Pharm-3A

Card Set Information

Author:
atmu
ID:
206406
Filename:
Pharm-3A
Updated:
2013-03-11 23:39:46
Tags:
Pharm 3A
Folders:

Description:
Pharm-3A
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user atmu on FreezingBlue Flashcards. What would you like to do?


  1. What are hypertension levels?
    -Stage I
    -Stage II
    over 140/90

    Stage I: 140-159(SBP); 90-99(DBP)

    Stage II: >=160(SBP); >=100(DBP)
  2. Thiazides
    -What is it
    • - 1st line therapy for mild to moderate HTN
    • - inhibits NaCL reabsorption from distal collecting duct

    major differences are half lives and duration of effects
  3. Thiazide AE (9) & Drug interactions/contraindications (3)
    • AE:
    • 1. hypokalemia, hyponatremia, hypoMg, hypercalcemia

    2. muscle cramps, dizziness, sexual dysfunction, hyperlipidemia, hyperuricemia

    • Interactions/contraindications:
    • 1. NSAIDS
    • 2. Quinidine and digitalis (increased arrythmias)
    • 3. not useful in renal failure without adequate urine outpout
  4. Loop diuretics indications and agents (4)
    • - For edema and volume overload associated w/ heart failure
    • - "High ceiling" means most effective diuretic since it works earlier in NaCL absorption
    • - blocks Na/Cl symporter in ascending loop
  5. Loop diuretic AE (4) and DI (3)
    • AE:
    • 1. similar to thiazides w/ electrolytes; also Na+ and volume depletion esp. in elderly pts
    • 2. hypocalcemia and hypomagnesium
    • 3. ototoxicity (IV)
    • 4. rash, photosensitive, bone marrow suppression

    • DI:
    • 1. aminoglycosides
    • 2. anticoags (increased)
    • 3. digitalis (K+)
  6. K+ Sparing Diuretics
    -indications
    -MOA
    • Indications:
    • - used in conjunction with loop or thiazide diuretics to minimize risk of hypokalemia

    • MOA: 
    • - blocks Na+ channels in late DCT and blocks secretion of K+
    • - antagonize effects of aldosterone (blocks Na+ reabsorption and K+ secretion)
  7. Amiloride
    (Midamor)

    K+ Sparing Diuretic

    - blocks Na/K+ exchange mechanism in distal nephron
  8. Triamterene
    (Dyrenium)

    K+ Sparing Diuretic

    - blocks Na/K+ exchange mechanism in distal nephron
  9. Spironolactone
    (Aldactone)

    K+ Sparing Diuretic

    - severe heart failure
  10. Eplerenone
    (Inspra)

    K+ Sparing Diuretic

    -normokalemia is essential
  11. hydrochlorothiazide
    Thiazide diuretic
  12. chlorthalidone
    Thiazide diuretic
  13. metolazone
    Thiazide diuretic
  14. indapamide
    Thiazide diuretic
  15. Furosemide
    (Lasix)

    Loop diuretic

    -Most Common
  16. Bumetamide
    (Bumex)

    Loop diuretic
  17. Ethacrynic acid
    (Edecrine)

    Loop diuretic

    - not a sulfonamide...not in US
  18. Torsemide
    (Demadex)

    Loop diuretic
  19. K+ Sparing diuretic AE (3) and DI (1)
    • AE:
    • 1. spironolactone may cause gynecomastia, decreased libido, impotence, menstrual irregularities, diarrhea, and dyspepsia
    • 2. hyperkalemia is C/I to taking these; can lead to arrhythmias
    • 3. CNS effects

    • DI:
    • 1. ACE inhibitors and angiotensin II receptor blockers can increase K+
  20. ACEI Indications (3)
    Drugs end in -pril

    • 1. HTN
    • 2. all patients post MI and heart failure
    • 3. diabetic and non-diabetic proteinuria
    •     - reduce progression to clinical nephropathy
  21. ACEI AE (7)
    • 1. rash
    • 2. cough
    • 3. hyperkalemia (rare)
    • 4. acute renal failure and elevated serum creatinine
    • 5. hypotension
    • 6. angioedema (common in AA pts)
    • 7. dysgeusia (distortion of sense of taste)
  22. ACEI C/I (4) and DI (2)
    • C/I
    • 1. pregnancy
    • 2. angioedema
    • 3. bilateral renal artery stenosis
    • 4. hyperkalemia

    • DI
    • 1. NSAIDS (decreased effects)
    • 2. DIG and lithium levels can be increased
  23. ANG II Receptor Blockers (ARBs)
    - MOA
    - Drugs suffix
    -blocks the ANG II receptor so action of ANG II is inhibited

    -no effect on bradykinin metabolism

    -end in "-artan"
  24. ARBs AE (5)
    • 1. less cough
    • 2. less angioedema
    • 3. good for pts who cannot tolerate ACEI
    • 4. may reduce progression of Type 2 diabetic nephropathy
    • 5. same pregnancy C/I
  25. Types of CCBs (3)
    1. Verapamil - most cardiac effects; negative inotropic and chronotropic; slows conduction through AV node

