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55 Cards in this Set
- Front
- Back
DIURETICS
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Most cause the blockade of sodium and chloride reabsorption; Adverse impacts on extracellular fluid whicch can cause hypovolemia, acid-base imbalance, and altered electrolyte levels; drugs classified into 5 categories, high-ceiling (loop), Thiazides, Potassium-sparing, Osmotic, and Carbonic anhydrase inhibitors
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Classification and MOA of Furosemide
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-High-ceiling (loop) diuretic; MOA: acts on ascending loop of Henle to block reabsorption
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Pharmacokinetics and Therapeutic uses of Furosemide (Lasix)
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Rapid onset (PO 60 min, IV 5 min) used for pulmonary edema, edematous states, and hypertension
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Adverse effects of Furosemide (Lasix)
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Hyponatremia, hypochloremia, dehydration, hypotension (due to loss of volume or relaxation of venous smooth muscle), & Hypokalemia
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Classification and MOA of Hydrochlorothiazide
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Thiazide diuretic that acts on the early segment distal convoluted tubule by increasing renal excretion of sodium, chloride, potassium and water (it also elevates levels of uric acid and glucose)
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Adverse effects of Hydrochlorothiazide
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Hyponatremia, hypochloremia, dehydration, hypokalemia, hyperglycemia, hyperuricemia, impact on lipids, calcium, and magnesium, enters breast milk
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Pharmacokinetics and uses of Hydrochlorothiazide
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Peak action in 4-6 hours, therapeutic uses include : essential hypertension, edema, & diabetes insipidus
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Classification and MOA ofMannitol
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Osmotic diuretic; promotes diuresis by creating osmotic force within lumen of the nephron
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Pharmacokinetics and Uses of Mannitol
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Drug MUST BE given parenterally ; Used for prophylaxis of renal failure, reduction of intracrainal pressure, and reduction of intraocular pressure
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Adverse effects of Mannitol
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Edema, headache, nausea, vomiting, and fluid & electrolyte imbalance
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Adverse effects and drug interactions of Spironolactone
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Adverse: hyperkalemia, benign and malignant tumors, & endocrine effects; Interactions: Thiazide and loop diuretics and agents that raise potassium levels
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Classification and MOA of Spironolactone
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Potassium-sparing diuretic (this one is specifically an aldosterone antagonist); MOA -Blocks aldosterone in the distal nephron, -retention of potassium, & -increases excreation of sodium
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Pharmacokinetics and uses of Spironolactone
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RARELY used alone ; Used for: hypertension, edematous states, heart failure, primary hyperaldosteronism, premenstrual syndrome, polycystic ovary syndrome, and acne in young women
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What are the side effects of ACE inhibitors
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-First-dose hypotension -fetal injury -cough -angioedema -hyperkalemia -dysgeusia (distortion in sense of taste) and rash -renal failure -neutropenia
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List the ACE inhibitors indicated on our sheet
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Enalapril, Lisinopril
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What are the therapeutic uses of ACE inhibitors
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hypertension, heart failure, myocardial infarction (MI), diabetic and nondiabetic nephropathy, prevention of MI, stroke, and death in patients at high cardiovascular risk
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What are the actions Angiotensin II receptor blockers
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-block access of angiotensin II, cause dilation of arterioles and veins, prevent angiotension II from inducing pathologic changes in cardiac structure, reduce excretion of potassium, decrease release of aldosterone, increase renal excretion of sodium and water, do not inhibit kinase II, do not increase levels of bradykinin (opening of vessels)
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What are the angiotensin II receptor blockers on our list
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Ibesartan and losartan
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What are the therapeutic uses of angiotensin II receptor blockers
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-hypertension, heart failure, myocardial infarction, diabeticnephropathy, Used if unable to tolerate ACE inhibitors, migraine headache, may prevent development of diabetic retinopathy
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What are the adverse effects of angiotensin II receptor blockers
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angioedema, fetal harm, renal failure, possibility of promoting cancer
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What is Eplerenone and what is its MOA
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It is an aldosterone antagonist that works by selective blockade of aldosterone receptors
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What are the therapeutic uses of Eplerenone
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It is used to treat hypertension and heart failure
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What is the pharmacokinetics of Eplerenone
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Absorption is not affected by food
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What are the adverse effects of eplerenone (Inspra)
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Hyperkalemia
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Aliskiren adverse effects are ...
