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49 Cards in this Set

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clonidine and methyldopa class?

MOA?

which one works both peripherally and centrally?
antihypertensive

a2 agonist thus decreases symp outflow

clonidine
clonidine SE (3)
dry mouth
sedation
severe rebound hypertension after witdrawal
methyldopa SE? (2)
sedation
positive Coombs test
clonidine and methyldopa drug interaction
antidepressant

(they cancel each other)
when are B1 selective blockers used
in pts with severe pulmonary disease b/c nonselective B blockers could cause fatal bronchoconstriction
B1 selective blockers (5)

HINT: A BEAM
acebutolol
betaxolol
esmolol
atenolol
metoprolol
name two mixed antagonists (i.e. block both a and B blocker)
labetolol
carvedilol
a1 selective blockers? (3)

name a use of these besides antiHTN
prazosin
terazosin
doxazosin

BPH symptoms (i.e. relax urethra to decrease urinary retention)
SE of prazosin (3)
1st dose orthostatic hypotension
dizziness
headache
nonselective a blockers (3)
phentolamine
tolazoline
phenoxybenzamine
Name two adrenergic blockers and their MOA?
reserpine
(blocks uptake of NT into synaptic vesicles)

guanethidine
(inhibits release of stored NE)
reserpine SE and drug interaction
depression

antidepressants
what agents will block the action of guanethidine
any reuptake inhibitor
hexamethonium, trimethaphan, mecamylamine

MOA?
ganglionic blockers that block the nicotinic receptors
Name 3 smooth muscle vasodilators used to treat HTN that are not ca channel blockers
hydralazine
minoxidil
Nitroprusside
hydralazine:

usually taken with (2)

SE
B blocker to prevent reflex tach
diuretic to prevent salt/water retension

lupus like syndrome
(note procainamide has the same SE)
Hydralazine/nitrate used for?
CHF

this is an alternative to ACE inhibitors
Minoxidil SE
hypertrichosis (i.e. grows hair)
Nitroprusside MOA?

SE?
via NO

cyanide toxicity
(nausea, psychosis,spasms, tissue hypoxia)

(give nitrites to control cyanide and Hb interaction)
Name 3 Ca channel blockers
verapamil
diltiazem
nifedipine
(all 3 decrease TPR but the first two can also slow AV conduction)
verapamil SE
constipation
Name two ACE inhibitors

name one contraindication
Captopril
enalapril

renal artery stenosis
Captopril SE

Remember mnemonic
Cough (very imp- Losartan does not)
Angioedema
Proteinuria
Taste changes
hypOtenstion
Preg problems (fetal renal problems)
Rash
Increased renin
Lowers AII
Antiarrhythmic classes:
name all 4
I: Na channel blockers
II: B blockers
III: K channel blocker (i.e. prolong AP)
IV: Ca channel blockers
Name 4 Class 1A (mnemonic) agents

MOA?

arrhythmias?
Quinidine Amiodarone
Procainamide Disopyramide
(Queen Amy Proclaims Diso's pyramid)

slows phase 0 depolarization
(increases AP duration)

atrial and ventricular
procainamide SE
reversible SLE-like syndrome
(remember increased anti-histone Ab)
quinidine SE (3)
cinchonism
(headache and tinnitus)
thrombocytopenia
torsades de pointes
Class IB agents (3)

MOA?
Lidocaine mexiletine
tocainamide

shortens phase 3 repolarization
Class IB

best use of these agents (2)
hypoxic - post-MI

depolarized - digitalis toxicity
Class IC (name 3)

MOA?

main use?

SE?
felcainide encainide
propafenone

severe phase O depression

fatal ventricular arrhythmias

proarrhythmic
Class II agents (5)

MOA
propanolol esmolol
metoprolol atenolol
timolol

inhibit AV node conduction
Class II SE of importance
they may mask signs hypoglycemia
Name 4 Class III

MOA

use
amiodarone bretylium
sotalol ibutilide

block K thus increase repol

used when other antiarrhythmics fail
ibutilide SE
torsades
sotalol SE
torsades and excessive B block
bretylium SE
causes new arrhythmias
amiodarone SE (4)

remember mnemonic
pulmonary fibrosis
hepatotoxicity
hypo/hyperthyroidism
grey man syndrome (smurf skin)

(always check the PFTs, LFTs, TFTs)
Class 4 agents (2)

MOA

what agent is not used b/c it causes torsades
Verapamil Diltiazem

slows conduction through AV node

bepridil
Nmae two other agents imp in digoxin toxicity
K
Mg
MOA of cardiac glycosides (digoxin)

use (2)
inhibit Na-K ATPase, increses intracellular Na, slows Na-Ca exchanger, thus increases intracellular ca

CHF
atrial fibrillation
SE of cardiac glycosides (4)

what increases these se (3)
nausea vomiting blue-yellow vision (van Gogh)
life threatening arrhythmias

renal failure
hypokalemia
quinidine
antidote for digoxin (4)
K
lidocaine
cardiac pacer
anti-dig Fab fragments
Drugs that increase digoxin toxicity
verapamil
quinidine
thiazides
K wasting diuretics
Name 3 classes of drugs used to treat angina
organic nitrates
Ca channel blockers
B blockers
Nitroglycerin MOA

SE
increses NO

Monday disease (headache, tachycardia, dizziness)
Niacin MOA

Lipids?

SE?
decrease VLDL synthesis

decreases LDL, TG
increases HDL (the best at this)

red flushed face
Gemfibrozil and Clofibrate MOA
(fibric acid derivatives)
Lipids?

SE?
inhibit lipoprotein lipase

same as niacin but major decrease in TGs

LFTs and myositis
Cholestyramine and colestipol MOA

Lipids?

SE?
bind bile acids

decreases LDL

bad taste and GI discomfort
Statins MOA

Lipids?

SE?
HMG CoA Reductase inhibitors

same as niacin but major effect on LDL

rhabdomyosarcoma