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Flashcards in Pharmacology Deck (226)
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1

list the current first line drugs for treating HTN

thiazide diuretics (chlorthalidone, HCTZ)
ACEi (captopril, enalapril, benazepril, lisinopril)
ARBs (losartan, valsartan, candesartan)
CCB dihydropyridines (amlodipine, nifedipine)
CCB non-dihydropyridines (verapamil, diltiazam)

2

anti-hypertensive drugs that are safe to use in pregnancy (3)

methyldopa
nifedipine
labetalol

3

anti-hypertensive drugs that should NEVER be used during pregnancy (3)

ACEi
ARBs
direct renin inhibitors

4

list the alpha antagonist drugs used to treat HTN (4)

(-osin)
prazosin
tamsulosin
terazosin
doxazosin

5

MOA of prazosin

competitive antagonist of alpha1-AR --> vasodilation --> decreased peripheral resistance and BP

6

difference of tamsulosin, terazosin, doxazosin from prazosin

each selectively antagonist alpha 1a, 1b, and 1c specifically

7

other clinical applications of tamsulosin, terazosin, doxazosin (other than tx of HTN)

benign prostatic hypertrophy (BPH)
help kidney stones pass

8

characteristic adverse effects of alpha antagonists (-osins)

orthostatic hypotension, syncope, palpitations, edema

retrograde ejaculation, priapism, urinary frequency

dizziness, drowsiness, decreased energy, weakness

9

which is the most selective beta1 blocker?

bisoprolol

10

characteristic of esmolol

short half life as a beta1 blocker

11

adverse effects of propranolol

bronchospasm, dyspnea

cold extremities

disrupted sleep

bradycardia, AV block, CHF, cardiogenic shock, hypotension, syncope

hyperglycemia, hyperkalemia, hyperlipidemia, hypoglycemia

12

what is contraindicated for propranolol?

peripheral vascular disease

13

what beta blocker is lipid soluble? what effects does that have?

metoprolol is lipid soluble --> more likely to produce adverse CNS effects (lethargy, confusion, nightmares)

14

what is the drug of choice for gestational HTN?

alpha-methyldopa

15

list the alpha2 agonists

clonidine
alpha-methyldopa

16

MOA of clonidine

crosses the BBB --> acts on CNS --> shuts down sympathetic flow (alpha 2 effects)

17

is clonidine used as first line or adjuvant therapy?

adjuvant therapy

18

adverse effects of clonidine

REBOUND HTN IF DOSE MISSED
bradycardia or tachycardia, AV block, arrhythmia, syncope, etc.

drowsiness, fatigue, dizziness

xerostomia, upper abd pain

19

what two drugs have the adverse effect of drug-induced SLE-like syndrome?

alpha-methldopa
hydralazine

20

what happens with an abrupt withdrawal of beta blockers?

excessive cardiac stimulation in response to normal SNS tone (receptors become unmasked) --> tachycardia, HTN, MI, angina, arrhythmia (REBOUND HTN)

21

what happens with an abrupt withdrawal of alpha2 agonists?

excessive SNS tone (breaks have been released) --> REBOUND HTN

22

list the prostanoids (4)

(-prost)
epoprostenol
treprostenil
iloprost
selexipag

23

pharmacokinetics of epoprostenol

very short half life (6 min!)
continuous IV
drugs must be kept cold

24

pharmacokinetics of treprostenil

longer half-life (4 hrs)
subQ infusion but very painful
does NOT need to be refrigerated

25

pharmacokinetics of iloprost

INHALATION 6-9 times/day

26

disadvantage of selexipag

expensive af

27

drugs used to treat PAH

prostanoids
endothelin antagonists
PDE-5 inhibitors
guanylate cyclase sensitizers

28

MOA of prostaonids

mimics action of endogenous prostacyclin
- vascular dilation
- inhibits platelet aggregation
- decreases pulmonary vascular resistance

tx PAH

29

list the endothelin antagonists (3)

bosentan
amrbisentan
macitentan

30

which drug(s) nonspecifically blocks ETa and ETb endothelin receptors?

bosentan
macitentan