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"Diarrhea, stomach pain, heartburn, cough, rash, dizziness, headache, back pain SERIOUS ones include lightheadedness and fainting, swelling, blisters or peeling skin, hoarseness, difficulty swallowing or breathing, seizures, slow/weak/irregular heart beat
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What is Aliskiren
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a direct renin inhibitor that is used in hypertensive patients
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VASODILATORS
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WEEK 8
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What is Nitroglycerin
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It is a vasodilator
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How does Nitroglycerin work
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It works by selective dilation of veins which has a vasodilating effect
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What are the adverse effects of nitroglycerin
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headache, orthostatic hypotension, reflex tachycardia
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What are the 4 factors with tolerance when taking nitroglycerin
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can develop rapidly, cross-tolerance to all other nitrates, to minimize, use the lowest effective dose, long-acting formulas: 8 drug-free hours per day
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what are the therapeutic uses of nitroglycerin
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1. acute anginal therapy 2.sustained anginal therapy 3.iv for perioperative control of blood pressure and treatment of heart failure with MI, unstable angina, and uncontrolled exacerbations of chronic angina
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What is phentolamine
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it is a antihypertensive alpha-adrenergic blocker that is used to decrease blood pressure by blocking the sympathetic nervous system
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What is Clonidine
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It is a central-acting sympathetic nervous system inhibitor
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What are the adverse effects of clonidine
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-depression -drowsiness -edema -liver dysfunction -numbness, tingling -vertigo
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What are the drug-drug interactions of Clonidine
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W/ Tricyclin antidepressants blood pressure may increase W/CNS depressants the CNS depression may worsen
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What is Hydralazine (Apresoline)
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it is a vasodilator
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What is the MOA of Hydralazine (Apresoline)
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selective dilation of arterioles (but the specific mechanism is unknown)
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What are the therapeutic uses of Hydralazine
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Essential hypertension, Hypertensive crisis, heart failure
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What are the adverse effects of Hydralazine
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Reflex tachycardia, increased blood volume, systemic lupus erythematosus-like syndrome, headache, dizziness, weakness, and fatigue
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CALCIUM CHANNEL BLOCKERS
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Drugs that prevent calcium ions from entering cells having greatest impact on heart and blood vessels by relaxing and widening blood vessels by directly affecting the muscle of the arterial wall
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What is nefedipine
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it is a calcium channel blocker that increases myocardial oxygen supply by preventing the passage of calcium ions across the myocardial cell membrane and vascular smooth-muscle
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What is amlodipine
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it is a calcium channel blocker that increases myocardial oxygen supply by preventing the passage of calcium ions across the myocardial cell membrane and vascular smooth-muscle
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What are the adverse effects of nefedipine and amlodipine
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orthostatic hypotension, heart failure, hypotension
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What is the use of Verapamil
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It works as a calcium channel blocker by acting directly on the vascular smooth muscle and the heart
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What are the 5 direct hemodymamic effects of VERAPAMIL / DILTIAZEM
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1.Blockade at peripheral arterioles (reduces arterial pressure) 2.Blockade at arteries and arterioles of heart (increases coronary perfusion) 3.Blockade at SA node (reduces heart rate) 4.Blockade at AV node (most important) (does this by decreases AV nodal conduction) 5.Blockade in the myocardium (decreases force of contraction)
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What are the 4 statins on our drug list
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Atorvastatin, Lovastatin Rosuvastatin, Simvastatin
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What are the therapeutic uses for statins
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1.hypercholesterolemia 2. primary and secondary prevention of CV events 3.Post-MI therapy 4.Diabetes 5.Potential uses
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What is the MOA of statins
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lower lipid levels by interfering with cholesterol synthesis
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What are the adverse effects of statins
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Common: headache, rash, GI disturbances RARE: myopathy/rhabdomyolysis, hepatotoxicity
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What are drug interactions of statins
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-most other lipid-lowering drugs (except bile acid sequestrants) -Drugs that inhibit CYP3A4 -USE IN PREGNANCY -GREATEST IMPACT WHEN GIVEN IN THE EVENING
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What is the actions of Niacin (nicotinic acid)
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1.Reduces LDL and TG levels 2. Increases HDL (more effectively than any other drug) 3.Effect on plasma lipoproteins (by lowering TG levels and raising HDL cholesterol)
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What are the adverse effects of niacin
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*Skin (flushing, itching) *Gastrointestinal *Hepatotoxicity *Hyperglycemia *Gouty arthritis *can raise blood levels of uric acid
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What does fish oil do
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It helps increase HDL and decrease inflammation
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What does red yeast rice do
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It works like a statin by inhibiting cholesterol synthesis
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