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FNU Module 5 Exam
drugs
115
Pharmacology
Graduate
08/15/2013

Additional Pharmacology Flashcards

 


 

Cards

Term
The 2 main systems related to hypertension include the?
Definition
1. Sympathetic Nervous System
2. Renin-Angiotensin-Aldosterone System
Term
To treat hypertension and lower blood pressure you must lower the _____ _____ ______ or _______ _______.
Definition
Systemic Vascular Resistance or
Cardiac Output.
Term
Blood Pressure equals _____ _____ _____
X ______ ________.
Definition
Systemic Vascular Resistance X
Cardiac Output.
Term
Cardiac Output is ______ ______ X
_______ _______ _______.
Definition
Heart Rate X Systemic Vascular Resistance.
Term
The majority of hypertension seen in the United States today is _______ hypertension.
Definition
Essential - the cause is unknown
Term
The Sympathetic Nervouse System controls ______ ______ & __________.
Definition
Heart Rate and Contractility
Term
Beta-Adrenergic Stimulation via epinephrine causes increased _______ ______ in the heart muscle.
Definition
Stroke Volume
Term
Beta-Blockers decrease ______ _______ thereby lowering _______ _______.
Definition
Stroke Volume thereby lowering
Blood Pressure.
Term
An example of a Beta-Blocker is?
Definition
Propranolo (Inderal)
Term
Calcium Channel Blockers ______ the entry of calcium into the ______ ______ or _______ _______ ______ ______ causing a _______ in contractility, a decrease in heart rate and __________.
Definition
Block the entry of calcium into myocaridial cells or vascular smooth muscle cells ......decrease in heart rate and vasodilation.
Term
An example of a Calcium Channel Blocker is?
Definition
Nifedipine (Procardia)
Term
How does Nifedipine stop preterm labor?
Definition
It blocks calcium from entering the smooth muscle cells of the uterus and prevents it from contracting.
Term
Centrally Acting Drugs _______ cardiac output and ________ peripherial resistence.
Definition
decrease cardiac output and decreases peripherial resistence
Term
Centrally Acting Drugs affect the vasomotor center in the brain by limiting the ________ ________ to the _______ and ________ ________.
Definition
the sympathetic outflow to the heart and blood vessels.
Term
An example of a Centrally Acting Drug is?
Definition
Methydopa (Aldomet)
Term
Vascular Tone is effected by ________.
Definition
Vasodilators
Term
Vasodilators are Alpha-Adrenergic ________ that cause direct __________.
Definition
Blockers that cause direct Vasodilation.
Term
An example of a Vasodilator is?
Definition
Prazosin (Minipress)
Term
Vascular Volume is effected by _______, _____ _____ ______ _____, and ______ _______ ________.
Definition
Diuretics, Angiotensin Enzyme Inhibitors (ACE) and Angiotensin Receptor Blockers.
Term
__________ decrease blood volume and sodium levels.
Definition
Diuretics
Term
The different types of diuretics are classified by what anatomic site within the _______ _______ they exert their influence.
Definition
Kidney Tubule
Term
What are three types of Diuretics?
Definition
1. Thiazide Diuretics
2. Loop Diuretics
3. Potassium Sparing Diuretics
Term
What does ACEI stand for?
Definition
Angiotensin Coverting Enzyme Inhibitor
Term
ACE Inhibitors inhibit the conversion of _________ __ into _________ __ thereby decreasing ________ _________.
Definition
angiotensin I into angiotensin II therby decreasing Arterial Pressure.
Term
An example of an ACE Inhibitor is?
Definition
Enalapril (Vasotec)
Term
An example of an Angiotensin Receptor Blocker is?
Definition
Valsartan (Diovan)
Term
_______ to generica names are helpful in catorgorizing antihypertnedive medications.
Definition
Suffixes
olol = Beta Blocker
sartin = Angiotensin Receptor Blocker
pine = Calcium Channnel Blocker
pril = Angiotensin Converting Enzyme Inhibitor
Term
Beta Blockers decrease _______ output be decreasing the ____, _____, and ____ velocity of the heart.
Definition
Cardiac Rate, Contractility, and Conduction
Term
Beta Blockers have a ______ ionotropic effect and should be used with extreme caution in patients with _____ ______.
Definition
Negative Heast Failure
Term
How are Beta Blockers catagorized acccording to their selectivity?
Definition
Beta 1 & Beta 2
Beta 1 selective, with less effect on Beta 2 receptors and intrinsic sympathomimetic activity. (ISA)
Term
Beta Blockers target Beta _________ on all smooth muscles in the body.
Definition
Receptors
Term
Beta Receptors allow stress hormones (endogenous catacholamines) like ________ and __________ to work.
Definition
Epinephrine and Norepinephrine
Term
Beta Receptors are part of the _______ ________ __________ throughout the body.
Definition
Synpathetic Nervous System
