The Pharm of Old McDonald 3

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  1. dihydropyridine
    • amlodipine, clevidipine, nicadipine, nifedipine, nimodipine
    • block vascular smooth muscle voltage-gated L type Ca channel with minor cardiac activity. (except nimodipine) hypertension (not first line), angina, Prinzmetal angina, Raynaud
    • peripheral edema, flushing, dizziness, gingival hyperplasia
    • dipin dots kid w/ fat fingers (-dipines, peripheral edema, block Ca peripherally)
  2. amlodipine (class/special?)
    • dihyropyridine
    • dipin dots kid w/ fat fingers (-dipines, peripheral edema, block Ca peripherally)
  3. clevidipine (class/special?)
    • dihydropyridine
    • hypertensive urgency, hypertensive emergency
    • dipin dots kid w/ fat fingers (-dipines, peripheral edema, block Ca peripherally)
  4. nicardipine (class/special?)
    • dihydropyridine
    • hypertensive emergency (not 1st line)
    • dipin dots kid w/ fat fingers (-dipines, peripheral edema, block Ca peripherally)
  5. nifedipine (class/special?)
    • dihydropyridine
    • hypertension in pregnancy(not 1st line)
    • dipin dots kid w/ fat fingers (-dipines, peripheral edema, block Ca peripherally)
  6. nimodipine (class/special?)
    • dihydropyridine
    • block cerebral vascular smooth muscle voltage-gated L type Ca channel with minor cardiac activity, preventing cerebral vasospasm. Prevent vasospasm seen 1 week post subarachnoid hemorrhage, resulting in ischemic infarct
    • nimrodipine (nimodipine, cerebral, mechanism seems counterintuitive)
    • dipin dots kid w/ fat fingers (-dipines, peripheral edema, block Ca peripherally)
  7. non-dyhydropiridines
    • diltiazem, verapamil and class IV antiarrhythmics
    • block cardiac smooth muscle voltage-gated L type Ca channel with little vascular activity. Hypertension (definitely not first line), angina, atrial fibrillation/flutter
    • and slow phase 0 of SA and AV pacemakers to reduce conduction velocity, increase effective repolarization time and PR interval. Prevention of nodal arrhythmias (SVT), rate control in afib
    • Cardiac depression (sinus depression, HF), AV block, hyperprolactinemia, constipation, flushing, edema
  8. hydralazine
    • increase cGMP causing smooth muscle relaxation dilating arterioles more than veins to reduce afterload. Severe acute hypertension, HF with nitrate, hypertension in pregnancy (2nd to labetalol)
    • reflex tachycardia (give with beta blocker, contrainidcated in angina/CAD), fluid retention, headache, angina, drug-induced lupus
    • an gingah bread baby escaped on the wolf over warter (say like NYC) (angina, safe in pregnancy, lupus, hydralazine, arterioles)
  9. nitroprusside
    • release NO to increase cGMP, relaxing smooth muscles. Hypertensive emergency
    • cyanide toxicity (cured with nitrite plus thiosulfate to induce methemoglobin)
  10. fenoldopam
    • dopamine D1 agonist, decreasing blood pressure and increasing natriuresis by vasodilation of coronary, peripheral, renal, and splanchnic systems. Hypertensive emergency, postoperative antihypertensive
    • Also promotes natriuresis
    • hypotension and tachycardia
  11. nitrates
    • nitroglycerin, isosorbide dinitrate, isosorbide mononitrate
    • increase NO to increase cGMP in vascular smooth muscle, dilating veins more than arteries to reduce preload and thereby myocardial oxygen consumption. Angina, acute coronary syndrome, pulmonary edema
    • reflex tachycardia (treat with beta blocker), hypotension, flushing, headache
    • don't take with sildenafil/tadalafil
    • "Monday disease" if industrial exposure to NO with increasing tolerance over week lost on weekend (tachycardia, dizziness, head ache)
  12. nitroglycerin (class)
    nitrate
