p1 fall

Diltiazem — Brand

Cardizem; Cartia XT; Taztia XT; Tiazac

which glucocorticoid has most formualtions, include for rectal and enema

Hydrocortisone (cortef, solucortef)

what is IV Aprepitant caleld

aponvie, cinvanti

aprepitant (emend) MOA

Substance P/NK-1 Receptor Antagonist: a human substance P/neurokinin 1 (NK1) receptor antagonist in the CTZ and vomiting center with high selectivity and affinity and little or no affinity for serotonin (5–HT3), dopamine, and corticosteroid receptors.

aprepitant ad eff

Common: dizziness, fatigue, constipation, weakness, hiccups

aprepitant CI

Do not use with pimozide or cisapride (CYP3A4 substrates)

• no grapefruit juice

scopolamine brand

transderm scop

what drug is teh belladona alkaloid indicated for motion sickness

scopolamine

scopolamine ad eff

"Common: dry mouth, CNS effect (dry mouth, drowsiness, dizziness, sedation, confusion), tachycardia, heat intolerance, stinging of eyes, pupil dilation

Serious: increased IOP (glaucoma) "

what is a unique/not often mentioned other formualtion for scopolamine

ophthalmic

• treat iridocyclitis (inflammation of eyeball in the iris/pupil— causes mydriassi or dialated pupil to stop the spasms)

what do the systemic glucocorticoids actually do

Systemic glucocorticoids: cause inhibition of inflammatory response. Suppresses neutrophil migration and decreases inflammatory mediators and reverses capillary permeability.

indications for glucocorticoids

Inflammatory and autoimmune conditions (RA, asthma, COPD exacerbations, acute gout)

which two systemic glucocortoids have ophthalmic formulations

dexamethasone, prednisolone

Prednisone brand

deltasone

Methylprednisolone brand

Medrol, Solumedrol

which class 3 antiarrth is preg cat x

dronedarone

which antihist NOT renal adjust

diphenhydramine

which class 3 antiarrthm should be started in hospital and requires monitoring of CrCl and QTc?

dofetilide

• (sotalol also started in hospital)

Diltiazem — Indication

Angina; HTN; A-fib rate control (off-label)

what is the big deficiency with ppis?

hypomagnesima

what is Zollinger-Ellison syndrome

a rare condition where one or more tumors, called gastrinomas, grow in the pancreas or upper small intestine. These tumors secrete excess amounts of the hormone gastrin, which forces the stomach to overproduce acid, leading to severe peptic ulcers, chronic diarrhea, and abdominal pai

how does digoxin work

• block na/k atpases

• more na in cell means less na comes in to remove ca

• more ca means more contraction

also increase PNS tone of vagal nerve— slow down av node so atria and ventricles on same place

digoxin ci

ventricular fibrillation

digoxin ad eff

"Common: Nausea, Vomiting, Dizziness, Headache, Mental Disorder

Serious: Cardiac Dysrhythmia, Ischemia, Sinus Bradycardia, SA Block, Thrombocytopenia"

digoxin adjustment

• "Digitek

  Lanoxin"

r

ranolazine moa

Antianginal Agent: Inhibits the late phase of the sodium channel and reduces calcium influx, reducing ventricular tension and myocardial oxygen consumption

ranolazine brand

ranexa

Ranolazine ind

Chronic Stable Angina Ventricular Arrhythmias

Ranolazine adjust

r

Ranolazine ad eff

Common: Bradycardia, Hypotension, Palpitations, Abdominal Pain, Constipation, Nausea, Vomiting Serious: QT Prolongation

what is prinzmetal angina

RANDOM angina

what is big bacterial infection risk with ppis

c dif!

Diltiazem — Adjustment

N

Diltiazem — Route

PO; IV

Diltiazem — Boxed Warning

None

Diltiazem — Contraindications

2nd/3rd degree AV block; hypotension; sick sinus syndrome; acute MI; pulmonary congestion

Diltiazem — Side Effects

Common: Edema, hypotension, constipation, dizziness, headache. Serious: Gingival hyperplasia, AV block, MI, pulmonary edema.

Diltiazem — Major DDI

CYP3A4 inhibitors

Diltiazem — Other Comments

Non-DHP calcium channel blocker. Negative inotropic and chronotropic effects. Used for angina, HTN, and rate control.