    2. Diltiazem - cardiac and peripheral blood vessel effects

    • 3. 6 dihydropyridines (more peripheral arteriolar vascular smooth muscle vasodilation)
    • -end in "pine"
  26. CCBs indications (3), DI (2), C/I (2)
    • Indications:
    • 1. HTN
    • 2. Angina
    • 3. SVT (supraventricular tachyarrhythmias)
    • -non-dihidropyradines

    • DI:
    • 1. metabolized by p450
    • 2. verapamil is CYP3A4 inhibitor

    • C/I:
    • 1. use caution when combine w/ beta blockers
    • 2. severe CHF and high degree heart blocks for non-DHP
  27. CCB adverse effects (5)
    • 1. dizzy, flushing, HA (vasodilation)
    • 2. worsening angina (DHP-type)
    • 3. peripheral edemia (vasodation); DHP-type
    • 4. constipation (verapamil), GI complaints
    • 5. heart conduction abnormalities are possible w/ verapmil and diltiazem
  28. Beta antagonists (beta blockers)
    -MOA
    -Properties (4)
    • MOA:
    • -block beta receptors in heart and other tissue
    • -slows heart rate, reduces contractility and output

    • Properties:
    • 1. beta 1 selectivity (nonselective vs selective)
    • 2. intrinsic sympathomimetic activity (partial agonist)
    • 3. lipid soluble (crosses BBB)
    • 4. membrane stabilizing (depresses action potential)
  29. Indications for beta antagonists (6)
    • People with HTN and:
    • 1. stable angina
    • 2. stable heart failure
    • 3. post myocardial infarction
    • 4. migraine HA
    • 5. situational panic
    • 6. symptoms related to hyperthyroidism
  30. Propanolol
    Non-selective Beta Antagonists (Block Beta1 and Beta2 receptors)

    -most commonly used and highly lipophilic
  31. Nadolol
    Non-selective Beta Antagonists (Block Beta1 and Beta2 receptors)

    -long half life 20 hrs
  32. Timolol
    Non-selective Beta Antagonists (Block Beta1 and Beta2 receptors)

    -used for glaucoma
  33. Pindolol
    (ISA)

    Non-selective Beta Antagonists (Block Beta1 and Beta2 receptors)
  34. Labetolol
    (Normodyne)

    Non-selective Beta Antagonists (Block Beta1 and Beta2 receptors)
  35. Carvediolol
    (Coreg)

    Non-selective Beta Antagonists (Block Beta1 and Beta2 receptors)
  36. Metaprolol
    (Lopressor, Toprol XL)

    Cardio-selective beta antagonist (greater affinity for beta1 receptors)

    -common anti-HTN agent
  37. Atenolol
    (Tenormin)

    Cardio-selective beta antagonist (greater affinity for beta1 receptors)
  38. Esmolol
    Cardio-selective beta antagonist (greater affinity for beta1 receptors)

    -short half life, given IV for rapid beta blockade
  39. Acebutolol
    Cardio-selective beta antagonist (greater affinity for beta1 receptors)
  40. Prazosin
    Peripheral Alpha1 blocker

    -shorter half life; BID dosing
  41. Doxazocin
    Peripheral Alpha1 blocker
  42. Terazocin
    Peripheral Alpha1 blocker
  43. Clonidine
    (Catapres)

    Central Alpha2 Receptor Agonist
  44. Methyldopa
    (Aldomet)

    Central Alpha2 Receptor Agonist

    • -reserved for moderate to severe caess
    • -use with diuretic (avoid Na and water retention)
    • -use for HTN in pregnancy
  45. Guanfacine
    Central Alpha2 Receptor Agonist
  46. Guanabenz
    Central Alpha2 Receptor Agonist
  47. Hydralazine
    vasodilator - direct arteriolar smooth muscle relaxation

    -used for severe, resistant cases of HTN in combo w/ diuretics, beta blockers

    -immunologic reactions such as drug induced lupus
  48. Minoxidil
    vasodilator - direct arteriolar smooth muscle relaxation

    -used for severe, resistant cases of HTN in combo w/ diuretics, beta blockers

    • -water/Na retention, increased HR, contractility
    • -hypertrichosis (not good for the ladies)
  49. Tekturna
    (Aliskiren)

    -new class, direct renin inhibitor

    • -edema of face, neck, hands
    • -renal dysfunction
    • -diarrhea, cough
  50. Azor
    (amlodipine besylate; olmesartan medoxomil)

    • New Drug
    • -CCB plus ARB
  51. Guanethidine & guanadrel
    Postganglionic sympathetic inhibitors (not commonly used for HTN)

    -deplete NE from postganglionic sympathetic nerve terminals

    -blocks effects of NE --> reduces PVR

    • -lost of AE's
    • -does not cross BBB so less sedation and craziness than reserpine
  52. Reserpine
    Postganglionic sympathetic inhibitors (not commonly used for HTN)

    –Binds to storage vesicles in central and peripheral adrenergic neurons and makes them dysfunctional so nerves cannot secrete NE

    –SEDATION, depression which may lead to suicide (RARE)
  53. Sodium Nitroprosside
    For HTN emergencies

    -excessive and rapid hypotension

    -must use special infusion pump and close monitoring

    -toxic accumulation of cyanide 
  54. Labetolol IV
    For HTN emergencies

    -effective w/ little effect on HR and CO

What would you like to do?

Home > Flashcards > Print Preview