Term
| Loop (Furosemide) and Spironolactone Use |
|
Definition
CHF
dec (1)preload(2)intravascular volume overload(3)cardiac size(4)EDP |
|
|
Term
|
Definition
CHF, anti-HTN
dec (1) preload (2) EC volume (3) CO (4) cardiac size (5) EDP (6) TPR - long term |
|
|
Term
|
Definition
Furosemide
Thiazide
Spironolactone |
|
|
Term
|
Definition
| inhibits Na-K-2Cl co-transporter in the thick ascending LoH dec Na retention |
|
|
Term
|
Definition
| inhibits Na-Cl co-transporter in the distal tuble dec Na retention |
|
|
Term
|
Definition
| inhibits aldosterone R in the collecting tubules blocking Na reabsorptive effects of aldosterone |
|
|
Term
|
Definition
| hypokalemia, hypokalemic metabolic alkalosis, ototoxicity, enhances digitalis toxicity |
|
|
Term
|
Definition
| hypokalemia, hypokalemic metabolic alkalosis, hyperlipidemia, hyperglycemia, enhances digitalis toxicity, not useful if pt has dec GFR |
|
|
Term
| what is probably the best anti-hypertensive tx for elderly pts that have low renin levels no renal insufficiency? |
|
Definition
|
|
Term
| Spironolactone Side Effects |
|
Definition
|
|
Term
|
Definition
Isosorbide Dinitrate
Nitroglycerin
Amyl Nitrite
Sodium Nitroprusside (nipride) |
|
|
Term
| Isosorbide Dinitrate, Nitroglycerin Use |
|
Definition
CHF, all forms of angina
dec (1)preload(2)afterload - 2o
inhibits platelet aggregation, coronary spasm, restenosis |
|
|
Term
| Isosorbide Dinitrate, Nitroglycerin, Amyl Nitrate MOA |
|
Definition
diffuse into sm muscle grps and is converted to NO by reductants (enzymes w/ sulfhydryl grps) -> relaxation of vessels via cGMP
inc myocardial O2 supply and dec myocardial O2 demand |
|
|
Term
| Isosorbide Dinitrate, Nitroglycerin, Amyl Nitrite Side Effects |
|
Definition
| HA, palpitations (reflex tachycardia), flushing, tolerance, orthostatic hypotension, methemoglobinemia, contraindicated in pts who have taken ED meds |
|
|
Term
|
Definition
all forms of angina
dec (1)preload (2) afterload - 2o
inhibits platelet aggregation, coronary spasm, and restenosis |
|
|
Term
| Sodium Nitroprusside (nipride)Use |
|
Definition
anti-HTN
drug of choice in emergency HTN crisis (IV infusion) |
|
|
Term
| Sodium Nitroprusside (nipride)MOA |
|
Definition
| decomposes and released NO when contacts RBCs -> diltation of arterioles and venules leading to an overall dec in myocardial O2 demand |
|
|
Term
| Sodium Nitroprusside (nipride) Side Effects |
|
Definition
| excessive vasodilatation and hypotension, conversion to cyanide and thiocyanate (toxicity that can be avoided w/ concom admin of Na thiosulfate) |
|
|
Term
| Digoxin (US), Digitoxin (Canada) Use |
|
Definition
|
|
Term
| Digoxin (US), Digitoxin (Canada) MOA |
|
Definition
| inhibit Na-K-ATPase (pos ionotrope) -> inc intensity/force of contraction, dec sympathetic activity, inc parasympathetic activity (anti-arrhythmic property), dec AP duration, dec renin conc |
|
|
Term
| Digoxin (US), Digitoxin (Canada)Side Effects |
|
Definition
Early: anorexia, nausea, EKG changes
Late: disorientation, visual effects
Life Threatening: arrhythmias
inc toxicity if taken w/ thiazide or furosemide |
|
|
Term
| Digoxin (US), Digitoxin (Canada)Toxicity Management |
|
Definition
| give Fab abs, K, anti-arrhythmics(class IB) |
|
|
Term
|
Definition
|
|
Term
|
Definition
acute heart failure
inc contractility, vasodiltation (dec preload and afterload), inc CO, dec systemic vascular resistance |
|
|
Term
|
Definition
| phosphodiesterase inhibitors (pos ionotrope) -> inc levels of cAMP and cytosolic Ca |
