Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
71 Cards in this Set
- Front
- Back
Pts with CHF can have their survival increased by tx of what 2 things?
|
1)increased SNS activity
2)elevated renin-angiotension-aldosterone system |
|
What 3 types of drugs increase survival in CHF pts?
|
1)ACE inhibitors
2)Beta blockers 3)Aldosterone antagonists (spironolactone and epelerone |
|
What are the 3 currently accepted management regimes for CHF pts?
|
1)increased contractility
2)decrease afterload 3)decrease preload |
|
What 3 drugs work to increase contractility?
|
1)digoxin
2)dobutamine 3)milirone |
|
What is important to remember about milirone and dobutamine?
|
both are reserved for the tx of acute CHF; milirone has been shown to increase mortality if used chronically
|
|
What is the MOA of dobutamine?
|
beta-1 agonist
|
|
What is the MOA of milirone?
|
PDE-3 blocker
|
|
What 2 drug classes can be used to decrease afterload?
|
1)ACE inhibitors
2)hydralazine |
|
What are the two key side effects of ACE inhibitors? What population of people are at greatest risk?
|
angioedema and dry cough; African Americans
|
|
What is the major side effect of hydralazine? What population of people are at greatest risk?
|
SLE; slow acetylators
|
|
What 2 drugs can be used to help decrease preload?
|
1)furosemide
2)isosorbide mononitrate |
|
What is an adverse drug rx seen with isosorbide mononitrate?
|
can cause dangerously low BP when used in combination with PDE-5 inhibitors
|
|
What is the MOA for furosemide?
|
causes vasodilation through synthesizing prostaglandins and also quickly causes diuresis
|
|
An increased chance of what drug toxicity can be seen with furosemide?
|
digoxin
|
|
What is the suffix for all ACE inhibitors?
|
-PRIL
|
|
What is the suffix for AII receptor blockers?
|
-SARTAN
|
|
What 3 types of drugs should not be used in CHF pts?
|
1)Na+ retention increasing drugs (NSAIDS, corticosteroids, and liqourice)
2)drugs that decrease myocardial contractility (CCBs, beta blockers) 3)Herceptin (trausumab) |
|
What is MOA for digoxin?
|
affects the Na+/K+ ATPase by decreasing Na+ extrusion from cell which decreases driving force for Na+/Ca++ exchanger resulting in increased cytosolic Ca++
|
|
Decreasing extracellular K+ has what effect on digoxin binding?
|
increases binding and can lead to toxicity
|
|
Increasing extracellular K+ has what effect on digoxin binding?
|
decreases binding
|
|
What drug toxicity can cause an elevated T wave on EKG, N/V, diarrhea, and seeing yellow spinning halos?
|
digoxin
|
|
What is the tx for digoxin overdose?
|
digoxin specific Abs
|
|
What 4 drugs are contraindicated in pts on digoxin?
|
1)amiodarone
2)quinidine 3)verapamil 4)spironolactone |
|
What 3 categories of drugs that reduce the formation of fluid in the eye and are helpful in tx of glaucoma?
|
1)beta blockers
2)alpha-2 agonists 3)CA inhibitors |
|
What 3 categories of drugs act by increasing the outflow of fluid in the eye and are helpful in the tx of glaucoma?
|
1)prostaglandins
2)muscarinic agonists 3)non-selective adrenergic agonists |
|
*What is the important beta blocker used for the tx of glaucome?
|
timolol
|
|
What is the important alpha-2 agonist used for the tx of glaucoma?
|
apraclonidine
|
|
What are the 2 important CA inhibitors used for glaucoma tx?
|
acetazolamide
dorzolamide |
|
*What is the important prostaglandin used to tx glaucome?
|
latanoprost
|
|
What are 2 parasympathomimetics used to tx glaucoma?
|
pilocarpine
carbachol |
|
What are the 3 non-selective alpha agonists used in glaucoma tx?
|
epinephrine
dipivefrin |
|
What type of glaucoma is a medical emergency?
|
closed angle glaucoma - lens moves anteriorly due to pressure
|
|
*What drugs are contraindicated in closed angle glaucoma?