  13. isosorbide dinitrate (class)
    nitrate
  14. isosorbide mononitrate (class)
    nitrate
  15. ranolazine
    • cardiac late-phase sodium current inhibition to reduce diastolic wall tension and oxygen consumption without affecting heartrate or contractility. Refractory angina
    • constipation, dizziness, headache, nausea, QT prolongation
  16. statins
    • atorvastatin, cerivastatin, fluvastatin, lovastatin, mevastatin, pitavastatin, pravastatin, rosuvastatin, simvastatin
    • HMG-CoA reductase inhibitors prevent formation of mevalonate (cholesterol precursor). Best LDL reducer, mild HDL increase, mild trycliceride decrease. Decrease mortality in CAD patients
    • hepatotoxicity (increased LFTs), myopathy (esp. w/ fibrates and niacin)
  17. cholestyramine
    • bile acid resin
    • prevent intestinal reabsorption of bile acid so liver used cholesterol to make more. Reduce LDL with slight increases in HDL and triglycerides
    • GI upset, decreased absorption of other drugs and fat-soluble vitamins
  18. colestipol
    • bile acid resin
    • prevent intestinal reabsorption of bile acid so liver used cholesterol to make more. Reduce LDL with slight increases in HDL and triglycerides
    • GI upset, decreased absorption of other drugs and fat-soluble vitamins
  19. colesevelam
    • bile acid resin
    • prevent intestinal reabsorption of bile acid so liver used cholesterol to make more. Reduce LDL with slight increases in HDL and triglycerides
    • GI upset, decreased absorption of other drugs and fat-soluble vitamins
  20. ezetimibe
    • prevent brush border absorption of cholesterol. Reduce LDL with no effect on HDL or triglycerides
    • rarely hepatotoxic (increased LFTs), diarrhea
  21. gemfibrozil
    • fibrate
    • upregulate lipoprotein lipase (LPL) to increase triglyceride clearance and activates peroxisome proliferator-activated receptor alpha (PPAR-alpha) to induce HDL synthesis. Best reducer of triglycerides with mild decrease in LDL and mild increase in HDL
    • myopathy(esp w/ statins), cholesterol gall stones
    • trigrates (triglyceride reduction with fibrates)
  22. bezafibrate
    • fibrate
    • upregulate lipoprotein lipase (LPL) to increase triglyceride clearance and activates peroxisome proliferator-activated receptor alpha (PPAR-alpha) to induce HDL synthesis. Best reducer of triglycerides with mild decrease in LDL and mild increase in HDL
    • myopathy(esp w/ statins), cholesterol gall stones
    • trigrates (triglyceride reduction with fibrates)
  23. fenofibrate
    • fibrate
    • upregulate lipoprotein lipase (LPL) to increase triglyceride "clearance" from VLDL to adipose tissue and activates peroxisome proliferator-activated receptor alpha (PPAR-alpha) to induce HDL synthesis. Best reducer of triglycerides with mild decrease in LDL and mild increase in HDL
    • myopathy(esp w/ statins), cholesterol gall stones
    • trigrates (triglyceride reduction with fibrates)
  24. niacin
    • Vit B3
    • inhibits hormone sensitive lipase to reduce lipolysis in adipose tissue, reducing hepatic VLDL synthesis. Best increaser of HDL, reduces LDL and mild triglycerides reduction
    • flushed face (treat with NSAIDs/long term use of niacin), hyperglycemia, hyperuricemia
  25. digoxin
    • cardiac glycoside
    • inhibits Na/K ATPase to inhibit the Na/Ca exchanger to increase Ca levels in myocytes increasing inotropy. HF (increase contractility), afib (decrease AV and SA conduction)
    • bradycardia (vagal response), yellow blury vision, arrhythmias, AV block, hyperkalemia, nausea, vomitting, diarrhea
    • increased toxicity with renal failure, hypokalemia (permits more digoxin binding on Na/K ATPase), verapamil, amiodarone, quinidine (displace digoxin from tissue binding and reduce clearance)