|
|
Term
| Amrinone, Milrinone Side Effects |
|
Definition
| nauea, vomiting, thrombocytopenia, liver abnormalities, arrhythmias |
|
|
Term
|
Definition
|
|
Term
|
Definition
emergency heart failure
inc urinary output (relieves edema), inc CO, dec ventricular filling pressures |
|
|
Term
|
Definition
| renal arteriolar vasodilation (D1 R) and pos ionotrope (B1 agonist) |
|
|
Term
|
Definition
severe LV dysfunction that is unresponsive to conventional drugs
inc CO, dec systemic vascular resistance, dec ventricular filling pressures |
|
|
Term
|
Definition
| selective B1 agonist at lose doses (5mg/kg/min), pos ionotrope |
|
|
Term
| Dopamine and Dobutamine Side Effects |
|
Definition
| tachyplaxis, dose-dependent tachycardia and arrhythmias |
|
|
Term
|
Definition
Propanolol
Carvedilol
Atenolol
Metoprolol
Nadolol
Pindolol
Acebutolol
Carteolol
Penbutolol |
|
|
Term
|
Definition
| CHF, stable angina, angina w/ recent MI hx, mild HTN, all arrhythmias arising from symp stimulations, prevention of recurrent infarction due to ventricular arrhythmias in pts recovering from AMI, termination and prevention of AVNRT, congenital long QT syndrome |
|
|
Term
|
Definition
| non-selective B-blockers w/o intrinsic sympathomimetic activity that causes (1)dec renin release - dec TPR over time(2)dec preload and afterload (3)dec ventricular remodeling(4)dec HR and contractility via a dec in the slope of phase 4 depolarization(5)inc refractory period |
|
|
Term
|
Definition
| bradycardia, fatigue, exacerbation of pre-existing asthma or diabetes, dec HDL and inc TG, nightmares, depression, memory loss, GI disturbances, sexual dysfunction, peripheral vascular insufficiency, |
|
|
Term
|
Definition
| CHF, stable angina, angina w/ recent MI hx |
|
|
Term
|
Definition
non-selective B-blocker (neg ionotrope) -> dec renin release (dec in preload and afterload), dec HR, contractility, and BP
dec myocardial O2 demand |
|
|
Term
| Atenolol and Metoprolol Use |
|
Definition
| CHF, stable angina, angina w/ recent MI hx, HTN pts who suffer asthma, DM, or peripheral vascular insufficiency, all arrhythmias arising from symp stimulation, prevention of recurrent infarction 2o to ventricular arrhythmias in the recovering AMI pt, termination of AVNRT, congential long QT syndrome |
|
|
Term
| Atenolol and Metoprolol MOA |
|
Definition
| selective B1 blocker -> 1)dec renin release - dec TPR over time(2)dec preload and afterload (3)dec ventricular remodeling(4)dec HR and contractility via a dec in the slope of phase 4 depolarization(5)inc refractory period |
|
|
Term
|
Definition
| stable angina, angina w/ recent MI hx, HTN |
|
|
Term
|
Definition
| non-selective B-blocker w/o intrinsic sympathomimetic activity -> (1)dec HR, contractility, BP (2)dec myocardial O2 demand at rest and during exercise |
|
|
Term
| Pindolol and Acebutolol Use |
|
Definition
| stable angina, angina w/ recent MI hx, HTN, all arrhythmias arising from symp stimulation, prevention of recurrent infarction 2o to a ventricular arrhythmias in a recovering AMI pt, termination of AVNRT, congenital QT syndrome |
|
|
Term
| Pindolol and Acebutolol MOA |
|
Definition
| partial B-agonist w/ intrinsic sympathomimetic activity -> (1)dec HR, contractility, and BP (2) dec myocardial O2 demand at rest and during exervise (3) dec TPR and CO |
|
|
Term
| Carteolol and Penbutolol Use |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| partial B agonist w/ intrinsic sympathomimetic activity |
|
|
Term
|
Definition
Captopril
Lisinopril
