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85 Cards in this Set

  • Front
  • Back
Calcium channel blockers can be used for:
HTN
Angina
Arrythmia
...
Proteins that interact with Ca++ in vessels:
Calmodulin

Myosin

Actin
DHP CC Blockers primarily affect
Blood Vessels
True or False

DHP CC Blockers are used to treat arrythmia
False

more selective for blood vessels
Are all classes of calcium channel blockers useful to treat HTN and angina?
Yes
Ca channel blockers affect ____ better than _____ decreasing ______
Arteries

Veins

Afterload
Diltiazem (Cardizem) is a ________ Non-DHP CC Blocker
Benzothiazepine
Verapamil (Calan, Isoptin) is a _________ Non-DHP CC Blocker
Phenalkylamine
Metabolic considerations for Verapamil
1st pass metabolism - low bioavailability
This calcium channel blocker has a short structural integrity but remains active as a metabolite
Diltiazem (Cardizem)
____ concentrations of Na+
____ concentrations of K+
mMol Na+

micro - Mol K+
Four major ways to classify diuretics
Chemical Nucleus

Site of Action

Mechanism of Action

K+ Effect
Due to the amount of reabsorption taking place at the descending limb; _________ diuretics are often used for glaucoma
Carbonic Anhydrase Inhibitor
Acetazolamide (Diamox)
Carbonic Anhydrase Inhibitor

contains sulfonamide!
Thiazide diuretics are not metabolized in the _____ because they contain _____
Liver

Sulfur
Thiazide Diuretic

25 - 50mg
Intermediate Action
10X Potency of Chlorothiazide
HCTZ
Thiazide Diuretic

2.5 - 5 mg
Long Action
100X Potency of Chlorothiazide
Bendroflumethiazide

(Naturetin)
Thiazide Diuretic

0.5 - 1mg
Long Action
500X potency of Chlorothiazide
Polythiazide (Renese)
Quinethazone
Thiazide-Like Diuretic

10X Potency Chlorothiazide
Metolazone
Thiazide-Like Diuretic

100X Potency Chlorothiazide
Chlorothalidone
Very long acting thiazide-like diuretic
Chlorindapamide
Very long acting thiazide-like diuretic
Saluretic =
Does not spare K+

Hypokalemia
Bumetanide
Loop Diuretic
Furosemide (Lasix)
Loop Diuretic
Ethacrynic Acid
Loop Diuretic
Which loop diuretic can be used in patients with a sulfur allergy
Ethacrynic Acid
Aldactazide
K+ Sparing Thiazide Combo Diuretic
K+ Na+ Exchange is controlled by _________ at the collecting duct
Aldosterone
Spironolactone
K+ Sparing Diuretic

competes with aldosterone
Triamterene
K+ Sparing Sodium Channel Blocker Diuretic
Amiloride
K+ Sparing Sodium Channel Blocker Diuretic
Systems that control physiologic BP
Blood Vessel Epithelium

Adrenergic NS

Renin Angiotensin System (Kidney)
An alpha 2 agonist used to treat HTN would be given
Orally - slow NE release in brain - less effect on vessels
Tolazoline is a nonselective _____ blocker that is ____ lipophilic than an agonist, and is used to treat
alpha blocker

less lipophilic

Pulmonary HTN
Metyrosine (_______) specifically inhibits _______ ______
Demser

Tyrosine Hydroxylase
Methyldopa is a ______ that inhibits _______ ______ preventing the formation of Dopamine
prodrug alpha 2 agonist

DOPA decarboxylase
Endothelin receptors found on vessels ___
B
Endothelin receptors found on lungs ___
A
Bosentan
Endothelin Antagonist

targets A - lungs
Sulur Allergy: Do not take

A. Bosentan
B. Ethacrynic Acid
C. Bumetanide
D. HCTZ
E. Acetazolamide
F. Amiloride
G. Metyrosine
E. Guanabenz
A
C
D
E
Iloprost (Ventavis)
Prostaglandin Agonist
Epoprostenol (Flolan)
Prostaglandin Agonist
3 Classes of Ca++ Channel Blockers
Dihydropyridine

