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Pharm HTN CHF
KYCOM Block 13
89
Pharmacology
Graduate
01/30/2014

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Cards

Term
what is the general order for tx htn 12
Definition
thiazide diruetic
ACE inhibitor / ARB
CCB
BB
other: renin inhibitor, ALD receptor antagonist, a1 adrenergic blocker, a2 agonist, peripherial adrenergic blockers, non-specific adrenergic blockers, vasodilators
Term
what is the general order for tx of CHF 10
Definition
ACEI/ARB
BB: metaprolol, bisprolol
Non-specific BB: carvedilol
amlodipiine
hydralazine
inotropic: B agonist, phosphodiesterase inhibitor, nesiritide, digitalis
Term
explain the theatment of eldelry of AA with HTN 2
Definition
thiazide
CCB
other
Term
explain the TX of HTN post MI 2
Definition
24h: ACEI
maintain: ARB, BB
Term
explain the TX of HTN in pt with renal failure 1
Definition
ACEI/ARB
Term
explain TX of HTN in pt with DM 1
Definition
ACEI/ARB
Term
explain TX of HTN in pregnant pt
Definition
mehyldopa
Term
explain TX of HTN in pt with renal HTN
Definition
clonidine
Term
what is #1 and #2 choice for acute HTN
Definition
1. sodium nutroprusside
2. non-specific adrenergic blockers (labelalol, carvedilol)
Term
explain TX of HTN in pt with asthma or peripherial vascular disease
Definition
CCB
Term
what HTN drugs can tx diabetic nephropathy 2
Definition
ACEI, ARB
Term
ther than HTN what can BB treat 4
Definition
hyperthyroid
migraine prophylaxia
glaucoma
cardiomyopathy
Term
other than HTN what can a1 adrenergic blocker tx
Definition
BPH
Term
what than HTN what vasodilator has another use, what is it
Definition
minoxidil: topical male pattern baldness
Term
what drug do you use in CHF renal failure pt (#1 and #2)
Definition
DOC: ACEI/ARB
2: hydralazine
Term
2 thiazide diruetics
Definition
chlorthalidone
hydrochlorothiazide
Term
3 ACEI
Definition
catopril
lisinopril
-pril
Term
2 ARN (ANGII receptor blocker)
Definition
losartin
-sartin
Term
3 CCB, which can be used for CHF
Definition
verapamil
diatiazem
amlodipine - CHF and HTN
Term
explain naming of BB, which can be used in CHF
Definition
A-M B1 selective -olol
N-Z B1/2 non-selective -olol
metapropolol
bispropolol
Term
1 renin inhibitor
Definition
aliskirein
Term
2 ALD receptor antagonist
Definition
spironolactone
eplerenone
Term
2 a1 adrenergic blockers
Definition
prazosin
terazosin
doxazosin
Term
2 a2 agonist
Definition
clonidine
methyldopa
Term
1 peripherial adrenergic blocker
Definition
risperidine
Term
2 non-specific adrenergic blockers, which is used in CHF
Definition
labetalol
carvedilol - CHF and HTN
Term
4 vasodilators, which can be used for CHF
Definition
hydralazine - CHF and HTN
minoxidil
Na nitroprusside
isorbide dinitrate
Term
4 categories of inotropic drugs
Definition
B adrenergic antagonist
phosphodiesterase inhibitor
nesiritide
digitalis
Term
1 B adrenergic antagonist
Definition
dobutamine
dopamine
Term
2 phosphodiesterase inhibitor
Definition
inamirone
milrione
Term
what is nesiritide made of
Definition
recombinant human BNP
Term
2 tyes of digitalis
Definition
digoxin
digitoxin
Term
MOA thiazide diruetic
Definition
stops electrolyte transport causing Na/water excretion

decreases BV, CO and BO
increases urine output

urineoutput, CO, and BV return to normal in days but BP stays fixed due to vascular reactivity to NE and secreased structural resistance

overall: DECREASES PRELOAD
Term
MOA ACEI
Definition
stops conversion of ANGI to ANGII and bradyinin to inactive

causes vasodilation: inc preload and afterload
water/NA excretion: dec preload
prevents ALD cardiac remodel

stops renin feedback and renin builds up
Term
MOA ARB
Definition
stops ATI receptors so ANGII can't activate ALD or vasoconstrict

vasodilation: dec preload and afterload
water/Na excretion: dec preload
stops cardiac remodeling
Term
MOA verapamil
Definition
block L Ca channels in HEART MUSCLE slowing phase 4/0 at AV

decreases CO, increases PR, negative inotropic
Term
MOA dialtiazem
Definition
blocks L Ca channel in VESSELS AND HEART causing vasodilation and dec CO
Term
MOA aliodipine
Definition
block L Ca channels in VESSELS causing vasodilation
most likley to cause reflex tachycardia
Term
MOA BB
Definition
antagonize B1 on heart dec CO
antagonize B1 on JG decreasing renin

vasodilation
Na/water excretion
stops cardiac remodeling - some...

