Pharmacology II Test 2

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ckitejr
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298810
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Pharmacology II Test 2
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2015-03-24 12:30:37
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medical pharmacology
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pharmacology for PAs
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  1. Eplereone
    • Diuretic
    • K sparring
    • collecting duct--weak diuretic
  2. Furosemide
    • loop diuretic
    • inhibits Na,K,Cl reabsorpting in thick ascending limb
    • increases excretion of Na,K,Cl,H,Mg,Ca
    • high efficacy, prompt action
    • SE--hypokalemia, hypomagnesemia, alkalosis, hyperurecemia, hyperglycemia
    • OTOtoxicity
    • Tx CHF, renal failure (nephrotic syndrome)
    • Breaking phenomenon--loss of efficacy with multiple administrations
  3. Hydrochlorothiazide
    • thiazide diuretic
    • Inhibits Na,Cl cotransporter causing decreased Na reabsorption in early DCT
    • Increased K excretion
    • SE-hypoK, hyperCa, hyperuricemia, hyperglycemia, hyperlipidemia
    • Tx HTN, CHF edema, nephrogenic diabetes insipidus, Ca wasting, nephrolithiasis
    • Good for postmenopausal women
  4. Spironolactone
    • diuretic
    • competitively antagonizes aldosterone binding to mineral corticoid receptor
    • increases Na and Cl excretion and decreases K excretion
    • SE hyperkalemia, gynecomastia, menstral irregularities,
    • Tx HTN and diurectic of choice for liver cirrhosis
    • used with thiazides
    • Agent of choice for ascities
    • 30% reduction in morbidity with CHF
  5. Atenolol
    • beta blocker
    • MOA in angina--decreases HR and contractility will improve exercise tolerance
    • acts synergistically with vasodilators to prevent reflex tach
    • SE--brady, AV block, HF, bronchoconstriction
    • Tx chronic stable and vasospasm angina
  6. Carvedilol
    beta blocker
  7. Labetalol
    beta blocker
  8. Metoprolol
    • beta blocker
    • MOA in angina--decreases HR and contractility will improve exercise tolerance
    • acts synergistically with vasodilators to prevent reflex tach
    • SE--brady, AV block, HF, bronchoconstriction
    • Tx chronic stable and vasospasm angina
  9. Nadolol
    beta blocker
  10. Propranolol
    • beta blocker
    • MOA in angina--decreases HR and contractility will improve exercise tolerance
    • acts synergistically with vasodilators to prevent reflex tach
    • SE--brady, AV block, HF, bronchoconstriction
    • Tx chronic stable and vasospasm angina
  11. Timolol
    beta blocker
  12. Benazepril
    ACE inhibitor
  13. Captopril
    ACE inhibitor
  14. Enalapril
    ACE inhibitor
  15. Fosinopril
    ACE inhibitor
  16. Lisinopril
    ACE inhibitor
  17. Moexipril
    ACE inhibitor
  18. Quinapril
    ACE inhibitor
  19. Ramipril
    ACE inhibitor
  20. Candesartan
    ARB
  21. Eprosartan
    ARB
  22. Irbesartan
    ARB
  23. Losartan
    ARB
  24. Olmesartan
    ARB
  25. Telmisartan
    ARB
  26. Valsartan
    ARB
  27. Amiodipine
    CCB
  28. Diltiazem
    • CCB
    • slows AV condution
    • relieves vasospasm
    • variant angina Pritzmental's
    • works on heart and vessels
  29. Felodipine
    CCB
  30. Isradipine
    CCB
  31. Isradipine
    CCB
  32. Nifedipine
    • CCB
    • arteriolar vasodilator
    • Tx variant angina Printzmantal's
    • SE-flushing, HA, hypotension, relfex tach
  33. Nisoldipine
    CCB
  34. Verapamil
    • CCB
    • more cardiac selective
    • slows AV conduction
    • weaker vasodilator
    • CI with cardiac dysfunction
    • can increase digoxin levels
  35. Acebutolol
    • beta blocker
    • no bronchoconstriction
  36. Isosorbide
    • Nitrodilator
    • decrease coronary vasoconstriction
    • relax veins (venus pooling) through increase of cGMP via nitric oxide
    • decreases myocardial consumption
    • larger arteries and veins are more selective to vasodilation
    • SE-Flushing, HA, postural hypotension, relfex tach
    • CI with sildenafil (phosphodiesterase inhibitor)
  37. Nitroglycerine
    • Nitrodilator
    • decrease coronary vasoconstrictionrelax veins (venus pooling) through increase of cGMP via nitric oxide
    • increases myocardial consumption
    • larger arteries and veins are more selective to vasodilation
