Term
|
Definition
|
|
Term
| What is the pharmacological action of Triamterene? |
|
Definition
| K-sparing, blocks Na absorbtion in cortiacal collecting duct. DIRECT. |
|
|
Term
What is triamterene used for (two things)?
How long does it take the drug to act? |
|
Definition
| HT, edema, 2-4hrs to act. |
|
|
Term
| What are the adverse effects of Triamterene? |
|
Definition
| hyperalkemia, nausea/vomiting, cramps and dizziness |
|
|
Term
| What is the pharmacological action of spironolactone? |
|
Definition
| K-sparing, aldosterone cannot increase Na reabsorbtion in cortical collecting duct, leads to increased Na excretion, and decreased K excretion. |
|
|
Term
| What does spironolactone treat and what is the latency of the drug? |
|
Definition
| HTN, edema, primary hyperaldosteronism, Decreases mortality in heart failure, 48hrs to act |
|
|
Term
| What are the adverse effects of spironolactone? |
|
Definition
|
|
Term
| Classification of Hydrochlorothiazide? |
|
Definition
|
|
Term
| What is the pharmacologic action of HCTZ? |
|
Definition
| Thiazide diuretic that blocks Na Cl co-transporter in the distal tubule |
|
|
Term
What is HCTZ used for primarily?
Other uses? |
|
Definition
| Primary hypertension, Decrease the risk of kidney stones, Used in combination with K+ sparing diuretics to mitigate K loss. Used in mild-moderate HTN (low renin or volume-expanded forms) |
|
|
Term
| Can HCTZ be used for Renal failure? |
|
Definition
| Yeah, but it does not work very well. |
|
|
Term
| What are the risks of HCTZ? |
|
Definition
| Gout, oops too much, Increased lipid levels, HYPOalkemia |
|
|
Term
| Is HCTZ appropriate for monotherapy? |
|
Definition
| Not recommended, Best if in combination to prevent adverse effects. |
|
|
Term
| Can HCTZ be used in pregnancy? |
|
Definition
| Contraindicated in pregnancy |
|
|
Term
| What are the effects of HCTZ on digoxin and litium? |
|
Definition
| Increases effects of Digoxin and litium toxicity |
|
|
Term
| What is the classification of Furosemide, bumetadine, and torsemide? |
|
Definition
|
|
Term
| What is the use of furosemide, bumetadine, and torsemide and what is the duration of onset of action? |
|
Definition
| Quick, 60 minutes po, 5 minutes if IV. edema, hypertension |
|
|
Term
| What is the mechanism of action of Furosemide, bumetadine, and torsemide? |
|
Definition
| Na-K-Cl cotransporter blocker, blocks cotransporter in TAL. |
|
|
Term
| What is the classification of Triamterene? |
|
Definition
|
|
Term
| What is the classification of spironolactone? |
|
Definition
|
|
Term
| What is the drug class of ethacrynic acid? |
|
Definition
|
|
Term
| What is the duration of the onset of action for ethacrynic acid? |
|
Definition
| Quick onset, 60 min po, 5 min IV, |
|
|
Term
| What is ethacrynic acid used for? |
|
Definition
|
|
Term
| What are the contraindications and drug interactions of ethacrynic acid? |
|
Definition
| Contraindicated in pregnancy, Drug interaction with digoxin and lithium |
|
|
Term
| Why is ethacrynic acid particularly useful? |
|
Definition
| It can be used in patients with SULFA ALLERGY. |
|
|
Term
| What is the classification of acetazolamide? |
|
Definition
| Carbonic anhydrase inhibitor |
|
|
Term
| What is pharmacologic action of acetazolamide? |
|
Definition
| It is seldomly used for sodium bicarbonate diuresis,and HYPERchloremic acidosis. |
|
|
Term
| What is acetazolamide used for? |
|
Definition
| Treats urinary alkalinazation, metabolic alkalosis, glaucoma, and mountain sickness |
|
|
Term
| What are the risks of ethacrynic acid? |
|
Definition
| Higher risk of kidney stones, oops too much, HYPOkalemia, OTOTOXICITY, gout risk, increased lipid levels |
|
|
Term
| What are the adverse effects of acetazolamide? |
|
Definition
| Renal stones, potassium wasting, and HYPERchloremic acidosis. |
|
|
Term
| What are the osmotic diuretics? |
|
Definition
