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Cardio/Renal 1 Final > Pharmacology > Flashcards

Pharmacology Flashcards

(56 cards)

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1
Q

Loop Diuretics MOA

A

inhibits Na+/K+/CI- in ascending loop of henle which allows more water and CI- to travel to distal tubule

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2
Q

Loop diuretics MOA in HTN

A

Arteriolar vasodilator and diuretic effect (decreases peripheral resistance)

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3
Q

AE of loop diuretics

A

Orthostatic hypotension / Hypokalemia / hypomagnesemia / hypochloremia / hyponatremia / metabolic acidosis

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4
Q

What is Elperenone and its MOA

A

New aldosterone agent that selectively binds to mineralocorticoid receptors and blocks aldosterone

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5
Q

Feature of Elperenone

A

It has less affinity for steroid receptors compared to spironolactone

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6
Q

Canrenoate & Canrenone are…

A

metabolites of spironolactone

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7
Q

What do the 2 metabolites of spironolactone do and treat

A

they bypass hepatic metabolism and treat primary or secondary hyperaldosteronism / HTN / CHF / ascites due to hepatic cirrhosis

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8
Q

Which of the following are vasodilators ?

A

sodium nitropursside / nesirite / hydralazine / minoxidil

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9
Q

What is sodium nitroprusside and what does it do ?

A

It is a vasodilator and it decreases cardiac work + no reflux tachycardia + decreases pre load on heart

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10
Q

MOA of sodium nitroprusside

A

It makes RBCs convert nitropursside to NO - also relaxation by non-enzymatically to NO by glutathione

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11
Q

What are the AE of sodium nitroprusside ?

A

palpitation / abdomen pain / cyanide toxicity / lactic acidosis

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12
Q

What causes SE of sodium nitroprusside ?

A

the release of cyanide (thiocyanate)

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13
Q

Kinetics of nitroprusside

A

during biotransformation of nitroprusside. cyanice is produced which is then converted to thiocynate in the liver and excreted by the kidneys

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14
Q

What is Nesiritide

A

a recombinant form of human natriuretic peptide

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15
Q

Where does nesiritide release from and what does it do ?

A

it is secreted by the ventricles and increases cGMP

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16
Q

what does nesiritide cause ?

A

natriuresis

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17
Q

MOA of hydralazine

A

molecules combine with receptors in the endothelium of arterioles -> NO release -> relaxation of vascular smooth muscle -> fall in BP

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18
Q

How is hydralazine taken ?

A

combination with isosorbide dinitrate

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19
Q

What do beta blockers do for CHF

A

decrease reflux tachycardia + load on heart

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20
Q

What is an advantage of carvedilol ?

A

it reduces free radical induced lipid peroxidation and prevents cardiac and vascular smooth muscle mitogenesis

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21
Q

What is a SE of non-specific BB carvedilol ?

A

bronchoconstriction with higher doses

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22
Q

What are DI of carvedilol and what does the CYP one do ?

A

CCB / Cimetidine / CYP2D6 –> increases levels of carvedilol

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23
Q

What are the positive inotropes and what does inotrope mean ?

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A

Digoxin, dopamine, dobutamine, milrinone / it means contraction

24
Q

What can positive inotropes lead to ?

25
What does digoxin treat and what is the moa for each one ?
CHF -> increases calcium availability which reverses HF Atrial fibrillation -> decrease HR / blocks A-V nodal conduction Another MOA is the Na+/K+ ATPase -> more Na+ in
26
When Digoxin reverses HF, what does that lead to ?
CO returns to normal with dilated heart, with tachycardia / and also decreases peripheral edema + congestion
27
Main ADRs of digoxin ?
Hallucination, disturbed vision
28
What are digoxins digital toxicities
Narrow therapeutic index / depends on electrolytes
29
What are the non-digital positive inotropes that resemble NE
Dopamine / dobutamine / amrinone / milrinone
30
What type of drugs are amrinone and milrinone
Theophylline drugs that inhibit phosphodiesterase and have positive inotropic activity and are inotropic vasodilators
31
Whats the MOA of non-inotropic drugs
inhibit peak III cAMP phosphodiesterase isoenzyme in cardiac + vasculature
32
Whats a DI of non-inotropic drugs
forms precipitate with IV furosemide
33
Whats the ARNI + ARB combination
Sacubtril + valsartan = entresto
34
What kind of drug is entresto ?
nephrylism inhibitor
35
what is nephrylism ? and what amplifys its effect
endopeptidase that has naturetic + vasodilatory effects valsartan amplifies the effects
36
is sacubitril a pro-drug or not and if it is what is is activated by
it is a pro drug and it is activated by esterase hydrolysis
37
what does entresto do for patients with CHF
reduces risk of cardiovascular death + hospitalization with reduced ejection rate for patients with reduced ejection fraction
38
what kind of drug is Ivabradine and its MOA
1) HR lowering drug MOA - selectively inhibits the "funny" channel pacemaker in SA node -> HR + more blood flow to myocardium
39
What kind of patients is ivabradine good for ?
patients with ejection rate of < or equal to 35% and has less SE
40
Which ones are the OD and what are OD and hypertonic solutions used for
mannitol, sorbitol, and isosorbital and used for cerebral edema and acute renal failure
41
What are features of ODs
LMW + hydrophilic and pass through bowmans capsule into renal tubules
42
What does mannitol decrease
intraocular + intracranial pressure
43
what is used to treat metabolic acidosis
sodium bicarbonate
44
what are examples of hyperkalemia agents
calcium chloride/gluconate, sodium bicarbonate, dextrose-insulin infusion, albuterol nebulizer, furosemide, kayexalate
45
What can hyperkalemia drugs lead to
cardiac arrest
46
What are drugs that treat hyperphosphotemia
calcium carbonate/acetate, sevelamer & lanthanum, aluminum hydroxide gel
47
What kind of disease is sevelamer used for and what does it do
used in patients with chronic renal disease and binds directly to phosphate
48
Lanthanum MOA
Breaks down in acid environment of the GI tract -> release lanthanum ions bind to dietary phosphate which is why its taken with food
49
Everything about erythropoietin stimulating agents
- used for anemia of chronic renal failure - 2 types -> erythropoietin alpha and darbepoetin alpha - recombinant human erythropoietin
50
MOA of desmopressin and what is it used for
- increase cyclic AMP in renal tubular cells which lead to retention of water in the body - bleeding and diabetes insipidus
51
Everything about potassium chloride
1) slows down HR 2) used for hypokalemia because it increases K+
52
What are the DIs of potassium chloride and why are they an interaction
ACE inhibitors and K-sparing diuretics (Sprinolactone, Traimetene, Amilornone) and because they elevate a persons K+ levels
53
What does calcium gluconate do and treat ?
increase calcium levels + treats hyperkalemia
54
What is Cinacalet and what does it do ?
it is a calcium sensitizer that decreases PTH in patients with renal failure
55
What is Doxercalciferol ?
It is a vitamin D2 analog that undergoes metabolic activation in vivo to 1a,25-dihydroxyvitamin D2, a naturally occurring, biologically active form of vitamin D2
56
Everything about vaptans
1) Tolvapatan (1st one) / Conviaptan 2) Hyponatremia is defined as serum sodium concentration <135 3) Vaptans are nonpeptide vasopressin receptor antagonists (VRA) 4) VRAs offer a novel therapy for water retention 5) Conivaptan is a V1 a/V2 nonselective VRA approved for euvolemic and hypervolemic hyponatremia

Cardio/Renal 1 Final (1 decks)

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