pharmacology: cadiovascular/ anti coag/ and cholesterol
Terms in this set (68)
name examples of ace inhibitors
lisinopril, ramipril, enalapril, benazapril, quinapril, captopril perindopril, moexipril, fosinopril
Ace inhibitors often end in?
ARB's or angiotensin receptor blockers often end in?
Give examples of ARB's or angiotensin receptor blockers
losartan, telmisartan, valsartan
betablockers usually end end?
give examples of beta blockers
metoprolol,propranolol , atenolol, nebivolol, carvedilol, labetaol
Name some calcium channel blockers
amlodipine, felodipine, nisoldipine, verapamil, diltiazem
what are examples DHP (dihydropyridines) calcium channel blockers?
amlodipine, felodipine, nisoldipine
what are examples of non-DHP calcium cahnnel blockers?
explain what a DHP calcium channel blockers do
aterial vasodilation, decreses afterload, decreases oxygen demand, has a greater affect on the smooth muscle and therefor effects or works on the periphery.
they block smooth muscle calcium channels at level much less than needed for effects on the heart
explain what NON-DHP calcium channel blockers do
NON-DHP are more selective they have some vasodilatory effects, decreases myocardial contractility, decreases rate of contraction, decreases oxygen demand. It work predominantly on the heart
what are adverse effect of DHP calcium channel blockers?
orthostatic hypotentsion, peripheral edema, reflex tachycardia, GERD
what are adverse effects of NON-DHP calcium channel blockers
constipation, AV block, Bradycardia, GERD, less hypotension
what are type or examples of loop diuretics
furosemide (lasix) tersemide (demadex) bumetanide (bumex) and ethacrynic acid
what are endings you can use to remember loop diuretics what is one exception
"mide" "nide" ethancrynic acid
give some examples of thiazide diuretics
hydrochlorothiazide (HCTZ) chlorthalidone (thlitone) metolazone (zaroxolyn)
what are potassium sparing diuretics
Triamterene, amiloride, a combination with HCTZ makes primarily Maxide and Diazide
which diuretics are best for edema and which and not as good? what is potassium sparing used for?
no as good-Thiazide
potassium sparing- weak direutic but is good to maintain K+ levels
What should a patient be counseled on with diuretic use? what should they expect?
They should expect frequent urination and instruct them to take their meds in the A.M.
compliance is necessary for therapeutic response, and to take daily weight to assess for body changes in fluid
what monitoring is necessary with diuretics
electrolytes, therapeutic response, compliance, s/s fluid overload, I&O's. daily weight and volume depletion
why is K+ supplemented with diuretic therapy?
to prevent hypokalemia
what is normal blood pressure
what are adverse affect of ace inhibitors
dry unproductive cough, angio edema (rapid swelling of dermis, subq, mucosa and submucosa) skin eruptions, rash. loss of taste (ageusia), teratogenic
what are adverse effects of spironolactone
hyperkalemia, gynecomastia, impotence, renal dysfunction
what class is spironolactone in?
what are adverse effects of loop diuretics
acute renal failure, over diuresis, hypokalemia, hypomagnesemia, hypotension, otoxicity
what are adverse effects of beta blockers?
bradycardia, AV block, bronchospasms, decreased excersise tolerance, fatigue, vasospasm, mask the effects of hypoglycemia
what are the adverse effects of clonidine
dry mouth and sedation
what are the adverse effects of ARB's
what are the adverse effects of nitrites
HA, flushing, syncope with lowered BP, skin rash, gives, nausea
what is a selective beta blocker, what do they do
they are cardio-selective for B1 receptors. They block B1 receptors that stimulate the heart. They reduce systolic pressure, heart rate, cardiac contractility and output, so decrease myocardial oxygen demand and increase exercise tolerance.
what are examples of selective beta blockers
metoprolol, atenolol, nebivolol
explain non-selective beta blockers
Beta adrenergic blockers prevent stimulation of the beta adrenergic receptors at the sympathetic nervous system, decreasing the activity of the heart..
can cause significant bronchial constriction and could be harmful especially in patients with respiratory conditions such as asthma or chronic obstructive pulmonary disease.
what are examples of non-selective beta blockers
propranolol, carvedilol, labetalol
how are nitrates used?
they are used for angina or heart failure. Nitrates open (dilate) the arteries to the heart. This increases blood flow to the heart, relieving angina symptoms such as chest pain or pressure, also dilates veins
what is immediate nitrate use for?
what is chronic nitrate use, used for?
chronic diseases like coronary artery disease, found with patches, creams, long acting pill etc.
what would you counsel a patient on when using nitroglycerin
to be aware of symptoms like HA, nausea, flushing, tachycardia, dizziness, GI complaints.
