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67 Cards in this Set
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This drug has weak diuretic properties that work on the proximal convoluted tubule
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Acetazolamide - a carbonic anhydrase inhbitor that inhibits the reabsorption of HCO3 in the proximal convoluted tubule
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Inhibits the reabsorption of Na and Cl in the distal convoluted tubule, resulting in retention of water in the tubule
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Thiazides - most commonly used diuretic
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Aldosterone antagonist that inhibits the aldosterone mediated reabsorption of Na and secretion of K and works at the collecting tubule and duct
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Spironolactone - can prevent loss of K that occurs with thiazide or loop diuretics
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These work at the collecting tubule and duct. Block Na channels
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amiloride and triamterene - can prevent loss of K that occurs with thiazide or loop diuretics
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These diuretics are the most efficacious. Inhibit the Na/K/2Cl cotransport in the ascending loop of Henle resulting in retention of Na, Cl and water in the tubule
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Bumetanide, Furosemide, Torsemide, Ethacrynic Acid
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This is the diuretic of choice if a patient has a true sulfa allergic reaction to the thiazides and loops
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Ethacrynic Acid 25 or 50mg - has no sulfa in the molecule
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These diuretics decrease Na, K, Mg, and Ca and have risk of ototoxicity
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Loop diuretics - Lasix (Furosemide), Bumex (Bumetanide), Demadex (Torsemide), Edecrin (Ethacryinic Acid)
ototoxicity more common with Edecrin |
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What milligram of Demadex (Torsemide) is equivalent to 40 mg Lasix (Furosemide)
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20 mg (Twenty = torsemide, Forty = Furosemide)
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These diuretics decrease Na, K, Mg and INCREASE Ca (advantage in HTN elderly females at risk for osteoporosis)
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Thiazides (HCTZ, indapamide, chlorthalidone)
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Indicated in the treatment of hyperaldosteronism
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Aldactone (Spironolactone)
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What is the HTN dose of Spironolactone?
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25 mg BID
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What is the ascites in cirrhosis dose of Spironolactone?
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50 mg QID
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How many mg of the PO formulation of Propranolol is equivalent to the 1mg of the IV formulation?
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40 mg - the hepatic extraction and first-pass metabolism leaves only 1 out of the 40 mg left in the circulation
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Which Beta Blocker is highly lipohilic?
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Inderide - Propranolol/HCTZ 40/25mg - monitor for depression
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Long acting, non-selective BB, renally eliminated
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Corgard (Nadolol) 20, 40, 80, 120, 160 mg QD
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This BB causes less bradycardia and CNS depressing effects than other beta-blockers
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Visken (Pindolol) - non-selective BB w/ ISA (intrinsic sympathomimetic activity) 5, 10 mg BID
similar to Acebutolol (Sectral) |
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This BB is B1 selective (less COPD warning) with increased Nitric Oxide production (increases NO results in vasodilation)
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Bystolic (Nevibolol) 2.5 mg, 5 mg, 10 mg per day
2 ways to lower BP = Bi The most cardioselective BB |
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This BB is B1 selective in low doses, QD or BID, not as lipophilic as propranolol
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Lopressor (Metoprolol Tartrate) 25, 50, 100 mg
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Long acting BB, scored, can be cut in half
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Toprol XL - Metoprolol Succinate - 25, 50, 100, 200 mg QD dose
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B-1 selectivity in low doses
this is the most hydrophilic one once daily |
Tenormin (Atenolol) - 25, 50, 100
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Non-selective BB (Blocks 1 and 2) alpha 1 blocker
TAKE WITH FOOD to slow rate of absorption and reduce incidence of orthostasis |
Coreg (carvedilol) 3.125, 6.25, 12.5, 25 BID
Coreg CR 10, 20, 40, 80 mg QAM |
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What is the conversion of Coreg to Coreg CR?
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3.125 mg BID = 10 mg QD
6.25 mg BID = 20 mg QD 12.5 mg BID = 40 mg QD 25 mg BID = 80 mg QD |
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This drug slows and strengthens the heart (negative chronotrope, positive inotrope)
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Lanoxin, Digitek (Digoxin) - yellow 0.125 mg, white 0.25 mg (1 tsp of oral solution = 1 white tablet)
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Name the adverse effects of Digitalis toxicty and name the treatment
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GI upset, slow pulse, then visual disturbance (doesn't eat and feels bad).
Give Digibind |
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What is the half-life of Digoxin?
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40 hours
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This drug is a centrally acting alpha-2 agonist: decreases NE flow = lowering BP, used to treat HTN in pregnant patients
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Aldomet (Methyldopa) 125, 250, 500 mg (250 2 to 3 times a day)
similar to clonidine Bradycardia & depression (risk of syncope) |
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What color is the 1 mg coumadin?
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Pink
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What color is the 2 mg coumadin?
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Lavender
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What color is the 2.5 mg coumadin?
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Green
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What color is the 3 mg coumadin?
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Brown
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What color is the 4 mg coumadin?
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Blue
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What color is the 5 mg coumadin?