Phenalkylamine

Benzothiazepine
O-demethylation will completely inactivate Verapamil but N-demethylation will:
give Verapamil 1/7th activity
Osmotic Diuretics used for
HTN
CHF
Edema
Glaucoma
IOP
ICP
High Ceiling diuretics refers to ____ diuretics in that on an HPLC scale measuring sodium content in the urine, levels are very high.
Loop Diuretics
K+ Sparing Diuretics combined with Thiazide Diuretics in order to
Prevent hyper + hypokalemia while effectively treating HTN
Distinct characteristic of metyrosine allowing treatment of pheochromocytoma via inhibition of tyrosine hydroxylase
Amino Acid - like structure allows for active transport
True or False

Methyldopa is an inhibitor of DOPA decarboxylase

Mathyldopa is a substrate of DOPA decarboxylase
True
methyldopa + chlorothiazide =
Aldoclor
Consideration for Reserpine
low therapeutic index

Gaunadrel +
Guanethedine safer to use
Prostaglandin Agonist uses
Pulmonary HTN
Asthma
Fe+3
Ferric Iron
Diazoxide
K+ Channel Activator

HTN Crisis
Renin is an ______ while angiotensin is a _______
Enzyme

Hormone
Tekturna (Aliskirene)
Renin Inhibitor
ACE Inhibitors characterized by a _____ bond
peptide
What groups tend to coordinate with Zinc at enzyme binding sites
Sulfhydryl

Carboxylic
Lipid transport protein
APO protein
After hydrolysis of triglycerides in tissue, remnant chylomicrons center is primarily __________
cholesterol esters
APO ____ has high affinity for arteries, carrying Low Density Lipoproteins there
APO B-100
3 Main Mechanisms of Cholesterol Lowering Agents
Interfere with:

Lipoprotein Synthesis

APO protein Synthesis

Breakdown of TG
(Lipoprotein Lipase)
Nicotinic Acid (Niacin)
Vitamin B3

Broad Spectrum Cholesterol Lowering Agent
Gemfibrozil (Lopid)
Fibrate Lipid Lowering Agent

selective for type-5 (high triglycerides)
Consideration for Gemfibrozil metabolism
Low Bioavailability 70% excreted in kidney
Which HMG CoA Reductase Inhibitor isn't metabolized in the liver?
Rosuvastatin (Crestor)
HMG =
3-Hydroxy-3-Methyl Glutaric Acid
In the statin family, two are characterized by the lactone structure
Lovastatin

Pravastatin
Colestipol
Bile Acid Sequestrant

prevents reabsorption
Questran
Bile Acid Sequestrant

prevents reabsorption
Ezetimibe (Zetia)
Transport Inhibitor

inhibits absorption in GIT
Consideration with Zetia
Often combo with statins - absorption inhibition causes upregulation of HMG CoA reductase - increasing endogenous cholesterol synthesis
When the lumen of the coronary artery becomes restricted, it becomes less efficient in supplying blood and oxygen to the heart, and the heart is said to be _______
ischemic
__________ = vessels lost elasticity can’t dilate
Arteriosclerosis
Three drug classes used to treat angina
CCB's (decrease afterload)

Nitrates (decrease preload)

Beta Blockers (decrease contraction HR)
CCB’s are no good to treat angina related to _________ because they cannot induce vasodilation
arteriosclerosis
Prophylaxis for exertion induced angina
Beta Blockers
HNO2
Nitrous Acid
HNO3
Nitric Acid
Glyceryl trinitrate (Nitroglycerin)
Organic Nitrate

(venous effect) - headaches
Dipyridamole (Persantine)
Miscellaneous anti-angina agent
Ranolazine (Ranexa)
Miscellaneous anti-angina agent
The outside of chylomicron is ____; the inside is ______.
polar

nonpolar
Simvastatin + Ezetimibe
Vytorin