Pharm II Flashcards
(255 cards)
1
Q
types of HF
A
ischemic (atherosclerosis, hypertension, post MI)
or
Non-ischemic (idiopathic cardiomyopathy, cardiac toxins, post partum)
2
Q
ACE and ARBs are less effective in african americans due to decreased RAA activation
what is the next best choice
A
calcium channel blockers
3
Q
depolarizing vs nondepolarizing neuromuscular blocks
A
succinylcholine (depolaration, fast and short acting)
tubocrarine (nondepolarizing, slow, long acting)
4
Q
what BP med is useful in pregnancy
A
hydralizine
5
Q
indications for cholinergic agoists
A
glaucoma
ileus
bladder atony
myasthenia gravis
alzehiemers
mushroom poisoning
anesthesia reversal
6
Q
drugs to restore sinus rhytm
A
BB’s and propafenone and flecinamide
7
Q
alpha II receptor effects
A
↑platelet aggregation, ↓lipolysis
8
Q
ANS effect on the eyes
A
sym: pupil dilation, increased far vision
para: pupil dilation, increased near vision
9
Q
-stigmine is for what
A
reversible anticholinesterases
10
Q
Trazodone
A
Antidepressant
11
Q
three antiemetics that block dopamine
A
phenathiazine (compazine)
sub. benzamides (reglan)
butyrophenons (haldol)
12
Q
when are myopathy related to statins an issue
A
in older people as it can reduce their activity and quality of life
13
Q
colace is a…
A
stool softener
14
Q
apocrine sweat glands (axilla and groin) are inneratvaed by what
A
adrenergic alpha recepors
15
Q
two types of antidiarrhea meds
A
antimotility agents
absorbents
16
Q
what is the function of pralidoxime
A
reverse anticholinesterase action
17
Q
types of hyperlipidemia
A
familial and non-familial
18
Q
importnat autonomic neuotransmitters
A
acetylcholine
norepi
dopamine
serotonin
histamine
GABA
19
Q
myasethenia gravis
symptoms
cause
A
an autoimmune order that causes weakness of volunary muscles that improves with rest
ptosis, diplopia, dysphagia, msucle weakness
antibodies against ACh receptors
20
Q
general suffixes to determine type of HTN druve
A
- lol: beta blocker
- pril: ace inhibitor
- sin: alpha blocker
- sartan: ARB
- pine: calcium channel blocker
21
Q
when is single drug HTN therapy indicated
multi drug
A
pre HTN, stage I
Stage II
22
Q
what is the risk with a hyperkalemia
A
fatal cardiac arryhtmia
23
Q
Zolpidem
A
Hypnotic for Insomnia
24
Q
diuresis for CHF
A
spironolactone (risky with ACE, prevents remodeling)
loop (especially helpful wth fluid overload
25
antiarrhytmia drugs for a fib
beta blockers, amioderone, propafenone
26
Metformin
Diabetes (type II)
27
death from spironolactone is from
hyperkalemia due to lack of surveliance
28
alpha selective agonists
phenylephrine, methoxamine (A1\>A2)
clonidine (A2\>A1)
29
Oxycodone/APAP
Analgesic-narcotic
30
benefit of digoxin over digitalis
less protein binding
shorter onset
shorter half life
31
RAA targets for HTN treatment
inhibit Renin
block ACE
block angiotensin II
block aldosterone
32
what are motillin like agents
examples
when is it used
what is the issue
drugs that mimic motilin a protein that stimulates smooth muscle
macrolides (erythromycin, azithromycin)
diabetic gastroparesis, expulsion of bezoars
tolerance
33
what causes serotonin syndrome
symptoms
too much serotonin activity from multiple serotonin agonists or a monamine oxidase inhibitor
**high body temp**, agitiation, hyperreflexia, sweatting
34
supportive treatment for acute MI
O2, pain relief, manage arrhythmias, anti-platelets
35
many -pine drugs are CCBs. two exceptions
diltiazem and verapamil
36
three types of cholinergic antagonists
antimuscarinics
ganglionic blockers
neuromusclar blockers
37
antiemetics with uncertain mode of action
corticosteroids (decadron)
cannabinoid (marinol)
benzodiazepines (xanax)
38
adverse Beta 1 effects
tachycardia, anxiety, tremors
39
what are ganglionic blocking drugs used for
adjuncts for ECT and in a hypertensive emergency or dissecting aortic aneurysm
40