Compliance is necessary to help with BP/ pulse and heart failure symptoms . don not take with alcohol or with these drugs: viagra/ cilalis and levitra.
there also needs to be a 8-12 hour nitrate free period a day to avoid tolerance
what is chronic failure
a clinical syndrome resulting from any disorder that either impacts the ability of the ventricle to fill (diastole) or to eject blood (systole). or the heart is unable to pump blood at a rate sufficient to meet the metabolic demands of the body
what classes of drugs are used to treat chronic heart failure?
ACE-I, Diuretics, Digoxin, Spirinolactone
k+ sparing diuretics
what are drug examples of HMG-COA
lovastatin, simvastatin, fluvastatin, and atorvastatin
what ending would you use for HmG-CoA drugs?
what are examples of fibrate drugs
gemfibrozil, fenofibrate, choiline fenofibrate
whate are examples of omega-3 fatty acids
OTC drugs fish oil
icosapent ethyl and lovaza
what are examples of niacin drugs?
nicotinic acid, vitamin B3, niacor, slo-niacin, niaspan
what are side effects of HmG-CoA drugs?
myopathy, increased hepatic enzyme, increase risk of diabetes
what are side effects of fibrates
increased hepatic transaminases, increased risk of gall stones
what are side effects of omega-3 fatty acids?
gastrointestinal issues, fishy belches, nausea, increases LDL and antiplatelet effects
what are effects of niacin drugs ?
cutaneous vasodialtion, flushing, hepatic enzyme elevation, gout glucose intolerance, aggravation of peptic ulcer disease.
what cholesterol lowering drug is best used for LDL
what cholesterol lowering drug is best used for triglycerides?
what cholesterol lowering drug is best used for raising HDL?
what are counseling point with statin drugs?
the pills can usually be taken in one dose, other medication may or will interact with them. Do not take grape fruit while on medication, and your AST and ALT will need continual monitoring
Rhabdomyolysis is explained as? and why is it a concern with statin drugs
the catatrophic muscle breakdown which releases myoglobin and acute kidney failure. it is a myopathy side affect
when taking a statin drug why is myopathy associated with it?
Risk for myopathy is related to serum levels and therefore
to drug dose and drug interactions interfering with drug
what are antiplatelet drugs?
apririn, ticlopidine, clopidogrel, presugrel,ticagrelor, dipyrodamide, abciximab, tirofiban, aptifibatide
what are anticoagulant drugs
warfarin, heparin, anoxaparin, dalteparin, fondaparinux, rnaroxaban, apixaban, lepirudin, bivalirudin, argatroban, desirudin, dabigartran, LMWH
alteplase, reteplase, tenecteplase, urokinase
explain how warfarin is used for clinically
it can be used orally or through injection, it is
what are examples of LMWH
enoxaparin and dalteparin
Explain what/how warfarin is used clinically
it is used for stroke precautions and recurrent venous thrombosis embolism. It is administer orally or through injection. It is a vit k antagonist with a slow onset.
explain what and how heparin is used clinically
IV and SC injections only NO IM. used in acute impatient situations. Deep vein thrombosis prevention. it is a thrombin inhibitor
explain what and how low molecular heparin is used clinically.
SC only, longer duartions, used in outpatient settings. it is more effective in preventing venous thrombosis embolism than regular heparin. there is a less risk of heparin induced thrombocytonpenia
what is the cure for warfarin
what is the cure for heparin
what are things you watch for with any anti coagulants?
bleeding, bruising, inter cranial hemorrhage CBC's, stool guaic, clotting tudies
what kind of diet can affect coagulation
foods high in k+ bananas, leafy greens, white beans, baked potatoes, prune juice, oranges... etc..
what are some dangerous warfarin drug interactions
a ton! cox-2 selective inhibs, nasids, ssri's, steroids, sulfonamides,penicillins, heparin,erythromyscin, glucagon,quinolone intiinfectives, estrogens, carbamzepine, phenytoin, rifampin, alcohol ,many herbals
(this is not inclusive)