| Mannitol, Urea, glycerine, isosorbide |
|
|
Term
| What are osmotic diuretics used for? |
|
Definition
| decrease intracranial pressure, prophylaxis of renal failure, decreases intraoccular pressure in glaucoma |
|
|
Term
| What is the pharmacologic action of osmotic diuretics (urea, glycerin, mannitol, isosorbide)? |
|
Definition
| These are non-reabsorbale solutes that keep water in the proximal tubules-> distal -> urine |
|
|
Term
| How is osmotic diuretics administered and what is the onset of action? |
|
Definition
| Administered via IV in large volumes and has an onset of action of 30min to an hour. |
|
|
Term
| What are the risks of administering osmotic diuretics? |
|
Definition
| Large volume of administration can exacerbate patients with heart failure as well as cause electrolyte imbalance. Nausea/vomiting/headache |
|
|
Term
| What drug class are the vaptans? |
|
Definition
|
|
Term
| What is the pharm action of the vaptans? |
|
Definition
| Vaptans prevent water absorption by the collecting ducts, thereby decreasing the urine osmolality, and decrease plasma volume. There is also an increase in plasma osmolality via increase in plasma |
|
|
Term
| Are there any adverse effects of vaptans and how is it administered? |
|
Definition
| Vaptans are administered IV only and are generally well tolerated. |
|
|
Term
What drug class are "-pril" drugs?
(enalapril, captopril, lisinopril) |
|
Definition
|
|
Term
| What is the action of ACE inhibitors? (enalapril, lisinopril, captopril) |
|
Definition
| ACE Inhibitors LOWER ANGIOTENSIN 2 levels by working on renin-angiotensin. |
|
|
Term
|
Definition
CHF, arrhythmias, diabetes mellitus, BEST FOR PATIENTS WITH ASTHMA!
GREAT FOR MONOTHERAPY!
ENHANCED BY DIURETICE |
|
|
Term
| What effect does diuretics have on ACE-I? |
|
Definition
| DIURETICS enhance the effect of the ACE-I. |
|
|
Term
| What are the contraindications for Ace-INhibitors? (enalapril, lisinopril, and captopril) |
|
Definition
| Contraindicated in pregnancy |
|
|
Term
| Are ACE inhibitors good for high renin HTN? |
|
Definition
|
|
Term
| What are the side effects of ACE inhibitors (Enalapril, lisinopril, and captopril)? |
|
Definition
| Increases bradykinin, but is otherwise well tolerated. rash, neutropenia ANGIONEURONIC EDEMA swells shut throat |
|
|
Term
| Which ACE inhibitor effects taste? |
|
Definition
|
|
Term
|
Definition
| they are Angiotensin II Receptor Blockers |
|
|
Term
| What is the pharmacologic action of the sartans? |
|
Definition
Reduces release of aldosterone by blocking the angiotensin receptors
(works on renin-angiotensin) |
|
|
Term
| What are sartans used for? |
|
Definition
| Sartans are used for hypertension, heart failure, and prevention of re-stenosis following angioplasty (rare). |
|
|
Term
| What are the benefits of sartans? |
|
Definition
| NO BRADYKININ effects (coughing?) |
|
|
Term
| What are the classifications of -olol's? |
|
Definition
| They are B blockers, note: labetAlol is alpha also. |
|
|
Term
| Which are the selective B blockers |
|
Definition
| Metoprolol, atenolol, acebutolol |
|
|
Term
| What are the side effects of sartans? |
|
Definition
| Dizziness, myalgia, GI effects, congestion. |
|
|
Term
| What are the indications of sartans? |
|
Definition
| as with ACE I's, except with angioedema due to ACE-I's. |
|
|
Term
| Which B blocker can also have action at alpha receptors? |
|
Definition
|
|
Term
| What is the pharmacological action of sartans (Beta blockers)? |
|
Definition
| Works on renin-angiotensin to inhibit renin release, -cardiac output, -renin release, -sympathetic outflow |
|
|
Term
| What is the cariological effect of -olol's? |
|
Definition
|
|
Term
| How does -olo's effect renin? |
|
Definition
| inhibition (decreased) renin release |
|
|
Term
| What is the neurological effect of olol's? |
|
Definition
| inhibition of sympathetic outflow |
|
|
Term
How can olol's be used?
