Brs Pharm Chapter 4

Front 1

if you have LV dysfunction what should you be on

Back 1

ACE inhibitor or ARB

Front 2

what increases renin release?(4)

Back 2

reduced arterial pressure
decreased sodium delivery to the cortex
increased sodium at the distal tubule
stimulation of sypathetic

Front 3

what does renin do in RAAS?

Back 3

cleaves angiotensinogen and releases angiotensin I

Front 4

what does ACE do in RAAS

Back 4

converts angiotensin I to andgiotensin II

Front 5

what goes angiotensin II do

Back 5

vasoconstricts and causes sodium retention by releasing aldosterone

Front 6

ACE inhibitors do what?

Back 6

cause vasodilation and induce natriuresis which reduces preload

Front 7

captopril, enalapril, fosinopril, lisinopril, quinapril, benazepril, moexipril, perindopril, ramipril, trandolapril

Back 7

ACE inihibtors

Front 8

losartan, valsartan, irbesartan, candesartan, telmisartan, eprosartan, olmesartan

Back 8

ARBS!

Front 9

used for CHF, reducing risk of recurrent post MI, hypertension

Back 9

ACE inhibitors or ARBS

Front 10

diabetic patients should be on

Back 10

enalapril

Front 11

adverse effects include blood dyscrasias, aplastic anemia, drug cough, andioedema, hypotension and hyperkalemia

Back 11

ACE inhibitors

Front 12

dizziness and hyperkalemia

Back 12

advsere effects of ARB

Front 13

if your pt gets angioedema switch to

Back 13

ARB

Front 14

angioedema is cause by

Back 14

increased bradykinins because ACE is blocked

Front 15

aliskiren

Back 15

renin inhibtor

Front 16

cadiac glycosides are used in pts with

Back 16

arrythmias and CHF

Front 17

digoxin and digitoxin, digitalis

Back 17

cadiac glycosides

Front 18

how do cardiac glycosides work

Back 18

cardiac glycosides inhibit Na/K-ATPase= increased Na which reduces the normal exchange of intracellular Ca for extracellular Na= greater release of Ca= positive ionitropic effect

Front 19

cardiac glycosides do what to heart

Back 19

increase stroke volume and enhance cardiac output, end-diastolic volume decrease and improves circulation

Front 20

what do cardiac glycosides do to vagal tone

Back 20

increase vagal activity

Front 21

dosing of digoxin is

Back 21

individualized

Front 22

for acute digoxin toxicity what do you give

Back 22

digoxin immune FAB- digibind

Front 23

inamirnone lactate and milrinone

Back 23

PDE 3 inhibitors in caridiac and increase cAMP= more Ca for better contractions

Front 24

inamirnone lactate and milrinone

Back 24

PDE 3 inhibitors in caridiac and increase cAMP= more Ca for better contractions

Front 25

if you dont respond to digitalis what do you give?

Back 25

inamrinone lactate or milrinone

Front 26

dobutamine can be used for

Back 26

short term therapy of seevr chronic cardiac failure and support after MI or surgery

Front 27

nesiritide- MOA

Back 27

increases cGMP and produces vasodilation, inccreases stroke volume

Front 28

nitroprusside, nitroglycerin

Back 28

vasodilators

Front 29

for severe, decompensated CHF use

Back 29

vasodilators

Front 30

isosorbide, hydralazine, prazosin, carevdilol

Back 30

long term therapy vasodilators

Front 31

class I drugs MOA

Back 31

block Na channels and reduce phase 0 depolarization

Front 32

class 1A do what to heart

Back 32

prolong refractory period and slow conduction

Front 33

class 1B do what to heart

Back 33

shorten duration of refratory period

Front 34

class 1 C does what to heart

Back 34

slows conduction

Front 35

quinidine, procainamide, disoyramide

Back 35

class IA- suppresses ventricular arrythmias

Front 36

lidocaine, mexiletine

Back 36

class 1B- suppresses ventrciular arrythmias

Front 37

flecanide

Back 37

class 1C- treat severe ventricular arrythmias

Front 38

propanolol, atenolol nadolol

Back 38

class II- suppress some ventricular arrythmias and inhibit AV node

Front 39

amiodarone

Back 39

class III- suppresses ventricular arrythmias

Front 40

verapamil

Back 40

class IV- treats reenterant supraventrciular tachycardia, suppress AV node conduction

Front 41

adenosin

Back 41

class V- treat paroxysmal atrial tachycardia

Front 42

atropine used for

Back 42

increase heart rate in bradycardia and heart blocks

Front 43

digoxin uses

Back 43

inhibit AV node and treat A fib

Front 44

class IA- quinidine uses

Back 44

supraventricular and ventricular arrythmias, used to maintain sinus rhythm after conversion of A fib or A flutter

Front 45

causes cinchonism- ringing of ears and dizzines

Back 45

quinindine- class 1A

Front 46

procainamide-class IA

Back 46

safer, fewer effects then quinidine-causes lupus like syndrome!!

