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Pharmacology NGUYEN
| Question | Answer |
|---|---|
| What is the BP categorized as normal according to the JNC? | <120/80 |
| What is the BP categorized as pre-HTN according to the JNC? | 120-139/80-89 |
| What is the BP categorized as HTN according to the JNC? | > or equal to 140/90 |
| What is the BP categorized as Stage 1 according to the JNC? | 140-159/90-99 |
| What is the BP categorized as Stage 2 according to the JNC? | > or equal to 160/100 |
| What is the BP goal for those ages 60 and up according to the JNC 8? | < 150/90 |
| What is the BP goal for those under 60 with either HTN & DM or HTN & CKD according to the JNC 8? | < 140/90 |
| What is the BP goal for those ages 30-59 according to the JNC 8? | Diastolic BP <90 |
| What is the MOA of alpha-2 adrenergic agonists | Inhibition of peripheral sympathetic activities and vasodilation in the peripheral blood vessels |
| Name some central acting sympathetic nervous system inhibitors. | Clonidine HCl (Catapres) and Methyldopa (Aldomet) |
| What are AE of alpha-2 adrenergic agonists? | Orthostatic symptoms, CNS-drowsiness, sedation, dry mouth, impotence |
| What are some precautions to take with alpha-2 adrenergic agonists? | Avoid abrupt cessation due to a rebound effect |
| What are some counseling points for methyldopa? | Patient may have a positive Coombs test, can be used in pregnancy/preeclampsia |
| What are some DDIs that occur with alpha-2 adrenergic agonists? | TCAs can negate the HOTN effects of clonidine and worsen depression, Alcohol may increase clonidine's HOTN effects |
| Name some alpha-adrenergic blocking drugs | Prazosin (Minipress), Terazosin (Hytrin), Doxazosin (Cadura) |
| What do alpha-adrenergic blocking agents relieve problems with? | Benign Prostatic Hypertrophy (BPH) |
| What are adverse effects of alpha-blockers? | Orthostatic hypotension and syncope |
| What is hydralazine used for? | Decrease BP in hypertensive emergencies; preeclampsia and eclampsia of pregnancy |
| What is a precaution with hydralazine? | Drug induced SLE syndrome |
| What is the only drug approved for African Americans with systolic heart failure? | BiDil (hydralazine/isosorbide dinatrate) |
| What is a potent vasodilator that is particularly effective in patients with renal failure and severe HTN and has an adverse effect of hirsutism? | Minoxidil |
| What is diazoxide used for? | Severe, malignant HTN and hypertensive emergencies |
| What is a drug for hypertensive emergencies that should not be used in chronic kidney disease due to cyanide toxicity? | Sodium Nitroprusside |
| What drug class should be selected for patients with PMH of an MI? | Beta Blockers |
| What is a contraindication of beta-blockers? | Patients who have a heart rate of 55-60 should not be put on a beta-blocker due to increased risk of heart failure |
| Which beta-blockers can be used in patients with liver problems? | Propanolol and Nebivolol |
| Name a dihydropyridine calcium channel blocker. | Amlodipine (Norvasc), Nifediine (Adalat, Procardia), Nimodipine (Nimotop) |
| Name a phenylakylamine calcium channel blocker. | Verapamil (Calan, Isoptin) |
| Name a benzothiazine calcium channel blocker. | Diltiazem (Cardiazem) |
| Which drug improves neurologic deficits that are caused by spasm following subarachnoid hemorrhage? | Nimodipine |
| Which calcium channel blocker has a proarrhythmic effect? | Bepridil |
| What is the drug of choice for HTN in diabetic patients? | ACE Inhibitors |
| Which ACE inhibitor formulation is available IV for HTN emergencies? | Enalaprilat |
| What are some precautions that need to be taken with ACEIs? | First dose effect, Hyperkalemia |
| What are some adverse effects of ACEIs? | Angioedema, cough, elevations of liver enzymes, BUN/SrCr, K |
| Which drug class has similar but less side effects than ACEIs? | ARBS: end in -artan |
| Which drug is a direct renin inhibitor? | Tekturna (Aliskiren) |
| Which diuretic is used for glaucoma and works in the proximal tubule? | Acetazolamide, Methazolamide |
| Which diuretics work in the proximal tubule by drawing water from extravascular spaces into the tubular lumen? | Mannitol, glucose, urea, glycerin |
| What is the GFR level that thiazide diuretics work best at? | Greater than 30 mL/min |
| What populations are thiazide diuretics the initial drug of choice for? | Elderly, African Americans, some diabetic patients, obese |
| What are the adverse effects of thiazide diuretics? | Hypokalemia, hypoMg, hyponatremia, hypercalcemia, hyperglycemia, hyperuricemia, increases BUN/SrCr, elevates cholesterol, TG, LDL |
| What are the thiazide-like diuretics? | Metolazone (Zaroxolyn), Chlorthalidone (Hygroton), Indapamide (Lozol) |
| Which class of diuretics is effective even when GFR is less than 30 mL/min? | Loop diuretics |