Enalapril
Ramipril
Fosinopril
Quinapril |
|
|
Term
| Captopril, Lisinopril, Enalapril, Ramipril, Fosinopril, Quinapril Use |
|
Definition
| all pts w/ HF, HTN w/ high plasma renin, ACS, diabetic nephropathy |
|
|
Term
| Captopril, Lisinopril, Enalapril, Ramipril, Fosinopril, Quinapril MOA |
|
Definition
block the enzyme needed to generate AT-II + inhibits degradation of bradykinin
(1) dec TPR and afterload(2)dec Na and H2O retention(3)dec long-term ventricular remodeling |
|
|
Term
| Captopril, Lisinopril, Enalapril, Ramipril, Fosinopril, Quinapril Side Effects |
|
Definition
| dry cough, angioedema, hyperkalemia, excessive hypotension, skin rash, loss of taste, proteinuria, neutropenia, contraindicated in pregnancy and pts w/ bilateral renal artery stenosis |
|
|
Term
| why should you not take spironolactone and ACEi together? |
|
Definition
| both inc K = hyperkalemia |
|
|
Term
|
Definition
Candesartan
Eprosartan
Irbesartan
Losartan
Olmesartan
Telmesartan |
|
|
Term
|
Definition
| pts in HF who do not respond to ACEi, HTN w/ high plasma renin |
|
|
Term
| Candesartan, Eprosartan, Irbesartan, Olmesartan, Telmesartan Use |
|
Definition
| pts in HF that do not respond to ACEi |
|
|
Term
| Captopril, Lisinopril, Enalapril, Ramipril, Fosinopril, Quinapril MOA |
|
Definition
| inhibit action of AT-II by blocking its binding to AT-I R -> dec TPR and afterload, dec Na and H2O retention |
|
|
Term
| Captopril, Lisinopril, Enalapril, Ramipril, Fosinopril, Quinapril Side Effects |
|
Definition
| hyperkalemia (no dry cough or angioedema) |
|
|
Term
|
Definition
Hydralazine
Nesiritide
Minoxidil
Diazoxide |
|
|
Term
|
Definition
| CHF pt's that cannot tolerate ACEi or ARBs, HTN in pregnancy, 3rd line for mod or severe HTN (combo w/ diuretic and B-blocker) |
|
|
Term
|
Definition
| hyperpolarize vascular sm muscle causing arteriolar dilation ->(1)dec afterload(2)dec resistance in coronary/cerebral/renal circulation |
|
|
Term
|
Definition
| HA,nausea, palpitation, sweating, drug induced lupus, reflex tachycardia, flushing, inc renin, angina |
|
|
Term
|
Definition
| CHF -> dec preload and afterload |
|
|
Term
|
Definition
| recombinant human B-type natriuretic peptide -> naturiesis and diuresis by dec Na reabsorption in the collecting tubules, dec plasma renin |
|
|
Term
|
Definition
| hypotension, inc risk of renal dysfunction |
|
|
Term
| Management for CHF Class 1 |
|
Definition
|
|
Term
| Management for CHF Class 2 |
|
Definition
ACEi
digitalis (if AF)
diuretics (if congestion)
B-blocker (if hemodynamically stable) |
|
|
Term
| Management for CHF Class 3 and 4 |
|
Definition
ACEi
diuretics
digitalis (if AF)
B-blocker (if hemodynamically stable) |
|
|
Term
|
Definition
Dihydropyridines: Nifedepine, Amlodepine, Nicardipine
Non-dihydropyridines: Verapamil, Diltiazem, Bepridil (not used) |
|
|
Term
| Nifedepine, Amlodepine, Nicardepine Use |
|
Definition
| variant angina, angina, mild-mod HTN (esp if low renin) |
|
|
Term
| Nifedepine, Amlodepine, Nicardepine MOA |
|
Definition
inhibit L-type Ca channels in the vasculature -> dec vascular resistance, dilate coronary arteries
dec afterload and myocardial O2 demand |
|
|
Term
| Nifedepine, Amlodepine, Nicardepine Side Effects |
|
Definition
| hypotension, peripheral edema due to hydrostatic pressure, flushing, reflex tachycardia |
|
|
Term
|
Definition
| 3rd line agent for severe HTN |
|
|
Term
|
Definition
hyperpolarization (K channel opening)->
potent stimulator of renin secreton, arteriolar vasodilation in the skin/sk muscle/GI tract/heart |
