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CV Pharm
Tough CV drugs to Remember and their mechanism of action
| Question | Answer |
|---|---|
| Bumetanide | Loop Diuertic |
| Ethacrynic Acid - MOA? Special use? | Loop diuretic, Ototoxicity - used for people who are overly reactive to other drugs |
| Chlorthalidone | Thiazide Diuretic |
| Metolazone | Thiazide Diuretic |
| Triamterene | Na Channel Blocker |
| Amiloride | Na Channel Blocker |
| Spironolactone | Aldosterone Receptor Blocker in collecting duct |
| Eplerenone | Aldosterone receptor blocker in collecting duuct |
| Verapamil - what can it cause | NON-DHP Ca channel blocker. Constipation |
| Diltiazem | NON-DHP Ca+ Channel blocker |
| drugs that end in -amide | Carbonic anhydrase inhibitors |
| Drugs that end in -dipine | DHP Ca+ channel blockers |
| Drugs that end in -pril | ACE Inhibitors |
| Drugs that end in -sartan | Angiotension II receptor antagonist |
| Aliskiren | Renin inhibitor |
| Side effects of ACE inhibitors | cough, blood deficencies, angioedema |
| Side effects of captopril | Rash, metallic taste |
| When are ACE inhibitors NOT used | Bi-lateral renal artery stenosis, any renal disease or compromise and heart failure |
| Which drug is used to treat primary and secondary aldosteronism, hirtusim, acne, etc | Spironolactone |
| Common drugs for nephrogenic diabetes insipidous | thiazide diuretics |
| ARB's are generally used when? | When ACEI's cannot be tolerated |
| Which type of drugs are given in for ascities caused by liver cirrhosis | Loop diuretics |
| What causes the chronic effect of decreasing PVR in the use of diuretics | loss of Na+ in Smooth muscle cells |
| High levels of aldosterone will do what to metabolic pH | alkolosis |
| True or False: THiazides and Betablockers increase risk for development of diabetes | True |
| CCB's can cuase diabetes, true or false? | flase |
| Should you use beta blockers post MI | YES! |
| Removing someone quickly from a beta blocker could cause what | rebound hypertension |
| Which drug is used to target cerebral arteries and help with subarachnoid hemmorage | Nimodipine |
| Nifedipine has the greatest ability of the CCB's to cause edema, what woudl you use to counter this | ACEI's |
| Can ACEI's be used for acute or post MI | YES! |
| Which class of drugs can be deamed renal-protective | ACEI's |
| MOA for methydopa | Alpha 2 agonist, used in pregnancy |
| MOA for clonidine | Alpha 2 agonist (works in CNS to reduce sympathetic outflow) |
| Hydralazine MOA | vasodialator (ateries)by hyperpolarization |
| Minoxidil MOA | vasodilator (arteries) by hyperpolarization |
| Fenoldopam MOA | vasodilator (arteries)(dopmaine receptors) |
| Often times, what drug is needed to conbat the relfex triggered by hydralazine/minoxidil | beta blockers and diuretics |
| lupus like reactions are developed from what drug | hydralazine |
| Trichimosis | Minoxidil |
| Uripril MOA | A1 antagonist |
| Where are V2 receptors found. | Kidneys |
| What role do loop diuretcis serve in renal failur | reduce hyperkalemia and wash out intratubular cast |
| The combination of loop and thiazde diuretics is used to treat what | diabetes insipidous |
| Which drug needs a GFR or more than 30-40 to be effective | Hydrochlorothiazide |
| The combination of spironolactone and furosemide is used to treat whatq | ascities/cirrhosis |
| Would you see gynomastia, menstral irregularities and Impotence in eplerenone use | Nope, only acts on kidneys, not other places |
| Which drugs can be used to treat mountain sickness | carbonic anhydranse inhibitors |
| Which drugs coudl be used to cause high levels of acidic drug excretion | carbonic anhydrase inhibitors |
| Which drugs are conraindicated in those with Gout | Loop and Thiazide diuretics |
| Can patients with diabetes mellitus take loop and thoiazides | yup |
| When woudl you not use ARB's | Post MI and CAD risk |
| When do you not use CCB's | post MI, kidney and heart disease |
| When would you not use a diuretic | post MI |
| What are the five types of FIRST line drugs for hypertension | Diuretics, B-antagonist, CCB's, ACEI's, and Angiotensin II receptor blockers |
| which has longer lasting effects, loops or thiazides | thiazides |
| Which drugs have the best end organ protection | Aldosterone blockers |
| Which class of drugs works to protect against diabetic onset | ACEI's |
| Do Beta blockers lower CO, PVR or both | both, due to preventing the release of Renin |
| Which drugs is selective for cerebral arteries and is used in hemmorrhage | Nimodipine |
| Which of the CCB's causes the most edema | Nifedipine |
| Which class of drug can be used to help in alziehmers, parkinsons, migranes, glaucoma, mercury intox, valve disease, and lung cancer | ACEI's |
| Are phentolamine and phenoxybenzamine used to treat hypertension | NOPE! |
| orthstatic hypotension is a main S/E of which class of drugs | Alpha 1 blockers |
| What property of Alpha 2 agonist allows them to decrease Sympathetic outflow | lipid soluable, reaches brain |
| Which drug, specifically, is hepatotoxic | Methyldopa |
| Which drug can produce a positive coombs test | methydopa |
| Nicardipine is known to treat hypertension from what | catecholamine excess |
| Which class of drugs can cause a precipitate of Ca+ salts | Carbonic anhydrase inhibitors |
| What are the major side effects of vaspressin | Hypertension and MI |
| Siezures due to hyponatuermia can be a result of what drug | desmospressin |
