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Pharm 2 Module 1.1-1.2 > More drug's unique properties > Flashcards

More drug's unique properties Flashcards

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1
Q

Neprilysin inhibitor / ARB

Combo drug

A

Sacubitril/valsartan Entresto

Neprilysin is an enzyme that contributes to the breakdown of the biologically active natriuretic peptides. By blocking the enzyme we increase our endogenous ANP, BNP, and CNP

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2
Q

alpha1, alpha 2 antagonist Not used for long term treatment

A

phentolamine

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3
Q

Hypos - calc, mag, K, H = met. alkalosis, ototoxicity (avoid aminogylcosides)

A

furosemide

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4
Q

Treat Severe pulmonary arterial HTN

A

bosentan

Endothelin (ET) receptor antagonist

ambrisentan

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5
Q

HF with renal dysfunction who cannot tolerate ACEI. HTN emergencies in pregnancy

A

hydralazine

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6
Q

Dilation of coronary arteries, systemic (peripheral) arterioles

Dihydropyridine - bind to inactivated L-type

A

nifedipine

amlodipine

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7
Q

Aldosterone/mineralocorticoid receptor antagonist - potassium sparing metabolized by liver

A

spironolactone

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8
Q

alpha1, alpha 2 antagonist Irreversible

A

phenoxybenzamine

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9
Q

Teratogenic, Hyperkalemia

A

ARBs

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10
Q

Decreases systemic vascular resistance AND Na absorption by the kidney (by blocking formation of ATII)

A

aliskiren tekturna

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11
Q

No effect on bradykinin - minimal incidence of cough and angioedema. K sparing diuretics contraindicated

A

ARBs

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12
Q

Natriuretic peptide 6 actions

A

promote vasodilation

relax smooth muscle

increased capillary endothelial permeability

promote natriuresis increased renal Na excretion

promote increase in GFR

suppress SNS outflow

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13
Q

ARB what channel?
What type of receptor is it?

A

AT1
GQ

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14
Q

diuretic that leads to

Hyperglycemia, hypokalemia, metabolic alkalosis

A

Hydrochlorothiaze

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15
Q

Low dose - D1 - vasodilation, decreased SVR (afterload), increases renal blood flow and ANP/BNP; intermediate dose - Beta1 - increased contractility and HR; high dose - alpha1 - vasoconstriction

A

dopamine

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16
Q

longer half life than prazosin

A

terazosin

doxazosin

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17
Q

Hyperkalemia, met. Acidosis. Blocks androgen receptors (impotence and gynecomastia)

A

spironolactone

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18
Q

Initial treatment of HTN

A

propranolol

metoprolol

atenolol

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19
Q

Pro-drug - metabolized to release NO in the body. Requires mitochondrial aldehyde dehydrogenase (ALDH2) (sometimes missing in Chinese population)

A

nitroglycerin, glyceryl trinitrate

isosorbide dinitrate

isosorbide 5-mononitrate

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20
Q

Ventricular arrhythmias, thrombocytopenia (low blood platelet count)

A

milrinone

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21
Q

Prolong NMB, headache, dizziness, Peripheral edema, negative chronotropy/inotropy, overdose pulmonary edema

A

CCB

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22
Q

Renin inhibitor

A

aliskiren Tekturna

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23
Q

eNOS inhibitor

A

methylene blue

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24
Q

Short term severely decompensated HF and severely failing circulation. Bridge to cardiac transplantation