|
|
Term
|
Definition
| Na and H2O retention, reflex tachycardia, hirsutism |
|
|
Term
|
Definition
| drug of choice in hypertensive emergency crisis IF accurate infusion pumps are not available to admin Na nitroprusside |
|
|
Term
|
Definition
| activates K-ATPase channels -> relaxation of arterial sm muscl |
|
|
Term
|
Definition
| Na and H2O retention, hyperglycemia (inhibits sec of insulin) |
|
|
Term
| Verapamil and Diltiazem Use |
|
Definition
| stable and variant agina, mild-mod HTN (esp if low renin), re-entrant supraventricular tachycardia |
|
|
Term
| Verapamil and Diltiazem MOA |
|
Definition
| inhibits L-type Ca channels in the vasculature and in the heart -> (1)dec cardiac contractility(2)dec vascular resistance(3)dilate coronary arteries |
|
|
Term
| Verapamil and Diltiazem Side Effects |
|
Definition
| constipation (verapamil), peripheral edema, bradycardia, hypotension, heart block, heart failure |
|
|
Term
|
Definition
|
|
Term
|
Definition
| direct renin inhibitor -> dec AT-II production |
|
|
Term
|
Definition
| stomach pain, diarrhea, hypersensitivity rxn, hypotenson, no dry cough or angioedema |
|
|
Term
|
Definition
HTN pt w/ dyslipidemia
mod HTN w/ diuretic and B-blocker
HTN w/ prostatism |
|
|
Term
|
Definition
| a-blocker -> dec arterial pressure by dilating both arterioles and venules |
|
|
Term
|
Definition
| variable amt of postural hypotension, Na and H2O retention, pos test for anti-nuclear factor |
|
|
Term
|
Definition
|
|
Term
|
Definition
mod HTN in combo w/ thiazides
HTN in pregnancy |
|
|
Term
|
Definition
| mod HTN w/ diuretic (2nd line) |
|
|
Term
| a-Methyldopa and Clonidine MOA |
|
Definition
| activate centrally located a2 R -> dec release of presynaptic NE |
|
|
Term
| a-Methyldopa Side Effects |
|
Definition
| sedation, mental lassitude, impaired mental concentration, auto-Abs agains the Rh locus causing a pos Coombs test (long-term) |
|
|
Term
|
Definition
| dry mouth, sedation, rapid withdrawal can cause life-threatening hypertensive crisis |
|
|
Term
| Colestipol, Cholestyramine Use |
|
Definition
| bile acid binding resins that dec overall CHL and inc LDL uptake from plasma |
|
|
Term
| Colestipol, Cholestyramine MOA |
|
Definition
| reduce fat absorption from intestine by binding bile acids -> inc metabolism of CHL to bile acids in order to replace |
|
|
Term
| Colestipol, Cholestyramine Side Effects |
|
Definition
| constipation, irritant, can interfere w/ other orally given drugs, vit ADEK absorption |
|
|
Term
| Lovastatin, Mevastatin, Pravastatin, Atorvastatin, Simvastatin, Fluvastatin Use |
|
Definition
| CHL synthesis inhibitors that dec LDL and overall CHL levels |
|
|
Term
| Lovastatin, Mevastatin, Pravastatin, Atorvastatin, Simvastatin, Fluvastatin MOA |
|
Definition
| HMG-CoA reductase inhibition -> block enzyme needed for liver CHL synthesis |
|
|
Term
| Lovastatin, Mevastatin, Pravastatin, Atorvastatin, Simvastatin, Fluvastatin Side Effects |
|
Definition
| usually well tolerated if normal liver FN, myopathy |
|
|
Term
|
Definition
|
|
Term
|
Definition
| dec secretion of VLDL from the liver |
|
|
Term
|
Definition
| PG release (can prevent w/ concom NSAIDs), GI distress, ulcers (can prevent w/ concom antacids) |
|
|
Term
|
Definition
Gemfibrozil
Fenofibrate
Clofibtrate |
|
|
Term
| Gemfibrozil, Fenofibrate, Clofibrate Use |
|
Definition
| inc TG clearance, dec LDL, and inc HDL |
|
|
Term
| Gemfibrozil, Fenofibrate, Clofibrate MOA |
|
Definition
