Week 4 Pharm Flashcards
(24 cards)
Which diuretic is an aldosterone antagonist, increases Na and water excretion, and decreases K excretion?
Spironolactone
What does Spironolactone treat?
Used to treat ascites. Combination with Furosemide improves ascites more rapidly than either alone. Maintaining a 100 mg: 40 mg ratio of spironolactone to furosemide helps maintain normokalemia.
What are the side effects of Spironolactone?
hyperkalemia, gynecomastia, dehydration
Which diuretic is a loop diuretic, inhibits NKCC2, and reduces reabsorption of Na, Cl, K, Mg, and Ca?
Furosemide
What does Furosemide treat?
Used to treat ascites. Combination with Spironolactone improves ascites more rapidly than either alone. Maintaining a 100 mg: 40 mg ratio of spironolactone to furosemide helps maintain normokalemia.
What are the side effects of Furosemide?
hypokalemia, hypomagnesemia, hypotension, dehydration
What does the colloid drug, Albumin, do?
Colloid that increases intravascular oncotic pressure and causes mobilization of fluids from interstitial to intravascular space
What is Albumin used to treat?
Large volume paracentesis > 5 L, hepatorenal syndrome
What are the side effects of albumin?
Rare hypersensitivity reactions
What does Midodrine (alpha-1 agonist) do?
Active metabolite is an alpha-1 agonist, which increases arteriolar and venous tone, resulting in increased blood pressure
What does Midodrine treat?
Refractory ascites, hypotension with diuretic use, hepatorenal syndrome
What are the side effects of Midodrine?
Hypertension, bradycardia
What does Octreotide (a somatostatin analog) do?
Inhibits release of vasodilator hormones, leading to splanchnic vasoconstriction, decreased portal vein pressure, and decreased variceal pressure
What does Octreotide treat?
Treatment of acute variceal bleeding, given for 3-5 days after variceal bleed
What are the side effects of Octreotide?
Cholelithiasis, hyperglycemia, pancreatitis, hypothyroidism, bradycardia, abdominal discomfort, dizziness, nausea/vomiting
What do the non-selective beta blockers, Nadolol and Propranolol, do?
Decrease cardiac output, which reduces portal pressure; produce splanchnic vasoconstruction, which reduces portal blood flow
What do Nadolol and Propranolol treat?
Used for primary and secondary prophylaxis of variceal bleeding
What are the side effects of Nadolol and Propranolol?
Bradycardia, hypotension, bronchoconstriction, fatigue, impotence
What does Entecavir, Lamivudine, and Tenofovir (Nucleoside/Nucleotide Analogs) do?
(Adefovir and Telbivudine are also used but not needed for course)
Competitively inhibit HBV DNA polymerase
What do Entecavir, Lamivudine, and Tenofovir treat? (Adefovir and Telbivudine)
Hepatitis B treatment. Adefovir is slower to suppress HBV DNA levels. Entecavir has greater suppreession of HBV DNA leevels than adefovir or lamivudinee and a lower rate of resistance. Lamivudine shows initial rapid and potent HBV suppression, but rseistance develops quicky and at a high rate. Telbivudine has greater suppression of HBV than lamivudine or adefovir but has a high rate of emergence of resistance. Tenofovir has a low rate of emergence of resistance
What are the side effects of Entecavir, Lamivudine, and Tenofovir? (Adefovir and Telbivudine)
Infrequent, depends on agent, greater risk for lactic acidosis with decompensated cirrhosis. Adefovir: AKI, hypophosphatemia, lactic acidosis. Entecavir: lactic acidosis. Lamivudine: pancreatitis, lactic acidosis. Telbivudine: elevated CK, myopathy, preipheral neuropathy, lactic acidosis
What do NS5B Polymerase Inhibitors like Sofosbuvir do?
Inhibit the HCV NS5B RNA polymerase, which is essential for viral replication
What does Sofosbuvir treat?
Hepatitis C
What are the side effects of Sofosbuvir?
Fatigue, headache