special consideation for aldosterone agonists
antiandrogenic (gynecomastia, ↓hirsutism)
41
other vasodilators besides CCBs
minoxidil, hyralazine
42
what is the logic behind anticholinesterases on dementia
some forms of alzheimers display ↓ACh in the CNS
giving drugs like donepezil can help with memory
43
drugs to treat a fib
rate control (BBs, amioderone, digoxin)
restore sinus (drugs, cardiovert, ablation)
anticoagulation (warfarin, prazaxa)
44
1st line treatment for single druge HTN
2nd
HCTZ, lisinopril, losartan, dilitizem
atenolol, labetolol, clonidine, prazosin
45
two types of antacid liquids
aluminum hydroxide (gelusil)
magnesium hydroxide (mylanta)
46
Simvastatin
Lipid (cholesterol)-lowering
47
main clinical indications for lipid lowering drungs
another possible indication
prevent issues in patients with hyperlipidemia, treat patients with known CVD/CAD
maybe ↓risk of plaque rupture
48
Tiotropium
COPD, Asthma
49
what drugs are contradicated with nitrates for angina
ED drugs (viagra, cialis)
50
three drugs that will increased serum concentrations at normal dosing when given with cimietidine
warfarin, diazepam, phenytoin
51
functions of aldosterone
↑salt and fluid retention to increase volume
forces cardiac growth and remodeling
52
alpha blockers
indications
prazosin
HTN, BPH
53
risk of a fib
mural thrombi (LA clot)
54
adverse effects of cholinergic drugs
Miosis
sweating
diarrhea/cramps/nausea
bronchospasm
urinary urgency
bradycardia/syncope
55
ANS effect on CNS
sym increased alertness
para decreases alertness
56
adverse effects of fibrates
contraindications
Cancer, Nausea, gallstones
severe hepatic or renal failure, pregnancy
57
Fluticasone
Anti-inflammatory for allergies
58
ANS effects on the uterus
sym: relaxation
para: variable
59
where is doapmine most important
in the CNS, renal and splanchic vasculature
60
how long does it take H2 blockers to work
45 minutes
61
T/F treatment of HTN reduces mortality and morbidity
true
62
ANS effects on GI and bladder
sym rduce activity
bladder increase activity
63
Lisinopril
Antihypertensive (ACEI)
64
three classic adrenergic agonists
norepi, epi, isoproterenol
65
ACE inhibitors
important side effects
benazepril, ramipril
hyperkalemia
66
eccrine sweat glands are innervaated by what
both sympathetic and parasympathetic
67
Sertraline
Antidepressant
68
indications for Omega-3s
contraindications
hypertriglyceridemia, prevention of MI reccurence
mild anticoagulant, ↑LDL, more difficult to conttrol sugar
69
functions of angiotensin II
direct vasoconstriction
increased sympathetic tone
releases aldosterone
70
Duloxetine
Antidepressant
71
risk of Propafenone (Rythmol) & flecainamide (Tambocor
caution with prior MI, negative inotropes
72
cholinergic drugs are what
parasympathomimetics
73
beta II adrenergic receptor actions
bronchiole dilation, myometrium relaxation, ↑glycogenesis
74
craniosacral vs thoracolumbar
parasympathetic vs sympathetic
75
general adrenergic agonists (alpha = beta effects)
epinephrine (A1=A2, B1=B2)
norepinephrine (A1=A1, B1\>\>B2)
76
two sources of cholestrol
exogenous (diet)
endogeneous \*from the liver)
77
methods to control HR
cardic output \*block Beta 1, increase venous capacity, reduce blood volume
resistance (block alpha 1, block central sympathetic action, dilate vasculature)
78
Amlodipine
Antihypertensive (CCB)
79
adverse effects of loop diuretics
hypokalema, ototoxicity
80
misoprostol is contraindicated in what condition
pregnancy (can trigger first trimester abortion)
81
when should PCSK-9 inhibitors be used
when nothing else works (very expensive, doesn't reduce mortality)
82
Levothyroxine
Thryoid hormone
83
function of loop diuretics (lasix)
block NA reabsorption
direct venous dilation
84
lipid lowering drug strategies
first line statins
second bile acids, fibrates, sterol absorption inhibitors, omega 3
third PCSK-9
85
two common ARBs
