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Pharmacology NGUYEN

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
Created by: LexFuturePAC