Verapamil — Brand

Calan SR; Verelan

Verapamil — Indication

Angina; HTN; PSVT prophylaxis; A-fib rate control

Verapamil — Adjustment

• "Calan SR

  Verelan"

H

Verapamil — Route

PO; IV

Verapamil — Boxed Warning

None

Verapamil — Contraindications

2nd/3rd degree AV block; hypotension; sick sinus syndrome; LV dysfunction; cardiogenic shock; atrial flutter

Verapamil — Side Effects

Common: Edema, hypotension, constipation (greater than diltiazem), dizziness, headache. Serious: Gingival hyperplasia, AV block, MI, pulmonary edema.

Verapamil — Major DDI

CYP3A4 inhibitors

Verapamil — Other Comments

Non-DHP calcium channel blocker. More constipating than diltiazem. Negative inotropic/chronotropic effects.

Amlodipine — Brand

Norvasc

Amlodipine — Indication

• norvAsc

CAD (stable angina); HTN; Prinzmetal angina

Amlodipine — Adjustment

H

Amlodipine — Route

• norvasc

PO

Amlodipine — Boxed Warning

None

Amlodipine — Contraindications

None listed

Amlodipine — Side Effects

Common: Peripheral edema, reflex tachycardia, hypotension, dizziness, headache, flushing, fatigue. Serious: Gingival hyperplasia, MI.

Amlodipine — Major DDI

CYP3A4 inhibitors; Simvastatin (maximum 20 mg/day)

What do both Lotrel and Exforge contain?

amlodipine!

Lotrel — am + benazepril

Exforge- valsartan

Nifedipine ER — Brand

Procardia; Adalat CC

Nifedipine ER — Indication

Procardia, Adalat CC

CAD (stable angina); HTN; Prinzmetal angina

Nifedipine ER — Adjustment

N

Nifedipine ER — Route

PO

Nifedipine ER — Boxed Warning

None

Nifedipine ER — Contraindications

Adalat CC: Strong CYP3A4 inducers; cardiogenic shock

Nifedipine ER — Side Effects

Common: Peripheral edema, reflex tachycardia, hypotension, dizziness, headache, flushing, fatigue. Serious: Gingival hyperplasia, MI.

Nifedipine ER — Major DDI

CYP3A4 inhibitors

Nifedipine ER — Other Comments

DHP calcium channel blocker. Shell of ER tablet may be seen in stool.

Nicardipine — Brand

Cardene

Nicardipine — Indication

HTN; Hypertensive emergency

Nicardipine — Adjustment

• cardene

R/H

Nicardipine — Route

IV

Nicardipine — Boxed Warning

None

Nicardipine — Contraindications

Aortic stenosis

CARDENE

narrowing of aortic valve— the vasodilation means there is less blood flow back to the heart, so harder to get preload up/blood out

Nicardipine — Side Effects

Common: Peripheral edema, reflex tachycardia, hypotension, dizziness, headache, flushing, fatigue. Serious: Gingival hyperplasia, MI.

Nicardipine — Major DDI

CYP3A4 inhibitors

Nicardipine — Other Comments

DHP calcium channel blocker used IV.

Hydralazine — Brand

Apresoline

Hydralazine — Indication

HTN; CHF; Pregnancy-induced HTN (off-label)

Hydralazine — Adjustment

N

Hydralazine — Route

PO; Injection

Hydralazine — Boxed Warning

None

Hydralazine — Contraindications

CAD; Mitral valvular rheumatic heart disease

Hydralazine — Side Effects

Common: Headache, edema, palpitations, tachycardia, hypotension. Serious: Drug-induced lupus.

• causes SLE bc can trigger immune response that becomes lupus (against own body cells)

Hydralazine — Major DDI

None listed

Hydralazine — Other Comments

Direct arteriolar vasodilator. Administer consistently with or without meals. Combination product: BiDil (+isosorbide dinitrate).

Ivabradine — Brand

Corlanor

Ivabradine — Indication

Heart failure

Ivabradine — Adjustment

N

Ivabradine — Route

PO

Ivabradine — Boxed Warning

None

Ivabradine — Contraindications

Acute decompensated HF; BP <90/50; sick sinus syndrome; SA block; 3rd-degree AV block (unless paced); resting HR <60 bpm before treatment; severe hepatic impairment (Child-Pugh C); pacemaker dependence; strong CYP3A4 inhibitors

Ivabradine — Side Effects

• corlanor

Common: Bradycardia, hypertension, atrial fibrillation. Serious: Bradyarrhythmia, luminous phenomena, prolonged QT, torsades de pointes.

Ivabradine — Major DDI

CYP3A4 inhibitors; QT-prolonging drugs; calcium channel blockers (bradycardia)

Ivabradine — What channel is blocked

HCN ("funny") channel blocker. Use only in stable symptomatic HFrEF (LVEF