    • SE-Flushing, HA, postural hypotension, relfex tach
    • CI with sildenafil (phosphodiesterase inhibitor)
  38. Ranolazine
    • metabolic agent
    • pFOX inhibitor--inhibits fatty acid oxidation in hear and improves metabolic status of ischemic tissue
    • can block arrhythmias
    • SE--dizziness, nausea, constipation HA, QT prolongation
    • Don't take with grapefruit juice as it affects p450
  39. Aspirin
    • Antiplatelet drug
    • inhibits synthesis of thrombaoxane¬†
    • decreases platelet stickiness
    • Tx stroke risk pt's
    • SE--gastric irritation, bleeding, dyspepsia, NV
    • impaired renal function and decreases excretion of uric acid
    • CIHX of GI bleed, gout, PUD, Fe deficiency
    • Warfarin and ASA bind to proteins and enhance each other
  40. Clopidogrel
    • ADP receptor antagonist
    • inhibits cyclic AMP which activates platelet activation-->decreases platelet activation and clotting
    • SE--Increased bleeding
    • Tx reduce risk of thrombosis
    • Indicated when pt is intolerant to ASA
    • clopidogrel is safer than ticlopidine
  41. Ticlopidine
    • ADP receptor antagonist
    • inhibits cyclic AMP which activates platelet activation-->decreases platelet activation and clotting
    • SE--Increased bleeding
    • Tx reduce risk of thrombosis
    • Indicated when pt is intolerant to ASA
    • clopidogrel is safer than ticlopidine
  42. Dipyridamole
    • MOA--increase activity of cyclic GMP
    • increases in cGMP--> decreased platelet stickiness
    • Not plasma protein bound so can be used with ASA and Warfarin
  43. Abciximab
    • Glycoprotein IIb/IIIa Receptor Blocker
    • monoclonal antibody
    • MOA--inhibits common pathway of platelet activation-->inhibits clot formation
    • SE--excessive bleeding
  44. Tirofiban
    • Glycoprotein IIb/IIIa Receptor Blocker
    • MOA--inhibits common pathway of platelet activation-->inhibits clot formation
    • SE--excessive bleeding
    • peptide binds to receptor blocking fibrinogen
  45. Eptifibatide
    • Glycoprotein IIb/IIIa Receptor Blocker
    • MOA--inhibits common pathway of platelet activation-->inhibits clot formation
    • SE--excessive bleeding
    • binds to receptor blocking fibrinogen
  46. Heparin
    • Anticoagulant
    • Unfactionated--interacts with thrombin, reversible by protamine sulfate
    • HIT---heparin induced thrombocytopenia
    • can be used with prgnancy
    • LMWH--less risk of HIT
    • Rage of heparin with range of MW
  47. dalteparin
    • LMWH
    • less risk of HIT
    • longer action
    • not used with spinal anesthesia and pregnancy
  48. enoxaparin
    • LMWH
    • less risk of HIT
    • longer action
    • not used with spinal anesthesia and pregnancy
    • CI in pts with sever renal impairment
  49. Bivalirudin
    • direct thrombin inhibitor
    • use with ASA
    • less bleeding than UFH
    • only binds to thrombin
  50. Fondaparinux
    • indirect inhibitor of factor Xa
    • longer half life
    • risk of hemorrhage increases with impaired renal function
    • used in patients with chronic heparin exposure
  51. Warfarin
    • oral anticoagulant
    • acts in liver to inhibit vitamin K dependent clotting
    • abnormal vit K levels will affect bleeding times
    • high plasma protein binding so CI with ASA
    • monitored with INR
    • high interactions with numerous foods
    • CI 1st trimester and 2 weeks before delivery, recent stroke, uncontrolled HTN
    • SE--excessive bleeding
  52. Alteplase
    • Fibrinolytic
    • clot buster
    • tissue plasminogen activator
    • naturally occuring enzyme
    • SE--bleeding
    • $$$
  53. Tenecteplase
    • fibrinolytic
    • genetically engineered
    • decreased plasma clearance-->longer half life
    • SE--less bleeding compared to Alteplase
  54. Streptokinase
    • thrombolytic
    • cheap--comes from bacteria BHSC
    • can cause immune response--risk of allergic reactions increase with each administration
    • SE--increased risk of bleeding
    • OD treated with aminocaproic acid
  55. Digitalis
    • cardiostimulatory (inotropic)
    • Tx edema from weakened heart
    • MOA--inhibits Na/K ATPase--allowing more Ca to come into cell and increases contractility
    • increases EF, decreases preload, decreases pulmonary edema/congestion
  56. Dopamine
    • beta agonist
    • increase contractility, relaxation rate, HR
    • smooth muscle relaxor-vasodilator