| What are some adverse effects of loop diuretics? | Electrolyte imbalances, hyperuricemia, permanent deafness with rapid IV administration |
| What diuretics work by inhibiting sodium influx through iron channels without competing with aldosterone? | Triamterene & Amiloride |
| What are the adverse effects of spironolactone? | Gynecomastia, hyperkalemia |
| Nitrates come in every formulation except for? | SQ |
| What is the MOA of nitrates? | Reduce cardiac O2 demand and increasing blood flow through the collateral coronary vessels |
| What are the adverse effects of nitrates? | Flushing, pounding or pulsating, headache, N/V, hypotension |
| How can you avoid nitrate tolerance? | Need nitrate-free intervals of 8-12 hours |
| What is the DOC for SVT? | Verapamil |
| What are the CI of diltiazem? | Sinus syndrome, 2nd or 3rd degree block |
| What is the MONA treatment for patients with CAD? | Morphine, Oxygen, Nitrates, Aspirin |
| What is a very potent drug used in HF that has positive inotropic and negative chronotropic effects? | Digoxin |
| What is the therapeutic serum level and toxic level of digoxin? | 0.5-2; toxic is greater than 2.5 |
| What are the adverse effects of digoxin? | Anorexia, n/v/d, fatigue, disorientation, depression, visual disturbances, yellow vision and green halos around lights |
| Which drug increases digoxin by about 50%? | Quinidine |
| What are the beta-blockers that have shown a reduction in mortality in HF? | Bisoprolol, Carvedilol, Metoprolol XL, Nebivolol |
| What drug is a beta 1 adrenergic agonist used to treat heart failure? | Dobutamine |
| What is the drug of choice for Torsades de Pointe? | Magnesium |
| Which antidysrhythmic drug has both class 2 and 3 properties? | Sotalol |
| Name the sodium channel blockers of group 1. | Procainamide, Quinidine, Disopyramide, Lidocaine, Phenytoin, Tocainide |
| Which drug is an antiseizure drug that depresses spontaneous depolarization in ventricular tissue? | Phenytoin |
| Agranulocytosis and development of positive ANA titers are side effects of which drug? | Procainamide |
| Which drug has an anticholinergic effect and is used in hypertrophic obstructive cardiomyopathy? | Disopyramide |
| What is considered the drug of choice for treating ventricular dysrhythmias associated with AMI and cardiac surgery? | Lidocaine |
| Which 2 beta blockers are indicated for portal HTN? | Propanolol, nadolol |
| What are amiodarone's effects on digoxin and warfarin? | Inhibits renal excretion of digoxin, potentiates the anticoagulant effect of warfarin |
| What is the BBW of Dronedarone? | Liver toxicity |
| Which drug inhibits the effects of catecholamine stimulation and restores the myocardial supply/demand ratio? | Adenosine |
| What are atropine sulfate and isoproteronol indicated for? | Bradydysrhythmias |
| What is CHADS2? | Cardiac failure, HTN, age over 75, DM, Stroke |
| What are the treatments based on CHADS2 scores? | 0= Aspirin, 1= Aspirin or Warfarin, 2= Warfarin or -ban drugs, or aspirin + plavix 2nd line |
| How can you avoid the DIs of antacids? | Separate interacting drugs from antacids by 2 hours |
| Which cytoprotective agent is pregnancy category X? | Misoprostol (Cytotec) |
| Which absorbent antidiarrheals can be used for simple diarrhea? | Kaopectate, Pepto-Bismol |
| Which drug is used for travelers diarrhea and has adverse effects of hypersensitivity reactions? | Rifaximin |
| Which drug is indicated for diarrhea caused by cryptosporidum parvum and Giardia? | Nitazoxanide |
| Dimenhydrinate (Dramamine), Diphenhydramine (Benadryl) and Hydroxyzine (Vistaril/Atarax) are what types of drugs? | Antiemetics specifically antihistamines |
| Prochlorperazine has what MOA and why is its use currently limited? | Blocks dopamine receptors, not used due to EPS effects |
| What are the adverse effects of Ondansetron (Zofran)? | Abdominal pain, GI symptoms, dizziness, drowsiness, headache, fatigue, hypersensitivity reaction, QT prolongation |
| Which drug has a BBW of tardive dyskinesia or involuntary and repetitive movements? | Metochlorpramide (Reglan) |
| What are the adverse effects of H2RA receptors? | Agranulocytosis, granulcytopenia, thrombocytopenia, and aplastic anemia |
| Which 2 PPIs are metabolized by the CYP450 system? | Omeprazole and lansoprazole |
| What is the triple regimen therapy for H.pylori eradication? | Tetracycline or Amoxicillin, Metronidazole, PPI or Pepto-Bismol |
| What are the CI of Ipecac syrup? | Comatose, unconscious, no gag reflex, seizing, caustic substances ingested |
| Which laxative is CI in pregnancy? | Castor oil |
| Which laxatives should be used with caution in CKD? | Magnesium salts |
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LexFuturePAC
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