Term
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Definition
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Term
What is the pharmacological action of Triamterene? |
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Definition
K-sparing, blocks Na absorbtion in cortiacal collecting duct. DIRECT. |
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Term
What is triamterene used for (two things)? How long does it take the drug to act? |
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Definition
HT, edema, 2-4hrs to act. |
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Term
What are the adverse effects of Triamterene? |
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Definition
hyperalkemia, nausea/vomiting, cramps and dizziness |
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Term
What is the pharmacological action of spironolactone? |
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Definition
K-sparing, aldosterone cannot increase Na reabsorbtion in cortical collecting duct, leads to increased Na excretion, and decreased K excretion. |
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Term
What does spironolactone treat and what is the latency of the drug? |
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Definition
HTN, edema, primary hyperaldosteronism, Decreases mortality in heart failure, 48hrs to act |
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Term
What are the adverse effects of spironolactone? |
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Definition
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Term
Classification of Hydrochlorothiazide? |
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Definition
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Term
What is the pharmacologic action of HCTZ? |
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Definition
Thiazide diuretic that blocks Na Cl co-transporter in the distal tubule |
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Term
What is HCTZ used for primarily? Other uses? |
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Definition
Primary hypertension, Decrease the risk of kidney stones, Used in combination with K+ sparing diuretics to mitigate K loss. Used in mild-moderate HTN (low renin or volume-expanded forms) |
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Term
Can HCTZ be used for Renal failure? |
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Definition
Yeah, but it does not work very well. |
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Term
What are the risks of HCTZ? |
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Definition
Gout, oops too much, Increased lipid levels, HYPOalkemia |
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Term
Is HCTZ appropriate for monotherapy? |
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Definition
Not recommended, Best if in combination to prevent adverse effects. |
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Term
Can HCTZ be used in pregnancy? |
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Definition
Contraindicated in pregnancy |
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Term
What are the effects of HCTZ on digoxin and litium? |
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Definition
Increases effects of Digoxin and litium toxicity |
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Term
What is the classification of Furosemide, bumetadine, and torsemide? |
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Definition
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Term
What is the use of furosemide, bumetadine, and torsemide and what is the duration of onset of action? |
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Definition
Quick, 60 minutes po, 5 minutes if IV. edema, hypertension |
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Term
What is the mechanism of action of Furosemide, bumetadine, and torsemide? |
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Definition
Na-K-Cl cotransporter blocker, blocks cotransporter in TAL. |
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Term
What is the classification of Triamterene? |
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Definition
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|
Term
What is the classification of spironolactone? |
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Definition
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Term
What is the drug class of ethacrynic acid? |
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Definition
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Term
What is the duration of the onset of action for ethacrynic acid? |
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Definition
Quick onset, 60 min po, 5 min IV, |
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Term
What is ethacrynic acid used for? |
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Definition
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Term
What are the contraindications and drug interactions of ethacrynic acid? |
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Definition
Contraindicated in pregnancy, Drug interaction with digoxin and lithium |
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Term
Why is ethacrynic acid particularly useful? |
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Definition
It can be used in patients with SULFA ALLERGY. |
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Term
What is the classification of acetazolamide? |
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Definition
Carbonic anhydrase inhibitor |
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Term
What is pharmacologic action of acetazolamide? |
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Definition
It is seldomly used for sodium bicarbonate diuresis,and HYPERchloremic acidosis. |
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Term
What is acetazolamide used for? |
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Definition
Treats urinary alkalinazation, metabolic alkalosis, glaucoma, and mountain sickness |
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Term
What are the risks of ethacrynic acid? |
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Definition
Higher risk of kidney stones, oops too much, HYPOkalemia, OTOTOXICITY, gout risk, increased lipid levels |
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Term
What are the adverse effects of acetazolamide? |
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Definition
Renal stones, potassium wasting, and HYPERchloremic acidosis. |
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Term
What are the osmotic diuretics? |
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Definition
Mannitol, Urea, glycerine, isosorbide |
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Term
What are osmotic diuretics used for? |
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Definition