    • increased blood flow to kidneys
  57. Dobutamine
    • beta agonist
    • dose related activation of alpha 1
    • low dose more beta high dose more alpha
    • use low dose to avoid vasoconstriction
    • SE angina, HA, arrhythmia
  58. Acetazolamide
    • carbonic anhydrase inhibitor
    • ACTs on PCT
    • increases excretion of Na, K HCO3 & H2O
    • decreases excretion of H+-->acidosis
    • SE--sulfonamide reactions, bone marrow depression, skin toxicity, allergic rxns
    • Tx--short term, adjunct, correction of diuretic induced alkalosis
  59. Dorzlamide
    • carbonic anhydrase inhibitor
    • ACTs on PCTincreases excretion of Na, K HCO3 & H2O
    • decreases excretion of H+-->acidosis
    • SE--sulfonamide reactions, bone marrow depression, skin toxicity, allergic rxns
    • Tx--short term, adjunct, correction of diuretic induced alkalosis
    • used topically to treat glaucoma
  60. Bumetanide
    • loop diuretic
    • inhibits Na,K,Cl reabsorpting in thick ascending limb
    • increases excretion of Na,K,Cl,H,Mg,Ca
    • high efficacy, prompt action
    • SE--hypokalemia, hypomagnesemia, alkalosis, hyperurecemia, hyperglycemia
    • OTOtoxicity
    • Tx CHF, renal failure (nephrotic syndrome)
    • Breaking phenomenon--loss of efficacy with multiple administrations
  61. Ethacrynic acid
    • loop diuretic
    • inhibits Na,K,Cl reabsorpting in thick ascending limb increases excretion of Na,K,Cl,H,Mg,Ca
    • high efficacy, prompt action
    • SE--hypokalemia, hypomagnesemia, alkalosis, hyperurecemia, hyperglycemia
    • OTOtoxicity
    • Tx CHF, renal failure (nephrotic syndrome)
    • Breaking phenomenon--loss of efficacy with multiple administrations
  62. Toresemide
    • loop diuretic
    • inhibits Na,K,Cl reabsorpting in thick ascending limbincreases excretion of Na,K,Cl,H,Mg,Cahigh efficacy, prompt action
    • SE--hypokalemia, hypomagnesemia, alkalosis, hyperurecemia, hyperglycemia
    • OTOtoxicity
    • Tx CHF, renal failure (nephrotic syndrome)
    • Breaking phenomenon--loss of efficacy with multiple administrations
  63. Chlorothiazide
    • thiazide diuretic
    • Inhibits Na,Cl cotransporter causing decreased Na reabsorption in early DCT
    • Increased K excretion
    • SE-hypoK, hyperCa, hyperuricemia, hyperglycemia, hyperlipidemia
    • Tx HTN, CHF edema, nephrogenic diabetes insipidus, Ca wasting, nephrolithiasis
    • Good for postmenopausal women
  64. Chlorthalidone
    • thiazide diuretic
    • Inhibits Na,Cl cotransporter causing decreased Na reabsorption in early DCT
    • Increased K excretion
    • SE-hypoK, hyperCa, hyperuricemia, hyperglycemia, hyperlipidemia
    • Tx HTN, CHF edema, nephrogenic diabetes insipidus, Ca wasting, nephrolithiasis
    • Good for postmenopausal women
  65. Indapamide
    • thiazide diuretic
    • Inhibits Na,Cl cotransporter causing decreased Na reabsorption in early DCT
    • Increased K excretion
    • SE-hypoK, hyperCa, hyperuricemia, hyperglycemia, hyperlipidemiaTx HTN, CHF edema, nephrogenic diabetes insipidus, Ca wasting, nephrolithiasis
    • Good for postmenopausal women
  66. Metalazone
    • thiazide diuretic
    • Inhibits Na,Cl cotransporter causing decreased Na reabsorption in early DCT
    • Increased K excretion
    • SE-hypoK, hyperCa, hyperuricemia, hyperglycemia, hyperlipidemia
    • Tx HTN, CHF edema, nephrogenic diabetes insipidus, Ca wasting, nephrolithiasis
    • Good for postmenopausal women
  67. Mannitol
    • Osmotic Diuretic
    • MOA--increased renal tub osmolarity (whole nephron)
    • can sustain flow of urine when GFR is low
    • increases excretion of all electrolytes
    • expands extracellular volume-->BAD with CHF and pulmonary edema
    • Tx--acute renal failure, elimination of toxins, prophylactic ARF for surgery, cerebral edema, glaucoma
  68. Glycerin
    • Osmotic Diuretic
    • MOA--increased renal tub osmolarity (whole nephron)can sustain flow of urine when GFR is low
    • increases excretion of all electrolytesexpands extracellular volume-->BAD with CHF and pulmonary edema
    • Tx--acute renal failure, elimination of toxins, prophylactic ARF for surgery, cerebral edema, glaucoma
  69. Triamterene
    • K sparring diuretic
    • directly inhibits Na channels in late DCT through aldosteron independent mechanism
    • increases Na and CL excretion
    • SE--CNS, gynecomastia, Heme effects, MS

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