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;
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
|