decrease intracranial pressure, prophylaxis of renal failure, decreases intraoccular pressure in glaucoma |
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Term
What is the pharmacologic action of osmotic diuretics (urea, glycerin, mannitol, isosorbide)? |
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Definition
These are non-reabsorbale solutes that keep water in the proximal tubules-> distal -> urine |
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Term
How is osmotic diuretics administered and what is the onset of action? |
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Definition
Administered via IV in large volumes and has an onset of action of 30min to an hour. |
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Term
What are the risks of administering osmotic diuretics? |
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Definition
Large volume of administration can exacerbate patients with heart failure as well as cause electrolyte imbalance. Nausea/vomiting/headache |
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Term
What drug class are the vaptans? |
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Definition
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Term
What is the pharm action of the vaptans? |
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Definition
Vaptans prevent water absorption by the collecting ducts, thereby decreasing the urine osmolality, and decrease plasma volume. There is also an increase in plasma osmolality via increase in plasma |
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Term
Are there any adverse effects of vaptans and how is it administered? |
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Definition
Vaptans are administered IV only and are generally well tolerated. |
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Term
What drug class are "-pril" drugs? (enalapril, captopril, lisinopril) |
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Definition
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Term
What is the action of ACE inhibitors? (enalapril, lisinopril, captopril) |
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Definition
ACE Inhibitors LOWER ANGIOTENSIN 2 levels by working on renin-angiotensin. |
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Term
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Definition
CHF, arrhythmias, diabetes mellitus, BEST FOR PATIENTS WITH ASTHMA! GREAT FOR MONOTHERAPY! ENHANCED BY DIURETICE |
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Term
What effect does diuretics have on ACE-I? |
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Definition
DIURETICS enhance the effect of the ACE-I. |
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Term
What are the contraindications for Ace-INhibitors? (enalapril, lisinopril, and captopril) |
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Definition
Contraindicated in pregnancy |
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Term
Are ACE inhibitors good for high renin HTN? |
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Definition
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Term
What are the side effects of ACE inhibitors (Enalapril, lisinopril, and captopril)? |
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Definition
Increases bradykinin, but is otherwise well tolerated. rash, neutropenia ANGIONEURONIC EDEMA swells shut throat |
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Term
Which ACE inhibitor effects taste? |
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Definition
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Term
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Definition
they are Angiotensin II Receptor Blockers |
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Term
What is the pharmacologic action of the sartans? |
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Definition
Reduces release of aldosterone by blocking the angiotensin receptors (works on renin-angiotensin) |
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Term
What are sartans used for? |
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Definition
Sartans are used for hypertension, heart failure, and prevention of re-stenosis following angioplasty (rare). |
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Term
What are the benefits of sartans? |
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Definition
NO BRADYKININ effects (coughing?) |
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Term
What are the classifications of -olol's? |
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Definition
They are B blockers, note: labetAlol is alpha also. |
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Term
Which are the selective B blockers |
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Definition
Metoprolol, atenolol, acebutolol |
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Term
What are the side effects of sartans? |
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Definition
Dizziness, myalgia, GI effects, congestion. |
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Term
What are the indications of sartans? |
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Definition
as with ACE I's, except with angioedema due to ACE-I's. |
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Term
Which B blocker can also have action at alpha receptors? |
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Definition
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Term
What is the pharmacological action of sartans (Beta blockers)? |
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Definition
Works on renin-angiotensin to inhibit renin release, -cardiac output, -renin release, -sympathetic outflow |
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Term
What is the cariological effect of -olol's? |
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Definition
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Term
How does -olo's effect renin? |
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Definition
inhibition (decreased) renin release |
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Term
What is the neurological effect of olol's? |
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Definition
inhibition of sympathetic outflow |
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Term
How can olol's be used? (therapy, type of htn) |
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Definition
monotherapy, best with high renin HTN |
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Term
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Definition
During high crisis HTN. Reduce the need for nitroglycerin and not for spastic angina (stable only). |
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Term
What is the purpose of the antiarrythmic effect of beta blockers? |
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Definition
