Pharm Exam 2

Front 1

Normal BP Values

Back 1

SBP < 120

-AND-

DBP < 80

Front 2

Prehypertension BP Values

Back 2

SBP 120-139

-OR-

DBP 80-89

Front 3

Stage 1 BP Values

Back 3

SBP 140-159

-OR-

DBP 90-99

Front 4

Stage 2 BP Values

Back 4

SBP (> or =) 160

-OR-

DBP (> or =) 100

Front 5

CO x SVR = ?

Back 5

BP

Front 6

for Afib and HTN, use what?

Back 6

a beta-blocker

Front 7

centrally acting is acting where?

Back 7

in the brain

Front 8

for a Norepinephrine infiltrate, use what?

Back 8

Regitine

Front 9

example of secondary HTN

Back 9

Preeclampsia

(HTN and protein in the urine that develops after the 20th week of pregnancy).

Front 10

for HTN + chronic kidney disease, use what?

Back 10

an ACE inhibitor

Front 11

Initial drug therapy for HTN (for people with non compelling indications)

Back 11

Thiazide-type diuretics

Front 12

Beta-blockers and ACE inhibitors are more effective in who?

Back 12

Caucasians because the renin response is blocked

Front 13

CCB's and diuretics are more effective in who?

Back 13

African American and geriatric patients

Front 14

3 Adrenergic agents

Back 14

Dopamine
Epinephrine
Norepinephrine

Front 15

6 antihypertensive classifications

Back 15

Adrenergic agents
ACE inhibitors
ARBs
CCBs
Diuretics
Vasodialators

Front 16

the sympathetic nervous system is the same as

Back 16

the adrenergic nervous system

Front 17

Adrenergic agents act where?

Back 17

centrally (alpha2)

and

peripherally (alpha1)

Front 18

Where do beta-blockers work?

Back 18

in the heart

Front 19

2 things Adrenergic blocking agents block

Back 19

Epinephrine

and

Norepinephrine

Front 20

Adrenergic agents do what to BP?

Back 20

decrease it

Front 21

Reserpine works where?

Back 21

Centrally

and

Peripherally

Front 22

1 Reserpine side effect

Back 22

Impotence

Front 23

Drug of choice for HTN in pregnancy

Back 23

Aldomet (methyldopa)

Front 24

1 drug used for HTN and BPH

Back 24

Cardura (doxazosin)

Front 25

makes you drowsy
comes in a patch
opioid withdrawl

Back 25

Clonidine

Front 26

a Cardura side effect

Back 26

Impotence

Front 27

4 Adrenergic agent common side effects

Back 27

orthostatic hypotension
dry mouth
drowsiness
constipation

Front 28

Dual Alpha1 and Beta blockers do what 2 things?

Back 28

decrease HR
cause vasodilation

Front 29

4 Beta-blockers

Back 29

propranolol (Inderal)
atenolol (Tenormin)
metoprolol (Lopressor)
metoprolol ext (Toprol XL)

Front 30

Dual Alpha1 and Beta blocker

Back 30

carvedilol (Coreg)

Front 31

Aldosterone increases what 2 things?

Back 31

preload and BP

Front 32

RAAS increases what 2 things?

Back 32

afterload and BP

Front 33

RAAS does what, and what are 2 results?

Back 33

coverts angiotensin I to II
results are potent vasoconstriction and stimulation of aldosterone

Front 34

for HTN and HF, use what?

Back 34

ACE inhibitors

Front 35

ACE inhibitors prevent what 2 things and result in what 3 things?

Back 35

prevent angiotensin II formation and breakdown of bradykinn
result is decreased preload, afterload and BP

Front 36

what might not work so good in African Americans for HTN?

Back 36

ACE inhibitors

Front 37

HF can be treated with?
What does it do to the heart?

Back 37

ACE inhibitors
decreases preload and afterload

Front 38

Slows the progression of left ventricular hypertrophy after an MI

Back 38

ACE inhibitors

Front 39

What provides renal protection for diabetes patients?
How does it work?

