Pharm - Cvs

Front 1

diuretic given for mild HTN

Back 1

thiazide

Front 2

diuretic given for moderate to severe HTN

Back 2

loop diuretics

Front 3

do diuretics induce a compensatory response

Back 3

no

Front 4

alpha-2 agonists: 2

Back 4

clonidine, methyldopa

Front 5

what is the compensatory response of alpha-2 agonists

Back 5

salt & H2O retention

Front 6

if clonidine is sudden stopped, what is a potential tox

Back 6

severe rebound HTN

Front 7

hematologic fx of methyldopa 2

Back 7

RBC agglutination, hemolytic anemia

Front 8

ganglion-blocking drugs? 2

Back 8

hexamethonium, trimethaphan

Front 9

2 CNS fx of ganglion-blocking drugs?

Back 9

PNS blockade, SNS blockade

Front 10

postganglionic SNS nerve terminal blockers 2

Back 10

reserpine, guanethidine

Front 11

compensatory response of postganglionic SNS blockers?

Back 11

minimal

Front 12

tox of reserpine? 4

Back 12

diarrhea, stuffy nose, sedation, depression

Front 13

tox of guanethidine? 2

Back 13

orthostatic hypotension, sexual dysfxn

Front 14

Compensatory response of alpha-1 blockers? 2

Back 14

salt & H2O retention; slight tachycardia

Front 15

worst tox of alpha blocker?

Back 15

orthostatic hypotension (usu just initially)

Front 16

do beta-blockers have a compensatory response?

Back 16

no

Front 17

tox of beta-blocker? 3

Back 17

sedation, impotence, asthma exacerbation

Front 18

common tox of vasodilators?

Back 18

salt & H2O retention

Front 19

why is hydralazine rarely used? 2

Back 19

toxicity (lupus-like syndrome, tachycardia)

Front 20

minoxidil is reserved for

Back 20

severe HTN (due to severe compensatory response)

Front 21

preferred vasodilators 3

Back 21

CCB: nifedipin, verapamil, dilitazem

Front 22

nitroprusside mech?

Back 22

release NO -> inc cGMP -> relaxation

Front 23

diazoxide mech?

Back 23

opens K channel -> hyperpolarization -> relaxation

Front 24

what odd tox is assoc w/ nitroprusside?

Back 24

cyanide/thiocyanate accumulation

Front 25

Fenoldopam is reserve for HTN emergencies. Why?

Back 25

long duration of action but prompt response (D1 agonist)

Front 26

do angiotensin antagonists have compensatory responses?

Back 26

minimal

Front 27

what are the common tox to angiotensin antagonists?

Back 27

renal damage to fetus, hyperkalemia

Front 28

ACE-I end in

Back 28

pril

Front 29

ARBS end in

Back 29

sartan

Front 30

renin-I

Back 30

aliskiren

Front 31

3 mech of ACE-I

Back 31

block AII (vasoconstrictor), dec aldosterone (dec Na), inc kinins (vasodilators)

Front 32

stepwise approach to HTN: 5

Back 32

lifestyle change -> diuretic -> sympathoplegic -> ACE-I -> vasodilator

Front 33

older pt respond better to

Back 33

ACE-I

Front 34

blacks respond better to which HTN medication? 2

Back 34

diuretic, CCB

Front 35

short acting nitrates 3

Back 35

amyl nitrate (inhaled), sublingual nitroglycerin, isosorbide dinitrate

Front 36

intermediate acting nitrates 3

Back 36

nitroglycerin, isosorbide dinitrate, mononitrate

Front 37

long acting nitrate 1

Back 37

transdermal nitroglycerin patch

Front 38

first pass fx for nitroglycerin is

Back 38

~ 90%

Front 39

what route of nitroglycerin avoid the first-pass fx

Back 39

sublingual

Front 40

nitrates mech

Back 40

denitrate -> NO -> guanyl cyclase -> cGMP -> dephosphorylation of myosin light chain -> SM relaxation

Front 41

tox of nitrates 4

Back 41

tachycardia, hypotension, throbbing headache, metHb at high conc

Front 42

which CCB work more on heart than vessel

Back 42

diltiazem, verapamil

Front 43

which CCB work more on vessel than heart

Back 43

nifedipine

Front 44

mech of CCB

Back 44

block voltage-gated L-type channels

Front 45

CCB can be used for which type of angina

Back 45

stable, Prinzmetal's

Front 46

CCB tox: 5

Back 46

N/C, pretibial edema, flushing, dizziness

Front 47

beta-blockers are only used for

Back 47

stable angina prophylaxis (after AMI)

Front 48

mech of cardiac glycosides

Back 48

inh Na/K ATPase -> inc Na in cell -> less Ca removed from cell

Front 49

cardiac mechanical fx of glycosides 3

Back 49

dec HR, dec preload, dec afterload

Front 50

Arrhythmias promoted by glycosides 7

Back 50

Atrial tachycardia, Afib, AV block, AV tachycardia, premature beat, Vtach, Vfib

Front 51

what anti-HTN can precipitate dig tox?