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Term
What is the relationship of olol's with asthma patients? |
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Definition
Bad for asthma PTs. Worsening of peripheral vascular disease, heart block, hypoglycemia. Angina attack after abrubt withdrawl. GI and CNS. Sexual dysfxn. |
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Term
What are the adverse effects of beta blockers? |
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Definition
Worsens peripheral vascular disease, heart block, HYPOglycemia, GI and CNS effects, sexual dysfunctions. |
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Term
What is the effect of abrupt withdrawal of beta blockers? |
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Definition
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|
Term
What is the classification of Ranolazine? |
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Definition
Inhibition of the late sodium current |
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Term
What are the side effects of ranolazine? |
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Definition
arrythmias, n/v, weakness, palpataions, dizziness. |
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Term
What is the classificaiton of -amines? |
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Definition
NON-selective alpha blockers |
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Term
What is the pharmacological effect of -amines? |
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Definition
Blockade of vascular alpha receptors. |
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Term
What is the therapeutic use of -amines? |
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Definition
Hypertension crisis in pheochromocytoma (rare situation) |
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Term
What are the adverse effects of -amines? |
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Definition
Postural HYPOtension, reflex tachycardia, FLUID RETENTION (may require diuretic) |
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Term
What is the classification of -zosin? |
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Definition
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Term
What is the use for -zosin's? |
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Definition
Blockade of vascular alpha receptor |
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Term
What is the pharmacological indication (use) for -zosin's? |
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Definition
Used for monotherapy and adjunctive therapy of hypertension. |
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Term
What is the adverse effects of -zosin's? |
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Definition
FIRST DOSE EFFECTS, TACHYCARDIA, nasal, dry mouth, and GI. |
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Term
What is the classification of aliskiren? |
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Definition
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Term
What is the pharmacological effect of aliskiren? |
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Definition
POOR PO ABSORPTION, works on renin-angiotensin. |
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Term
What is the therapeutic use for aliskerin? |
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Definition
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|
Term
What are the adverse effects of aliskerin? |
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Definition
NO BRADYKININ EFFECT. HYPERkalemia dizziness and diarrhea |
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Term
What are the contraindication of aliskerin? |
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Definition
NOT FOR USE IN PREGNANCY or bilateral stenosis |
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Term
What is the classification of nifedipine? |
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Definition
Calcium channel blockers of the L type |
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Term
How effective is nifedipine in vasodilation relative to other ca channel blockers (diltiazem and verapamil)? |
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Definition
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Term
What is the pharmacology of nifedipine? |
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Definition
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Term
What is the therapeutical use for nifedipine? |
|
Definition
initial choice for mild to moderate HT. Given IV in HYPERTENSIVE EMERGENCIES. |
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Term
What are the adverse effects of nifedipine? |
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Definition
Nifedipine causes flushing, headache, and edemas. There is also increased risk of cardiac events in short-acting drugs. |
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Term
What are therapeutic use for L-type calcium channel blockers? |
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Definition
Treat angina, paroximal tachycardia, atrial flutter, fibrilation, and essential HTN |
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Term
What are the L-type Calcium channel blockers? |
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Definition
Verapamil, nifedipine, and diltiazem. |
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Term
What is the structural classification of verapamil? |
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Definition
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Term
What is the mechanism of action of L-type calcium channel blockers? |
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Definition
They treat angina, proximal tachycardia, atrial flutter, fibrilation, and essential HTN. |
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|
Term
What is the structural pharmacology of diltiazem? |
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Definition
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Term
How effective is diltiazem in comparison to the verapamil and nifedipine? |
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Definition
Diltiazem is the least potent of the CCB's. (nifedipine>verapamil>diltiazem) |
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Term
What is the therapeutic use for verapamil and diltiazem? |
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Definition
SLOWS SA NODE! LACKS Reflex TACHY. Most useful in low renin HTN, blacks and elderly. NO FLUID RETENTION. Ca channel blocker for arrythmia Class IV |
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Term
What are the adverse effects of verapamil and diltiazem? |
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Definition
Flushing, headache, edemas and bradychardia, AV node conduction defects, risk of cardiac events in short-acting drugs. |
