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FNP Pharmacology part 4
My study guide for part of my comprehensive finals for pharmacology in my FNP school. Cardiac meds are included in this set.
55
Medical
Graduate
04/19/2009

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Term
What do Graves disease and pheochromocytoma both do to the cardiovascular system (in general)?
Definition
Cause hypertension
Term
In regards to cardiovascular diseases, what does TOD stand for?
Definition
Target organ damage.
Term
What part of the nephron do thiazide act on?
Definition
The distal convoluted tubules.
Term
What is the mechanism of action of thiazide diuretics?
Definition
They inhibit resorption of NaCl in the distal convoluted tubules, creating loss of Na+ with water. These also waste potassium.
Term
What is the CrCl cutoff for use of thiazide diuretics?
Definition
Thiazides should not be used with CrCl<30mL/min.
Term
Is efficacy of thiazide diuretics dose dependent?
Definition
Not necessarily - lower doses are as effective in tx'ing HTN as higher ones.
Term
One week after initiating HCTZ, what lab should be checked?
Definition
Serum K+
Term
What is more effective to use with heart failure patients, thiazide or loop diuretics?
Definition
Loop diuretics.
Term
What part of the nephron do loop diuretics act upon?
Definition
The Loop of Henle.
Term
How was the name "Lasix" developed?
Definition
Lasix = Lasts Six Hours
Term
What are 2 examples of potassium-sparing diuretics?
Definition
Spironolactone & triamterene.
Term
Where are Beta 1 adn Beta 2 receptors?
Definition
Beta 1= Heart, Beta 2=Respiratory tract
Term
What can coreg cause r/t hair changes?
Definition
It can increase hair growth.
Term
What disease state is a contraindication of beta blockers?
Definition
Asthma
Term
What byproduct in the lung may cause cough associated with ACE inhibitors?
Definition
Bradykinin.
Term
What rare, but potentially lethal side effect can ACE inhibitors cause?
Definition
angioedema (swelling in the facial area)
Term
Do ACE inhibitors cause potassium loss?
Definition
No, they tend to preserve it.
Term
What kind of protection do ACE inhibitors offer diabetic patients?
Definition
Renal protection
Term
Name one common ACE inhibitor.
Definition
Lisinopril
Term
What advantage do ARBs have over ACE inhibitors?
Definition
No ACE cough.
Term
Name 2 common ARBs.
Definition
Benicar, Cozaar
Term
What is the mechanism of action of calcium channel blockers?
Definition
They block the inward draw of calcium through the "slow channels" adn work on smoothe muscle, as well as SA/AV nodes
Term
What are 3 adverse effects of calcium channel blocker use?
Definition
Bradycardia, lower leg edema, constipation
Term
What drug used to treat HTN can also be used for migraine prophylaxis (according to teacher)?
Definition
Calcium channel blockers
Term
What 2 classes of CCB's are there?
Definition
Dihydropyridines & nondihydropyridines
Term
What's the advantage of nondihydropyridines vs. dihydropyridines?
Definition
Nondihydropyridines do not affect heart rate.
Term
Name 2 common dihydropyridine CCBs.
Definition
Norvasc (amlodipine), nifedipine (Procardia).
Term
Name 1 common nondihydropyridine CCB.
Definition
Verapamil.
Term
Should Nondihydropyridine CCB's (Verapamil) be used in bradycardic patients?
Definition
Yes.
Term
Other than HTN, what other condition that affects only men do alpha blockers treat?
Definition
BPH (b/c of relaxing smoothe muscle - to facilitate urine drainage).
Term
What should you be looking for with the first dose of an alpha blocker (adverse effect)?
Definition
Orthostatic hypotension.
Term
Name 1 common alpha blockers.
Definition
Cardura (doxazosin)
Term
What time of day should the first dose of an alpha blocker (doxazosin) be given?
Definition
at night.
Term
Do alpha blockers carry a high or low risk of injury for elderly patients?
Definition
High, esp if used for BPH in a pt that needs to urinate at night.
Term
Alpha blockers affect DBP or SBP more?
Definition
Diastolic blood pressure.
Term
What drug central alpha 2 antagonists is used in pregnancy-induced HTN?
Definition
Methyldopa
Term
Should a full dose be used when starting central alpha 2 antagonists (clonidine, methyldopa)?
Definition
No, it should be tapered up & down, otherwise rebound HTN can occur.
Term
What central alpha 2 antagonist can be administered dermally with a patch weekly?
Definition
Clonidine.
Term
What type of diuretics are usually used in CHF?
Definition
Loop diuretics, usually.
Term
Should ACE inhibitors be used in a patient with heart failure?
Definition
Yes - they modify the course of heart failure & they need to stay on them, even if they're getting a bit hypotensive.
Term
Does Digoxin have a wide or narrow therapeutic index?
Definition
Narrow.
Term
What's the most common dose of Digoxin?
Definition
0.125mg
Term
Should beta blockers be used in HF patients?
Definition
Yes. They used to be contraindicated, but now it's appropriate to start HF patients on BB. 1/3 do better, 1/3 do worse, 1/3 are unchanged.
Term
When should CCB's be used in CHF patients?
Definition
In diastolic dysfunction.
Term
What common cheap drug is given to CAD/Angina patients for prophylaxis purposes?
Definition
Aspirin.
Term
What should patients know about nitroglycerin?
Definition
It's inactivated by light, heat and oxygen. When administering, be wary of rebound tachycardia.
Term
What class of antiarrhythmic are beta blockers?
Definition
Class II
Term
What class of antiarrhythmic are CCB's?
Definition
Class IV
Term
What common drug falls under class III antiarrhythmic?
Definition
Amiodarone.
Term
What drug class is Arixtra?
Definition
Pentasaccharide
Term
What peripheral vascular dilator is used for peripheral artery disease?
Definition
Tentral.
Term
When coagulation inhibition is needed in pregnant women, what drug should be used?
Definition
Heparin.
Term
What does heparin inhibit?
Definition
Antithrombin
Term
What does coumadin block (simple answer)?
Definition
Vitamin K dependent coagulation
Term
What animal allergy is a contraindication for heparin use?
Definition
Pork allergy
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