| stimulate lipoprotein lipase -> dec VLDL and cleave TG (dec their number) |
|
|
Term
| Gemfibrozil, Fenofibrate, Clofibrate Side Effects |
|
Definition
| inc risk of CHL gallstones |
|
|
Term
| what happens if you combine Gemfibrozil, Fenofibrate, Clofibrate w/ statins? |
|
Definition
|
|
Term
|
Definition
dec LDL via inhibition of LDL oxidation and uptake by mac; can dec HDL (limits overall use) = not very useful
pt will have GI side effects |
|
|
Term
|
Definition
Na channel blockers
(A) quindine, procainamide, disopyramide
(B)lidocaine, mexiletine, tocainide
(C) flecainide |
|
|
Term
|
Definition
| B-blockers: propanolol, atenolol, metoprolol, acebutolol, pindolol |
|
|
Term
| Class III Antiarrhythmics |
|
Definition
| K Channel Blockers: amiodarone, bretylium, sotalol, ibutilide |
|
|
Term
|
Definition
| CCBs: verapamil, diltiazem |
|
|
Term
|
Definition
| IA: AF, Atrial Flutter, Vent Tachycardia |
|
|
Term
| Quinidine, Procainamide, Disopyramide MOA |
|
Definition
| blocks activated Na channels and K channels -> depresses SA node, slows repolarization, lengthens QT, depresses excitability and conduction |
|
|
Term
|
Definition
| anti-muscarinic effect may cause in AV conduction (dose-dependent), torsades de pointes, cinchonism (HA, lightheadness,dizziness,tinnitus), diarrhea; contraindicated in pts w/ long QT and sick sinus syndrome; inc plasma levels of digoxin |
|
|
Term
|
Definition
| IA: atrial and ventricular arrhythmias during and/or immediately after MI to prevent re-entrant arrhythmias |
|
|
Term
| Procainamide Side Effects |
|
Definition
| less anti-muscarinic effects, torsades de pointes, drug induced lupus, can cause peripheral diltation due to inhibition of NT at symp ganglia |
|
|
Term
|
Definition
|
|
Term
| Disopyramide Side Effects |
|
Definition
| anti-muscarinic effect > quinidine (dry mouth, blurred vision, constipation, worsening of pre-exisitng, glaucoma, urinary retention), torsades de pointes, contraindicated in CHF pts |
|
|
Term
|
Definition
| (IB) emergency ventricular arrhythmias (V tach, PVCs) |
|
|
Term
| Lidocaine, Mexiletine, and Tocainide MOA |
|
Definition
| blocks both activated and inactivated Na channels -> dec repolarization, dec refractory period |
|
|
Term
|
Definition
| paresthesias, tremor, light-headednes, hearing disturbances, slurred speech, convulsions |
|
|
Term
| Mexiletine and Tocainide Use |
|
Definition
| (IB) adjunct for ventricular arrhythmias |
|
|
Term
| Mexiletine and Tocainide Side Effects |
|
Definition
| tremor, blurred vision, lethargy, does not prolong QT, and does not have anti-muscarinic effects |
|
|
Term
|
Definition
| (IC) suppress PVC, life-threatening paroxysmal supraventricular tachycardia |
|
|
Term
|
Definition
| potent blocker of Na channels but has slow kinetics -> depress rate of phase 0 in ventricular AP |
|
|
Term
|
Definition
may exacerbate arrhythmias in pts w/ pre-existing ventricular tachyarrhythmias and those w/ a previous MI, can cause sinus node dysfunction and conduction block
no anti-muscarinic effect |
|
|
Term
|
Definition
prevention of recurrent ventricular tachycardia or fibrillation in pt w/ CHF or hx of MI
maintain normal sinus inAF
adjunct w/ Mexiletine for pt w/ ICDs |
|
|
Term
|
Definition
blocks all K channels -> (1)inc refractory period(2)lengthen plateau
effective blocker of inactivated Na channels -> (1)dec rate of firing of pacemaker cells(2)slows sinus rate and AV conduction velocity(3)inc atrial/AV node/ventricular refractory periods(4)anti-angina effects
really has class I-IV activity |