Back 39

ACE inhibitors
relaxes the efferent arterial

Front 40

Drugs of choice for HTN + HF

Back 40

ACE Inhibitors

Front 41

2 side effects of ACE inhibitors

Back 41

dry, nonproductive cough
possible hyperkalemia

Front 42

3 Angiotensin II receptor blockers (ARBs)

Back 42

losartan (Cozaar, Hyzaar)
valsartan (Diovan)
candesartan (Atacand)

Front 43

Angiotensin II receptor blockers (ARBs) do what?

Back 43

allow angioitensin I to convert to II but block the receptors that receive II

Front 44

Angiotensin II receptor blocker (ARBs) side effects

Back 44

Hyperkalemia much LESS likely to occur, but can

Front 45

What 6 things should we think when we hear Adernergic agents?

Back 45

SNS
Epinephrine
Norepinephrine
Alpha1
Beta1
Beta2

Front 46

What 6 things should we think when we hear Cholonergic agents?

Back 46

PNS
Acedacholine
Nicotinic
Muscurinic
Sludge
Anti-sludge

Front 47

cause smooth muscle relaxation

Back 47

CCBs

Front 48

Do not block Epinephrine / Norepinephrine

Back 48

CCBs

Front 49

Cause a negative inotropic effect on the heart

Back 49

CCBs

Front 50

RAAS

Back 50

renin angiotensin-aldosterone system

Front 51

Do not block Epinephrine / Norepinephrine

Back 51

CCBs

Front 52

What cause a negative inotropic effect on the heart?

Back 52

CCBs

Front 53

Used for BP and HR control

Back 53

CCBs

Front 54

CCB that controls HR, but causes constipation

Back 54

Verapamil (Calan, Isoptin)

Front 55

CCB that controls BP, but causes peripheral edema

Back 55

amlodipine (Norvasc)

Front 56

Decrease the workload of the heart, decrease BP

Back 56

Diuretics

Front 57

Directly relax arteriolar smooth muscle

Back 57

Vasodilators

Front 58

sodium nitroprusside (Niprise, Nitropress)
diazoxide (Hyperstat)

Back 58

Vasodilators
Give intervenously in HTN emergency

Front 59

2 things about HTN urgency

Back 59

No end organ damage
Oral meds

Front 60

2 things about HTN emergency

Back 60

End organ damage
IV meds

Front 61

Sodium nitroprusside side effect

Back 61

possible cyanide toxicity

Front 62

stopping HTN drugs abruptly causes

Back 62

rebound HTN crisis

Front 63

4 HTN emergencys

Back 63

Heart - chest pain
Stroke - headache
Renal failure - urine positive for protein; edema
Eyes - ruptured blood vessels

Front 64

2 primary forms of lipids in the blood

Back 64

Triglycerides
Cholesterol

Front 65

Lipoprotein produced by the liver

Back 65

VLDL
Very low density lipoprotein

Front 66

the lipoprotein we want to be low in a cholesterol reading

Back 66

LDL
low density lipoprotein

Front 67

the lipoprotein we want to be high in a cholesterol reading

Back 67

HDL
high density lipoprotein

Front 68

Recycles cholesterol

Back 68

HDL

Front 69

Which lipoprotein has the most protein?

Back 69

HDL

Front 70

which lipoprotein has the least lipids?

Back 70

HDL

Front 71

Where is HMG-CoA reductase?

Back 71

in the liver

Front 72

Where are clotting factors produced?

Back 72

in the liver

Front 73

optimal LDL level

Back 73

< 100

Front 74

normal Triglyceride level

Back 74

< 150

Front 75

low HDL level

Back 75

< 40

Front 76

high HDL level

Back 76

> or = 60

Front 77

desirable cholesterol level

Back 77

< 200

Front 78

What is NOT a positive risk factor for high cholesterol

Back 78

obesity

Front 79

CHD

Back 79

coronary heart disease

Front 80

inhibits HMG-CoA reductase

Back 80

HMG-CoA reductase inhibitors (also called HMGs, statins)

Front 81

2 Antilipemics

Back 81

HMG-CoA
Niacin (vitamin)

Front 82

what are Statins used for?

