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Name the 2 classes of CCBs. Which one bigger effect n heart?
- Dihydropyridines--> don't affect heart much, safer S/P heart failure or in bradycardia.
- Non-dihydropyramidines.--> negative chronotrope and ionotrope. Good for reducing tachycardia.
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What are some drugs CCBs increases the serum level of? What food item can elevate certain dihydropyramidine concentrations?
Statins and carbamazepine (Tegretol). Grapefruit juice can interact.Allow 2 hrs before and 4 hours after consumption of pills.
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Which bp meds are associated w/ sexual dysfct?
- (Beta-blockers, diuretics)
- Not so much ACEI or CCB
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Which class is often standard tx for diabetics?
ACEI, ARBs or non-dihydropyradine CCBs because of possible renal-protective effects (definitely for non-diabetic nephropathy)
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What is Cardizem?
Diltiazem.
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What is Lotensin?
Benazepril (ACEI)
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What is Vasotec?
Enalapril. (ACEI)
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What is Accupril?
Quinapril (ACEI)
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What is Altace?
Ramipril. (ACEI)
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What is Avapro?
Irbesartan (ARB)
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What is Cozaar?
Losartan. (ARB)
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What is Micardis?
Telmisartan. (ARB)
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What is Benicar?
Olmesartan.
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What is Diovan?
Valsartan.
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What is Catapres?
Clonidine (Antiadrenergic)
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What is Coreg?
Carvedilol (B-blocker)
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What is Lopressor?
Metoprolol. (B-blocker)
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What is Bystolic?
Nebivolol. (B-blocker)
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What is Inderal?
Propanolol (B-blocker)
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What is Norvasc?
Amlodipine (CCB)
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What is Plendil?
Felodipine.
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What is Adalat or Procardia?
Nifedipine.
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When should you dose diuretics?
In morning to prevent nocturnal diuresis
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Which diuretic has better anti-hypertensive effects?
Thiazides > loop
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What effect does thiazides have on K+, Mg, Ca, and uric acid?
- Hypokalemia, hypomagnesemia, hypercalcemia,
- Hyperuricemia. Also hyperlipidemia and hyperglycemia
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What effect does loop diuretics have on K+, Mg, Ca, and uric acid?
- Hypokalemia, hypomagnesemia, hypocalcemia,
- Hyperuricemia
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Which 2 classes of diuretics should be avoided in CKD or DM pts?
K+sparing and aldosterone antagonists.
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Name 2 aldosterone antagonists
Spirpnolactone (aldactone), , eplerenone
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What's the most common loop diuretic?
Furosemide (Lasix)
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Name 2 K+ sparing diuretics
Triamterene, amiloride
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Which class of diuretics are used with thiazides diuretics?
K+ sparing (they're weak diuretics with minor antihypertensive effects)
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Are carbonic anhydrase inhibitors used for HTN or heart failure?
No, weakest of all diuretics, used for glaucoma
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What's a side effect that up to 10% of patients have with Spironolactone?
Gynecomastia
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Which diuretics contain sulfa?
All thiazides and loops and carbonic anhydrase inhibitors but studies show low chance of cross reactivity with sulfa allergy.
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What's 1st line bp class for DM? CKD? Post-MI? LVH?
- DM and CKD: ACEI/ARB
- Post-MI: beta-blocker, then ACEI
- LVH/ heart failure: diuretic w/ ACEI then beta- blocket
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Which 3 beta-blockers are used for CHF?
CBM: carvedilol, bisoprolol, metoprolol (long-acting)
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Which 2 beta blockers also have alpha- blocking activity?
Carvedilol and labetalol
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Name an alpha-2 agonist
Clonidine (acts centrally in brain reducing sympathetic tone)
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Which beta blocker is nonselective?
Propanolol
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Which beta blockers are cardioselective?
Man: metoprolol, atenolol, nebivolol,
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