|
|
Term
|
Definition
| sx bradycardia or heart block in pts w/ sinus or AV nodal dz, pulm fibrosis, concentrates in cornea, paresthesias, tremor, ataxia, HA, thyroid dysfunction |
|
|
Term
|
Definition
| life-threatening ventricular tachycardia and ventricular fibrillation after lidocaine or defibrillation has failed |
|
|
Term
|
Definition
drug concentrates in terminal of symp neurons and has pos ionotropic effects -> dec in catecholamines
effects are most pronounced in ischemic cells |
|
|
Term
|
Definition
| prolong refractoriness in Purkinje fibers (1o) and ventricular muscle (K blocking effect), transient HTN, proarrhythmic, nausea, vomiting |
|
|
Term
|
Definition
| supraventricular and ventricular arrhythmias |
|
|
Term
|
Definition
mixed class II and III antiarrhythmic agent
non-selective B-blocker that slows repolarization and prolongs refractory period |
|
|
Term
|
Definition
| bradycardia, torsades de pointes (prolonged QT) |
|
|
Term
|
Definition
| terminate AF and atrial flutter |
|
|
Term
|
Definition
| inc slow inward Na plateau current + dec outward K current -> prolong atrial and ventricular refractory period w/ minimal effect on conduction |
|
|
Term
|
Definition
| pro-arrhythmic, torsades de pointes (long QT) |
|
|
Term
|
Definition
| 1st line agent for conversion of paroxysmal supraventricular tachycardia to sinus; AVNRT |
|
|
Term
|
Definition
| activates K outward current (hyperpolarization), inhibits cAMP dependent Ca influx, suppression of Ca dependent AP -> directly inhibits SA node, atrial, AV node conduction |
|
|
Term
|
Definition
| flushing, SOB, bronchoconstriction in asthmatics, AV block, AF, HA, hypotension, nausea |
|
|
Term
| Unfractionated Heparin Use |
|
Definition
prevention and tx of DVT
prevention of PE
initial tx in AMI to prevent systemic thromboembolism
maintain patency in indwelling aterial and venous catheters
inital tx of angina |
|
|
Term
| Low Molecular Weight Heparain |
|
Definition
Enoxaparin
Dalteparin
Tinzaparin |
|
|
Term
| Enoxaparin, Dalteparin, Tinzaparin Use |
|
Definition
|
|
Term
Unfractionated Heparain, Enoxaparin
Dalteparin, Tinzaparin MOA |
|
Definition
binds to anti-thrombin III and induces conformational change to inc its affinity for clotting factors -> better inhibition of thrombin, Xa, IXa, VIIa
prolongs aPTT |
|
|
Term
Unfractionated Heparain, Enoxaparin
Dalteparin, Tinzaparin Side Effects |
|
Definition
bleeding, heparain induced thrombocytopenia, osteoporosis (long-term), excessive anti-coagulation
use LMWH w/ caution in renal insufficiency pts |
|
|
Term
| Lepirudin, Bivalirudin, Argotroban Use |
|
Definition
pts w/ heparin induced thrombocytopenia
B: percutaneous coronary angioplasty and unstable angina |
|
|
Term
| Lepirudin, Bivalirudin, Argotroban |
|
Definition
direct thrombin inhibitors -> inactivate thrombin w/in thrombi
side effect: bleeding |
|
|
Term
|
Definition
|
|
Term
|
Definition
| binds to anti-thrombin III induced conformational change to inactivate Xa (no effect on thrombin) |
|
|
Term
|
Definition
venous thrombosis
PE
may be used w/ ASA to prevent venous thrombosis, pulmonary and systemic emboli post-MI
prevention of thrombosis and emboli formation in pts w/ AF |
|
|
Term
|
Definition
| delayed acting oral anticoagulant (8-12hrs) -> inhibits the recycling of ketoK to hydroxyK that is needed for prothrombin formation |
|
|
Term
|
Definition
| crosses the placenta (hemorrhagic fever in fetus, abnormal bone formation), cutaneous necrosis w/ dec activity of protein C, bleeding |