Back 82

reducing LDL

Front 83

6 HMGs

Back 83

all drug names end in "statin"

Brand names:
Crestor, Lipitor, Zocor, Mevacor, Pravachol, Lescol

Front 84

used by the liver to produce cholesterol

Back 84

HMG-CoA reductase

Front 85

2 Statin side effects

Back 85

Increased LFTs
Rhabdo Myalysis - breakdown of muscle

Front 86

lowers triglyceride, serum cholesterol, LDL and increases HDL levels

Back 86

Nicotinic Acid (Niacin)

Front 87

4 Niacin side effects

Back 87

Flushing
Increased BG (blood glucose)
Hyperuricemia (gout)
Hepatotoxicity

Front 88

Gradually increase the dosage on what?

Back 88

Niacin

Front 89

works best on triglycerides

Back 89

Fibric Acid Derivatives

Front 90

3 Fibric Acid Derivatives

Back 90

clofibrate
gemfibrozil (Lopid)
fenofibrate (Tricor)

Front 91

4 Fibric Acid side effects

Back 91

increased LFT
dyspepsia
gallstones
myopathy

Front 92

prevent reabsorption of bile acids from small intestine

Back 92

Bile Acid Sequestrants (lower cholesterol)

Front 93

3 Bile Acid Sequestrants side effects

Back 93

constipation
belching
bloating

Front 94

Have no direct effect on a blood clot that has already formed

Back 94

Anticoagulants

Front 95

Prevent blood clot formation

Back 95

Anticoagulants

Front 96

Inhibit clotting factors

Back 96

Anticoagulants

Front 97

3 Anticoagulants

Back 97

Heparin
Lovenox
Coumadin

Front 98

inhibit platelet binding

Back 98

Antiplatelets

Front 99

2 Antiplatelets

Back 99

Asprin
Plavix

Front 100

Lyse blood clots, used for strokes or heart attacks

Back 100

Thrombolytics

Front 101

3 Thrombolytics

Back 101

all end in "ase"

alteplase (t-PA, Activase)
reteplase (Retavase)
tenecteplase (TNKase)

Front 102

Directly inhibits the clotting factor

Back 102

Heparin
(route=IV)

Front 103

Indirectly inhibits the clotting factor

Back 103

Coumadin
Warfarin
(route=oral)

Front 104

Indirectly inhibits vitamin K

Back 104

Coumadin
Warfarin
(route=oral)

Front 105

Anticoagulant that works the fastest

Back 105

Heparin

Front 106

2 Anticoagulant side effects

Back 106

Bleeding
Thrombocytopenia (50% or more drop in platelets; below 100,000)

Front 107

4 things Anticoagulants prevent and treat

Back 107

Stroke
MI
DVT
PE (pulmonary embolism)

Front 108

5 situations to use Anticoagulants

Back 108

MI
Unstable angina (acute coronary syndrome)
AFIB
Indwelling devices
Major ortho surgery

Front 109

monitored by APTTs

Back 109

Heparin
(activated partial thromboplastin times)

Front 110

First priority if PTT is high (>180)

Back 110

turn off Heparin IV

Front 111

If patient is bleeding from Heparin, this will reverse it

Back 111

Protamine Sulfate

Front 112

Anticoagulants given subcutaneously

Back 112

Low molecular weight heparins
Lovenox
Fragmin

Front 113

When using Heparin, monitor what 3 things?

Back 113

APTT
H&H to show bleed
Platelet count

Front 114

2 things that cannot cause thrombocytopenia

Back 114

warafrin sodium (Coumadin)
antiplatelets (asprin, plavix)

Front 115

INR values

Back 115

2.0 - 3.0 normal
2.5 - 3.5 mechanical heart valve

Front 116

For an INR less than 2.0, use what and why?

Back 116

Heparin
Risk of embolism

Front 117

Gold standard for heart attacks

Back 117

Cardiac catherization

Front 118

Use for ischemic stroke

Back 118

Thrombolytic agents

Front 119

Warfarin antidote

Back 119

Vitamin K

Front 120

A patient on anticoagulants needs to be on what diet?

Back 120

a consistant one

Front 121

What happens when O2 demand is higher than the supply of O2?

Back 121

increased HR

Front 122

What is coronary atherosclerosis and what can it result in?

Back 122

stiffened arteries
myocardial ischemia

Front 123

what is myocardial ischemia?

