Card Set Information

2013-03-12 15:19:07
Pharm 3B

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  1. Isosorbide dinitrate
    Nitrate for chronic angina

    -for acute attack and prophlaxis
  2. Isosorbide mononitrate
    Nitrate for chronic angina

    -for prophlaxis
  3. Ranolazine

    New drug for chronic angina

    AE: dizzy, HA, nausea, watch EKG for QT prolongation
  4. Morphine Sulfate
    For unstable angina / non-ST elevation MI (NSTEMI)

    -recommended for pts whose symptoms are not relieved after 3 serial sublingual NTG tablets
  5. Prasugrel

    antiplatelet drug

    • -less issues with genetics and PPIs
    • -more bleeding than Plavix
    • -do not use in patients >75yo
  6. Ticagrelor

    Antiplatelet drug
  7. Abciximab
    Antiplatelet glycoprotein inhibitor

    -for percutaneous coronary intervention w/ stenting
  8. Tirofiban
    Antiplatelet glycoprotein inhibitor

    -for NSTEMI with high risk features
  9. Eptifibatide
    Antiplatelet glycoprotein inhibitor

    -for NSTEMI with high risk features
  10. Enoxaparin

    LMWH used for pats not going for invasive therapy
  11. Bivalirudin

    -alternative to unfractionated heparin for pts going for invasive cardiac intervention
  12. Fondaparinux

    -alternative to unfractionated heparin for pts going for invasive cardiac intervention
  13. Dobutamine
    Inotropic agent

    B1 agonist used as IV infusion to increase CO
  14. Rosuvastatin

    New statin

    HMG-CoA reductase inhibitors (STATINS)
  15. Pitavastatin

    -only minimally metablized by the liver through P450 system, through which many other meds are metabolized
  16. HMG CoA Reductase Inhibitors (STATINS) AE (4) and DI (2)
    • AE:
    • 1. well tolerated!!!
    • 2. elevated hepatic transaminases
    • 3. GI upset
    • 4. myopathy with elevated creatine kinase
    • -monitor for muscle tenderness, soreness, weakness
    • -rhabdomyolysis (rare)

    • DI:
    • 1. DO NOT use with various P450 inhibitors
    • 2. caution w/ fibrates and nicotinic acid (increased myopathy risk)
  17. Statin C/I
  18. Bile Acid Sequestrants (BAS):
    - MOA
    - Reduction amount
    - AE (2)
    - DI (2)
    MOA: lower LDL-C by binding bile acids in intestine --> less cholesterol to liver --> increased LDL receptors --> lower LDL-C

    - LDL-C reduction by 15-30%

    • AE:
    • 1. mainly GI, esp. constipation, bloating, fullness, nausea, flatulence
    • 2. do NOT use in pts w/ high TG levels

    • DI:
    • 1. lack systemic toxicity --> not absorbed
    • 2. decrease absorption of many drugs so take other meds 1hr before or 4hr after
  19. Colesevelam

    -best tolerated with least effects on other drugs

    -Category B!!
  20. Cholestyramine powder
  21. Colestipol

    Category C
  22. Nicotinic Acid C/I(3) and DI(1)
    • C/I:
    • 1. chronic liver disease
    • 2. severe gout
    • 3. relative: DM and hyperuricemia

    • DI:
    • 1. caution with statins for myopathy
  23. Ezetimibe


    -used alone w/ diet in combination w/ statin to lower TC, LDL

    -provides higher reduction in LDL than statin

    -10mg/day given alone or w/ statin

    -inhibits intestinal absorption of cholesterol at brush border
  24. Ezetimibe (Zetia) AE (1)
    1. Safe and effective alone and in combo with statin

    -pregnancy category C
  25. Vytorin
    oral tablet form of Ezetimibe

    -enhance trial results
  26. Omacor/Lovaza
    Omega-3 fatty acid

    -indicated as adjunct to diet to decrease TG levels of adults w/ high TG levels
  27. Teratogens (4)
    • 1. chlorpromazine
    • 2. thalidomide
    • 3. diethylstilbestrol (DES)
    • 4. accutane
  28. Magnesium sulfate IV infusion

    -AE (3)
    • Tocolytic
    • -suppresses nerve impulses to uterus by antagonizing intracellular calcium

    • AE:
    • 1. pulmonary edema
    • 2. toxic doses tetany, (check patellar reflexes)
    • 3. muscle paralysis and respiratory depression
  29. Ritodrine (IV)

    -AE (1)
    Tocolytic B2 agonist

    • AE:
    • 1. meternal hyperkalemia, arrhythmias, hyperglycemia and pulmonary edema
  30. Nifedipine sublingually

    • -hypotension but less AE than other two agents
    • -indomethacin
  31. Beclomethasone
    Tocolytic antenatal steroid

    -given to pregnant women at 24-34 weeks who are risk of delivery in next 7 days
  32. Dexamethasone
    Tocolytic antenatal steroid

    -given to pregnant women at 24-34 weeks who are risk of delivery in next 7 days
  33. Prostaglandian analogs (E2) dinosprostone gel or misoprostol (E1 analog)
    Labor inducing drug - cervical ripening

    -soften cervix, relax smooth muscle and contraction of uterus
  34. Oxytocin

    Labor inducing drug - Uterine contractions
  35. Methyldopa

    -1st line agent for treatment of HTN during pregnancy
  36. Abortion drugs (2) and AE:
    1. mifepristone (Mifeprex) - competitively inhibits the actions of progesterone at progesterone-receptor sites, resulting in termination of pregnancy 

    2. misoprostol, prostaglandin analog - 400 mcg ORALLY 2 days after mifepristone; dilates cervix

    • AE:
    • -nausea, heavy bleeding watch for rare cases of serious infection

    -patients should have a follow-up visit approximately 14 days after administration of mifepristone to confirm termination of pregnancy

    -use BC immediately
  37. Ella ulipristal
    -Emerg Contrcptive Rx onlyprogesterone agonist/antagonist affects ovulation and implantationAE nausea cramps

    -Advise patient to seek medical attention if their period is delayed by more than 1 week following the use of ulipristal acetate.

    -Emergency contraception - Postcoital contraception: 30 mg ORALLY as soon as possible within 120 hours (5 days) of unprotected intercourse or a known or suspected contraceptive failure