|
|
Term
| how do amiodarone, clopidogrel, and fluconazole enhance warfarin activity? |
|
Definition
| dec metabolism by inhibiting P450 enzymes -> inc in prothrombin time |
|
|
Term
| how do broad spectrum antibiotics enhance warfarin activity? |
|
Definition
| eliminate gut flora causing dec absorption and availability of vitK w/in the body (inc prothrombin time) |
|
|
Term
| Aspirin (low =81mg/dy)Use |
|
Definition
| primary agent for prevention of arterial thrombosis leading to MI and stroke |
|
|
Term
|
Definition
| irreversible acetylation of COX causing inhibition of the enzyme |
|
|
Term
|
Definition
| GI disturbances, renal toxicity, prolonged bleeding time |
|
|
Term
|
Definition
| acute PE, DVT, AMI, arterial thrombosis |
|
|
Term
|
Definition
| combines w/ plasminogen to catalyze its conversion into plasmin which hydrolyzes fibrin plugs |
|
|
Term
| Streptokinase Side Effects |
|
Definition
| bleeding, hypersensitivity rxns, systemic fibrinolysis |
|
|
Term
|
Definition
|
|
Term
|
Definition
| activates plasminogen to plasmin, but obtained from human fetal renal cells |
|
|
Term
|
Definition
| bleeding, no allergic rxn |
|
|
Term
|
Definition
alteplase
reteplase
tenecteplase
anistreplase |
|
|
Term
| alteplase, reteplase, tenecteplase, anisetreplase Use |
|
Definition
| MI (most effective if admin w/in 6hr), PE, peripheral arterial thromboembolism |
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|
Term
| alteplase, reteplase, tenecteplase, anisetreplase MOA |
|
Definition
| serine protease = rapidly activates plasminogen that is bound to fibrin w/in the thrombus or hemostatic plus (fibrin selective) |
|
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Term
| alteplase, reteplase, tenecteplase, anisetreplase Side Effects |
|
Definition
| bleeding, cerebral hemorrhage, contraindicated in pts w/ recent hemorrhagic stroke |
|
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Term
|
Definition
2o prevention of thrombotic strokes in pts intolerant to ASA
combo w/ ASA to prevent stent thrombosis |
|
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Term
|
Definition
| prevention in pts w/ recent MI, stroke, vascular dz, after coronary bypass |
|
|
Term
| Ticlopidine and Clopidogrel MOA |
|
Definition
| inhibits ADP R -> inhibits platelet aggregation (no direct effect on coagulation cascade) |
|
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Term
|
Definition
| thrombocytopenia (blood counts must be monitored) |
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Term
|
Definition
|
|
Term
|
Definition
adjunct w/ warfarin = prevention of thrombosis in prosthetic heart valves
adjunct w/ aspirin = pts w/ thrombotic diathesis |
|
|
Term
|
Definition
| inhibits phosphodiesterase -> inc cAMP in platelets + vasodilatation of the arteries |
|
|
Term
| Dipyridamole Side Effects |
|
Definition
| bleeding, paradoxical angina (coronary steal phenom) |
|
|
Term
| Abciximab, Eptifibatide, Tirofiban Use |
|
Definition
|
|
Term
| Abciximab, Eptifibatide, Tirofiban Side Effects |
|
Definition
| bleeding (esp if used w/ fibrinolytics), contraindicated during acute tx of STEMI (can be given after angioplasty) |
|
|
Term
|
Definition
| humanized monoclonal Ab directed againast the IIb/IIIa complex |
|
|
Term
| Eptifibatide, Tirofiban MOA |
|
Definition
| fibrinogen analogs that cause reversible inhibition binding of fibrinogen R |
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|
Term
|
Definition
| bipolar disorder (tx both manic and depressive sx) |