why use them
Losartan, olmesartan
cough and angioedema are less common, often better tolerated than ACE
86
PPI increases the risk of what serious complication
MI
87
T/F PPI decreases risk of death by 25%
false, increases risk
88
Carisoprodol
Muscle relaxant
89
reperfusion for acute MI
percutaneous coronary intervention with thrombolytics
90
two types of bulking laxitives
colloids (agar, bran, psyllium)
saline cathartics (polyethylene glycol)
91
Azithromycin
Antibiotic
92
ADRs of amioderone
pulmonary fibrosis, liver toxic, blocks T4 to T3 conversion, photodermatitis
93
Gabapentin
Anticonvulsant
94
CHF strategy
↓cardiac workload
↓Na
give ACE or ARBs
95
what is the primary treatment for reccurent ventricular rhythms
what is the usefil adjunt medicine
ICD
amioderone
96
where is norepinephrine found
most sympathetic postganglionic synpases
97
what patients are calcium channel blockers particularly useful for
diabetics, asthmatics, people with angina
98
what is the most ocmmon chronic arrhytmia
A fib
99
Citalopram
Antidepressant
100
Atenolol
Beta blocker
101
beta selective adrenergic agonists
isoproterenol (B1=B2)
dobutamine (B1\>B2)
Terbutaline (B2\>\>B1)
102
RAA blockers
renin blocker
ACE
ARB
aldosterone blockers
103
metoclopramide (reglan) is a...
dopamine receptor antagonist gi motility agent
104
where is acetylcholine found
all preganglionic synapses
all parasympatheyic post ganglionic synapses
some sympathetic postganglionic synpases
105
digoxin toxcicity
arrhythmia (heart block, irritability)
Anorexia, Nausea
headache
106
what histamine receptor is targeted to decrease acid production
H2
107
reccomended monitoring for statins
AST/ALT
Creatine kinase
108
most common adverse effect of calcium channel blockers
constipation, followed by headache/dizziness/vertigo
109
paroxysmal atrial fibrillation is commonly seen when
before the development of chronic a fib
110
Methylprednisolone
Corticosteroid, anti-inflammatory
111
anti serotonin antiemetics (trons)
ondenestron (zofran)
112
necrotizing autoimmune myopathy
severe and potentially fatal disroder triggered by statins in certain genetically predisposed people
113
beta I adrenergic receptor actions
↑contractility and HR, ↑lipolysis
114
risk of irritant laxitives
atonic colon occurs with prolonged used
115
Hydrocodone & APAP
Analgesic-narcotic
116
Furosemide
Diruretic: loop type
117
two main cholinergic receptors
nicotinic and muscarinic
118
mainstay treatment of anaphylasis
adverse effects
beta sympathetic agonsists (epi)
tachycardia, hyperglycemia, maybe arrhythmia
119
Clonazepam
Anticonvulsant, sedative
120
T/F electrolyte loss from thiazides and loops is constant
false, eventually it will get to a new setpoint and hold
121
use of sodium channel blockers
ADRs
chronic managment, ↑exercise tolerance
ADRs: ↑QT intervals, inhibits CYP
122
risks with aldosterone antagonists and luminal membrane HTN agents
hyperkalemia
123
cycle of CHF
ischemia damages myocardium
↓
cardiomegaly
↓
reduced CO due to overstretched myocardium
↓
more ischemia
124
what would increase clinical suspcision of variant angina
fatigue
smoking
younger patients
125
Warfarin
Anticoagulant
126
Benazepril
Antihypertensive (ACEI)
127
antiarrhytmia drugs for v tach
lidocaine, amioderone
128
nicotinic receptor
acetylcholine receptor, found at the NMJ and sympathetic ganglia
129
antiarrhytmia drugs for SVT
adenosine
130
functions of CCBs in the treatment of angina
↓O2 demand
prevent vasospasm
poss slow develoopment of plaques
131
Clopidigrel
Anticoagulant-antiplatelet
132
long term issues with PPI
↓ absorption of B12 (↓acid)
↑risk of cdiff
↓serum mg
osteoporosis
CVD
133
what is the use of edrophonium with myasthenia gravis
if you give a pt with suspected MG edrophonium and their muscular strength improves short term, Dx of MG is confirmed
134
PPI can cause osteoporsis
appropriate managment?
