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109 Cards in this Set
- Front
- Back
Inhibit angiotensin-converting enzyme (ACE) |
Ace inhibitors
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MOA of class I A (eg. Procainamide), class IB (eg. Lidocaine), and class IC (eg. Flecainide) antiarrhythmics
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Sodium channel blockers
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Captopril and enalapril (-OPRIL ending) are
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Ace inhibitors
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MOA of sildenafil (Viagra)
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Inhibits phosphodiesterase-5, enhancing effects of nitric oxide-activated increases in cGMP
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Side effect of ACE inhibitors
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Dry cough, hyperkalemia.
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SE of procainamide
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Lupus-like syndrome
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Ace inhibitors are contraindicated in
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pregnancy and with K+
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MOA of Cardiac glycosides (eg. digoxin)
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Indirectly increase intracellular calcium and cardiac contractility by inhibiting Na+/K+ ATPase
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Losartan and valsartan block
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Angiotensin receptor
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Limiting side effect of Quinidine
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Prolongs QT interval
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Angiotensin receptor blockers do NOT cause
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Dry cough
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Drugs used in the management of angina
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Aspirin, Nitrates, CCB, and Beta blockers
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Block L-type calcium channel
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Calcium channel blockers
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Other side effects of Quinidine
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Thrombocytopenic purpura, and CINCHONISM
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CCB contraindicated in CHF
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Verapamil
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Digoxin is used in
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Atrial fibrillation and CHF
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CCB with predominate effect on arteriole dilation
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Nifedipine
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Major drug interaction with Quinidine
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Increases concentration of Digoxin
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SE of CCB
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Constipation, edema, and headache
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Aspirin reduces mortality in unstable angina by
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Platelet aggregation inhibition
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Reduce heart rate, contractility, and O2 demand
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Beta-blockers
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DOC for management of acute Ventricular arrhythmias
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Amiodarone
Note: lidocaine,use to be the DOC, but lidocaine is esp used in post MI and digitalis-induced arrhythmias. |
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B-blockers that are more cardioselective
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Beta-1 selective blockers
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Drugs decrease intestinal absorption of cholesterol
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Bile acid-binding resins
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Cardioselective Beta 1-blockers
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Atenolol, acebutolol, and metoprolol
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DOC for digoxin induced arrhythmias
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Phenytoin
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Beta-blockers should be used cautiously in
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Asthma (bronchospastic effects), diabetes (block signs of hypoglycemia) and peripheral vascular disease
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MOA of nitrates
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Relax vascular smooth muscle, at low doses dilate veins and at high doses dilate arterioles
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Non-selective Beta-blocker also used for migraine prophylaxis
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Propranolol
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SE of phenytoin
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Gingival hyperplasia
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SE of beta blockers
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Bradycardia, SEXUAL DYSFUNCTION, decrease in HDL, and increase in Triglycerols (TG)
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Digoxin toxicity can be precipitated by
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Hypokalemia
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Alpha 1selective blockers
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Prazosin, terazosin and doxazosin (-AZOSIN ending)
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Class of anti-arrhythmics that has a pro-arrhythmic effect (CAST trial), therefore are used as last line agents
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Class IC (flecainide, propafenone, moricizine)
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Non-selective Alpha1blockers use to treat pheochromocytoma
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Phenoxybenzamine
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Nitrate used for acute anginal attacks
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Nitroglycerin sublingual tablets
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For rebound HTN from rapid clonidine withdrawal
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Phentolamine
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Class II antiarrhythmics are
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B-blockers
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A1a-selective blocker with no effects on HTN used for BPH
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Tamsulosin (Flomax)
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Antidote for digoxin toxicity
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Digibind
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SE of alpha blockers
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Orthostatic hypotension (especially with first dose) and reflex tachycardia
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Antiarrhythmic that exhibits Class II and III properties
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Sotalol
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Presynaptic Alpha 2 agonist used in HTN, and acts centrally
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Clonidine, and methyldopa
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Nitrate used to prevent further attacks
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Oral and transdermal forms of nitroglycerin
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SE of methyldopa
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Positive Comb's test, depression
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Side effect of sotalol
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prolongs QT and PR interval
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Methyldopa is contraindicated in
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Geriatrics due to its CNS (depression) effects
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SelectiveB1 Receptor blockers that may be useful in treating patients even though they have asthma
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Acebutolol, atenolol, esmolol, metoprolol
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SE of clonidine
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Rebound HTN, sedation, dry mouth
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Used intravenously for acute arrhythmias during surgery
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Esmolol
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Direct vasodilator of arteriolar smooth muscle
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Hydralazine
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Nitrate free intervals are needed due to
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Tolerance
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SE of hydralazine
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Lupus-like syndrome
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Anti-arrhythmics that decrease mortality
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B-blockers
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Arterial vasodilator that works by opening K+ channels
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Minoxidil
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Phosphodiesterase inhibitors that increase mortality and have been found to have NO beneficial effects