Term
Beta Blockers bind with the Beta Receptors in lieu of the stress hormones, _________ their response on the body.
Definition
Weakening
Term
_________ is a Beta Blocker that should be avoided.
Definition
Atenolol
Term
Beta Blockers are ____ __ effective in preventing cardiovascular events in patients with HTN in spite of the effectiveness in lowering blood pressure.
Definition
not as
Term
For patients who have heart failure and those patients who have had a heart attack should be given ______ ______ for 2-3 years after the heart attack to improve cardiovascular outcomes.
Definition
Beta Blockers
Term
What are the two most effective Beta Blockers that improve cardiovascular outcomes?
Definition
Carvedilol and Metoprolol ER
Term
Beta Blockers acheive their effects by competing for adrenergic receptor binding sites. Beta 1 receptors are found predominately in the _______ _____ Beta 2 receptors are found in the _____ and ____ _____ _____, and the _____.
Definition
Beta 1 - Cardiac Tissue
Beta 2 - Bronchial and Vascular Smooth Muscles, and in the liver.
Term
Examples of Beta 1 Selective Beta Blockers are?
Definition
Metoprolol (Lopressor)
Timolol (Betim)
Propranolol (Indreal)
***Atenolol is Nonselective***
Term
Beta Blockers are _______ line treatment for uncomplicated hypertension.
Definition
Fourth
Term
Calcium Channel Blockers should not be used in patients with ___ ____.
Definition
Heart Failure
Term
What is the major side effect of Calcium Channel Blockers?
Definition
They have a tendency to cause peripheral edema and reflex tachycardia.
Term
What specific population does Calcium Channel Blockers work well with?
Definition
African Americans
Term
Calcium Channel Blockers (CCB's) major actions are what? (5 things)
Definition
Decreased Myocardial Contractility
Slowed Rate of Ventricular Contractions
Coronary Artery Dilation
Peripheral Artery Dilation
Reduce Peripheral Resistance
Term
There are 2 types of CCB's. What are they and which one is the largest?
Definition
Dihydropyridines - the largest
non-Dihydropyridines
Term
Dhydropyridines (DHP)which are CCB's do not affect the ________ _______ ________ and thus are not used for cariac arrhythmias.
Definition
Cardiac Conduction System
Term
2 examples of dihydropyridines are?
*****Remember these are CCB's*****
Definition
nifedipine (Procardia)
amlodipine (Norvasc)
Term
Non-Dihydropyridines (which are CCB's) are used for both hypertension and _______.
Definition
Arrhythemias
Term
2 examples of non-dihydropyridines (CCB's) are?
Definition
Verapamil (Calan)
Diltiazem (Cardiazem)
Term
Diuretics are the _____ drugs used for treating hypertension and Thiazide Diuretics are generally used first.
Definition
First
Term
Diuretics are distinguished by where they take effect in the renal tubule, which results in different reabsorption patterns of _____, _____, and ________.
Definition
Sodium, Calcium, and Potassium
Term
Thiazides (diuretic)inhibits ______ reabsorption in the distal tubule.
Definition
Sodium
Term
Thiazides (diuretic) deplete sodium and ________ while conserving ______.
Definition
Potassium while conserving Calcium
Term
An important adverse side effect of taking Thiazides is _______ which can be particularly dangerous in persons with heart disease.
Definition
Hypokalemia - low potassium
Term
Thiazides are the first drug of choice and are especialy useful for women with ________ because of the calcium sparing effects
Definition
Osteoporosis
Term
What is an example of a Thiazide Diuretic?
Definition
Hydrochlorothiazide (Microzide)
Term
ACE Inhibitors prevent the conversion of angiotensin I to II in the kidney, thus preventing _____ of the renal vessels.
Definition
Vasoconstriction
Term
Ace Inhibitors effect ____ and _____ loss but tend to spare potassium making them very effective when combined with potassium sparing diuretics because of their potential for hyperkalemia.
Definition
water and sodium
Term
ACE Inhibitors effect the release of _________, a vasodilator which also enhances insulin sensitivity. Thus ACE inhibitors are excellant choices for patients with diabetes mellitus.
Definition
Bradykinn
Term
An important thing to remember -- ACE Inhibitors and Angiotensin Receptor Blockers have a smaller effect on what population?
Definition
African Americans
Term
A side effect of ACE Inhibitors is a nonproductive _______ caused by the increase production of _________.
Definition
Cough Bradykinn
Term
A less common but more serious side effect of taking ACE Inhibitors is __________. Patients should be cautioned to immediately report any unexplained swelling of the face, mouth, tongue, or persistant _____ _____ and the drug should be stopped.
Definition
Angioedema