bisphosponated
135
T/F ototoxicity caused by loop diuretics is permanent
typically not, but can be synergistic with aminoglycosides and reduced renal function
136
when are antacids contraidincated
renal failure
137
action of alpha 1 adrenergic receptors
↑contractility, vascular constriction, dilated eyes (mydriasis), piloerection
138
indications for general adrenergic agonists (epi and norepi)
epi: anaphylaxis, asthma
norepi: IV for shock
dopamine: IV for shock
139
anticholinergics cause what significant neuro issue
worsening of dementia
140
side effects of antimotility agents
drowsiness, cramps, dizziness
risk of toxic megacolon
contraindicated in adults with severe colitis
141
fight or flight
neurotransmitter
described as
sympathetic
norepinephrine
adrenergic
142
HTN drug groups
Diuretics (lower volume, increase venous capacity)
adrenergic blockers (alpha and beta 1)
vasodilators (reduce periperhal resistnace)
black RAA (reduce blood volume and resistance)
143
antiarrhytmia drugs for v fib
lidocaine, amioderone
144
T/F combination therapy is more effective for antiemesis
truw
145
adjunct treatments to angina
lower lipids, ACE inhibitors (enhance post MI survival), revascularization
146
indications for beta blockers
HTN, hyperthyroid, others
147
two main adrenergic receptors
alpha and beta
148
Esomeprazole
Gastric acid inhibitor
149
statins are synergistic with what other drug
sterol absorption inhibitors
150
Albuterol
Asthma
151
Rest and digest
neurotransmitter
described as
parasympathetic
acetylcholine
cholinergic
152
emetic control centers
chemorecptor trigger zone
vomitting center
vestibular/cerebellar afferents
cortex inputs
peripheral inputs
153
Potassium
Electrolyte
154
antiemetic drug classes (8)
1. phenothaizines
2. substituted benzamides
3. butryophenones
4. benzodiazepines
5. corticosteroids
6. cannaboid receptor agonist
7. serotonin receptor blockers
8. substance P/neurokinin-1 receptors
155
catecholamine
enhanced tyrosine, epi and norepi
156
pro/con for transdermal or sublingual nitrates
sublingual is faster, shorter acting, can caused headaches
transdermal is slower to act but usually lasts longer
157
inotropic agents for CHF
cardiac glycosides (digitoxin, digoxin)
Beta agonists (dobutamine, dopamine)
phosphodiesterase inhibitors (amrinone)
158
three antidopamine antiemetic side effects
sedation
diarrhea
prolonged QT interval
159
pathology associated with variant angina
50-70% will have coronary artery stenosis which is paired with vasospasm causing angina
160
this drug class, including digitalis and digoxin, have a low theraputic index
cardiac glycosides
161
how are luminal membrane agents and aldosterone antatgonists used
as adjuncts to a thiazide or loop
162
what is the usual target for LDL
risks involved
\<100 or \<70 in diabetics
muscle weakness, poss increased cancer risk
163
cardiovascular effects of adrenergic drugs
increase HR, contractility, conduction, arrhythmia, vascular resistance
164
major complication of thiazide diuretics
hypockalemia
165
Atorvastatin
Lipid (cholesterol)-lowering
166
classes of antiarrhythmic drugs
I: Na channel blockers (quinidine, lidocane)
II: beta blockers (propranolol)
III: K+ blockers (amiodarone)
IV: CCBs (diltaizem, verapamil)
167
autonomic control of BP
Sympathetic (Alpha 1 vascular and Beta 1 cardiac)
renal blood flow (RAA, total volume)
168
diuretic action
↓Na and water retention
reduce blood volume
reduce cardiac output
reduce perpheral resistance
169
indications for beta agonists
dobutamine: severe HF and cardiogenic shock
terbutaline: inhalers for asthma, stopping labor
170
