Clinical Pharm Cardiovascular

Front 1

What are the main distinguishing characteristics of the diuretics furosemide, hydrochlorothiazide, and triamterene?

Back 1

Furosemide and HCTZ: inhibit Na reabsorption and increase the excretion of water and K
Triamterene: inhibits Na reabsorption and increases the excretion of water, but spares K

Front 2

Which major class of antihypertensive drugs can block the early clinical manifestations of hypoglycemia and why?

Back 2

Beta blockers: blunt the usual sympathetic NS response to hypoglycemia (sweating, agitation, tachycardia) and inhibits the cellular response to insulin; atenolol

Front 3

Which major class of antihypertensive drugs can produce angioedema and why?

Back 3

ACE inhibitors, because they prevent kinin and prostaglandin breakdown; prevent angiotensin production, which is a potent vasoconstrictor
Pril

Front 4

What is the name and mechanism of action of the antihypertensive drug, which reduces sympathetic outflow from the central nervous system? Give an example.

Back 4

Vasodilators; clonidine (alpha2-adrenergic agonists)

Front 5

Which major class of antihypertensive drugs has been associated with "cardiac steal" syndrome? give example

Back 5

Vasodilators; clonidine

Front 6

A patient, who has recently been prescribed an antihypertensive medication, is now experiencing frequent episodes of acute asthma even though she is compliant with her anti-asthma drug regimen. Which major class of antihypertensive drugs is most likely responsible for this drug-disease interaction? Give examples.

Back 6

Beta blockers; -olol

Front 7

7. Which major class of lipid lowering agents has been associated with rhabdomyolysis? Give examples.

Back 7

-statins; crestor, Lipitor, pravastatin sodium, simvistatin, vytorin

Front 8

8. Which major classes of cardiovascular drugs may be taken by a patient with coronary artery disease for the prevention of angina pectoris? Give examples.

Back 8

-Ca-channel blockers; amlopidine besylate & w/ benazepril, cartia XT dilitiazem), verapamil SR
-anti-anginal agents; isosorbide mononitrate
-β-blockers; olol

Front 9

9. What are the mechanisms of action of the following antithrombotic agents: acetylsalicylic acid and clopidogrel?

Back 9

-ASA: inhibits platelet aggregation by COX-1 inhibition (thromboxane A2)
-clopidogrel/Plavix: blocks ADP-dependent platelet aggregation

Front 10

10. After treatment with acetylsalicylic acid is stopped, cyclooxygenase activity recovers as a function of platelet turnover in about

Back 10

10-14 days

Front 11

11. Which laboratory test is required to determine the therapeutic level of warfarin (Coumadin) using the International Normalized Ratio (INR)?

Back 11

Prothrombin time

Front 12

12. Before invasive dental procedures, an assessment of the patient’s level of anticoagulation is imperative to ensure values that may preclude problematic bleeding yet maintain therapeutic anticoagulation. These goals may be achieved if on the day of the procedure the patient’s INR is ?

Back 12

2.0-3.0

Front 13

13. What is the appropriate use (method of delivery or application) of the following local hemostatic agent: absorbable gelatin sponge (Gelfoam), oxidized regenerated cellulose (Surgicel), microfibrillar collagen hemostat (Avitene), and tranexamic acid (Cyklokapone)?

Back 13

-absorbable gelatin sponge (Gelfoam): into bony sockets
-oxidized regenerated cellulose (Surgicel): temporary placement on wound
-microfibrillar collagen hemostat (Avitene): topical on soft tissues
-tranexamic acid (Cyklokapone): mouthrinse

Front 14

Which major class of antihypertensive agents has been associated with gingival hyperplasia? Give examples.

Back 14

-Ca-channel blockers; amlopidine besylate & w/ benazepril, Cartia XT (diltiazem), verapamil SR

Front 15

15. What are the major clinical indications (medical diagnoses), which may suggest treatment with a diuretic? Give examples.

Back 15

-HTN & edema (heart failure, hepatic failure, renal failure)
-HCTZ, furosemide, triamterene w/ HCTZ

Front 16

16. Which medical conditions (diagnoses) are appropriate indications for the administration of a competitive beta1-adrenergic receptor-blocking agent? Give examples.

Back 16

-HTN, angina pectoris, tachyarrhythmia, migraine
-atenolol, metoprolol tartrate, metoprolol succinate, toprol XL (metoprolol)

Front 17

17. What are the major adverse drug effects attributable to competitive beta1-adrenergic receptor blocking agents?

Back 17

-high risk of provoking type II diabetes
-xerostomia
-lichenoid stomatitis

Front 18

18. Which major class of antihypertensive drugs inhibits the conversion of angiotensin I to angiotensin II, produces vasodilatation, suppresses aldosterone synthesis, and potentiates the vasodilatating effects of bradykinins and prostaglandins? Give examples.

Back 18

-ACE inhibitors; lisinopril

Front 19

What are the major adverse drug effects attributable to treatment with an ACE inhibitor?

Back 19

-angioedema, hypotension, cough, hyperkalemia, HA, dizziness, fatigue, nausea, renal impairment, lichenoid stomatitis

Front 20

What pharmacological effects are attributable to calcium channel blocking agents?

Back 20

-inhibition of Ca ions from entering the “slow” channels of vascular smooth muscle & myocardium

Front 21

What are the major adverse drug effects associated with calcium-channel blocking agents?

Back 21

gingival hyperplasia (can lead to bone loss), edema, constipation, dizziness, HA, redness in face

Front 22

What are the potential medical diagnoses is a patient is taking a calcium channel-blocking agent?

Back 22

angina pectoris, supraventricular tachycardia, HTN

Front 23

Which drug is an alpha2-adrenergic receptor agonist that decreases vascular tone and heart rate?

Back 23

clonidine

Front 24

Give major class of lipid lowering agents inhibits a rate-limiting enzyme in the synthesis of VLDL and LDL, and increases the concentration of HDL? Give examples.

Back 24

statins; crestor (rosuvastatin Na), Lipitor (atorvastatin), pravastatin Na, simvastatin, vytorin (ezetimibe w/ simvastatin)

Front 25

Which major classes of drugs may be taken by patients for the treatment of cardiac arrhythmias? Give examples.

Back 25

β blockers (-olol), Ca channel blockers (amlopidine besylate & w/ benazepril, Cartia XT (diltiazem), verapamil SR), cardiac glycosides (digoxin)

Front 26

Which major class of drugs inhibits the sodium/potassium ATPase pump, increasing intracellular calcium ion concentrations and cardiac contractility (positive inotropic effect)? Give an example.

Back 26

cardiac glycosides (digoxin)

Front 27

How does the daily administration of low doses aspirin interferes with platelet function.

Back 27

inhibits the production of thromboxane A2, which binds platelets; not high enough concentration to inhibit the endothelin COX (which allows microclots to be dissolved)