(therapy, type of htn) |
|
Definition
| monotherapy, best with high renin HTN |
|
|
Term
|
Definition
| During high crisis HTN. Reduce the need for nitroglycerin and not for spastic angina (stable only). |
|
|
Term
| What is the purpose of the antiarrythmic effect of beta blockers? |
|
Definition
|
|
Term
| What is the relationship of olol's with asthma patients? |
|
Definition
| Bad for asthma PTs. Worsening of peripheral vascular disease, heart block, hypoglycemia. Angina attack after abrubt withdrawl. GI and CNS. Sexual dysfxn. |
|
|
Term
| What are the adverse effects of beta blockers? |
|
Definition
| Worsens peripheral vascular disease, heart block, HYPOglycemia, GI and CNS effects, sexual dysfunctions. |
|
|
Term
| What is the effect of abrupt withdrawal of beta blockers? |
|
Definition
|
|
Term
| What is the classification of Ranolazine? |
|
Definition
| Inhibition of the late sodium current |
|
|
Term
| What are the side effects of ranolazine? |
|
Definition
| arrythmias, n/v, weakness, palpataions, dizziness. |
|
|
Term
| What is the classificaiton of -amines? |
|
Definition
| NON-selective alpha blockers |
|
|
Term
| What is the pharmacological effect of -amines? |
|
Definition
| Blockade of vascular alpha receptors. |
|
|
Term
| What is the therapeutic use of -amines? |
|
Definition
| Hypertension crisis in pheochromocytoma (rare situation) |
|
|
Term
| What are the adverse effects of -amines? |
|
Definition
| Postural HYPOtension, reflex tachycardia, FLUID RETENTION (may require diuretic) |
|
|
Term
| What is the classification of -zosin? |
|
Definition
|
|
Term
| What is the use for -zosin's? |
|
Definition
| Blockade of vascular alpha receptor |
|
|
Term
| What is the pharmacological indication (use) for -zosin's? |
|
Definition
| Used for monotherapy and adjunctive therapy of hypertension. |
|
|
Term
| What is the adverse effects of -zosin's? |
|
Definition
| FIRST DOSE EFFECTS, TACHYCARDIA, nasal, dry mouth, and GI. |
|
|
Term
| What is the classification of aliskiren? |
|
Definition
|
|
Term
| What is the pharmacological effect of aliskiren? |
|
Definition
| POOR PO ABSORPTION, works on renin-angiotensin. |
|
|
Term
| What is the therapeutic use for aliskerin? |
|
Definition
|
|
Term
| What are the adverse effects of aliskerin? |
|
Definition
NO BRADYKININ EFFECT.