Montelukast
Asthma
171
Cyclobenzaprine
Muscle relaxant
172
HDL paradox
increasing HDL above a certain point doesn't decrease risk
173
what will happen if you block cholinergic effects
sympathetic influence will increase (dilated pupils, tachycardia, constipation, confusion)
174
ANS sexual effects
sym: orgasm
para: arousal
175
special consideration with luminal membrane diruetics
the effect is enhanced with ACEI and NSAIDs
176
what is the most powerful acid reducers
PPI
177
uses of Class I arrthymia drugs based on effect
IA: (quinidine) can cause arrhymias
IB: (lidocaine) good at preventing v tach and fib
IC: (flecainide) caution with prior MI
178
two types of GI motility agents that work on cholergic receptors
agonists (carbachol, bethanechol)
acetylcholinesterase inhibitors
179
Memantine
Dementia
180
adverse side effects of statins
Liver damage
myopathy/rhabdo
contraindicated in pregnancy, lactation, kids/teens
181
three types of serotonin receptor modulator motility drugs
cisapride (propulsid)
metoclopramide (reglan
ondansetron (zofran)
182
omeprazole will decrease the effectivness of what drug
plavix
183
important vasodilators for CHF
ACE/ARBs
nitrates + hydralazine
minoxidil
184
Rosuvastatin
Lipid (cholesterol)-lowering
185
classes of CCBs
nonselective verapamil
some what selective diltiazem
selective nifedipine
186
Meloxicam
NSAID
187
Aripiprazole
Antipsychotic
188
Fexofenadine
Antihistamine
189
two main types of anticholinesterases
reversible and irreversible
190
spironlactone can cause what in mean
bitch tits
191
four types of laxitives
irritants/stimulants
bulking agents
stool softeners
chloride channel activators
192
treatment for myasthenia gravis
ACh agnoists
immunosuppression
thymectomy
193
rate H2 antagonists least to most potent
cimetidine
ranitidine, nizatdidine
famotidine
194
types of K sparing diuretics
agents active at the luminal membrane (triameterene, amiloride)
mineralocortocoid antagonists (spironolactone)
195
pathophysiology of stable angina
unmet oxygen demand from coronary artery stenosis
can be exacerbated by anemia, fever, hyperthyroid, arrhytmia
196
important adverse side effects of niacin in ↓cholesterol
cutaneous flush/pruritis
hepatotoxic
197
Escitalopram
Antidepressant
198
uses for antimuscarinics
atropine (opthlmic, irritable GI, reflex suppression, organophosphates)
scopolamine (motion sickness)
Ipratropium (asthma, COPD)
199
important issues with cimetidine
anti androgen
inhibits 6 cyp 450 enzymes
200
ventricular response to a fib
"irregularly irregular"
201
three types of angina
stable (predictable and relieved with rest)
variant (atypical, hallmark extreme fatigue with minimal exertion)
unstable
202
main risk of hyperlipidemia
atherosclerosis
203
three cautions with beta blockers
care ful with dose, esp with left heart failure
severe bradycardia
contraindicated for the treatment of variant angina
204
HCO can cause what if taken too often
metabolic acidosis
205
can CHF be reversed
some success with non-ischemic CHF
206
what is the gastric effect of prostaglandings
protective (↓ acid, ↑mucin, ↑HCO3,)
207
short and long term indications for PPI
ST: erosive esophagitis, acute peptic ulcer
LT: Z-E syndrome, refractory gerd
208
effect of autonomic function on spit and sweat
sympathetic ↓ spit and ↑sweat
parasympathetic increases both
209
what are beta blockers best used for in the treatment of angina
prevention of attacks by decreasing output and afterload
210
three types of antacid tablets
aluminum hydroxide (gelusil)
magnesium (mylanta)
CaCO (tums)
211
diuretics
thiazides, loop, K sparring
212
