Pharm Test 2- Diuretics/ Nitrates/heart Failure

Front 1

Mannitol (Osmitrol)

Back 1

Osmotic diuretic. Reduces CSF pressure with cerebral edema or pre & post neuro surgery, reduce intraocular pressure for glaucoma & pre-PO, increase urine flow to prevent nephrotoxicity, contra with CHF

Front 2

Acetazolamide (Diamox)

Back 2

Carbonic an hydrate inhibitors. Plays key role in reabsorption of NaHC03, urine alkalinizes, used in glaucoma, eye surgery, altitude sickness. Adver: hypokalemia, metabolic acidosis, parathesia, risk of renal calculus

Front 3

Hydrochlorothiazide ( HCTZ)

Back 3

Thiazide diuretic. Use: edema in CHF & hepatic disease, HTN first lie drug in mild to mod, combo with anti HTN, excrete Na, H2O, K, retain Ca, contain sulfa,

Front 4

Flurosimide (Lasix)

Back 4

Loop diuretic high ceiling, contiains sulfa, rapid onset short duration, increase loss of K, Mg, acid, ammonia, increase renal blood flow, use: edema cardiac, renal, hepatic origin, acute pulmonary edema, early renal failure, can decrease Bp by decreasing fluid. Adverse: ototoxicity, DM hyperglycemia, loss k,Na, ca, mg,

Front 5

Spironalactone (Aldactone)

Back 5

Aldosterone antagonist. K sparing diuretic, slow onset 24-48 hrs, use:HTN , edema ( esp for acitis with hepatic disease) treat primary hyperaldosteronism ( adrenal tumor). Adverse hyperkalemia, afginity for progesterone & androgen receptors that can cause gynecomastia, impotence,

Front 6

Nitroglycerin (NTG)

Back 6

Nitrates, relaxes smooth vascular muscles, reduce pre& after load, no change in hr or force of contraction, use: treat or prevent angina, chest pain, reduce size of MI, adjunct therapy to CHF, adverse: HA, hypotension,don't take with Viagra,

Front 7

Nitroprusside (nipride)

Back 7

Major potent drug. Use treat hypertensive crisis, treat severe CHF with inotropics, give iv pump tritrate to effect, rapid onset short duration, monitor Bp & thiocyanate levels

Front 8

Inotropics

Back 8

Affects cardiac contraction, positive- increase force of contraction, negative decrease force of contraction.

Front 9

Chronotropic

Back 9

Affects heart rate. Positive increase HR, negative decrease HR

Front 10

Digoxin (lanoxin)

Back 10

+ inotropics, - chronotropic, use to slow ventricular rate in atrial fib and flutter by increasing contractility in CHF! Adverse toxicity halos around lights, seeing yellow & red spots. Tx give digibind

Front 11

Dopamine (intropin)

Back 11

+ inotropics & chronotropic use in hypotension shock, severe CHF or cardiogenic shock, monitor dose, iv site for extravasation, EKG for tachycardia given iv pump in ICU,

Front 12

Dopamine low dose

Back 12

Affects dopamine receptors, dilate renal & mesentric vessels improve response to diuretics

Front 13

Dopamine moderate dose

Back 13

Affects beta 1 receptors, increase HR contractility, some in Bp due to norepinephrine release

Front 14

High dose dopamine

Back 14

Affects alpha receptors, increase Bp, vasoconstriction, most useful in shock sepsis, anaphylaxis

Front 15

Nesiritide ( natrecor)

Back 15

Reduces endogenous hBNP, naturiusis, diuretics, reduces pre & after load, can see hypotension, for acute CHF tx give IV, can be given with diuretics or othe CHF meds