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Peach
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What color is the 6 mg coumadin?
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Teal
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What color is the 7.5 mg coumadin?
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Yellow
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What color is the 10 mg coumadin?
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White - no color, no dye
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Interferes with the hepatic synthesis of Vitamin K-dependent clotting factors II (prothrombin), VII, IX, X
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Coumadin (Warfarin)
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What is the usual INR target range?
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2 to 3 except prosthetic heart valves are up to 3.5
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The INR will be increased when these types of drugs are given with Warfarin increasing risk of hemorrhage
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CYP - 450 inhibitors: Tagamet, Prozac, Paxil
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The INR willbe decreased increasing risk of clot when warfarin is given with these types of drugs
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CYP450 inducers: St. John's Wort, Phenytoin, carbamazepin, barbiturates, griseofulvin, and rifampin
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These potassiun chloride tablets can be mixed in water to drink
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K-dur
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What is the target K level?
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3.5 to 5 (remember GPA of 4)
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1 mEq = ? mg of KCL
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75 mg (mwt of KCL = 75.1
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How many mg of nitroglycerin is in 1/150 grain
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0.4 mg
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What are the new guidelines of when to call 911 when taking nitrates
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If, after the first SL dose, the chest pain worsens, or does not get better, call 911
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Why should you not shake the Nitrolingual Pumpspray?
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This would result in inaccurate delivery. More of the diluent goes on or under the tongue and less of the drug
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How do you apply the nitro-bid ointment 2%?
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0.5 to 2 inches measured out on paper and spread a thin layer over 2 to 3 inches area of chest or back in AM and then 6 hrs later. NEED 10-12 hour nitrate free period!
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Adjunct to coumarin-type anticoagulants (coumadin) in the prevention of thromboembolic complications of cardiac valve replacement, inhibits platelet adhesion, may be inappropriate for elderly -orthostasis, gi upset
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Persantine (Dipyridamole) 25, 50, 75 mg
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Tartaric Acid is included in this drug providing 50% higher absorption than the immediate-release formulation
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Aggrenox (200 mg ER Dipyridamole with 25 mg aspirin)
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These have a potential for pedal edema, dizziness, gingival hyperplasia
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Calcium Channel Blockers: Dihydropyridine class (-ipines)
nifedipine, isradipine, nisoldipine, amlodipine, felodipine, nicardipine |
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Name the Calcium Channel Blockers - NON-dihydropyridine
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Diltiazem, Verapamil
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This ACE inhibitor is great for patients who can not swallow pills, open capsule and put in apple sauce
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Altace (Ramipril) 1.25, 2.5, 5, 10 mg
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This ACE inhibitor is eliminated 50% in urine and feces - advantage in renally impaired patients
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Monopril (Fosinopril) 10, 20, 40 mg
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Which antihypertensive medication is a Direct Renin Inhibitor?
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Tekturna (Aliskiren) 150, 300 mg
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What is the max dose of clonidine per day?
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2.4 mg (comes 0.1, 0.2, 0.3 mg usually BID to TID)
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These are alpha-1 blockers, long acting alpha-1 antagonist
Take at 8 pm First dose Syncope Must be combined with other Antihypertensive meds, compelling indication HTN and BPH |
Hytrin (Terazosin) 1, 2, 5, 10
Cardura (Doxazosin) 1, 2, 4, 8 |
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An arteriolar vasodilator that causes drug induced systemic Lupus erythematosus (SLE), reversible upon discontiuation used for HTN in pregnant patients
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Apresoline (Hydralazine)
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The only fibrate approved for use in combination with a statin
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Trilipix (fenofibric acid (the metabolite of fenofibrate)) Capsules delayed release 45, 135 mg QD
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If take Questran first how long should a patient wait to take another drug?
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4-6 hours
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If take drug first, how long should a patient wait to take Questran?
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2 hours
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Class I anti-arrhythmic Drugs are?
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Na Channel Blockers (Na+ = valence of sodium is 1)
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Class II anti-arrhythmic Drugs are?
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Beta-Blocker (2 words Beta Blocker)
Mostly Inderal and Sotolol |
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Class III anti-arrhythmic Drugs are?
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Amiodarone and Sotolol (Cor-dar-one = 3 syllables)
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Class IV anti-arrhythmic Drugs are?
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Calcium Channel Blockers (Verapamil - Ver-ap-a-mil = 4 syllables)
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Class Ic antiarrhythmic
Blocks Sodium Channels should be dosed Q12h |
Tambocor (Flecainide) 50, 100, 150 mg
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Indicated for life-threatening Ventricular Arrhythmias
Unlabeled use: A-Fib, maintenance of sinus rhythm |
Cordarone (Amiodarone) 200 mg, inj
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This Drug has characteristics of all 4 Vaughn Williams classes - predominantly Class 3 effects
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Cordarone (Amiodarone)
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This drug has potential fatal toxicity - Hypersensitivity pneumonitis
Potential Optic Neuropathy and/or neuritis Pulomonary Problems (Smurf Syndrome) - rare |
Cordarone (Amiodarone)
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