    • treat toxicity with slow K normalization, cardiac pacer, anti-digoxin Fab fragments, Mg2+
  26. procainamide
    • class 1A antiarrhythmic
    • slow Na conduction in frequently depolarized (tachycardic) tissue causing medium flattened phase 0 and prolonged AP, which increases the refractory period and QT interval. Re-entrant and bothectopic atrial and ventricular tachycardia/arrhythmias
    • induced lupus, torsades de pointes, thrombocytopenia
    • the queen proclaims Diso's pyramid (Queen is 1st [1A], procainamide, disopyramide)
  27. disopyramide
    • class 1A antiarrhythmic
    • slow Na conduction in frequently depolarized (tachycardic) tissue causing medium flattened phase 0 and prolonged AP, which increases the refractory period and QT interval. Re-entrant and bothectopic atrial and ventricular tachycardia/arrhythmias
    • heart failure, torsades de pointes, thrombocytopenia
    • the queen proclaims Diso's pyramid (Queen is 1st [1A], procainamide, disopyramide)
  28. lidocaine
    • class 1B antiarrhythmic
    • slow Na conduction in frequently depolarized (tachycardic) ventricular tissue barely flattening phase 0 and shortening AP, which increases the refractory period and QT interval. Ventricular arrhythmias (esp post MI) and digitalis-induced arrhythmias
    • CNS stimulation/depression, cardiovascular depression
    • IB Is Best post MI
    • I'd Buy Liddy's Mexican Fajitas (IB, lidocaine, mexiletine, phenytoin[somehow sound the same?])
  29. mexiletine
    • class 1B antiarrhythmic
    • slow Na conduction in frequently depolarized (tachycardic) ventricular tissue barely flattening phase 0 and shortening AP, which increases the refractory period and QT interval. Ventricular arrhythmias (esp post MI) and digitalis-induced arrhythmias
    • CNS stimulation/depression, cardiovascular depression
    • IB Is Best post MI
    • I'd Buy Liddy's Mexican Fajitas (IB, lidocaine, mexiletine, phenytoin[somehow sound the same?])
  30. phenytoin
    • class 1B antiarrhythmic
    • slow Na conduction in frequently depolarized (tachycardic) ventricular tissue barely flattening phase 0 and shortening AP, which increases the refractory period and QT interval. Ventricular arrhythmias (esp post MI) and digitalis-induced arrhythmias
    • CNS stimulation/depression, cardiovascular depression
    • IB Is Best post MI
    • I'd Buy Liddy's Mexican Fajitas (IB, lidocaine, mexiletine, phenytoin[somehow sound the same?])
  31. propafenone
    • class 1C antiarrhythmic
    • slow Na conduction in AV node and accessory tracts, greatest flattening of phase 0 without affecting AP, which increases the effective refractory period in AV and bipass tracts. SVTs, afib, last resort in VT
    • proarrhythmic (contraindicated post MI)
    • IC Is Contraindicated post MI
    • I Cover wires in propaflex (IC, arrhythmias, propafenone, flecainide)
  32. flecanide
    • class 1C antiarrhythmic
    • slow Na conduction in AV node and accessory tracts, greatest flattening of phase 0 without affecting AP, which increases the effective refractory period in AV and bipass tracts. SVTs, afib, last resort in VT
    • proarrhythmic (contraindicated post MI)
    • IC Is Contraindicated post MI
    • I Cover wires in propaflex (IC, arrhythmias, propafenone, flecainide)
  33. metoprolol
    • class II antiarrhythmic, beta 1 selective blocker
    • decrease cAMP and Ca currents to reduce SA and especially AV nodal activity and flatten phase 4 (funny) of ectopic pacemakers. SVT and rate control for afib and flutter. Angina, MI, hypertension, heart failure reduced mortality
    • increase PR interval, dyslipidemia, impotence, less exacerbation of COPD/asthma, bradycardia, AV block, HF, sedation/sleep (CNS), mask hypoglycemia, unopposed alpha (bad for pheo and cocaine)
