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94 Cards in this Set
- Front
- Back
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What type of drug is gemfibrozil?
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Fibrate
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What type of drug is clofibrate
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Fibrate
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What action does gemfibrozil have?
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Lowers TG!!!! and VLDL!! Main function.
Can also slightly decrease LDL and slightly increase HDL. |
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What action does clofibrate have on lipid?
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Lowers TG!!!! and VLDL!!! Main function.
Can also slightly decrease LDL and slightly increase HDL. |
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What is the drug of choice for type IV hyperlipidemia?
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Gemfibrozil.
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What is drug of choice for type III hyperlipidemia?
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Gemfibrozil
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What is mode of action of ezetimibe?
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localizes to brush border of small intestine and decreases cholesterol absorption!
This then increases LDL uptake into cells. |
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What is the side effect of ezetimibe?
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increases liver function test (ALT/AST).
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What is MOA of cholestyramine?
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Inhibits bile acid reabsorption, so gets excreted in feces. Then more cholesterol used to replenish bile poool. **Can also be used to treat itching/pruritis during liver failure.
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What is MOA of colestipol?
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Inhibits bile acid reabsorption, so gets excreted in feces. Then more cholesterol used to replenish bile poool. **Can also be used to treat itching/pruritis during liver failure.
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What is the effect of ezetimbie on lipid panel?
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Lowers LDL
No change in HDL or TGs. Can be associated with ALT/AST increase |
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What is effect of cholestyramine on lipid panel?
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Lowers LDL
Slight INCREASE IN TG. |
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What is the major side effect of cholestyramine?
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HORRIBLE TASTE
GI discomfort!!! patients hate it!!!! |
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What is the mechanism of gemfibrozil?
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Increases activity of Peroxisome proliferator-activated receptor-alpha (PPARα), a receptor which is involved in metabolism of carbohydrates and fats, as well as adipose tissue differentiation. This increases synthesis of lipoprotein lipase therefore increasing clearance of triglycerides.
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What is mechanism of fibrates?
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Increases lipoprotein lipase to increase VLDL breakdown into IDL and LDL!!!!!!
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What is MOA of niacin?
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Inhibits VLDL secretion and synthesis from the liver cholesterol.
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What effect does niacin have on lipid panel?
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1) Decreases LDL
2) Decreases TG 3) Increases HDL significantly! |
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What is a common side effect of niacin?
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Red, flushed face, which is decreased by aspiring.
CONTRAINDICATED IN PREGNANT WOMEN!!! |
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What is MOA of lovastatin?
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HMG-CoA redutase inhibitors.
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what is effect of lovastatin on lipid panel??
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1) Decreases LDL significantly
2) Increases HDL 3) Decreases TG. |
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What is major side effect of statins?
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myositis, and rhabdomyolysis!! and reversible increase in LFTs!
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What do you need to decrease HTN? Mechanisms please
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1) Decrease Cardiac Ouput
2) Decrease Total Peripheral Resistance 3) Decrease blood volume (Decrease total body Na++) |
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Is hydrochlorothiazide an anti-hypertensive?
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Yes, it decreases blood volume by lowering total body Na++
Hyper GLUC Hypokalemia Metabolic Alkalosis |
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Are loop diuretics anti-hypertensive?
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Yes, they lower total body na++ and decrease blood volume.
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What drug combination is contraindicated due to high incidence of rhabdomyolysis?
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Concurrent use or statins and fibrates!!!!
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What is the side effect of taking too much statins?
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Higher risk of myalgias and myopathies. Can progress to rhabdomyolysis which can cause myoglobinuria and renal dysfunction!!!
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What are the side effects of loop diuretics?
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OTOTOXICITY: so contraindicated with aminoglycoside use
GOUT!! Sulfa allergy!!! Can be used to treat HTN b/c decreases Total body Na+ and decreases blood volume. |
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How does clonidine work?
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Binds to alpha-2-receptors in CNS!!!! This decreases NE release fromn nerve terminal: causes a decrease in sympathetic tone!!
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What can clonidine be used for?
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1) HTN: decrease
2) Opiate withdrawal symptoms such as tachycardia and hypertension! |
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What are two major side effects of clonidine?
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1) rebound hypertension after discontinuation of drug
2) Dry mouth. |
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What is MOA of methyldopa?
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Has exact same effect as clonidine: binds to alpha 2 receptors in CNS decreasing sympathetic response NE.
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This drug blocks nicotonic receptors at autonomic ganglia, causing loss of sympathetic tone to blood vessels and decreasse in blood pressure?
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Hexamethonium.
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Mechanism of hexamethonium please?
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Blocks nicotonic receptors
Blocks at autonomic ganglia Blocks sympathetic response on blood vessels Decreases BP Used in HTN especially in situations like dissecting aorta. |
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What is MOA of reserpine?
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Prevents re-uptake of NE, 5-HT, and dopamine into nerve terminal. More in cytoplasm! So more broken down by MAO --> breaks down NE, 5-HT, DA.
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Which drug blocks the movement of DA, 5-HT, NE from cytoplasm into nerve terminal and thus used to treat HTN?
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Reserpine!!!
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What is MOA of guanethidine?
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Prevents release of catecholamines. Used as anti-HTN medications.
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What is MoA of prazosin?
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Alpha-1-blocker, so deceases TPR. Used to treat hypertension!!!
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What is the main side effect of prazosin?
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1st dose orthostatic hypotension!!! So tell patient to take first at night while lying down so they dont fall.
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What is the MOA of hydralazine? 1
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works by cGMP increase, so causes more smooth muscle relaxation of arterioles>veins.
Used for AFTERLOAD REDUCTION! |
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What is mechanism to treat CHF?
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1) Increase CO
2) Decrease workload of heart. =) Decrease TPR!!! |
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What is main effect of hydralazine?
