Pharmacology Exam 4

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r_webby
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15306
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Pharmacology Exam 4
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2010-04-20 02:44:47
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Drugs to Know
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  1. Hirudin
    • -a Direct Thrombin Inhibitor (DTI)
    • -prevents the fibrinogen -> fibrin conversion
    • -prevents ADP and TXA2 release from platelets
    • -must be percutaneous
  2. Unfractionated Heparin
    • -a mixture of high and low molecular weight heparins
    • -produces a high level of activity
    • -Stimulate Antithrombin 3 (inhibiting the clotting cascade)
    • -must be percutaneous
  3. Enoxaparin
    • -low molecular weight heparin
    • -less activity then unfractionated
    • -Stimulate Antithrombin 3 (inhibiting the clotting cascade)
    • -must be percutaneous
  4. Warfarin
    • -prevents the activation of vitamin K
    • -vitamin K is needed to form active clotting factors
    • -can be given orally, a delay is seen before effect
  5. Alteplase
    • -a recombinant version of t-PA (grown from human genes)
    • -activates plasminogen -> plasmin
    • -produces fibrin degradation
  6. Tissue Plasminogen Activator (t-PA)
    • -activates plasminogen -> plasmin
    • -produces fibrin degradation
  7. Streptokinase
    • -a purified bacterial enzyme that activates plasminogen
    • -activates plasminogen -> plasmin
    • -produces fibrin degradation
  8. Aspirin
    • -irreversibly inhibit COX 1 and 2
    • -prevents TXA2 synthesis (and release from clotting)
  9. Clopidogrel
    • -ADP receptor blockers
    • -prevent the effects of ADP released from platelets
    • -a prodrug (must pass through liver)
  10. Tirofiban
    • -A platelet-receptor antagonist
    • -GPIIa/IIIb receptor is fibrin binding site
    • -must be percutaneous
  11. Niacin
    • -inhibit VLDL synthesis in liver (more powerful)
    • -stimulate VLDL->LDL by lipoprotein lipase
    • -decreases LDL levels
    • -increases HDL levels
  12. Gemfibrozil
    • -inhibit VLDL synthesis in liver
    • -stimulate VLDL->LDL by lipoprotein lipase
    • -produces no net effect on LDL levels (only on VLDL)
  13. Colestipol & Cholestyramine
    • -Bind to bile in GI tract
    • -prevents re-absorption leading to an up-regulation of LDL receptors
  14. Pravastatin
    • -a low efficacy statin
    • -Inhibits HMG-CoA reductase (the rate-limiting step in cholesterol synthesis)
    • -pushes cell to generate more LDL receptors for a cholesterol source
  15. Simvastatin
    • -a medium efficacy statin
    • -Inhibits HMG-CoA reductase (the rate-limiting step in cholesterol synthesis)
    • -pushes cell to generate more LDL receptors for a cholesterol source
  16. Atorvastatin & Rosuvastatin
    • -a high efficacy statin
    • -Inhibits HMG-CoA reductase (the rate-limiting step in cholesterol synthesis)
    • -pushes cell to generate more LDL receptors for a cholesterol source
  17. Lovastatin & Fluvastatin
    • -a statin
    • -Inhibits HMG-CoA reductase (the rate-limiting step in cholesterol synthesis)
    • -pushes cell to generate more LDL receptors for a cholesterol source
  18. Ezetimibe
    • -Binds to a protein on GI epithelial cells that promotes cholesterol absorption
    • -reduces LDL levels
  19. Vytorin
    • -Simvastatin and Ezetimibe
    • -effects of the two medicines are additive
  20. Nitroglycerin, Isosorbide & di-/mono-nitrate
    • -dilate veins and large arteries
    • -Converted into NO gas, and then stimulate cGMP pathway in smooth muscle cells
    • -K+ channel opens and smooth muscle hyperpolarizes/relaxes
  21. Atenolol
    • -a cardioselective Beta Blocker
    • -Selective for Beta1 receptor -> decreased cardiac output
  22. Propranolol
    • -a nonselective Beta Blocker
    • -Targets both Beta1 and 2 -> decreased cardiac output and vasoconstriction (lungs, liver, etc.)
  23. Amlodipine
    • -a non-cardioactive Calcium Channel Blocker
    • -targets only Ca++ channels in vascular smooth muscles
    • -vasodilation by preventing depolarization
  24. Verapamil
    • -a cardioactive Calcium Channel Blocker
    • -vasodilates by preventing depolarization
    • -decreases cardiac output by weakening the contractions
    • -arterial dilation targets coronary arteries most strongly
  25. Dobutamine
    • -a Beta1 agonist
    • -stimulates an increase in cAMP production within heart cells, increasing force of contraction
  26. Milronone
    • -a Phosphodiesterase 3 inhibiter (PD3)
    • -PD3 breaks down cAMP, so the inhibitor increases cAMP concentrations
    • -increases the force of contraction
  27. Atropine
    • -a muscarinic receptor antagonist
    • -blocks parasympathetic effects on the heart
    • -increases cardiac output
  28. Captopril
    • -an ACE inhibitor
    • -by inhibiting Agiotension Converting Enzyme: relaxes arterial smooth muscle and prevents aldosterone release
    • -decreases afterload and preload
  29. Spironolactone
    • -an aldosterone antagonist
    • -prevents the function of aldosterone in h2o retention
    • -works well in conjunction with ACE inhibitors
  30. Digoxin
    • -a cardiac (digitalis) glycoside
    • -functions by inhibiting cardiac Na/K exchanger; producing a reduction in Ca release
    • -Ca becomes sequestered in sarcoplasmic reticulum; producing an increased contractile force
    • -binds commutatively at K+ site so K+ concentrations are very important
  31. Hydrochlorothiazide & Furosemide
    • -Diuretics that decrease Na+ and H2O re-absorption
    • -decrease preload
    • -used to treat edema and good with ACE inhibitors
  32. Carvedilol
    • -a Beta blocker (non-selective) with Alpha 1 antagonist effects
    • -decreases cardiac output
    • -constricts arteries in lungs and liver
    • -dilates arteries in non-essential areas
    • -theory says it would hurt, but improvement is seen (likely due to inhibition of myocardial remodeling)
  33. Isosorbide Dinatrate
    • -a venous dilator
    • -decreases preload on the heart
    • -good for R. Heart issues and pulmonary edema
  34. Hydralazine
    • -an arterial dilator
    • -decreases afterload on the heart
    • -good for L. Heart issues and fatigue

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