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Term
What pharmacological action of minodixil? |
|
Definition
potassium channel activator |
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Term
How is minodixil administered? |
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Definition
Used ONLY IN COMBO therapy orally |
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|
Term
What are the adverse effects of minodixil? |
|
Definition
Fluid retention, tachycardia, increased cardiac output which leads to CHF, pericardial effusions, hypertrichosis. |
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|
Term
What is the pharmacological action of guanethidine? |
|
Definition
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|
Term
How is guanethidine administered? i.e. monotherapy, combination |
|
Definition
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|
Term
What is the pharmacological action of diazoxide? |
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Definition
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Term
What three drugs are K channel activators? |
|
Definition
diazoxide, guanethidine, and minodixil |
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Term
What is the pharmacological action of hydrALAZine? |
|
Definition
ACTIVATES NO/guanylate cyclase pathway. |
|
|
Term
What are the therapeutic uses of hydrALAzine? |
|
Definition
ONLY IN COMBINATION, for HTN emergencies. available po and IV |
|
|
Term
What are the adverse effects of hydrALAZine? |
|
Definition
tachycardia, palpitations, HYPOtension, n/v, Lupus-like syndrome, and edema |
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|
Term
How is nitroprusside administered and why? |
|
Definition
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|
Term
What is the pharmacologic action of nitroprusside? |
|
Definition
Activation of NO/guanylate cyclase pathway |
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|
Term
What are the adverse effects of nitroprusside? |
|
Definition
sweating, tachycardia, nausea, psychosis, formation of cyanate ion |
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|
Term
What is the pharmacologic action of epoprostenol / prostacyclin / PGI2? |
|
Definition
IP prostanoid receptor agonist, short acting potent vasodilator. |
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|
Term
What is the therapeutic use for epoprostenol/prostacyclin/PGI2? |
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Definition
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|
Term
What is the pharmcological action of bosentan? |
|
Definition
nonselective alpha/beta endothelin receptor antagonist |
|
|
Term
How is bosentan administered and what for? |
|
Definition
Oral admin for pulmonary HTN |
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|
Term
What is the adverse effect of bosentan? |
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Definition
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|
Term
What is the contraindication for bosentan? |
|
Definition
contraindicated in pregnancy |
|
|
Term
What is the pharmacological action of sildenafil? |
|
Definition
PDE5 inhibition inhibits cGMP--> GMP |
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|
Term
What is the therapeutic use for sildenafil? |
|
Definition
|
|
Term
What are the adverse effects of sildenafil? |
|
Definition
dyspepsia, headache, and dizziness |
|
|
Term
What is the pharmacologic action of fenoldopam? |
|
Definition
D1 dopamine receptor agonists Increase renal blood flow, Decrease blood pressure, SHORT T1/2 |
|
|
Term
What is the therapeutic use for fenoldopam? |
|
Definition
IV emergency HTN situations |
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|
Term
What is the pharmacological action of nitroglycerin? |
|
Definition
Activation of NO/ guanylate cyclase pathway. ***Only 10% SURVIVE 1ST PASS METABOLISM |
|
|
Term
When is nitroglycerin used? |
|
Definition
|
|
Term
What are the side effects of nitroglycerin? |
|
Definition
HYPOtension, vasodilation, REFLEX TACHYCARDIA |
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Term
What are the adverse effects of isosorbides (mono and dinitrates)? |
|
Definition
HYPOtension, vasodilation, REFLEX TACHYCARDIA |
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|
Term
What is the pharmacological action of alpha methyldopa? |
|
Definition
Alpha-2 agonist Vasodilation and decrease in heart rate by reducing sympathetic tone |
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Term
How is alpha methyldopa activated? |
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Definition
PRODRUG converted to alpha-methylnorepinephrine |
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|
Term
How frequently is a-methyldopa used? |
|
Definition
not used often or alone. Old drugs. |
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Term
What is the mechanism of action of a-methyldopa, clonidine, guanabenz, and guanafacine and the resulting effects? |
|
Definition
IV: smooth muscle vascular a2 receptors open Ca2+ channels causing vasoconstriction. This leads to HYPOtension, sedation, withdrawal syndrome (HTN, Tachy, nervousness, excitement), Dry mouth, stuffiness, contact dermatitis, vivid dreams, restlessness, depression, and rebound HTN. |
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|
Term
What is the pharmacological action of clonidine? |
|
Definition
Alpha 2 agonist Vasodilation and decrease in HR due to reduction in sympathetic tone |
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Term
What are the alpha-2 agonists that induce vasodilation and decrease in HR by reducing sympathetic tone? Which is a prodrug**? |
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Definition
a-methyldopa** guanafacine, guanabenz, clonidine |
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|
Term
What is the classification of resperine? |
|
Definition
depleting drug: deplete Norepinephrine from nerve terminals and adrenal medulla |
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|
Term
What is the therapeutic use of resperine? |
|
Definition
Hardly any, not used very much, Increases catecholamine sensitivity (i.e. epinephrine) |
|
|
Term
What is the adverse effect of resperine? |
|
Definition
diarrhea, stuffiness, nausea, nightmares, sedation, fluid retention, decreases libido, tremors, arrhythmia, depression |
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|
Term
What is the pharmacological action of guanethadine and guanadrel? |
|
Definition
depleting drug: deplete Norepinephrine from nerve terminals and adrenal medulla |
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|
Term
What is the therapuetic use for guanethadine and guanadrel? |
|
Definition
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|
Term
When are Depleting drugs used? guanethadine, guanadrel, and resperine? |
|
Definition
Hardly any, not used very much, Increases catecholamine sensitivity (i.e. epinephrine) |
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