improves symptoms, exercise tolerance
Term
administration BB
Definition
low dose, build over 4-5 wks
Term
MOA renin inhibitor
Definition
stops conversion of angiotensinogen to ANG I

vasodilation
Na/water excretion
stoms cardiac remodeling - some...
increased renin due to loss of neg feedback
Term
MOA ALD receptor antagonist
Definition
K sparing diruetics (not awesome diruetics) block ALD which causes K wasting

cause Na/water excretion decreasing preload
Term
MOA a1 adrenergic blockers
Definition
block a1 on ARTERIOLES AND VEINS causing vasodilation
Term
MOA a2 agonists
Definition
decrease sympathetic outflow from brainstem vasopressors (main regulator of Na retention)
Term
MOA peripherial adrenergic blockers
Definition
blocks reuptake of NE/E causig depletion and decreased SNS

vasodilation, dec CO
Term
MOA non-specific adrenergic blockers
Definition
block A1, B1, B2
decrease TPR without reflex tachycardia
Term
MOA hydralazine
Definition
NO causes ARTERIOLE dilation (increases flow most)
Term
MOA minoxidil
Definition
opens K channels hypopolarizing, dilates ARTERIOLES
Term
MOA Na nitropursside
Definition
NO dilates VEINS AND ARTERIES
Term
administration Na nitroprusside
Definition
IV in ICU
Term
MOA isorbide dinitrate
Definition
VENOdilator, decreases proload
Term
TX acute CHF
Definition
B adrenergic antagonist: dobutamine, dopanine
pisphodiesterase inhibitor: inamirone, milrone
Term
TX CHF with AFib
Definition
digitalis
Term
MOA dobutamine
Definition
antagonize B1 and increase CO
Term
administration dobutamine
Definition
IV in ICU
Term
administration of dopamine and effect
Definition
<2ug/kg: D1 vasodilate renal
2-5ug/kg: V1 inc CO
5015ug/kg: A1 vasoconstrict, inc TPR
Term
MOA phosphodiesterase inhibitor
Definition
increase cAMP, phosphorlyates Ca channel
increases CO
Term
MOA
neisritide
Definition
vasodilate veins and arteries
Term
MOA digtaliz and digitoxin
Definition
reversibly bind Na/K ATPase
chances Ca/Na channel
Ca comes in
increases CO
decreases SNS, TPR
Term
what is the difference between digitalis and digitoxin
Definition
digitoxin: t1/2: 15d
digitalis: t1/2: 48h

toxin is more toxic
Term
SE thiazide diruetics 2
Definition
K depletion (restrict Na intake)
increased glucose (don't DC if become diabetic)
Term
interactions thiazide diruetics, why
Definition
digitallis: messes with Na/K ATPase
Term
contraindications thiazide diruetics 3, why
Definition
DM: increases glucose
chronic arrhythmia, acute MI: messes with K
Term
SE ACEI
Definition
catopril cough: due to brady build up
angioedema: face and mouth
teratogenic
acute renal failure
Term
why does ACEI cause acute renal failure
Definition
ANG II constricts efferent arteriole when renal perfusion is low (never use in bilateral renal artery stenosis)
Term
interactions/contraindications ACEI 2
Definition
never use with ARB
dont use in renal artery tenosis
Term
SE ARB 2
Definition
teratogenic
acute renal failure
Term
SE verapamil 3
Definition
constipation
dizzy
naturitic
Term
interactions/contrindications of verpamil 3
Definition
no diruetic: its a naturitic
no CHF
no BB
Term
interactions/contrindications of dialtiazem 3
Definition
no diruetic: its a naturitic
no CHF
no BB
Term
SE dialtiazem
Definition
dizzy
Term
SE amlodipine 3
Definition
gingival hyperplasia
dizzy
reflex tachycardia
Term
contraindications amlodipine
Definition
naturitic: no diruetics
Term
SE BB
Definition
inc LDL and TG
withdrawl: rebount HTN
hypotension
bradycardia
decreased lobido, lethargy

B2: bronchoconstriction, increases glucose
Term
contraindications to BB 2
Definition
dont use non-selective in asthmatic or diabetic
Term
SE aliskirenin 3
Definition
slight cough
angioedema
teratopenic
Term
SE ALD receptor antagonist
Definition
hyperkalemia
Term
contraindications to ALD receptor antagonist 2
Definition
CaCl >30
K > 5
Term
how can you prevent hyperkalemia in ALD receptor antagonist
Definition
use in combo with ACRI/ARB
Term
SE a1 adrenergic blocker 2
Definition
postural HTN on 1st dose
dizzy
Term
SE a2 agonist 4
Definition
sedation
dry mouth
withdrawl: rebound HTN
hemolytic anemia - methyldopa
Term
SE risperpine 3
Definition
sedation
bradycardia
depression
Term
SE non-specific BB 3
Definition
bronchoconstriction
arrhythmia (C blockade)
dec lobido
Term
SE all vasodilators 2
Definition
lupus like in slow acetylators
reflex tachycardia
Term
SE Na nitroprusside, why 2
Definition
hypotension
metabolized to cyanide
Term
tx cyanide poisoning
Definition
thiosulfate
Term
SE digitalis 7
Definition
anorexia, nausea, vomiting, headache, fatigue, confusion, blurred yellow vision
Term
digitalis toxicity signs 8, why
Definition
Ca overload increases automaticity causing DAD leading to ...
increased systole
tachycardia
PVC
fibrillation
complete block
VTac
VFib
Term
things that cause predisposition to digitalis toxicity 4
Definition
hypoklemia: arrhythmia
wuinidine and verapamil: displace it
diuretics: increase its binding
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