strategies for cholinergic drugs
give ACh (doesn't last long)
give an agonist (good)
give an anticholinesterase
213
Quetiapine
Antipsychotic
214
what is H pylori most related to
ulcer recurrance, not initial presentation
215
what is the paradox of antiarrhtmia meds
they can be used to prevent arrhythmias and are beneficial in acute settings, but risky to use in prevention of arrhythmia
216
three most important adrenergic receptors
Alpha I (vasoconstriction, increased bladder sphincter tone)
Beta 1 (↑HR)
Beta II (bronchiole dialtion, uterine relaxation)
217
useful CCBs
verapamil and diltiazem (less skeletal muscle decrease)
218
caution with beta blockers
careful with asthma pts (withdrawl can cause arrhytmia)
don;t use in uncompensated CHF
don't use in bradycardic pts
219
important systems under autonomic control
digestion
cardiac
otthers
220
Metoprolol
Beta blocker
221
Amoxicillin
Antibiotic
222
mimetic vs lytic or plegic
agonists vs antagonists
223
what type of beta blockers are prefered for managment of angina
selective beta 1 (atenolol)
224
Hydrochlorthiazide
Diuretic: thiazide type
225
where is VLDL converted into LDL
peripherally
226
Valsartan
Antihypertensive (ARB)
227
imodium is a...
antimotility agent
228
ANS effects on the bronchioles
sym dilate
para constrict
229
Carvedilol
Beta blocker, alpha blocker
230
autonomic effects on the bladder
sympathetic: sphincter contraction
para: destrusor contraction
231
Omeprazole
Gastric acid inhibitor
232
beta blockers (nonselective, selective, combined)
non: propranolol
selective (B1\>\>\>\>B2) metoprolol, atenolol
combined (A1, B1, B2) labetalol
233
steps of atherosclerosis
1. Fatty streaks (LDL accumulation under the vascular endothelium)
2. fatty oxidation
3. foam cells (lipid filled macrophages trying to get rid of LDL)
4. cell damage, accumulation of more LDL
234
treatment of HTN emergency
vasodilators (diazoxide), alpha & beta blocker (normodyne), dopamine agonist (fendolopam)
235
Iburpofen
NSAID
236
surgical options for CHF
revascularization
cardioplasty
237
Tramadol
Analgesic-atypical
238
most important lipid lowering drugs
HMG-CoA reductase inhibitors (statins)
PCSK-9 inhibitors
239
side effects of anti serotonin anti emetics
expensive
diarrhea
headache
dizziness
240
how to kill H pylori
it takes a long course of multiple drugs including Abx, PPI and/or Bismuth
241
CCBs are based used for what type of angina
variant
242
Digoxin
Inotropic agent for CHF
243
uses of class II, III, IV anti-arrhytmias
class II: tachycardia and ventricular arrhytmia
Class III: tachy sotolol (BB) useful
Class IV: most effective against atrial arrhytmia
244
when to use anorectic agents
morbid obese (30BMI or higher)
failure of diet and support groups
occasionally required before surgical intervention
245
Alprozolam
Sedative-antianxiety
246
adrenergic receptor subtypes
alpha 1: vascular, pupil, piloerection
Beta 1: heart
beta 2: smooth muscle (bronchioles, uterus, vascular)
247
Promethazine
Antihistamine, antiemetic
248
drug interactions with amioderone
fluconazole
macrolides
grapefruit juice
249
benign H2 antagonist effects
headache
dizziness
muscle pain
diarrhea
250
muscarinic receptor
a key cholinergic receptor subtype, creates a parasympathetic response
251
Methylphenidate
CNS stimulant, ADHD
252
PPI safety summary
ok for short term
careful for long term (+6months), especially with Cdiff, osteoporosis, heart disease
253
Cephalexin
Antibiotic
254
why is aluminum and mg paired together in antiacids
mg causes diarrhea
aluminum causes constipation
255
what is digoxin most commonly used
adjunct to CHF with chronic Afiv