Front 47

lidocaine-

Back 47

class IB- ventricular arrythmiasa second choice,

Front 48

mexiletene

Back 48

class 1B- used for long term ventricular arrythmias

Front 49

flecanide and encainide

Back 49

class 1C-ventricular tachyarrythmia and for paroxysmal A fib/ a flutter.

Front 50

propafenone

Back 50

1C- supraventricular arrythmias and life threatening ventrciular arrythmias

Front 51

class II

Back 51

B Blockers, inhibit phase IV, prolong AV conduction, treat A fib, A flutter

Front 52

amiodarone

Back 52

class III- like thyroxine, increases refractoriness and depresses sinus node, for atrial/ ventricular arrythmias

Front 53

pulmonary fibrosis, gray man syndrome, photosensitivity, corneal microdeposits, thyroid disorders

Back 53

adverse effects of amiodorone

Front 54

ibutilide

Back 54

class III- conversion of A fib/ A flutter, blocks inward Na channels

Front 55

sotalol

Back 55

class III- works as B blocker too, atrial or life threatening ventricular arrythmias

Front 56

dofetilide-

Back 56

class III- conversion in A fib or A flutter- inhibits K channels

Front 57

bretylium

Back 57

class III- inhibits catecholamines for severes refractory ventricular tachyarrythmias and ventrciular fibrillation

Front 58

L type-Ca channel blockers

Back 58

class IV- for supraventricular tachycadia and A flutter and A fib, negative iotropic effect - dont use in WPW

Front 59

adenosine

Back 59

class V- increases K and decreases Ca for paroxysmal superventricular tachycardia and WPW

Front 60

atropine

Back 60

blocks Ach and elevates HR at SA and AVfor bradyarrythmias

Front 61

classic angina

Back 61

due to diminished coronary flow when oxygen demand increases ( exercise)

Front 62

vasospastic- prinzmentals angina

Back 62

coronary vasospasm that decreases O2 supply and occurs at rest

Front 63

nitrates/nitrites MOA

Back 63

activates guynylate cyclase and increase cGMP to relax contractions and dilate all vessels

Front 64

nitroglycerin used for with angina

Back 64

unstable and prinzmetals

Front 65

angina drugs-

Back 65

nitrates/nitrites, B blockers, ca channel blockerss, dipyridamole

Front 66

nifedipine effects on heart

Back 66

less than verapamil and diltiazem

Front 67

dipyridamole used for?

Back 67

angia pectoris because its PGI2

Front 68

give K sparing diuretics with what heart medication?

Back 68

cardiac glycosides- to prevent potassium depletion

Front 69

reduced peripheral vascular resistance, decreases sympathetics, decreases renin release..which drug

Back 69

propanolol and beta blockers

Front 70

what happens if you abruptly stop B blockers when taking it for angina

Back 70

worsens angina and increases risk of MI

Front 71

prazosin, terazosin, doxazosin

Back 71

a blockers

Front 72

phentolamine and phenoxybenzamine

Back 72

block alpha 1 and alpha 2 receptors fror phenochromocytoma in hypertension

Front 73

labetolol

Back 73

blocks alpha and Beta

Front 74

labetolol use

Back 74

for hypertensive emergencies and hypertension of pheochromocytoma

Front 75

nifedipine, nicardipine, nisoldipine, isradipine, amlodipine, felodipine

Back 75

dihydropyridines -ca channel blockers- which dont effect heart and could cause reflex tachy. when combine with B blockers lower blood pressure even more then separately

Front 76

methyldopa

Back 76

blocks alpha 1 and alpha 2 and decreases peripheral resistance

Front 77

clonidine

Back 77

alpha 2 agonist whch reduces peripheral resistance

Front 78

guanabenz acetate

Back 78

activates alpha 2 and decreases sympathetics- lower BP

Front 79

reserpine

Back 79

elimiinates NE = lower BP; contraindicated in those with depression

Front 80

hydralazine, minoxidil, sodium nirtoprusside, diazoxide

Back 80

vasodilators

Front 81

hydralazine and minoxidil work on what vessels

Back 81

artery

Front 82

nitroprusside works on what vessels

Back 82

arteries more than veins

Front 83

ambrisentan and bosentan MOA

Back 83

ambrisentan works as a selective endothelin A receptor antagonist for pulmonary hypertension

bosentan antagonizes endothelin A and B receptors to reduce pulmonary hypertension

Front 84

sildenafil, tadalafil, vardenafil

Back 84

vasodilators to treat erectile dysfnction by inhibiting PDE 5

Front 85

statins inhibit

Back 85

HMG co A reductase

Front 86

myositis, rhabdmyolysis, hepatotoxicity and elevations in aminotransferases

Back 86

statin adverse effects

Front 87

nicotinic acid lowers

Back 87

cholesterol and triglycerides. reduces VLSL, IDL and LDL, HDL increases

Front 88

fenofibrate, gemfibrozil

Back 88

increases VLDL and chylomicrons, reduced triglycerides

Front 89

a flutter, given quinidine and has sporadic arrythmias so what will you add?

Back 89

digitalis