Exam 2 Pharm updated

What do CCB’s do

dec HR and contractility

MOA CCBs

block calcium channels, dec cardiac muscle contraction

What class are dihydropyrines

CCB

What class are non-dihydropyrines

CCB

What is Verapamil

non-dihydropyrine

What is diltiazem

non-dihydropyrine

What is nifedipine

dihydropyrine

What is amlodipine

dihydropyrine

Uses non-dihydropyrine

angina, cardiac arrhythmia (afib/ SVT)

When can non-dihydropyrine not be used

LV systolic dysfunction, conduction system disease

Uses dihydropyrine

HTN, angina, subarachnoid hemorrage

What are BB’s

block recepts dec renin, lower aldosterone and BP + HR + CO

What is propranolol

1st gen BB

What is carvedilol

3rd gen bb

What is metoprolol

2nd gen bb

Uses BB

HTN, CAD, MI, HF< arrhythmia

What is metoprolol

2nd gen BB

What is atenolol

2nd gen BB

What is bisoprolol

2nd gen BB

What is carvedilol

3rd gen BB

What is labetalol

3rd gen BB

MOA carvedilol

non-selective BB, blocks B1 and B2 dec HR/Vasodilates/ dec sns effects

What is used for severe HTN in pregnancy

labetalol

What is hydralazine

direct-acting vasodilator

MOA hydralazine

direct relaxation of arteriolar smooth muscle

Uses for hydralazine

severe HTN, HTN emergenices

What is sodium nitroprusside

direct acting vasodilator

MOA sodium nitroprusside

direct relax arteriolar and venous smooth muscle

Indications sodium nitroprusside

high alert med, HTN emergency

What do alpha1 blockers do

relax vessels and dec BP

What do alpha 2 agonists do

CNS dec sympathetic outflow and dec BP

Clinical a1 blocker

BPH, HTN

What is prazosin

a1 blocker

What is doxazosin

a1 blocker

What is Tamsulosin

a1 blocker

-osin is

a1 blocker

-lol are

BB

-dipine are

dihydropyridines CCB

clonidine clinical indications

reisistant HTN/ ADHD/ cancer pain

Guanfacine clinical indications

HTN

Methyldopa clinical indications

HTN in pregnancy

What does asprin affect

antiplatelets

What does Clopidogrel(plavix) affect

antiplatelets

What does ticagrelor(brillinta) affect

antiplatelet

What does prasugrel (effient) affect

antiplatelet

What does tirofiban (aggrastat) affect

antiplatelet

What does heparin affect

anticoag

What does warfrin affect

anticoag

What does dabigatran (pradaxa) affect

anticoag

What does rivaroxaban, apixaban (eliquis) affect

anticoag

What does alteplase (tPA) affect

fibrinolysis

Simple MOA heparin

activate antithrombin

Simple MOA warfarin

vitamin k angtagonist

Simple MOA dabigatran (pradaxa)

direct thrombin inhibitor

Simple MOA apixaban (eliquis)

direct Xa inhibitor

What is protamine sulfate used for

heparin antidote

what is 4-factor PCC

warfarin antidote

what is idarucizumab (praxbind) for

dabigatran (pradaxa) antidote

½ life TNKase

20-24min

½ life Alteplase

about 5 min

What are statins

first line antihyperlipidemic

What is ezetimibe (zetia)

antihyperlipidemic

What is evolocumab (Repatha)

antihyperlipidemic

What is fenofibrate

antihyperlipidemic

What is bempedoic acid (nexletol)

antihyperlipidemic

What type of antihyperlipidemic are statins

HMG-CoA reductase inhibitor

What type of antihyperlipidemic are ezetimibe (zetia)

cholesterol absorption inhibitor

What type of antihyperlipidemic are evolocumb (repatha)

PCSK9 inhibitor

What type of antihyperlipidemic are fenofibrate

fibrate

What type of antihyperlipidemic are bempedoic acid (nexletol)

ATP-citrate lyase inhibitor

MOA bempedoic acid (nexletol)

blocks cholesterol synth

MOA fenofibrate

inc lipolysis and triglyceride clearence, inc HDL synth

MOA evolocumab (repatha)

human monoclonal antibody that bins to PCSK9 inc LCL receptors

MOA ezetimibe (zetia)

blocks NPC1L1 sterol transporter inc hepatic LDL receptors

MOA statins

dec cholesterol synth, adds LDL receptors

MOA colesevelam (welchol)

bind bile acids and converts cholesterol to bile acids

When is colesevelam (welchol) perfered?

lipid lowering in pregnacy and lactation

What are ARNIs used for

Perfered HFrEF therapy

What are BB used for

dec BP + HR + remodeling for HF

What are MRA used for

dec fibrosis and remodeling in HF

What are loop/thazine diuretic used for

relive congestion hf

what is digoxin used for

symptoms of HF

1st choice HF

ARNI

alterative choice HF

ACEi

fallback HF

ARB

-pril

ACEi

-sartan

ARB

What is Sacubitril/Valsartan (Entresto)

ARNI

MOA spironolactone

aldosterone antagonist, works on late distal tubule and collecting duct

MOA thiazide diuretics

blocks NA/Cl- in early DCT

Lasix MOA

blocks NA+/K+/2CL- in ascending henle

BP goal with treatment

below 130/80

Uses BB

hypertension, angina, rate control, HF therapy

What do BB do

lower HR, contractility, av conduction and renin release

What is different with nonselective BB

inc bronchospasm risk

Monitoring on a BB

bradycardia, hypotension, fatigue, masked hypotension

Nursing considerations BB

no abrupt withdrawal, check BP and HR before admin

What is the preferential beta-1blocker

metoprolol

Metoprolol tartare- dosage and release time

divided doses, immediate release