|
muscarinic agonists for example atropine
|
|
What is the suffix for H2 receptor antagonists?
|
-TIDINE
|
|
What is the MOA for H2 receptor antagonists?
|
reduce volume of gastric acid secretion and pepsin secretion
|
|
*Which H2 receptor antagonist inhibits cytochrome p450?
|
cimetidine
|
|
What is the suffix for PPIs?
|
-PRAZOLE
|
|
What is the MOA for PPIs?
|
irreversibly inhibit K+/H+ ATPase in parietal cells and greatly reduces acid secretion
|
|
*What 2 PPIs inhibits cytochrome p450?
|
omeprazole
lansoprazole |
|
*What drug is used to prevent NSAID-induced gastric injury?
|
misoprostol
|
|
Can misoprostol be used during pregnancy?
|
no
|
|
What is the MOA of sucralfate in the tx of gastric ulcers?
|
provides a protective barrier by forming a gel that adheres to ulcer crater
|
|
What are the MOA of the bismuth compounds?
|
form a protective coating, increase prostaglandin production, have anti- H.pylori activity
|
|
What tx for gastric ulcers should be used with caution in CHF and HTN pts?
|
antacids; you don't want pts to retain Na+ and water
|
|
What is metoclopramide?
|
prokinetic agent used to tx GERD; increases release of Ach which results in increased LES pressure and increased gastric emptying
|
|
What can chronic GERD lead to?
|
Barrett's esophagus which can be a precursor to esophageal cancer
|
|
What is the most important complication seen in pts w/ diarrhea?
|
acute salt and water depletion that can lead to dehydration and/or electrolyte imbalance
|
|
When should you prescribe nonspecific antidiarrheals?
|
in mild cases of diarrhea with painful cramps, but with NO FEVER AND NOT FOR >3 DAYS
|
|
Which pts should not use antimotility agents (opioids) for diarrhea?
|
pts with acute, severe colitis as manifested by bloody, mucoid diarrhea
|
|
What is the effect of opioids acting on mu receptors?
|
reduced motility, increased transit time which increases time for absorption of water and salts
|
|
What is the effect of opioids acting through delta receptors?
|
decreased secretion and/or increased absorption of water and salts
|
|
Which opioid can enter the CNS? Which can't?
|
diphenoxylate
loperamide |
|
Which drug is useful for preventing and tx traveler's diarrhea? What are the 2 side effects of this drug?
|
bismuth subsalicylate; can cause dark stools and staining of teeth
|
|
What drug can be used to reduce diarrhea caused by functioning GIT tumors?
|
octreotide
|
|
What are the 2 ways that the drugs used to tx constipation can work?
|
either by increasing the bulk in the intestinal lumen or by softening the stool
|
|
What are the 2 saline and osmotic laxatives?
|
Mg(OH)2 and lactulose
|
|
What are the 2 stimulant laxatives?
|
bisacodyl and castor oil
|
|
What are the 2 bulk forming laxatives?
|
bran and psyllium
|
|
What are the 2 surfactant and emollient laxatives?
|
docusate and mineral oil
|
|
What are the contraindications for the use of laxatives?
|
pts with cramps, colic, N/V, undiagnosed abd pain, or symptoms of appendicitis
|
|
What is the drug used for IBS with constipation?
|
tegaserod (5HT4 agonist)
|
|
What is the drug used for IBS with diarrhea?
|
alosetron (5HT3 antagonist)
|
|
What is the drug used for chronic constipation?
|
lubiprostone
|
|
What is the anti-cholinergic drug used for vomiting?
|
scopolamine
|
|
What are the 2 H1 antagonists used for vomiting?
|
diphenhydramine and promethazine
|
|
What are the 2 D2 antagonists used for vomiting?
|
droperidol and metoclopramide
|
|
What is the cannibinoid drug used for vomiting?
|
nabilone
|
|
What is the corticosteroid drug used for vomiting?
|
dexamethasone
|
|
What is the suffix for 5HT3 antagonist?
|
-SETRON
|
|
What is the use of 5HT3 antagonists in cancer pts?
|
can help reduce vomiting
|
|
What drugs can be used for "anticipatory vomiting" in cancer pts?
|
benzodiazepines
|