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81 Cards in this Set
- Front
- Back
which four bp drugs can you give a pregnant lady?
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hydralazine
labetolol methyldopa nifedipine (keep the moms hydrated and fed to keep lababe happy, no meth.) |
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mechanism of hydralazine, clinical use and major SE (2)
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increases cGMP-->smooth muscle relaxation-->dilation
use: hypertension, CHF, pregnancy SE: compensatory tachy, lupus like syndrome |
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minoxidil mechanism, use, SE (
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K+ channel opener, hyperpolarizes, relaxes vascular SM
use: severe HTN SE: hair growth, reflex tachy, pericardial effusion |
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which type of vessels do NITRATES work on?
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large VEINS!
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mechanism that nitrogylcerin relaxes smooth muscle?
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releasing NO--> increases cGMP-->smooth muscle relaxation.
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which calcium channel blockers only work on the heart?
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non-dihydropyridine: verapamil, diltiazem
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which ca2+ channel blockers only work on BVs?
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dihydropyridine: nifedipine
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which BP drug causes cyanide toxicity?
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nitroprusside
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how do calcium channels reduce muscle contractility?
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block voltage dependent L type calcium channels in cardiac and smooth muscles
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major mechanism is to reduce LDL by inhibiting HMG-CoA reductase
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statins
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three major side effects of statins...
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1. hepatotoxic- monitor LFTs- is reversible
2. rhabdomoylysis leading to 3. muscle aches |
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primary effect is increasing HDL...
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niacin
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major SE of niacin...what can you do to prevent these from happening?
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red, flushed face...take aspirin 30 minutes before niacin
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mechanism of niacin...
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inhibits lipolysis in adipose tissue; reduced hepatic VLDL secretion into circulation
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which lipid lowering agent can be used to bind a bacterial toxin..and what is the toxin?
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cholestyramine; binds the C. Diff toxin
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which lipid drug do patients hate and why?
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bile acid resins- tastes bad and causes GI discomfort
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mechanism of action of bile acid resins?
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prevent intestinal re-absorption of bile acids; liver must use cholesterol to make more
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what is the action of ezetimibe?
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lipid lowering agent- prevents cholesterol reabsorption in the small intestine brush border.
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which lipid drug would you use to lower triglycerides? most common SE?
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fibrates- myosites, maybe increase in LFTs
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which two lipid drugs should you NEVER combine? why?
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statins and fibrates...MYALGIAS!!
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digoxin acts by initially inhibiting the movement of which ion?
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sodium- it inhibits the Na/K ATPase, which leaves no Na to bring back in through the Na/Ca pump--increase intraceuular Ca
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what are some SE of digoxin? 3
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yellow halos around lights
increase parasympathetic activity increase in PR, dec QT |
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clinical uses for digixon? 2
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CHF and atrial fibrillation
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name three class IA anti-arrhythmics.
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procanamine, disopyramide, procainamide
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what happens to AP and ERP in class IA
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increase AP and increase ERP
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which drugs create an SLE like syndrome?
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SHIPP
solfonamides hydralazine INH procanamide phenytoin |
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name three class 1B antidysarrhythmia drugs
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lidocaine
mexiletine tocainide |
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what happens to AP and ERP in class 1B?
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decrease AP increases ERP
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namde three class 1c antiarrhythmics
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flecamide ecanide propafenone
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what happens to AP and ERP in class 1 C drugs?
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AP is not changed, ERP increases
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what are the class two antiarrhythmics and what is their mechanism/which part of the slope do they change?
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beta blockers
decrease calcium currents, decrease slope of phase 4 |
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important side effects of beta blockers 4
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impotence
exacerbation of asthma cardio effects (brady, AV block, CHF) CNS effects- sedation |
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what is the mechanism of class three antiarrhythmics?
name three |
K channel blockers
sotalol ibutilide amiodarone |
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what three things do you check with amiodarone?
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PFT- pulmonary fibrosis
LFT- liver TFT- thyroid (common to all K+ blockers) |
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what is class four of antiarrhythmics?
name 2 specific to the heart |
Ca2+ blockers
verapamil, diltiazem |
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what is the mechanism and use for adenosine? as an antiarrhythmic?
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increases K+ outside of cells, hyperpolarizing the cell and decreases calcium.
abolishes AV nodal arrhythmias |
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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
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sulfonylureas
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what is the major side effect of sulfonylureas?
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hypoglycemia
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this diabetes drug probably works by decreasing gluconeogenesis
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metformin
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major side effect of metformin
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lactic acidosis
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how do glitazones work?