Sore Throat
Term
Loop Diuretics are the most efficient diuretic but are reserved for clients with ________ _________.
Definition
Severe Hypertension
Term
Loop Diuretics deplete _____, _____, _____, and ______ in the distal tubule.
Definition
Sodium, Potassium, Magnesium, and Calcium
Term
An important adverse side effect of Loop Diuretics is ________ which can be particularly dangerous for clients with heart disease.
Definition
Hypokalemia
Term
An example of a Loop Diuretic is?
Definition
Furosemide (Lasix)
Term
Potassium Sparing Diuretics inhibits _____ reabsorption in the collecting duct, thereby sparing the postassium depletion that occurs when sodium is not ______ distally.
Definition
Sodium

Reabsorbed
Term
Most serious adverse effect for those taking Potassium Sparing Diuretics is ______ which is especially dangerous in clients on ACE Inhibitors or in clients with diabetes or ____ ____.
Definition
Hyperkalemia

Renal Impairment
Term
Potassium Sparing Diuretics are primarily used in conjunction with Thiazide Diuretics to counter the _____ loss.
Definition
Potassium
Term
An example of a Potassium Sparing Diuretic is?
Definition
Spironolactone (Aldactone)
Term
Patients on ACE Inhibitors or Angiotensin Receptor Blockers should avoid _______ as they can reduce the efficacy of those drugs.
Definition
NSAIDs
Term
Angiotensin Receptor Blocker are thought to have many of the advantages of ACE Inhibitors without the side effect of the ______.
Definition
Cough
Term
An example of a Direct Vasodilator is?
Definition
Hydralazine (Apresoline)
Term
An example of an Alpha Blocker is?
Definition
Doxazosin (Cardura)
Term
An example of an Alpha 2 Agonists is?
Definition
Guanabenz (Wytensin)
Term
For a patient who takes 3 or more blood pressure medications have the patient take one at ________.
Definition
Bedtime
early 2012 evidence suggested that taking at least one antihypertensive medication at bedtime may improve blood pressure control and reduce cardiovascular events in some patients.
Term
If the blood pressure is lowered too much at night there is an increased risk for _________.
Definition
Falls
Term
Should a diuretic be prescribed for taking at nighttime?
Definition
No - a patient taking a diuretic at bedtime would not be getting the rest that is needed because of having to go to the bathroom all night.
Term
If the patient is experiencing fatigue or dizziness with an antihypertensive the dosing can be changed to __________ __________.
Definition
Bedtime Dosing
Term
According to JNC 7 the first agent to be used to treat hypertension is generally a ________.
Definition
Diuretic
Term
________ diuretics are used more often than Loop or Potassium Sparing diuretics.
Definition
Thiazide
Term
If the diuretic alone is not effective ______ ______ may be added.
Definition
Another Agent
Term
If systolic blood pressure is > 160 or diastolic is > 100 the patient will be started on _____ _______.
Definition
Two Agents
This protocol is follwed unless there is a compelling indication for other type therapies.
Term
The JNC 7 acknowledges additional benefit of _______ agents for treating other conditions or complications and recommends therapy accordingly.
Definition
Antihypertensive
Term
Condition Indicated Drug Therapy
Diabetes Mellitus I with proteinuria
Definition
ACE Inhibitors
Term
Condition Indicated Drug Therapy

Diabetes Mellitus II with proteinuria
Definition
Angiotensin Receptor Blockers
Term
Condition Indicated Drug Therapy

