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81 Cards in this Set

  • Front
  • Back
which four bp drugs can you give a pregnant lady?
hydralazine
labetolol
methyldopa
nifedipine
(keep the moms hydrated and fed to keep lababe happy, no meth.)
mechanism of hydralazine, clinical use and major SE (2)
increases cGMP-->smooth muscle relaxation-->dilation
use: hypertension, CHF, pregnancy
SE: compensatory tachy, lupus like syndrome
minoxidil mechanism, use, SE (
K+ channel opener, hyperpolarizes, relaxes vascular SM
use: severe HTN
SE: hair growth, reflex tachy, pericardial effusion
which type of vessels do NITRATES work on?
large VEINS!
mechanism that nitrogylcerin relaxes smooth muscle?
releasing NO--> increases cGMP-->smooth muscle relaxation.
which calcium channel blockers only work on the heart?
non-dihydropyridine: verapamil, diltiazem
which ca2+ channel blockers only work on BVs?
dihydropyridine: nifedipine
which BP drug causes cyanide toxicity?
nitroprusside
how do calcium channels reduce muscle contractility?
block voltage dependent L type calcium channels in cardiac and smooth muscles
major mechanism is to reduce LDL by inhibiting HMG-CoA reductase
statins
three major side effects of statins...
1. hepatotoxic- monitor LFTs- is reversible
2. rhabdomoylysis leading to
3. muscle aches
primary effect is increasing HDL...
niacin
major SE of niacin...what can you do to prevent these from happening?
red, flushed face...take aspirin 30 minutes before niacin
mechanism of niacin...
inhibits lipolysis in adipose tissue; reduced hepatic VLDL secretion into circulation
which lipid lowering agent can be used to bind a bacterial toxin..and what is the toxin?
cholestyramine; binds the C. Diff toxin
which lipid drug do patients hate and why?
bile acid resins- tastes bad and causes GI discomfort
mechanism of action of bile acid resins?
prevent intestinal re-absorption of bile acids; liver must use cholesterol to make more
what is the action of ezetimibe?
lipid lowering agent- prevents cholesterol reabsorption in the small intestine brush border.
which lipid drug would you use to lower triglycerides? most common SE?
fibrates- myosites, maybe increase in LFTs
which two lipid drugs should you NEVER combine? why?
statins and fibrates...MYALGIAS!!
digoxin acts by initially inhibiting the movement of which ion?
sodium- it inhibits the Na/K ATPase, which leaves no Na to bring back in through the Na/Ca pump--increase intraceuular Ca
what are some SE of digoxin? 3
yellow halos around lights
increase parasympathetic activity
increase in PR, dec QT
clinical uses for digixon? 2
CHF and atrial fibrillation
name three class IA anti-arrhythmics.
procanamine, disopyramide, procainamide
what happens to AP and ERP in class IA
increase AP and increase ERP
which drugs create an SLE like syndrome?
SHIPP
solfonamides
hydralazine
INH
procanamide
phenytoin
name three class 1B antidysarrhythmia drugs
lidocaine
mexiletine
tocainide
what happens to AP and ERP in class 1B?
decrease AP increases ERP
namde three class 1c antiarrhythmics
flecamide ecanide propafenone
what happens to AP and ERP in class 1 C drugs?
AP is not changed, ERP increases
what are the class two antiarrhythmics and what is their mechanism/which part of the slope do they change?
beta blockers
decrease calcium currents, decrease slope of phase 4
important side effects of beta blockers 4
impotence
exacerbation of asthma
cardio effects (brady, AV block, CHF)
CNS effects- sedation
what is the mechanism of class three antiarrhythmics?
name three
K channel blockers
sotalol
ibutilide
amiodarone
what three things do you check with amiodarone?
PFT- pulmonary fibrosis
LFT- liver
TFT- thyroid

(common to all K+ blockers)
what is class four of antiarrhythmics?
name 2 specific to the heart
Ca2+ blockers
verapamil, diltiazem
what is the mechanism and use for adenosine? as an antiarrhythmic?
increases K+ outside of cells, hyperpolarizing the cell and decreases calcium.
abolishes AV nodal arrhythmias
this diabetic medication works on the K channels of the beta cell membranes by depolarizing them and triggering the release of insulin via Ca2+ influx
sulfonylureas
what is the major side effect of sulfonylureas?
hypoglycemia
this diabetes drug probably works by decreasing gluconeogenesis
metformin
major side effect of metformin
lactic acidosis
how do glitazones work?
increase target cell response to insulin
a PPAR agonsit
major side effects of pioglitazone and rosiglitazone?
weight gain, edema, hepatotoxicity
which diabetic drug works with an intestinal brush border enzyme?
a-glucosidases
acarbose
miglitol
this diabetic drug works to slow gastric empyting.
amylin/pramlintide
what is the major side effect of a-glucosidases?