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Amrinone and milrinone
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SE of minoxidil
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Hypertrichosis and hirsuitism
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MOA of class III antiarrhythmics
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Potassium channel blockers
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IV Drug used Hypertensive Crisis
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Nitroprusside
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SE of nitrates
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Postural hypotension, reflex tachycardia, hot flashes, and throbbing headache due to meningeal artery dilation
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Nitroprusside vasodilates
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Arteries and veins
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Class III antiarrhythmic that exhibits properties of all 4 classes
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Amiodarone
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Toxicity caused by nitroprusside and treatment
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Cyanide toxicity treated with sodium thiosulfate
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SE of amrinone
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Thrombocytopenia
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Specific pharmacokinetic characteristic of amiodarone
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Prolonged half-life, up to six weeks
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CCB are DOC for
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Prinzmetal's angina
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Antiarrhythmic effective in most types of arrhythmia
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Amiodarone
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Cholestyramine and colestipol are
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Bile acid-binding resins
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SE of Amiodarone
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Cardiac dysfunction, photosensitivity, skin (blue smurf syndrome), Pulmonary fibrosis, thyroid and corneal deposits
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Beta blockers are used for which type of anginal attack
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Classic
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MOA of class IV antiarrhythmics
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Calcium channel blockers
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Beta 1 agonists used in acute CHF
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Dobutamine and dopamine
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Life threatening cardiac event that prolong QT leads to
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Torsades de pointes
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Diuretics work in CHF by
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Reducing preload
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Agent to treat torsades de pointes
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Magnesium sulfate
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Combined alpha and beta blocking agents that may have application in treatment of CHF
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Labetalol and carvedilol
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Drug used supraventricular arrhythmias
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Digoxin
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Beta blockers work in CHF by
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Reducing progression of heart failure (never use in acute heart failure)
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DOC for paroxysmal supraventricular tachycardia; has high efficacy and short duration of action
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Adenosine
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Peptide drug used to treat CHF
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Nesiritide (BNP)
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Adenosine's MOA
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Activates acetylcholine sensitive K+ channels in SA and AV node
And inhibition of Ca++ current resulting in marked hyperpolarization |
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Major nutritional side effect of bile acid-binding resins
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Impair absorption of fat soluble vitamin absorption (A,D,E,K)
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Anti-arrhythmic with 15 second duration of action
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Adenosine
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MOA of nesiritide
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Increasing sodium excretion and decreases arterial and venous tone
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Anti-arrhythmic with 15 second duration of action
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Adenosine
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SE of nesiritide
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Excessive hypotension and kidney failure
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Beta blockers partial agonist activity (intrinsic sympathomimetic activity) cause some bronchodilation and may have an advantage in treating patients with asthma
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Pindolol and acebutolol
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Agent used in CHF that is a selective alpha and nonselective beta blocker
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Carvedilol
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Agent used in acutely decompensated CHF resembling natriuretic peptide
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Nesiritide (Natrecor)
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MOA of lovastatin (STATIN)
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inhibits HMG COA reductase
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This beta blocker lacks local anesthetic activity (a property which decreases protective reflexes and increases the risk of corneal ulceration) and used in treating glaucoma
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Timolol
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HMG CoA reductase inhibitors are contraindicated in
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Pregnancy
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This parenteral beta blocker is a short acting (minutes)
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Esmolol
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MOA of drug or foods (grapefruit juice) that increase statin effect
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Inhibit Cytochrome P450 3A4
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This beta blocker is the longest acting
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Nadolol
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SE of HMG COA reductase inhibitors
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Rhabdomyolysis and Hepatotoxicity
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These beta blockers are less lipid soluble
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Acebutolol and atenolol
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Monitoring parameter to obtain before initiation of STATINS
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LFT's
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This beta blocker is highly lipid soluble and may account for side effects such as nightmares
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Propranolol
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Decreases liver triglycerol synthesis
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Niacin
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Clinical uses of these agents include treatment of HTN, angina, arrhythmias, chronic CHF, and selected post MI patients
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Beta blockers
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SE of niacin
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Cutaneous flush
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Toxicity of these agents include bradycardia, AV blockade, exacerbation of acute CHF; signs of hypoglycemia may be masked (tachycardia, tremor, and anxiety)
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Beta blockers
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Cutaneous flush and be reduced by pretreatment with
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Aspirin
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Fibrates (gemfibrozil) increase activity of
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Lipoprotein lipase
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Most common SE of fibrates
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Nausea
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Fibrates are contraindicated in
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Pregnancy
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Concurrent use of fibrates and statins increases risk of
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Rhabdomyolysis
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New class of drugs that works by inhibiting absorption of intestinal cholesterol and can be given concurrently with the Statins
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Ezetimibe (Zetia)
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