|
|
Term
|
Definition
| unclear - sm monovalent cation that may effect electrolyte and ion transport, NT, and 2nd messengers that monitor transmitter action |
|
|
Term
|
Definition
widening of QRS, diabetes insipidus, hypothyroidism, rash, alopecia, leukocytosis, teratogenic
initial tox: fine hand tremor, GI upset, mild polyuria, polydipsia, muscle weakness
mod tox: coarse tremor, slurred speech, sedation, lethargy
sev tox: CV collapse, stupor, death |
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Term
|
Definition
| considered by some to be 1st line tx for bipolar over lithium |
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|
Term
|
Definition
| blocks Na channels, activates K channels, enhances GABA transmission |
|
|
Term
|
Definition
| nausea, weight gain, liver FN tests will have to be performed |
|
|
Term
|
Definition
delays tome to occurance of mood episodes in bipolar by blocking Ca and Na channels
s/e: rash |
|
|
Term
|
Definition
used in bipolar disorder w/ Li or if Li fails
blocks Na channel
s/e: blood dyscrasias |
|
|
Term
| Risperidone, Olanzapine, Quetiapine, Aripiprazole (anti-psychotics used in bipolar) |
|
Definition
mainly used during manic phase but also for psychotic sx seen during depressive episodes
moa: blockade of 5-HT2a R (mainly) |
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|
Term
|
Definition
Cloropromazine (thorazine)
Thiordazine (mellaril)
Trifluoperazine (stelazine)
Perphanazine (trilafon)
Mesoridazine (serentil)
Prochlorperazine (compazine) |
|
|
Term
Cloropromazine (thorazine)
Thiordazine (mellaril)
Trifluoperazine (stelazine)
Perphanazine (trilafon)
Mesoridazine (serentil)
Prochlorperazine (compazine)
Thiothixene (navane)
Haloperidol (haldol)
USE and MOA |
|
Definition
| old-antipsychotics for schizophrenia, manic phase of bipolar, and some are anti-emetic via their blockage of D2 R over 5-HT2a R |
|
|
Term
|
Definition
| extra use as an anti-emetic |
|
|
Term
Cloropromazine (thorazine)
Thiordazine (mellaril)
Trifluoperazine (stelazine)
Perphanazine (trilafon)
Mesoridazine (serentil)
Prochlorperazine (compazine)
Thiothixene (navane)
Haloperidol (haldol)
Side Effects |
|
Definition
| sedation, anticholinergic, extrapyramidal sx, tardive dyskinesia, weight gain, amenorrhea, galactorrhea, gynecomastia, dec libido, posutral hypotension, prolonged QT, ventricular arrhythmias, corneal/lens deposits, retinal deposits, neuroleptic malignant syndrome |
|
|
Term
|
Definition
Clozapine (clozaril)
Olanzapine (zyprexa)
Loxapine (loxitane)
Quetiapine (seroquel) |
|
|
Term
|
Definition
|
|
Term
|
Definition
Risperidone (risperdal)
Ziprasidone (geodon)
Paliperidone (invega)
Iloperiodone (fanapt)
Aripirazole (abilify) |
|
|
Term
Clozapine (clozaril)
Olanzapine (zyprexa)
Loxapine (loxitane)
Quetiapine (seroquel)
Molindone (moban)
Risperidone (risperdal)
Ziprasidone (geodon)
Paliperidone (invega)
Iloperiodone (fanapt)
Aripirazole (abilify)
Use and MOA |
|
Definition
new antipsychotics for schizophrenia that work by blockade of 5-HT2a R > D2 R
may also bind a1, histamine-1, M1, 5-HT2c |
|
|
Term
|
Definition
causes agranulocytosis, seizures, severe constipation, and weight gain
most effective for refractory schizophrenic cases |
|
|
Term
|
Definition
| causes hyperglycemia, DKA, and severe weight gain (why who class got black box) |
|
|
Term
|
Definition
causes dangerous arrhythmias, QT prolongation
contraindicated in recent MI and uncompensated CHF |
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