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AFTERLAOD REDUCTION!!
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What can hydralazine be used to treat?
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1) CHF: because increase CO by decreasing TPR!
2) HTN: decreases TPR! |
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What is nitroprusside used for?
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Malignatn Hypertension.
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How does minoxidil work?
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Vasodilator! so can be used in HTN, but can cause hypertrichosis, reflex tachy
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What is action of nitroprusside?
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It is a vasodilator!!!!!
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Hydralazine
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Vasodilator!!!!
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What is side effect of nitroprusside?
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Cyanide toxicity!
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What are the side effects of ACE inhibitors?
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Angioedema
Cough Protein in urine!! |
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What is side effect of losartan?
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fetal renal toxicity!!!!!
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What is mode of action of nifedipine?
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Blocks L-type calcium channels of both
CARDIAC and SMOOTH Muscle to reduce contractilyt. |
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What is MOA of verapamil?
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Blocks L-type calcium channels of both
CARDIAC and SMOOTH Muscle to reduce contractilyt. |
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What is MOA of diltiazem?
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Blocks L-type calcium channels of both
CARDIAC and SMOOTH Muscle to reduce contractilyt. |
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What drugs are better suited to treat arrythmias in terms of calcium blocking ability?
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Verapamil > diltiazem
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What drugs are better suited to treat vascular smooth muscle blockage of calcium/
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Nifedipine>diltiazem.
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This drug dilates by causing an increase in cGMP and smooth muscle relaxation!!! Dilate the veins >>> arteries
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Nitroglycerin: decreases preload
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What is MOA of hydralazine?
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Vasodilates arteriolar smooth muscle!!
Can cause lupus like syndrome. |
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What is MOA of nitroprusside?
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Release NO. It can be toxic at high concentratinons due to production of cyanide!
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What is a toxicity associated with alpha-1 blocker/
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First dose effect causing hypotension so recommend takin before slaaaaaaaaap.
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What is MOA of calcium channel blocker?
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Block calcium channels
1) Relax smooth muscle causing vasodilation 2) Increased myocardial oxygen supply. 3) Decrease muscle contractility. |
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How you treat prinzmetals angina?
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Verpamil and Diltiazem.
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What are side effects of verapamil?
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gingival hyperplasia.
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What are the effects of nitroglycerin?
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Vasodilate smooth muscle by increasing cGMP: more blood to myocardium and also dilates veins!!! So decreasse preload.
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What is nitroglycerin used to treat?
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Pulmonary Edema. Angina!!!!
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A patient is working and on Monday he has feelings of tachycardia, dizzines, and headache. What drug is he on?
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Nitroglycerin.
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What is the goal of antianginal therapy?
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Reduce myocardial oxygen consumption:
1) Decrease HR 2) Decrease contractiliy 3) Decrease afterload (BP) 4) Decrease preload (decrease time of ejection): EDV 5) |
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What drugs can be used to treat angina?
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Nitrates (affect preload)
Beta-blockers: affect afterload Nitrates + Beta blockers Calcium channel blockers: verapamil similar to B-blocker in effect. Nifedipine similar to Nitrates. Nifedipine/Nitrates! |
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What effect does nitrates have on End diastolic volume?
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Decreases: decreases preload
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How do cardiac glycosides like digoxin work?
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Block Na+/K+ ATPase
Increase intracellular Na+ Increase intracellular Ca++ (Na/Ca++ antiport not function), so more Ca++ inside celll. POSITIVE INOTROPY!!!! |
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What are side effects of digoxin?
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blurry yellow vision
Arrythmias (Increased PR segment) |
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What is digoxin contraindicated in?
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In hypokalemia!!! Because this potentiates digoxins effect!!!!!!
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WHAT OTHER DRUG CAN INCREASE TOXICITY OF DIGOXIN?
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QUINIDINE: DECREASES DIGOXIN CLEARANCE!
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What is side effect of quinidine?
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IA antiarrytmics so blocks Na+ channels. Cinchonism
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What drugs cause torsades de pointes?
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sotalol!
quinidine! |
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What drug causes reversible SLE like syndrome?
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procainamide
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What is cinchonism?
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Triad of headache, tinnitus, and thrombocytopenia.
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What drug can cause cinchonism?
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Triad of headache, tinnitus, and thrombocytopenia.
Qunididine |
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Which drug is useful to treat arrythmias after an MI?
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Lidocaine, mexiletine, tocainide.
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This drug affects ischemic tissue?
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lidocaine,
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This drug affects ischemic tissue?
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mexiletine.
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This drug affects ischemic tissue?
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tocainide,
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How you treat digitalis induced arrythmias?
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lidocaine, mexiletine
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this drug is a proarrythmic especially if given post MI?
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FEP
Flecainide, Encainide |
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This drug is contraindicated post MI?
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Flecainide, Encainide.
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Which are class II antiarrythmics?
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Beta-blockers
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What is side effect of sotalol?
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torsades de pointes
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What is side effect of bretylium
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new arrythmias
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What is side effect of amiodorane?
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arrythmic causing pulmonary fibrosis and corneal deposits and hepatotoxicity!!! Hypothyroidism/Hyperthyroidism.
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What drug can cause corneal deposits?
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amiodorone
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Name all the endocrine side effect of amiodorone?
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hypothyroidism/hyperthyroidism
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What is lung effect of amiodorone?
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pulmonary fibrosis
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What tests must be checked when using amiodorone?
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LFTs: liver function.
PFTs: pulmonary funciton TFTs: thyroid function |
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What can be given to treat torsades de pointes?
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Magnesium!!
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What drug to treat digoxin toxicity?
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Magnesiusm.
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What is 1st line drug to treat AV nodeal arrythmias?
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adenosine
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