Back 51

diuretics (promote hypokalemia, making tox worse)

Front 52

3 steps for Tx dig tox

Back 52

correct K def, antiarrhythmic, dig Ab

Front 53

first line HF Rx 2 (not congestion)

Back 53

diuretics, angiotensin antagonists

Front 54

beta-blockers block progression of

Back 54

CHF only

Front 55

for acute severe failure with congestion, use

Back 55

nitrates, nesiritide

Front 56

class 1 antiarrhythmics

Back 56

Na channel blockers

Front 57

class 2 antiarrhythmics

Back 57

beta-blockers

Front 58

class 3 antiarrhythmics

Back 58

K channel blockers

Front 59

class 4 antiarrhythmics

Back 59

Ca channel blockers

Front 60

prototype for class 1A

Back 60

procainamide

Front 61

class 3 drug that has 1A fx

Back 61

amiodarone

Front 62

other class 1A drugs

Back 62

quinidine, disopyramide

Front 63

conduction fx of 1A

Back 63

slow conduction in atria, AV, Purkinje, ventricles; inc AP & ERP

Front 64

EKG fx of 1A

Back 64

Inc QRS duration and QT

Front 65

prototype for class 1B

Back 65

lidocaine

Front 66

other class 1B drugs 2

Back 66

mexiletine, (phenytoin)

Front 67

conduction fx of 1B 2

Back 67

selectively affect ischemic/depolarized;
slows recovery of Na channels from inactivation

Front 68

EKG fx of 1B

Back 68

little fx seen but do shorten AP (selectively)

Front 69

prototype for class 1C

Back 69

flecainide

Front 70

other class 1C drugs 2

Back 70

encainide, propafenone

Front 71

conduction fx of 1C

Back 71

slow conduction in atria, ventricles

Front 72

EKG fx of 1C

Back 72

Inc QRS duration but not QT

Front 73

torsades is assoc with drugs that have what conduction fx?

Back 73

prolong AP duration

Front 74

cardiotox of class 1 drugs are exacerbated by

Back 74

hyperkalemia

Front 75

class 1 drug w/ antimuscarinic fx

Back 75

disopyramide

Front 76

class 1 drug that can cause lupus-like Sx

Back 76

procainamide

Front 77

class 1 drug that caused greater mortality than placebo

Back 77

flecainide

Front 78

beta-blockers are given mainly for

Back 78

prophylaxis after MI (protective fx)

Front 79

prototypes of class 3 drugs 2

Back 79

sotalol, ibutilide

Front 80

other class 3 drugs 2

Back 80

dofetilide, amiodarone

Front 81

Mech of class 3

Back 81

block K channel -> dec repolarization rate -> AP prolongation

Front 82

most important tox of class 3

Back 82

torsades de pointes

Front 83

class 4 are affective for

Back 83

converting AV nodal reentry to norm sinus

Front 84

quick acting drug given for AV nodal arrhythmia

Back 84

adenosine

Front 85

prototype of carbonic anhydrase inh

Back 85

acetazolamide

Front 86

carbonic anhydrase inh work at

Back 86

PCT (prevent NaHCO3 absorption)

Front 87

main use of carbonic anhydrase inh 2

Back 87

glaucoma, high alt sickness

Front 88

4 tox of carbonic anhydrase inh

Back 88

drowsiness, paresthesias, urine alkalinization, plasma acidosis

Front 89

prototype of loop diuretics

Back 89

furosemide

Front 90

loop diuretics work at

Back 90

loop of Henle (block Na/K/2Cl)

Front 91

loop diuretics primarily used for 2

Back 91

edematous states: HF, ascites, pulm edema; hypercalcemia

Front 92

ototox is assoc w/ which group of diuretics

Back 92

loop diuretics

Front 93

prototype of thiazides

Back 93

hydrochlorothiazide

Front 94

thiazides work at

Back 94

NaCl transport in early distal tubule

Front 95

primary use of thiazides 2

Back 95

HTN, hypercalcemia

Front 96

DM might develop hyperglycemia when on which diuretic

Back 96

Thiazides

Front 97

only diuretic group that does not cause sulfa allergy

Back 97

K-sparing

Front 98

prototype of K-sparing diuretics 3

Back 98

Spironolactone, amiloride, triamterene

Front 99

K-sparing diuretics work at

Back 99

collecting tubules

Front 100

Mech of spironolactone

Back 100

block aldosterone receptor -> prevent synth of Na channel & Na/K ATPase

Front 101

Mech of amiloride and triamterene

Back 101

block epithelial Na channels

Front 102

Uses of K-sparing diuretics 2

Back 102

hypokalemia assoc w/ other diuretics; hyperaldosternism (spironolactone)

Front 103

diuretics that promote acidosis 2

Back 103

carbonic anhydrase inh, K-sparing diuretics

Front 104

diuretics that promote alkalosis 2

Back 104

loop & thiazides

Front 105

prototype for osmotic diuretics

Back 105

mannitol

Front 106

common tox of mannitol 2

Back 106

headache, N/V

Front 107

ADH agonists 2

Back 107

desmopressin (vasopressin has short 1/2 life)

Front 108

ADH antagonist 2

Back 108

demeclocyline, conivaptan