    • metabolol (dyslipidemia)
    • treat overdose with saline, atropine, glucagon
    • 1st half of alphabet (A-M) is beta 1 selective
    • esmorelda is second class in the metoprolis (esmolol, class II antiarrhythmic, metoprolol)
  34. acebutol
    • partial beta 1 selective agonist resulting in beta 1 block. Angina, MI reduced mortality, hypertension
    • impotence, exacerbate COPD/asthma, bradycardia, AV block, HF, sedation/sleep (CNS), mask hypoglycemia, unopposed alpha (bad for pheo and cocaine)
    • proPrinzalol (prinzemetal angina)
    • treat overdose with saline, atropine, glucagon
    • 1st half of alphabet (A-M) is beta 1 selective
  35. propranolol
    • non-selective beta 1 and 2 blocker. Increase PR interval, Prinzmetal angina, angina, MI reduced mortality, hypertension, impotence, exacerbate COPD/asthma, bradycardia, AV block, HF, sedation/sleep (CNS), mask hypoglycemia, unopposed alpha (bad for pheo and cocaine)
    • proPrinzalol (prinzemetal angina)
    • treat overdose with saline, atropine, glucagon
    • 2nd half of the alphabet (N-Z) block 1 and 2 (non-selective)
  36. esmolol
    • class II antiarrhythmic, selectivve beta 1 blocker
    • decrease cAMP and Ca currents to reduce SA and especially AV nodal activity and flatten phase 4 (funny) of ectopic pacemakers. Very short acting SVT and rate control for afib and flutter. Also angina, MI reduced mortality, hypertension
    • increase PR interval, impotence, exacerbate COPD/asthma, bradycardia, AV block, HF, sedation/sleep (CNS), mask hypoglycemia, unopposed alpha (bad for pheo and cocaine)
    • treat overdose with saline, atropine, glucagon
    • 1st half of alphabet (A-M) is beta 1 selective
    • esmorelda is second class in the metoprolis (esmolol, class II antiarrhythmic, metoprolol)
  37. atenolol
    • selective beta 1 blocker. Angina, MI reduced mortality, hypertension
    • impotence, exacerbate COPD/asthma, bradycardia, AV block, HF, sedation/sleep (CNS), mask hypoglycemia, unopposed alpha (bad for pheo and cocaine)
    • proPrinzalol (prinzemetal angina)
    • treat overdose with saline, atropine, glucagon
  38. betaxolol
    • selective beta 1 blocker. Angina, MI reduced mortality, hypertension, glaucoma
    • impotence, exacerbate COPD/asthma, bradycardia, AV block, HF, sedation/sleep (CNS), mask hypoglycemia, unopposed alpha (bad for pheo and cocaine)
    • proPrinzalol (prinzemetal angina)
    • treat overdose with saline, atropine, glucagon
  39. nadolol
    • non selective beta 1 and 2 blocker. Angina, MI reduced mortality, hypertension, variceal bleeding
    • increase PR interval, impotence, exacerbate COPD/asthma, bradycardia, AV block, HF, sedation/sleep (CNS), mask hypoglycemia, unopposed alpha (bad for pheo and cocaine)
    • treat overdose with saline, atropine, glucagon
    • 2nd half of the alphabet (N-Z) block 1 and 2 (non-selective)
  40. nebivolol
    • special beta blocker with selective beta 1 (despite N) and stimulation of beta 3, activating nitric oxide synthase in the vasculature. Angina, MI reduced mortality, hypertension, variceal bleeding
    • increase PR interval, impotence, exacerbate COPD/asthma, bradycardia, AV block, HF, sedation/sleep (CNS), mask hypoglycemia, unopposed alpha (bad for pheo and cocaine)
    • treat overdose with saline, atropine, glucagon
  41. pindolol
    • partial beta 1 and beta 2 agonist (non selective). Angina, MI reduced mortality, hypertension
    • increase PR interval, impotence, exacerbate COPD/asthma, bradycardia, AV block, HF, sedation/sleep (CNS), mask hypoglycemia, unopposed alpha (bad for pheo and cocaine)
    • treat overdose with saline, atropine, glucagon
    • 2nd half of the alphabet (N-Z) block 1 and 2 (non-selective)
  42. timolol