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increase target cell response to insulin
a PPAR agonsit |
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major side effects of pioglitazone and rosiglitazone?
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weight gain, edema, hepatotoxicity
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which diabetic drug works with an intestinal brush border enzyme?
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a-glucosidases
acarbose miglitol |
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this diabetic drug works to slow gastric empyting.
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amylin/pramlintide
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what is the major side effect of a-glucosidases?
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GI distrubances, flatulence
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what class of drugs does exenatide belong to?
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GLP-1 mimetics
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which type of diuretic is mannitol? what is one of its major uses?
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osmotic diuretic
used to decrease intracranial pressure |
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which type of diuretic is acetazolamide?
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carbonic anhydrase inhibitor
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which area of the nephron does acetazolamide work?
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proximal convoluted tubule
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what metabolic distrubance does acetazolamide cause?
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hyperchloremic metabolic acidosis
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what type of drug is furosemide?
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loop diuretic- sulfonamide
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what are the major side effects of the loop diuretics?
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OH DANG!
ototoxicity hypokalemia dehydration allergy nephritis gout |
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do you give a patient with kidney stones loops or HCTZ?
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HCTZ because loops lose calcium and put more Ca2+ into the tubes. HCTZ does not cause a loss of Ca2+
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which type of drug is ethacrynic acid?
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loop diuretic that is not a sulfa drug.
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which part of the nepheron does HCTZ work on? (location and transporter)
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early distal tubule
Na/Cl transporter |
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what metabolic disturbance does HCTZ cause?
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hypokalemic metabolic alkalosis,
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what other side effects are seen with thiazides? 5
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hyponaturemia
hyperGLUC: hyperglycemia hyperlipidemia hyperuricemia hypercalcemia |
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what is the mechanism of spironolactone?
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competitive aldosterone receptor blocker
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what are the non-steroidal K sparing diuretics? 3
what do they do? |
triamterene
amiloride eplerenone they directly block the Na channels |
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what metabolic disturbance do K sparing diuretics cause?
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hyperkalemic metabolic acidosis
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what are major side effects of ACEI?
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cough from the buildup of bradykinin
angioedema proteinuria taste changes hypotension pregnancy rash increased renin lower AgII hyperkalemia |
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what is the mechanism of cyclosporine?
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binds to cyclophilins, blocks differentiation and activation of T cells, by inhibiting calcineurin and thus preventing production of IL2.
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what is the mechanism of tacrolimus?
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binds FK binding protein, inhibiting secretion of IL2 and other cytokines
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this drug is a precursor of MTX nad it interferes with the metabolism and synthesis of neucleic acids
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azathioprine
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monoclonal Ab that binds to CD3 no teh surface of T cells
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Muromonab- CD3 OTK3
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this drug binds to mTOR and inhibits T cell proliferation in response to IL2
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sirolimus
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this drug is an inhibitor of inosine monophosphate dehydrate...so it inhibits de novo guanine synthesis
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mycophenolate mofetil
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monoclonal Ab with high affinity for the IL2 receptor on activated T cells
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daclizumab
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this immunosuppressant may be nephrotoxic, but using mannitol can prevent the toxicity
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cyclosporine
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immunosuppressant used for lupus nephritis
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mycophenolate mofetil
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immunosuppressant that is not used anymore because of birth defects....drug and mechanism
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thalodomide- affects TNFa
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what is the mechanism of bromocriptine? 2 clinical uses...
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DA agonist- used for parkinsons and pituitary adenoma (prolactinoma)
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name the combination of treatment for parkinsons...5 drugs
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BALSA
bromocriptine amantadine levodopa (with carbidopa) selegiline (and COMT) antimuscarinics (benztropine) |
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what is the mecanism of benztropine and how does it help parkinsons?
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it is an antimuscarinic
improves tremor and rigidity but has little effect on bradykinesia |
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amatidine is used as an antiviral against the flu..how can it be used for parkinsons?
one toxicity |
increases DA release
toxicity: ataxia |
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what is L-DOPA and what does it always have to be administered with?
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precursor to DA, it increases the amount of DA in the brain. converted by dopa carboxylase in the brain.
administered with carbidopa |
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can L-DOPA or DA cross the BBB?
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L-DOPA only!
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what is selegiline and how is it used in treating parkinsons?
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it is an MAO-B inhibitor, therefore increases DA in the brain. used as an adjunctive with l-dopa
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name two COMT inhibitors used in the treatment of parkinsons.
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entacapone
tocapone |
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what is the first line for absence seizures?
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ethosuximide
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what three drugs are first line for tonic-clonic seizures?
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phenytoin
carbamazepine valproic acid |