SV, reduces HR

Question 27

Why is digoxin a second line agent

Answer 27

Many drug interactions and food interactions (black licorice) Narrow therapeutic range Hypokalemia and dysrythmias

Question 29

What are the 3 types of anti platelet agents

Answer 29

Aspirin P2Y12 inhibitors Glycoprotein IIb/IIa inhibitors

Question 30

Fibrinolytic function

Answer 30

Anti-thrombolitic Dissolves a thrombus by binding to plasminogen and converting more to plasmin More plasmin is going to cause fibrin lysis Anteplase- ends in plase

Question 31

Aspirin function

Answer 31

Antiplatelet drug Irreversibly inhibits cyclo-oxygenase which is the enzyme platelets use to create thromboxane for platelet aggregation

Question 32

Clopidogrel function

Answer 32

A P2Y12 inhibitor and antiplatelet drug Inhibits the P2Y12 receptors on platelets and prevents aggregation -often used as combo with aspirin -effects non reversible for 7-10 days so need to stop early if having an operation

Question 33

Glycoprotein IIb/IIIa receptor inhibitor function

Answer 33

Most effective antiplatelet drug Reversibly blocks receptors for IIb/IIIa making it so the receptors and platelets cannot bind to fibrinogen and connect to other platelets Used short term because of ability to reverse -administered IV

Question 34

HMG-CoA reductase inhibitors

Answer 34

Most effective statin for treating dyslipidemia HMG-CoA works in the liver to create cholesterol so inhibiting reduces the amount made and makes clearing LDLs more effective

Question 35

Cholesterol absorption inhibitor function

Answer 35

Inhibits absorption of cholesterol in SI allowing more to be excreted Ezitimibe

Question 36

PCSK9 inhibitors

Answer 36

PCSK9 binds to LDL receptors preventing it from being cleared in the liver Inhibiting allows more LDL to be cleared Evolocumab- ends in cumab

Question 37

difference between unfractioned and low molecular weight heparin

Answer 37

Unfractioned- prevents conversion of fibrinogen to fibrin and prothrombin to thrombin -more emergent situations like pulmonary embolism Low molecular weight- prevents conversion of prothrombin to thrombin -first line therapy in prevention of DVT

Question 38

Warfarin (Coumadin) function

Answer 38

Vitamin K antagonist- prevents vitamin K from being activated- VT-K activates clotting factors VII, IX, X and prothrombin Takes longer to take effect (42-72hrs) and thus is not used for emergencies but long term prophylaxis and preventing of DVT PO

Question 39

Thrombin inhibitors function

Answer 39

Anti-thrombolytic Prevents conversion of fibrinogen to fibrin, prevents activation of clotting factor XIII Ex Dabigatran Advantage over warfarin: rapid onset and same dose for all patients Treatment for DVT and because faster acting can be for PE also

Question 40

Factor Xa inhibitors function

Answer 40

Anti-thrombolytic Inhibits clotting factor Xa- thus inhibiting thrombin Advantage over warfarin- rapid onset so can be used to treat PR and DVT Ex Rivarozaban