Random Pharm Flashcards by Lisa Rosenfeld

Which type of antihypertensive must be used cautiously in decompensated CHF patients + is contraindicated in cardiogenic shock?

beta-blockers

How well did you know this?

Not at all

Perfectly

First-line antihypertensive in T2DM pts

ACEi/ARBs (protective against diabetic nephropathy)

How well did you know this?

Not at all

Perfectly

vasoselective Ca2+ channel blockers

amlodipine, nifedipine

dihydropyridine

How well did you know this?

Not at all

Perfectly

cardioselective Ca2+ channel blockers

verapamil > diltiazem
(“Verapamil = Ventricle”)

non-dihydopyridine

How well did you know this?

Not at all

Perfectly

how do Ca2+ channel blockers lower blood pressure

block L-type Ca2+ channels of cardiac and smooth muscle –> decreased muscle contractility
(decreased risk of vasospasm, hence used in prinzmetal angina and raynaud’s)

How well did you know this?

Not at all

Perfectly

which drug can be used to prevent cerebral vasospasm following subarachnoid hemorrhage?

nimodipine (dihydropyridine Ca2+ channel blocker)

Finding Nimo in the see of blood that is a subarachnoid hemorrhage

How well did you know this?

Not at all

Perfectly

antihypertensives used in pregnancy

hydralazine (can cause lupus-like syndrome) + methyldopa (can cause hemolytic anemia)

How well did you know this?

Not at all

Perfectly

how does hydralazine work?

inceases cGMP –> smooth muscle relax’n (arterioles > veins; afterload reducer)

How well did you know this?

Not at all

Perfectly

what drug is commonly given with hydralazine? why?

beta-blocker, to prevent reflex tachycardia

How well did you know this?

Not at all

Perfectly

which drug given in hypertensive emergencies is the only IV agent that increases renal perfusion and decreases BP (ie, is good for pts with renal failure)?

fenoldopam (D1 receptor agonist)

How well did you know this?

Not at all

Perfectly

feared side effect of nitroprusside (given in hypertensive emergency)

cyanide toxicity (treat with sodium thiosulfate)

How well did you know this?

Not at all

Perfectly

goal of antianginal therapy

reduce myocardial O2 consumption

How well did you know this?

Not at all

Perfectly

main effect of nitrates in treating angina (nitroglycerin, isosorbide, dinitrate)

reduce preload

How well did you know this?

Not at all

Perfectly

main effect of beta-blockers in treating angina

reduce afterload

How well did you know this?

Not at all

Perfectly

partial beta-agonists contraindicated in angina

pindolol and acebutolol

How well did you know this?

Not at all

Perfectly

mechanism of statins

HMG-CoA reductase inhibitors

How well did you know this?

Not at all

Perfectly

main effect of statins

reduce LDL

How well did you know this?

Not at all

Perfectly

statin side effects

hepatotoxicity and rhabdo (esp when used with fibrates and niacin/B3)

How well did you know this?

Not at all

Perfectly

main effect of niacin/B3

decrease LDL and increase HDL

How well did you know this?

Not at all

Perfectly

mechanism of niacin/B3

reduce VLDL synthesis and release by hepatocyte; inhibit lypolysis in adipocytes

How well did you know this?

Not at all

Perfectly

side effects of niacin/B3

flushing, hyperglycemia, hyperuricemia

How well did you know this?

Not at all

Perfectly

cholestyramine, colestipol, colesevelam

bile acid resins

How well did you know this?

Not at all

Perfectly

mechanism and effect of bile acid resins (“chol”, “col”)

prevent intestinal reabsorption of BILE ACIDS –> lower LDL

How well did you know this?

Not at all

Perfectly

side effects of bile acid resins

cholesterol gallstones, GI upset, decreased abs of fat soluble vits

How well did you know this?