    • non selective beta 1 and 2 blocker. Angina, MI reduced mortality, hypertension, variceal bleeding
    • increase PR interval, impotence, exacerbate COPD/asthma, bradycardia, AV block, HF, sedation/sleep (CNS), mask hypoglycemia, unopposed alpha (bad for pheo and cocaine)
    • treat overdose with saline, atropine, glucagon
    • 2nd half of the alphabet (N-Z) block 1 and 2 (non-selective)
  43. carvedilol
    • nonselective alpha and beta blocker. Angina, MI reduced mortality, hypertension, heart failure reduced mortality
    • increase PR interval, impotence, exacerbate COPD/asthma, bradycardia, AV block, HF, sedation/sleep (CNS), mask hypoglycemia, does NOT cause unopposed alpha (fine for pheo and cocaine)
    • metabolol (dyslipidemia)
    • treat overdose with saline, atropine, glucagon
    • special beta blocker because no -olol ending
  44. labetalol
    • nonselective alpha and beta blocker. Angina, MI reduced mortality, hypertension in pregnancy,
    • increase PR interval, impotence, exacerbate COPD/asthma, bradycardia, AV block, HF, sedation/sleep (CNS), mask hypoglycemia, does NOT cause unopposed alpha (fine for pheo and cocaine)
    • metabolol (dyslipidemia)
    • treat overdose with saline, atropine, glucagon
    • special beta blocker because no -olol ending
  45. sotalol
    • class III antiarrhythmic and non-selective beta 1, 2 blocker
    • block potassium channels to prolong AP and therefore effective refractory time and QT. A fib/flutter and ventricular tachycardia
    • torsades de pointes, increase PR interval, impotence, exacerbate COPD/asthma, bradycardia, AV block, HF, sedation/sleep (CNS), mask hypoglycemia, unopposed alpha (bad for pheo and cocaine)
    • I lied about my AIDS (-ilide, amiodarone, ibutilide, dofetilide, sotalol)
  46. amiodarone
    • class III antiarrhythmic and beta blocker (class II), class I, and class IV
    • block potassium channels to prolong AP and but also classes I, II, and IV, so does not prolong QT. A fib/flutter and ventricular tachycardia
    • pulmonary fibrosis, hepatotoxicity, hypo/hyperthyroidism (it's 40% iodine [amIODArone]), corneal deposits, blue gray skin deposits (acts as hapten aka conjugates w/ something to make an antigen), neurologic effects, constipation, bradycardia, heart block, heart failure
    • check PFTs, LFTs, TFTs on amiodarone (pulmonary fibrosis, hepatotoxicity, hypo/hyperthyroidism)
    • I lied about my AIDS (-ilide, amiodarone, ibutilide, dofetilide, sotalol)
  47. ibutilide
    • class III antiarrhythmic and beta blocker
    • block potassium channels to prolong AP and therefore effective refractory time and QT. A fib/flutter but NOT ventricular tachycardia
    • torsades de pointes
    • I lied about my AIDS (-ilide, amiodarone, ibutilide, dofetilide, sotalol)
  48. dofetilide
    • class III antiarrhythmic and beta blocker
    • block potassium channels to prolong AP and therefore effective refractory time and QT. A fib/flutter but NOT ventricular tachycardia
    • torsades de pointes
    • I lied about my AIDS (-ilide, amiodarone, ibutilide, dofetilide, sotalol)
  49. adenosine
    • short acting to increase potassium flow out of cells to hyperpolarize and reduce Ca permeability. Diagnose/terminate certain SVTs
    • caffeine and theophylline blunt effects (adenosine receptor antagonists)
    • impending doom, chest pain, bronchospam, flushing, hypotension
  50. magnesium
    block Ca channels. Treat torsades de pointes, digoxin toxicity

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Author:
countchocula58
ID:
318288
Filename:
The Pharm of Old McDonald 3
Updated:
2016-04-01 14:05:54
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tubberly tubblish pharm pharmacology step one
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