Back 123

lack of O2 in heart muscle
can cause necrosis
is reversable

Front 124

How is atherosclerosis fixed?

Back 124

Coronary angioplasty (balloon)

Front 125

What is Angina Pectoris and what causes it?

Back 125

chest pain
insufficient O2 in heart

Front 126

characteristics of unstable angina

Back 126

also called preinfarction or crescendo
3 or more attacks per day
more severe
happen even at rest

Front 127

3 things about vasospastic angina?

Back 127

spasm of coronary arteries
can occur at rest
not readily fixed w/ nitro

Front 128

immediate treatment for angina

Back 128

M - morphine
O - O2
N - Nitro
A - Asprin (160 - 325 mg)

Front 129

adjunct agents for angina

Back 129

nitrates
beta-blockers
CCBs

Front 130

how do Nitrates work?

Back 130

dialate coronary vessels allowing more O2 in

Front 131

How much and how long do you use Nitroglycerin SL?

Back 131

0.4 mg tab sublingual every 5 mins x3, after that call 911

Front 132

Nitrate side effects

Back 132

Headache
Tachycardia
Postural hypotension - lay pt down
Tolerance - need time between

Front 133

Nitro IV is no good if what colors?

Back 133

blue
green
dark red

Front 134

can use for long term prevention of angina

Back 134

beta-blockers

Front 135

Beta-blockers (increase / decrease) HR?

Back 135

decrease

Front 136

4 uses of beta-blockers

Back 136

Angina
Anti HTN
Heart protection after MI
Migraines

Front 137

Beta-blocker side effects

Back 137

Bradycardia
Hypotension
2nd or 3rd degree block
HF
Glucose
Lipids
Dizzy / tired / unusual dreams
Impotence
Wheezing
Constipation

Front 138

How do CCBs work and what is the result?

Back 138

block calcium inflow which vasodilates arteries
reduce myocardial contractility (negative inotropic action)
result: decreased O2 demand

Front 139

4 uses of CCBs

Back 139

Angina
HTN
Supraventricular tachycardia
Short term AFIB fix

Front 140

It is safe for COPD patients to use

Back 140

CCBs

Front 141

CCB side effects

Back 141

Hypotension
Palpitations
Bradycardia
Tachycardia
Constipation
Nausea
Dyspnea

Front 142

Moinitor blood levels when patients are taking what?

Back 142

CCBs

Front 143

What do diuretics do?

Back 143

remove sodium and water

Front 144

Where do diuretics work?

Back 144

in the loop of henle

Front 145

CAIs are in what class of drugs?

Back 145

diuretics

Front 146

What do CAIs do?

Back 146

Inhibit carbonic anhydrase which retains H+ and excretes bicarbinate
increases urine volume

Front 147

CAI drug

Back 147

acetazolamide (Diamox)

Front 148

Loop diuretic side effects

Back 148

hypokalemia (low K)
hyperuricemia (high uric acid)

Front 149

If a patient is prescribed a CAI, what are you going to monitor?

Back 149

electrolytes - k, na, ca
BUN/SCr

Front 150

If a patient is on a loop diuretic, what is not functioning?

Back 150

kidneys

Front 151

What 2 things reduce excessive intraocular pressure

Back 151

mannitol and CAIs

Front 152

1 osmotic diuretic

Back 152

mannitol (Osmitrol)

Front 153

What is Mannitol used for?

Back 153

Reduction of intracranial pressure - used in ER for head trauma
Reduction of high intraocular pressure

Front 154

Where do potassium-sparing diuretics work?

Back 154

collecting ducts and distal convoluted tubules

Front 155

4 Potassium-sparing diuretics

Back 155

amiloride (Midamor)
triamterene (Dyrenium)
spironolactone (Aldactone)
eplerenone (Inspra)

Front 156

What do Potassium sparing diuretics do?

Back 156

block aldosterone
retain potassium
excrete na + h2o

Front 157

potassium sparing diuretics spironolactone and triamterene are used for what?

Back 157

hyperaldosteronism
HTN
reverse potassium loss from lasix, loop diuretic

Front 158

spironolactone side effect

Back 158

gynecomastia (man boobs)

Front 159

What is Digoxin used for?

Back 159

CHF and Arythmias