HYPERkalemia
dizziness and diarrhea |
|
|
Term
| What are the contraindication of aliskerin? |
|
Definition
| NOT FOR USE IN PREGNANCY or bilateral stenosis |
|
|
Term
| What is the classification of nifedipine? |
|
Definition
| Calcium channel blockers of the L type |
|
|
Term
| How effective is nifedipine in vasodilation relative to other ca channel blockers (diltiazem and verapamil)? |
|
Definition
|
|
Term
| What is the pharmacology of nifedipine? |
|
Definition
|
|
Term
| What is the therapeutical use for nifedipine? |
|
Definition
| initial choice for mild to moderate HT. Given IV in HYPERTENSIVE EMERGENCIES. |
|
|
Term
| What are the adverse effects of nifedipine? |
|
Definition
| Nifedipine causes flushing, headache, and edemas. There is also increased risk of cardiac events in short-acting drugs. |
|
|
Term
| What are therapeutic use for L-type calcium channel blockers? |
|
Definition
| Treat angina, paroximal tachycardia, atrial flutter, fibrilation, and essential HTN |
|
|
Term
| What are the L-type Calcium channel blockers? |
|
Definition
| Verapamil, nifedipine, and diltiazem. |
|
|
Term
| What is the structural classification of verapamil? |
|
Definition
|
|
Term
| What is the mechanism of action of L-type calcium channel blockers? |
|
Definition
| They treat angina, proximal tachycardia, atrial flutter, fibrilation, and essential HTN. |
|
|
Term
| What is the structural pharmacology of diltiazem? |
|
Definition
|
|
Term
| How effective is diltiazem in comparison to the verapamil and nifedipine? |
|
Definition
| Diltiazem is the least potent of the CCB's. (nifedipine>verapamil>diltiazem) |
|
|
Term
| What is the therapeutic use for verapamil and diltiazem? |
|
Definition
SLOWS SA NODE!
LACKS Reflex TACHY.
Most useful in low renin HTN, blacks and elderly.
NO FLUID RETENTION.
Ca channel blocker for arrythmia
Class IV |
|
|
Term
| What are the adverse effects of verapamil and diltiazem? |
|
Definition
| Flushing, headache, edemas and bradychardia, AV node conduction defects, risk of cardiac events in short-acting drugs. |
|
|
Term
| What pharmacological action of minodixil? |
|
Definition
| potassium channel activator |
|
|
Term
| How is minodixil administered? |
|
Definition
| Used ONLY IN COMBO therapy orally |
|
|
Term
| What are the adverse effects of minodixil? |
|
Definition
| Fluid retention, tachycardia, increased cardiac output which leads to CHF, pericardial effusions, hypertrichosis. |
|
|
Term
| What is the pharmacological action of guanethidine? |
|
Definition
|
|
Term
| How is guanethidine administered? i.e. monotherapy, combination |
|
Definition
|
|
Term
| What is the pharmacological action of diazoxide? |
|
Definition
|
|
Term
| What three drugs are K channel activators? |
|
Definition
| diazoxide, guanethidine, and minodixil |
|
|
Term
| What is the pharmacological action of hydrALAZine? |
|
Definition
| ACTIVATES NO/guanylate cyclase pathway. |
|
|
Term
| What are the therapeutic uses of hydrALAzine? |
|
Definition
ONLY IN COMBINATION, for HTN emergencies.
