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52 Cards in this Set
- Front
- Back
Beta-1 blockers
|
"BEAM"
Atenolol Metoprolol (nebivolol) |
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Beta non-selective blockers
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Propranolol
Timolol Pindolol Nadolol |
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Non-selective beta blockers & alpha-1 blockers
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Labetalol (also some beta-2 agonist effect)
Carvedilol |
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MOA beta-blockers
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Decrease CO (anti-HTN)
Decrease workload of heart (chronic/stable CHF) Minimize s/s hyperthyroidism Decrease renin production |
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SE beta-blockers
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Fatigue
Insomnia Impotence Decreased HDL Increased TG |
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Who are non-selective beta-blockers contraindicated in?
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COPD
Asthma |
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MOA thiazide diuretic (most commonly used)
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Block Na uptake at DCT --> more Na excretion in urine
(Hydrochlorothiazide) |
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SE thiazides
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Hypokalemia
Hypercalcemia Hyperuricemia (possible - hypersensitivity in sulfa-allergic pt) |
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CCB names and main effect
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Diltiazem - heart (little - vasculature)
Nifedipine - vasculature Verapamil - heart & vasculature |
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SE CCB
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Constipation
Vertigo HA Fatigue Hypotension |
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ACE inhibitors
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(-prils)
Captopril Lisinopril Enalapril |
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MOA ACE inhibitors
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Inhibit ACE (enzyme that converts Ang I to Ang II)
--> VD & decreased water & Na retention Increased bradykinin (ACE degrades it) |
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SE ACE inhibitors
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Dry cough
Rash Fever Altered taste Hypotension Hyperkalemia Angioedema 1st dose syncopy |
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Can you use ACE inhibitors in pregnancy
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NO
(Fetotoxic) |
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Alpha-blockers
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Prazosin
Terazosin |
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MOA alpha-blockers
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Arteriolar VD --> decreased total PVR
|
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SE alpha-blockers
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Reflex tachycardia
1st dose syncopy |
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ARBs (angiotensin II R blockers)
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(-sartans)
Losartan Candesartan Valsartan |
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Difference in ARBs and ACE Inhibitors
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ACE Inhibitors increase bradykinin
ARBs have no effect on ACE, so no effect on bradykinin (AND NO ANGIOEDEMA) |
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MOA Clonidine
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Central alpha-2 agonist
(depress SNS outflow) |
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MOA hydralazine
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Smooth m. relaxant
|
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MOA Nitroprusside, SE
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VD
(poisonious if given PO b/c hydrolyzed to cyanide) |
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1st line tx for ALL PT to prevent HTN
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Lifestyle modification
optimal wt, healthy diet, cessation of smoking, exercise, restriction of Na, moderation in alcohol consumption |
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Target BP & 1st line tx for all pts
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< 140/90
Thiazides (stage 2 HTN - 2 drugs - thiazides being 1 of the 2) |
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What is stage II HTN
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SBP > 160 or DBP > 100
|
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Target BP & 1st line tx for high risk CAD pt
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< 130/80
Most - thiazide Chronic renal or DM pt - ACE inhibitor or ARB |
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What makes someone high risk for CAD in a/w HTN control
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DM
Chronic renal disease CAD (asymptomatic) |
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Target BP and 1st line tx for pt w/ hx stable angina, unstable angina, MI
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< 130/80
Bb + (ACEI or ARB) If unsuccessful - ADD CCB or thiazide If Bb not tolerated - Verapamil or Diltiazem |
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Target BP & 1st line tx for pt w/ CHF
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< 120/80
Bb + (ACEI or ARB) + (loop or thiazide) **if severe CHF - add aldosterone antagonist |
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What HTN drugs are contraindicated in CHF pt
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Verapamil
Diltiazem Clonidine Alpha blocker |
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What drug must be d/c if acute exacerbation of CHF
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Beta-blocker (until CO restored)
|
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DOC for HF
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Digoxin
|
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What is HTN emergency
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SBP > 210 & DBP > 150
(if pre-existing condition - DBP > 130) |
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Drugs used during HTN emergency
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Nitroprusside
Diazoxide Labetalol |
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MOA Nitroprusside
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VD - arteries & veins
(decreases pre-load) |
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Nitroprusside is metabolized into?
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Cyanide
(not a huge issue if IV, mostly if PO) Give Thiosulfate if problem |
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MOA Diazoxide
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Direct arteriolar VD
|
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MOA Labetalol
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Bb & alpha blocker
(prevents reflex tachycardia a/w most alpha blockers) |
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MOA Spironolactone
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"potassium-sparing diuretic"
Aldosterone antagonist at late DCT & CD |
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SE spironolactone
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Hyperkalemia
Metabolic acidosis H-related SE (similar to sex H) |
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MOA ergot alkaloids
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Block 5-HT2 R --> VC
|
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Ergotamine use
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moderate to severe migraines
(best if used during prodrome) |
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Ergotamine is contraindicated for
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Pregnancy
PVD CAD |
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Methysergide use
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Prevent migraine (only prophylactic)
|
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MOA Triptans
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5-HT 1 agonist --> VD
(more powerful than ergots) |
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Use of triptans
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Prevent migraines
Tx ongoing migraine |
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Who should triptans be avoided in
|
Prinzmetal's angina
PVD Uncontrolled HTN Taking SSRI, SNRI, MAOIs (promote serotonin syndrome) |
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MOA Cyproheptadine
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Blocks 5-HT 2 R --> VC
|
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Use cyproheptadine
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Prevent migraines
More so for cluster HA (not really used as much as others) |
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-setron drugs, MOA, use
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Ondansetron, Granisetron, Dolasetron, Palonosetron
5-HT 3 blocker Anti-emetic (CNS-driven vomiting) |
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Metoclopramide, MOA, use
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5-HT 4 agonist --> increase GI motility
Anti-emetic |
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Buspirone, MOA, use
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5-HT 1 agonist
Anxiolysis |