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Flashcards in Pharm1 - Pharm1 Deck (57)
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31

what effect does acetazolamide have on the following serum levels: K HCO3 Ca Mg urate

decreased decreased none none none

32

which diuretics decrease Mg?

furosemide HCTZ

33

which diuretics increase urate?

furosemide HCTZ

34

contraindication of spironolactone

acute renal failure

35

MOA nitroprusside

vasodilation of arteries and veins contact with RBC --> decomposition of drug and release of NO NO, via activation of guanylate cyclase --> vasodilation

36

clinical uses of nitroprusside

HTN crisis aortic dissection (must be given with B blocker) CHF

37

side effects of nitroprusside

hypotension reflex tachy CN release

38

contraindications for nitroprusside

known inadequate cerebral circulation hepatic/renal dz (increases thiocyanate toxicity)

39

MOA nitroglycerine

via guanylate cyclase --> increase cGMP which activates cAMP protein dependent kinases and leads to dephosphorylation of myosin light chains and decreased intracellular Ca --> relaxation of veins and increased venous capacitance

40

uses of nitroglyceride

treats angina (decresae coronary asospasm) CHF HTN

41

side effects of nitroglycerine

hypotension, tachycardia, throbbing HA from meningeal arterial dilation

42

MOA captopril

ACE inhibitor blocks formation of AII and degradation of bradykinin so, inhibits constriction of efferent arteriole, and potentiates vasodilation caused by bradykinin also causes venous vasodilation

43

uses of captopril

HTN CHF ischemic heart disease decreases proteinuria and progression of nephropathy in diabetics

44

side effects of captopril

cough from increased bradykinin can cause renal insufficiency b/c GFR is not increased in low volume states

45

contraindications of captopril

renal insufficiency bilateral renal artery stenosis

46

MOA losartan

AII receptor blocker

47

uses of losartan

HTN CHF

48

side effects of losartan

no cough can't maintain GFR by vasodilation of efferent arterioles

49

MOA milrinone

inhibits PDE III --> dilation of arteries and veins PDE III inactivates cAMP, so this process is inhibited --> increased Ca reflux in myocardium, with increased cardiac contractility

50

uses of milrinone

refractory CHF can increase mortality, and should ONLY be used if diuretics, digoxin, and vasodilators have failed a-fib

51

side effects of milrinone

ventricular arrhythmias hypotension hepatotoxicity

52

MOA sildenafil

blocks PDE V action (thus potentiating the action of cGMP dependent kinases that activate phosphatases that encourage the relaxation of smoooth muscle) also decreases the Ca concnetration --> smooth muscle relaxation

53

MOA digoxin

blocks the Na-K pump --> increased Na intracellularly this inhibits the Na concentration gradient from forming, blocking the Ca from leaving the cells this improves cardiac contractility also slows the conduction through AV node

54

uses of digoxin

CHF a fib, a flutter (slows conduction through AV node)

55

side effects of digoxin

narrow therapeutic window visual disturbances, nausea, blurred vision a-tac and AV block can result

56

contraindication of digoxin

hypokalemia 2nd/3rd degree heart block WPW who develop a-fib --> increased impulses through accessory pathway --> VF

57

what abnormalities can be seen on the EKG on a person taking digoxin

incresaed PR, decreased QT, scooping of ST segments, T wave inversion