available po and IV |
|
|
Term
| What are the adverse effects of hydrALAZine? |
|
Definition
| tachycardia, palpitations, HYPOtension, n/v, Lupus-like syndrome, and edema |
|
|
Term
| How is nitroprusside administered and why? |
|
Definition
|
|
Term
| What is the pharmacologic action of nitroprusside? |
|
Definition
| Activation of NO/guanylate cyclase pathway |
|
|
Term
| What are the adverse effects of nitroprusside? |
|
Definition
| sweating, tachycardia, nausea, psychosis, formation of cyanate ion |
|
|
Term
| What is the pharmacologic action of epoprostenol / prostacyclin / PGI2? |
|
Definition
| IP prostanoid receptor agonist, short acting potent vasodilator. |
|
|
Term
| What is the therapeutic use for epoprostenol/prostacyclin/PGI2? |
|
Definition
|
|
Term
| What is the pharmcological action of bosentan? |
|
Definition
| nonselective alpha/beta endothelin receptor antagonist |
|
|
Term
| How is bosentan administered and what for? |
|
Definition
| Oral admin for pulmonary HTN |
|
|
Term
| What is the adverse effect of bosentan? |
|
Definition
|
|
Term
| What is the contraindication for bosentan? |
|
Definition
| contraindicated in pregnancy |
|
|
Term
| What is the pharmacological action of sildenafil? |
|
Definition
PDE5 inhibition
inhibits cGMP--> GMP |
|
|
Term
| What is the therapeutic use for sildenafil? |
|
Definition
|
|
Term
| What are the adverse effects of sildenafil? |
|
Definition
| dyspepsia, headache, and dizziness |
|
|
Term
| What is the pharmacologic action of fenoldopam? |
|
Definition
D1 dopamine receptor agonists
Increase renal blood flow,
Decrease blood pressure,
SHORT T1/2 |
|
|
Term
| What is the therapeutic use for fenoldopam? |
|
Definition
| IV emergency HTN situations |
|
|
Term
| What is the pharmacological action of nitroglycerin? |
|
Definition
Activation of NO/ guanylate cyclase pathway.
***Only 10% SURVIVE 1ST PASS METABOLISM |
|
|
Term
| When is nitroglycerin used? |
|
Definition
|
|
Term
| What are the side effects of nitroglycerin? |
|
Definition
| HYPOtension, vasodilation, REFLEX TACHYCARDIA |
|
|
Term
| What are the adverse effects of isosorbides (mono and dinitrates)? |
|
Definition
| HYPOtension, vasodilation, REFLEX TACHYCARDIA |
|
|
Term
| What is the pharmacological action of alpha methyldopa? |
|
Definition
Alpha-2 agonist
Vasodilation and decrease in heart rate by reducing sympathetic tone |
|
|
Term
| How is alpha methyldopa activated? |
|
Definition
| PRODRUG converted to alpha-methylnorepinephrine |
|
|
Term
| How frequently is a-methyldopa used? |
|
Definition
| not used often or alone. Old drugs. |
|
|
Term
| What is the mechanism of action of a-methyldopa, clonidine, guanabenz, and guanafacine and the resulting effects? |
|
Definition
| IV: smooth muscle vascular a2 receptors open Ca2+ channels causing vasoconstriction. This leads to HYPOtension, sedation, withdrawal syndrome (HTN, Tachy, nervousness, excitement), Dry mouth, stuffiness, contact dermatitis, vivid dreams, restlessness, depression, and rebound HTN. |
|
|
Term
| What is the pharmacological action of clonidine? |
|
Definition
Alpha 2 agonist
Vasodilation and decrease in HR due to reduction in sympathetic tone |
|
|
Term
| What are the alpha-2 agonists that induce vasodilation and decrease in HR by reducing sympathetic tone? Which is a prodrug**? |
|
Definition
a-methyldopa**
guanafacine, guanabenz, clonidine |
|
|
Term
| What is the classification of resperine? |
|
Definition
| depleting drug: deplete Norepinephrine from nerve terminals and adrenal medulla |
|
|
Term
| What is the therapeutic use of resperine? |
|
Definition
| Hardly any, not used very much, Increases catecholamine sensitivity (i.e. epinephrine) |
|
|
Term
| What is the adverse effect of resperine? |
|
Definition
| diarrhea, stuffiness, nausea, nightmares, sedation, fluid retention, decreases libido, tremors, arrhythmia, depression |
|
|
Term
| What is the pharmacological action of guanethadine and guanadrel? |
|
Definition
| depleting drug: deplete Norepinephrine from nerve terminals and adrenal medulla |
|
|
Term
| What is the therapuetic use for guanethadine and guanadrel? |
|
Definition
|
|
Term
| When are Depleting drugs used? guanethadine, guanadrel, and resperine? |
|
Definition
| Hardly any, not used very much, Increases catecholamine sensitivity (i.e. epinephrine) |
|
|