Not at all

Perfectly

mechanism and effect of ezetimibe

prevent absorption of CHOLESTEROL from small intestinal brush border --> lower LDL

effect of fibrates

decrease TGs

mechanism of fibrates

``` upregulate LPL (lipoprotein lipase) --> increased TG clearance activate PPAR-alpha to induce HDL synthesis ```

side effects of fibrates

myositis (esp w/ statins); hepatotox; cholest gallstones (esp w/ bile acid resins, "chol" "col")

mechanism of digoxin

``` direct inhibition of Na/K ATPase --> indirect inhib of Na/Ca exchanger --> increased intracellular Ca --> increased contractility; stimulates vagus (how???) --> decreased HR ```

RFs for digoxin toxicity

renal failure (decreased excretion), hypokalemia, tx w/ verapamil, amiodarone, quinidine [--> decreased dig clearance]

digoxin: class of drug

cardiac glycoside

digoxin: use

CHF, A Fib

Nasty Bets Kill Cats

Class I: Na+-channel blocker (slow depolar'n, phase 0) Class II: Beta-blocker (slow SA/AV conduction rates, ie phase 4) Class III: K+-channel blocker (slow repol'n) Class IV: Ca2+-channel blocker (slows conduction velocity)

Double Quarter Pounder

Class IA: disopyramide, quinidine, procainamide

Lettuce, Tomato, Mayo

Class IB: lidocaine, tocainide, mexilitine (, +/- phenytoin)

Can i have More Fries Please?

Class IC: Moricizine, Flecainide, Propafenone

AIDS Kills

``` K = K+-channel blocker (class III antiarrhythmics) Amiodarone Ibutilide Dofetilide Sotalol ```

Class IB is Best for ???

post-MI, dig-induced arrhythmia

Class IC is Contraindicated in ???

structural and ischemic heart dz (eg, post-MI...pro-arrhythmic)

Which class II antiarrhythmic is very short acting?

Esmolol

Which class of antiarrhythmics may mask hypoglycemia?

class II (beta-blockers) I bet(a) you don't know I'm low on sugar!

Remember to check ??? (x3) when using amiadorone

PFTs, LFTs, TFTs

Drug of choice when diagnosing/abolishing SVTs

adenosine, very short acting (~15s)

First-gen H1-blockers

names contain "en/ine" or "en/ate" diphenhydramine, dimenhydrinate, chlorpheniramine

Second-gen H1-blockers

names usually end in "adine" (eg loratadine) + cetrizine used for allergy; far less sedating than first gen b/c decreased entry into CNS

Which asthma drug is rarely used due to its narrow therapeutic index?

theophylline (PDE inhibitor) --> cardiotox, neurotox

Which class of drugs is considered 1st-line therapy for chronic asthma?

corticosteroids (beclomethasone, fluticasone)

What drug is used in an acute asthma exacerbation?

albulterol (beta-agonist)

Examples of LABA

salmeterol, formoterol

What drug is used to diagnose asthma?

methacholine (muscarinic receptor agonist --> provocation challenge)

What drug is used to tx pulmonary arterial HTN?

bosentan (competitively antagonizes endothelin-1 receptors --> decreased pulm vasc resistance)

What diuretic is used to tx drug overdose?

mannitol (osmotic diuretic --> flush that shit out)

OH DANG

``` side effects of loop diuretics Ototoxicity Hypokalemia Dehydration Allergy (sulfa) Nephritis (interstitial) Gout ```

examples of loop diuretics

Furosemide, torsemide, bumetanide, ethacrynic acid

loop diuretic for pts w/ sulfa allergy

ethacrynic acid (phenoxyacetic acid deriv)

examples of thiazides

HCTZ, chlorthalidone, indapamine, metolazone | CHIMe

HyperGLUC

some side effects of HCTZ HyperGlycemia, Lipidemia, Uricemia, Calcemia [also causes hypoK, metabolic alKalosis]

The K+ STAys

K+-sparing diuretics: Spironolactone, eplerenone [aldo antagonists]; triamterene, amiloride [ENaC blockers]

Which diuretic causes gynecomastia, antiandrogen effects?

spironolactone (used to treat hirsutism)

Diuretic effects: Urine NaCl

increased (all except acetazolamide)

Diuretic effects: Urine K+

up in loop and thiazides | down in K+-sparing

Diuretic effects: blood pH

down (acidemia) in CAHi's, K+-sparing | up (alkalemia) in loops and thiazides

Diuretic effects: Urine Ca2+

up in loops | down in thiazides (used to prevent nephrolithiasis)

CATCHH

ACEi's side effects: cough, angioedemia (contraindicated in C1 esterase inhibitor defic), teratogen (fetal renal malform), elevated Cr (secondary to decreased GFR), hyperK, hypoTN

ACEi's = contraindicated in ???

bilateral renal artery stenosis; further decline in GFR can precipitate renal failure

Random Pharm Flashcards

(65 cards)