A

milrinone

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25
Reversible lupus erythematosus-like syndrome (primarily in slow acetylators)
hydralazine
26
MAO and dopamine B-hydroxylase (caution in patients with MAOIs)
dopamine
27
Reduces systemic vascular resistance (afterload), increases RENAL blood flow
fenoldopam corlopam D1 agonist
28
Treatment of BPH
terazosin Hytrin alpha1 antagonist
29
Greater effect in arterioles over veins. Anesthetic induced vasodilation may be exacerbated
prazosin Minipress
30
dyspnea, chest pain, hemolysis
methylene blue
31
AV block, bradyarrthymia, bronchospasm. Avoid in diabetics - decreases glycogenolysis and gluconeogenesis
labetalol
32
Pulmonary edema-initial increase in plasma volume due to oncotic pressure - increases preload
mannitol
33
Venous dilation equal to arteriolar dilation (balanced vasodilator). Short term administration (cyanide released during metabolism - avoid infusion rates above 2 mcg/kg/min)
sodium nitroprusside
34
HoTN, renal failure, teratogenic
aliskiren Tekturna
35
First line agent in HTN diabetics
captopril lisinopril ARBs
36
contraindicated in patient bilateral artery stenosis?
captopril lisinopril patients dependent on angiotensin 2 to maintain GFR
37
COMT (caution in COMT Inhibitor patients - Parkinsons)
dobutamine
38
combo drug used for HF
Sacubitril/valsartan Entresto
39
May precipitate - kidney stones
triamterene
40
Low dose - Beta1 - positive inotrope, lusitrope, chronotrope, and dromotrope, also vasodilation in SKM; High dose - alpha1 - generalized peripheral vasoconstriction increasing afterload
epi
41
hepatic metabolism, vasopressin receptor agonist
Vasopressin
42
four drugs for HTN crisis
Labetalol-b1/b2-a1 fenoldopam-D1 receptor agonist sodium nitroprusside-no donor furosemide-loop diuretic
43
**Beta1 - Positive inotrope, chronotrope, lusitrope. Beta2 - peripheral vasodilation and hypotension. No activity on alpha**
isoproterenol renal metabolism
44
Teratogenic, Hyperkalemia, dry cough, angioedema, first dose HoTN - acute renal failure. May precipitate profound refractory HoTN in presence of vasodilating anesthetics - use V1 agonists
captopril lisinopril
45
Contraindicated with PVD and COPD/asthma
propranolol
46
Headache, flushing, peripheral edema, reflex tachycardia
minoxidil
47
metabolized by renal OAT
Hydrochlorothiazide chlorothiazide
48
Renal metabolism verapamil decreases \_\_\_\_\_\_clearance by blocking the P-glycoprotein energy dependent efflux transporter (renal secretion)
digoxin
49
More selective than spironolactone - less anti-androgenic side effects
eplerenone Inspra
50
good for treating intraoperative hypotension exacerbated in a patient taking ace inhibitors receiving anesthesia VIA
terlipressin
51
Arteriolar smooth muscle relaxation, increases renal blood flow - NOT coronary arteries or venous smooth muscle.
hydralazine
52
Positive inotrope (improves diastolic dysfunction), vasodilation. Blocks metabolism of cAMP (inotropic effects), cGMP (vasodilatory effects)
milrinone
53
Contradications - ACE, ARBs, renal insufficiency with hyperkalemia
Spironolactone eplerenone amiloride triamterene
54
Low dose - Beta1 - positive inotrope, lusitrope, chronotrope, and dromotrope, also alpha1 - vasoconstriction with increased afterload. Little effect on Beta2
norepi
55
Inhibits pulmonary vasoconstriction and may cause V/Q mismatch, rebound hypertension, coronary steal, cyanide toxicity
sodium nitroprusside
56
Liddle's syndrome (super ENaC Na channel)
amilrode midamor triamtrene dyrenium
57
More effective with frequent channel openings - SA, AV, cardiac myocytes Non-dihydropyridine -bind to open conformation L-type
diltiazem verapamil
58
**Decrease ATII and increase bradykinin levels. Vasodilatory effects - RENAL PROTECTIVE. Avoid K sparing diuretics, NSAIDs. Contraindicated in patients with bilateral renal artery stenosis - dependent on ATII to maintain GFR by constriction of efferent arteriole**
captopril lisinopril
59
V2 selective agonist. Relieves PDPH, DOC for central DI, treatment of bleeding disorders
desmopressin
60
No reflex tachycardia
labetalol
61
What happens when the AT1 receptor is activated? 7
1. aldosterone secretion from adrenal cortex 2. Na reabsorption from renal PCT 3. Renal vasoconstriction-efferent arteriole 4. direct vasoconstriction 5. SNS discharge 6. Release of catecholamines from adrenal medulla 7. release of ADH (vasopressin) from pos pituitary
62
Low dose - Vasodilate VEINS and coronary arteries. High dose - decrease arteriolar resistance. Prefers epicardial coronary arteries and minimizes coronary steal
nitroglycerin, glyceryl trinitrate isosorbide dinitrate isosorbide 5-mononitrate
63
HTN emergencies and severe HF, Controlled hypotension during anesthesia to reduce bleeding
sodium nitroprusside
64
Prevent vasoplegic syndrome in CP bypass. Treatment for methemoglobinemia
methylene blue
65
To correct drug-induced kaliuresis and hypokalemia. Secondary HTN to hyperaldosteronism
Spironolactone
66
Inhibits Na/K ATPase on sarcoplasmic reticulum - less Na extracellular means less Na available for the Na/Ca exchanger = more Ca available to be stored and released intracellularly. Positive inotrope (from Ca), negative chronotropy, dromotropy
digoxin
67
HTN primarily, adjunct in HF; first line agent for African American patients
hydrochlorothiazide
68
HTN emergencies
labetalol
69
Opens ATP modulated K channels (inhibits influx of Ca through VGCC). Acts primarily on arterial smooth muscle cells - no effect on venous system
minoxidil

Pharm 2 Module 1.1-1.2 (5 decks)

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