| The loop diuertics cause a DIRECT effect of K+ loss or gain | gain |
| What is the fractionalexcretion of Na+ gained by LOOP DIURETICS | 15-25% |
| Which drugs are used to treat hepatorenal syndrome and hepatic encephalopathy | Loop diuretics |
| Hypertension in patients with renal insufficency shoudl be treated using which class of drugs | Loop diuretics |
| What ion do thiazide diuretics increase the absorption of | Ca+ |
| What is the fractional excretion of Na+ gained using thiazide dieuretics | 5% |
| Which drug class would be used to treat nephrolithiasis due to hyperclacemia | THiazides |
| Primary aldosteronism is best treated with what | spironolactone |
| What do you have to worry about when treating solely with spironolactone | hyperkalemia |
| Side effect of triamterene | Kidneys Stones |
| short term regulation of BP | baroreceptors |
| long term regulation of BP | Renin-angio-aldosterone system (kidneys) |
| Cronic effects of diuretics decrease PVR or Co | PVR |
| Which area of the heart do verapamil and diltiazem work on | SA node |
| Do CCB's have an effect on venous beds | no |
| would you give CCB's during heart failure or pulmonary edema | no |
| Three consequences of Angi II release | vasoconstriction, sympathetic nervous activity, and Na/water retention |
| Do ACE inhibitors work more on PVR or CO | PVR |
| What drugs are ACE inhibitors commonly given with | diuretics because ACEI's can cause hyperkalemia |
| What is a previous condition that warrants NOT using ACEI's | previous angioedema |
| Alpha agonist mainly work on PVR or CO? | PVR |
| What drugs woudl you use to combat the reflex tachycardia caused by direct vasodilatiors | diuretics or beta blockers |
| Which arteries does Fendolapam target and when is it used | Renal, used in hypertensive emergency |
| When woudl Nicardipine be contraindicated | HF |
| -statin's work how... | block HMG Co-reductase |
| when shoudl statins be taken | before bed |
| What must you check before starting a statin | liver enzymes |
| Rhabdomyolysis is a serious condition that can be brought on by which drug class | statins |
| Albuterol can be used to force K+ back intot cells after an episode of what drug S/E | rhabdomyolysis |
| How much of an effect do statins have on TG's? HDL? | modest, modest |
| Which drug class shoudl not be used in the pregnant or individuals with hepatic disease | statins |
| Cholestyramine MOA | Bile acid resin |
| Colestipol | bile acid resin |
| Colesevalam | bile acid resin |
| Which two drug classes upregulate LDL receptors | statins and bile acid resins |
| Does the increase of de novo synthesis due to bile acid resins have an overall effect on LDL levels | no |
| Whats one of the major problems with Bile Acid Resisn | poor patient compliance |
| Omega 3 FA's have been shown to lower ______ but raise ______ | TG, LDL |
| Which drug class has been shown to caue gallstones | Fibric acid derivatives |
| Hyperuricemia can occur with which class of drugs | Loops, thiazides and Niacin |
| Chronic liver disease is a contraindication for which TG lowering drug | Niacin |
| Niacin works best to lower TG's or LDL's | TG's |
| Which two drug classes increase HDL's | Niacin and Fibric acid derivatives |
| Which two cell types does Niacin work in | Hepatocytes and adipocytes |
| Which drug targets DGAT2 and where does this happen | Niacin, in the liver |
| Decreaseing TG's in the liver eventually leads to a reduction in what | VLDL |
| What condition does Bile Acid resins NOT treat | hypertriglercidemia |
| When would you use Ezetimibe as a monotherapy | When a statin is not tolerated or only need a small reduction |
| What effect does the increase of De novo synthesis when using a bile acid derivative have on overall LDL levels | NONE! |
| Gemfibrozil and statins have an increase in the incidence of what when combined | myopathy |
| Which enzyme does niacin ultimatley effect | hormone sensitive lipase |
| Which molecule is degraded if no TG's are available | ApoB |
| Do you need to check liver enzymes when using Niacin | yes |
| which drug is contraindicated by ulcers | niacin |
| Which class of drugs causes an increase in the action of extrahepatic lipoprotein lipase | fibric acid derivatives |
| Which vasodilator is used in pregnant women | hydralazine |
| Which two drugs are used for ecclempsia | mag sulfate and hydralazine |
| Which drug is used for acute MI, and why | nitroglycerine, dilates coronary |
| Main drug for aortic dissesction | propranolol |
| Which drug is a peripheral arteriole dialator that can cause massive drops in BP | diazoxide |
| One year survival for hypertesive emergency treated and untreated | treated: 90%Untreated: 25% |
| Which two drugs are used for antihypertensive withdrawl | labetalol and phenolamine |
| Mean diastolic pressure is taken over the course of how many measurements | 3 |
| When can you NOT give statins | to mothers and those with active hepatic disease |
| Which lipid lowering drug can be given to help improve glycemic controls in adults with type 2 diabetes | Bile acid resins |
| MOA for niacin | Binds to the GPR109A receptor and activates Gi. This lowers cAMP and blocks HSL from turning TG's into FFA's. Thus this stops FFA's from going to the liver to make VLDL'sALSO: targets DGAT2 which is what is making the TG's in the liver |
| Which drug is responsible for rasing the fasting glucose levels in diabetics and possibly raising insulin resistence | Niacin |
Created by:
lowryc