GI distrubances, flatulence
what class of drugs does exenatide belong to?
GLP-1 mimetics
which type of diuretic is mannitol? what is one of its major uses?
osmotic diuretic
used to decrease intracranial pressure
which type of diuretic is acetazolamide?
carbonic anhydrase inhibitor
which area of the nephron does acetazolamide work?
proximal convoluted tubule
what metabolic distrubance does acetazolamide cause?
hyperchloremic metabolic acidosis
what type of drug is furosemide?
loop diuretic- sulfonamide
what are the major side effects of the loop diuretics?
OH DANG!
ototoxicity
hypokalemia
dehydration
allergy
nephritis
gout
do you give a patient with kidney stones loops or HCTZ?
HCTZ because loops lose calcium and put more Ca2+ into the tubes. HCTZ does not cause a loss of Ca2+
which type of drug is ethacrynic acid?
loop diuretic that is not a sulfa drug.
which part of the nepheron does HCTZ work on? (location and transporter)
early distal tubule
Na/Cl transporter
what metabolic disturbance does HCTZ cause?
hypokalemic metabolic alkalosis,
what other side effects are seen with thiazides? 5
hyponaturemia
hyperGLUC:
hyperglycemia
hyperlipidemia
hyperuricemia
hypercalcemia
what is the mechanism of spironolactone?
competitive aldosterone receptor blocker
what are the non-steroidal K sparing diuretics? 3
what do they do?
triamterene
amiloride
eplerenone
they directly block the Na channels
what metabolic disturbance do K sparing diuretics cause?
hyperkalemic metabolic acidosis
what are major side effects of ACEI?
cough from the buildup of bradykinin
angioedema
proteinuria
taste changes
hypotension
pregnancy
rash
increased renin
lower AgII
hyperkalemia
what is the mechanism of cyclosporine?
binds to cyclophilins, blocks differentiation and activation of T cells, by inhibiting calcineurin and thus preventing production of IL2.
what is the mechanism of tacrolimus?
binds FK binding protein, inhibiting secretion of IL2 and other cytokines
this drug is a precursor of MTX nad it interferes with the metabolism and synthesis of neucleic acids
azathioprine
monoclonal Ab that binds to CD3 no teh surface of T cells
Muromonab- CD3 OTK3
this drug binds to mTOR and inhibits T cell proliferation in response to IL2
sirolimus
this drug is an inhibitor of inosine monophosphate dehydrate...so it inhibits de novo guanine synthesis
mycophenolate mofetil
monoclonal Ab with high affinity for the IL2 receptor on activated T cells
daclizumab
this immunosuppressant may be nephrotoxic, but using mannitol can prevent the toxicity
cyclosporine
immunosuppressant used for lupus nephritis
mycophenolate mofetil
immunosuppressant that is not used anymore because of birth defects....drug and mechanism
thalodomide- affects TNFa
what is the mechanism of bromocriptine? 2 clinical uses...
DA agonist- used for parkinsons and pituitary adenoma (prolactinoma)
name the combination of treatment for parkinsons...5 drugs
BALSA
bromocriptine
amantadine
levodopa (with carbidopa)
selegiline (and COMT)
antimuscarinics (benztropine)
what is the mecanism of benztropine and how does it help parkinsons?
it is an antimuscarinic
improves tremor and rigidity but has little effect on bradykinesia
amatidine is used as an antiviral against the flu..how can it be used for parkinsons?
one toxicity
increases DA release
toxicity: ataxia
what is L-DOPA and what does it always have to be administered with?
precursor to DA, it increases the amount of DA in the brain. converted by dopa carboxylase in the brain.
administered with carbidopa
can L-DOPA or DA cross the BBB?
L-DOPA only!
what is selegiline and how is it used in treating parkinsons?
it is an MAO-B inhibitor, therefore increases DA in the brain. used as an adjunctive with l-dopa
name two COMT inhibitors used in the treatment of parkinsons.
entacapone
tocapone
what is the first line for absence seizures?
ethosuximide
what three drugs are first line for tonic-clonic seizures?
phenytoin
carbamazepine
valproic acid