Heart Failure
Definition
ACE Inhibitors
Beta Blockers
Aldosterone Receptor Antagonists
Angiotensin Receptor Blockers
Term
Condition Indicated Drug Therapy

Isolated systolic hypertension in older adults
Definition
Diuretics
Calcium Channel Blockers
(Long Acting Dihydropyridines such as Procardia and Norvasc)
Term
Condition Indicated Drug Therapy

Nondiabetic Renal Disease
Definition
ACE Inhibitors
Term
Condition Indicated Drug Therapy

Post Myocardial Infarction
Definition
Bata Blockers (non-ISA Beta 1 such as Metoprolol (Lopressor)because they work on cardiac tissue)
ACE Inhibitors (when systolic function is present)
Term
May Affect Comorbid Conditions Favorably:

Angina
Definition
Beta Blockers
Calcium Channel Blockers
Term
May Affect Comorbid Cond. Favorably

Atrial Fibrillatin and Tachycardia
Definition
Beta Blockers
Calcium Channel Blockers (nondihydropyridines such as Verapamil and Diltiazem)
Term
May Affect Comorbid Cond. Favorably

Dylipidemia
Definition
Alpha Blockers such as Doxazosin (Cardura)
Term
May Affect Comorbid Cond. Favorably

Hyperthyroidism
Definition
Beta Blockers
Term
May Affect Comorbid Cond. Favorably

Migraine
Definition
Beta Blockers (non cardioseletive such as a Beta 2)
Calcium Channel Blockers (nonhydropyridines such as Verapamil (Calan) and Diltiazem (Cardiazem)
Term
May Affect Comorbid Cond. Favorably

Myocardial Infarction
Definition
Diltiazem
Verapamil
Term
May Affect Comorbid Cond. Favorably

Osteoporosis
Definition
Thiazide Diuretics
Term
Contraindicated May Adversely Affect

Bronchospastic Disease
Definition
Beta Blockers
Term
Contraindicated May Adversely Affect

Depression
Definition
Beta Blockers
Alpha Antagonist
Reserpine
Term
Contraindicated May Adversely Affect

Diabetes Mellitus Type I and II
Definition
Beta Blockers
High Dose Diuretics
Term
Contraindicated May Adversely Affect

Dyslipidemia
Definition
Beta Blockers (non ISA Beta 2)
High Dose Diuretics
Term
Contraindicated May Adversely Affect

Gout
Definition
Thiazide Diuretics
Term
Contraindicated May Adversely Affect

Heart Block
Definition
Beta Blockers
Calcium Channel Blockers (nonhydropyridines such as Verapamil and Diltiazem)
Term
Contraindicated May Adversely Affect

Heart Failure
Definition
Alpha Blockers
Calcium Channel Blockers (except amlodipine and feloipine)
Term
Contraindicated May Adversely Affect

Peripheral Vascular Disease
Definition
Beta Blockers
Term
Contraindicated May Adversely Affect

Pregnancy
Definition
Beta Blockers
ACE Inhibitors
Angiotensin Receptor Blockers
Term
Contraindicated May Adversely Affect

Renal Insuffiency
Definition
Potassium Sparing Diuretics
Calcium Channel Blockers (especially the dihydropyridines such as Nifedipine [Procardia] and Amiodipine [Norvasc])
Term
Contraindicated May Adversely Affect

Renovascular Disease
Definition
ACE Inhibitors
Angiotensin Receptor Blockers
Term
ACE Inhibitors are twice as likely to cause a noxious ______ in women as men.
Definition
Cough
Term
Thiazides are more likely to cause _____ in mean and ______ or ______ in women.
Definition
Gout
Hyponatremia or Hypokalemia
Term
African Americans typically do not respond well to ACE Inhibitors but have an increased response to _______ diuretics.
Definition
Thiazide
Term
NSAIDS can cause an increase in ______ ______ particularly when combined with ACE Inhibitors and Angiotensin Receptor Blockers
Definition
Blood Pressure
Term
NSAIDS can also worsen ____ _____ and should be avoided.
Definition
Heart Failure
Term
Clients with hypertension should be counseled not to use ____ ____, _____, ______, _____ _____, __ _____, ______, or _______.
Definition
Devil's Claw
Ginseng
Goldenseal
Black Licorice
Ma Huang
Squill
Yohimbe
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