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42 Cards in this Set
- Front
- Back
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How do ACE inhibitors work?
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Angiotensin Converting Enzyme (ACE) Inhibitors prevent the conversion of angiotensin I (inactive polypeptide) to angiotensin II (vasoconstrictor).
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What are ACE inhibitors indicated for?
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ACE inhibitors are indicated for treatment of hypertension and heart failure.
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What 2 things should pharmacist tell patients about ACE inhibitors?
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ACE inhibitors should not be administered to pregnant women. These medications may cause injury or death to the developing child. Hyperkalemia has been observed in patients taking ACE inhibitors. Potassium replacement products and potassium-sparing diuretics should be cautiously prescribed to patients taking ACE inhibitors. Pharmacists should counsel patients taking ACE inhibitors not to use salt substitutes that contain potassium.
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Which 2 ACE inhibitors need to be taken on an empty stomach?
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Capoten and Univasc
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Which 3 drugs should be prescribed cautiously to patients taking ACE inhibitors?
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Dyrenium, Aldactone, and amiloride
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What are Angiotensin II Receptor Antagonist indicated for and how do they work?
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Angiotensin II Receptor Antagonists are indicated for treatment of hypertension. They prevent angiotensin II from exerting vasoconstrictor effects by blocking angiotensin II receptor sits. The production of angiotensin II is not affected.
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What 2 things should pharmacists tell patients who are taking Angiotensin II Receptor Antagonists?
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Pregnant patients should not be prescribed Angiotensin II Receptor Antagonists. These medications may cause injury or death to the developing child. Hyperkalemia has been observed in patients taking Angiotensin II Receptor Antagonists. Potassium replacement products and potassium-sparing diuretics should be cautiously prescribed to patients taking Angiotensin II Receptor Antagonists. Pharmacists should counsel patients taking Angiotensin II Receptor Antagonists not to use salt substitutes that contain potassium.
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How do calcium channel blockers work and what are they indicated for?
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Calcium channel blocking agents inhibit calcium ion entry into cardiac and vascular smooth muscle. The reduction in intracellular calcium in smooth muscle results in dilation of coronary arteries, peripheral arteries, and arterioles. Calcium channel blocking agents are indicated for treatment of hypertension and angina pectoris.
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What is an off-label indication for calcium channel blockers?
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They are sometimes prescribed for migraine prophylaxis, however, this indication is not FDA approved.
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How do alpha-1 adrenergic blocking agents work?
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. Men diagnosed with BPH often have urinary outflow obstruction due to increased smooth muscle tone of the bladder neck. Symptoms include weak urinary stream and incomplete emptying of the bladder. The alpha-1 adrenergic blocking agents improve urinary outflow by relaxing smooth muscle in the bladder neck.
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What are some adverse effects of alpha-1 adrenergic blocking agents? How can you decrease the likelihood of these?
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This class of medication may cause marked hypotension, especially in the upright position, with syncope and dizziness. This is most common with the first dose, but can also occur when there is a dosage increase, or if therapy is interrupted for more than a few days. To decrease the likelihood of excessive hypotension and syncope, treatment should be initiated at bedtime and the dose slowly increased as needed.
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What are beta adrenergic receptor antagonist indicated for?
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hypertension, angina pectoris, and certain arrhythmias
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What should pharmacists counsel patients on who are taking Coreg?
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Pharmacists should counsel patients to take Coreg tablets with food in order to slow absorption and reduce the incidence of orthostatic hypotension.
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What is digoxin's mechanism of action?
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Digoxin exerts a positive inotropic action (increases the force of myocardial contractions).
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What is the therapeutic index of digoxin?
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Digoxin has a narrow therapeutic index – toxic serum levels are only slightly higher than therapeutic serum levels.
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What all is involved in digoxin toxicity?
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Potassium depleting diuretics (thiazide diuretics, loop diuretics) should be used cautiously in patients taking digoxin because hypokalemia enhances the possibility of digoxin toxicity. Signs of digoxin toxicity include nausea and vomiting, visual disturbances, and arrhythmias.
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What is the normal digoxin serum level for treatment of heart disease?
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0.5 – 0.8 ng/mL
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What is the normal digoxin serum level for treatment of arrhythmias?
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0.8 – 2 ng/mL
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What is different about Lanoxicaps compared to Lanoxin?
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Lanoxicaps have higher bioavailability than Lanoxin. Doses of 0.1 mg Lanoxicaps are equivalent to 0.125 mg doses of Lanoxin. Doses of 0.2 mg Lanoxicaps are equivalent to 0.25 mg doses of Lanoxin.
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What should be monitored in patients taking furosemide?
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Furosemide is a potassium-depleting diuretic. Patients should be monitored for signs of hypokalemia.
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What should happen to the potassium levels of a person taking Dyazide?
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Triamterene is a potassium-sparing diuretic. Hydrochlorothiazide is potassium depleting. Patients taking Dyazide should not experience any change in serum potassium levels.
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What is the conversion rate of potassium chloride?
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8 mEq is the same as 600 mg. 10 mEq equals 750 mg and 20 mEq equals 1,500 mg.
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What is the normal potassium level?
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3.5 to 5 mEq/Liter
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What can happen in patients suffering from hyperkalemia?
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Hyperkalemia is a medical emergency that may result in arrhythmias.
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What 2 things should the pharmacist counsel to patient taking a potassium replacement product?
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Because of their ulcerogenic tendency and the incidence of local tissue destruction produced from their dissolution, oral potassium chloride supplements should be taken with or immediately after a meal. They should also be administered with a full glass of water.
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What are adverse effects associated with niacin? What can make these worse? What can reduce these effects?
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Adverse effects associated with niacin include flushing, sensation of heat, and headache. Alcohol or hot drinks around administration time may increase the sensation of heat and flushing. These effects may be reduced by taking aspirin 30 minutes before taking niacin.
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Vitamin B1
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thiamin
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Vitamin B2
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riboflavin
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Vitamin B3
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niacin, nicotinic acid
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Vitamin B5
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pantothenic acid
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Vitamin B6
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pyridoxine
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Vitamin B12
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cyanocobalamin
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What is vitamin B1 deficiency called?
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beriberi
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What is vitamin B3 deficiency called?
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pellagra
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What is vitamin B12 deficiency called?
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pernicious anemia
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What is the onset of action of nitroglycerin?
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1 to 3 minutes
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What can accelerate loss of potency of nitroglycerin tablets?
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. Loss of potency through volatilization of nitroglycerin from sublingual tablets is accelerated by exposure to moisture. After the bottle is opened, the sublingual tablets will maintain potency through the expiration date provided the cap is replaced tightly.
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If this bottle is placed in a prescription vial for labeling, a child-resistant cap should or shouldn't be used?
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should not be used
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What should patients taking Nitrolingual be counseled to do?
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Patients should be counseled to spray onto or under the tongue. Patients may administer one spray every 5 minutes not to exceed 3 sprays in 15 minutes. If chest pain persist after 15 minutes, the patient should go to the emergency department.
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What "other" 2 dosage forms of nitroglycerin are available?
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Other available dosage forms of nitroglycerin include transdermal delivery systems and sustained release capsules. These dosage forms are only indicated for prevention of angina attacks. They will not relieve acute attacks.
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What is the major active metabolite of isosorbide dinitrate?
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Isosorbide mononitrate is the major active metabolite of isosorbide dinitrate. Most of the clinical activity of the dinitrate is attributable to the mononitrate metabolite.
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Why must doses of isosorbide mononitrate be given seven hours apart?
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doses are given seven hours apart to minimize nitrate tolerance
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