week 10/week9 drug study guide

pharm test 3

Sacubitril/valsartan class/action/use/education

Class: Neprilysin inhibitor/ARB

Action: increase in peptides=vasiodilation and diuresis, blcoks angiotension=vasoconstriction and lowered aldosterone

Use: HF w reduced ejection fracton

Education: salt substitues often have potassium, take consistently

sacubitril/valsartin adverse effects and contraindications

adverse effects: HYPOtension, HYPERkalemia, cough (less than ace), ANGIOEDEMA renal impairment

contraindication: USe with ACE hx of angioedema hepatic impairment PREGNANCY

Milrinone class/action/use/education

class: phosphodiesterase inhibitor

action:  increases cAMP=calcium in cardiac musles=vasodilation

POSTIVIE INOTROPE

Use: SHORT TERM iv therapy for heart failure or mechinical valve

Education: titrate, HIGH ALERT

Milrinone contraindications and adverse effects 

Contraindications: VALVULAR disease, renal impairment

Adverse effects: HYPOtension, ventricular arrhythmias, headache, thrombocyytopenia 

Ivabradine class/action/use/education

Class: Selective Sinus Node inhibitor

Action: inhibits the Sa node to slow depolarization=slower heartrate

Use: Reduce hospilizatino in HF

Education: NO BETABLOCKER no Grapefruit

Ivabradine contraindications adverse effects

Contra: Decomp HF, hepatic impairment, bradycardia, pacemaker, CYPS3A drugs

Adverse: bradycardia, visual issues, afib, hypotension, JUNCTIONAL r

Enalapril maleate class/action/use/education

class: ACE inhibitor

Action: prevents angiotension II

USe: HF, HTN, Left ventricular disfunction

education: RISE SLOWLY=orthopedic hypo

Enapril malate contraindication and adverse effects

Adverse: Hypotension, persistent cough, KYPERKALEMIA< dizzy, angioedema

Contraindication: pregnancy, hx of angioedema, bilateral renal stenosis, severe renal impairment 

Digoxin class action use education

Class: cardiac glycoside

Action: inhibits Na, K, and ATPase causing influx of calcium

Use: HF, afib and flutter

Education: NARROW therapeutic range

Digoxin contrindcations and adverse effects:

Adverse: Cardiac: bradycardia and PVC, n/v, fatigue/confuison, HALOS 

TOXICITY: n/v=sevre bradycardia arrythmias

BLACKBOX: arrythmias

Contraindication: hypo/hyperkalemia, vfib, AV blvok sick sinus syndrome

Metoprolol class action use education

Class: beta blocker

action: beta-1=no SNS stimulation, lowers cardiac output

Use: HTN, angina pectoris, HF, MI management, A fib

BLACKBOX: abrupt disontinuation may cause angina and MI 

Education: no digoxin diltiazem or verapamil, NSAIDS 

Metoprolol contraindications/adverse effects

Contraindications: Bradycardia, cardiac output, PAD

Adverse reactions: bradycardia, hypotension, fatigue, DEPRESSION, SEXual dysfunction, DECREASED EXCERSIZE INtollerance

Invokana: class/action/use/education

Class: SGL2 inhibitor

action: blocks sglt2=prevents glucose reabsorption

use: Type 2, Slow CKD, HF

Invokana adverse effects contraindications

adverse: yeast infections, UTI, hypotenion, polyuria RARE: ketoacidosos amputation

Contraindicated: severe renal impairment, type 1 DKA hx of limb amputation

Mannitol Class action use

Class: osmotic diuretic

Action: creates osmotic gradient and pulls water into renal tubulal

Use: ICP and IOP and diuresis in acute renal failire

Mannitol contraindications and adverse effefcts

Contraindications: Intracranial bleeding (except during craniotomy), severe dehydration, anuria, pulmonary edema or severeee HF

Adverse: fluid and electrolyte imbalance, dehydration, HYPOTENSION, headache, PULMONARY EDEMA 

Fat soluble vitamins 

Alli doesnt eat ketamine 

ADEK

Vitamin K use, adverse, source

Use: hypoprothombinemia and reverse warfarin

adverse: IV CAN CAUSE ANALYPHALACTIC SHOCK 

Source: green leafy veggies 

B12 use/causes/at risk/source

Use; make redblood cells

causes: Megaloblastic anemia (large, immature RBCs)

at risk: vegans, gastritis, medications

Source: animal products and fortified foods 

B3 name/adverse effects, B6 name/adverse effects

B3: nacin: Hypotension risk and facial flushing=take with aspirn

B6: pyroidoxine: levadopa effected, renal issues 

Folic acid use/ at risk/ sources

Use: cell growth

At risk: alcoholics, pregnancy, anemic, sulfa

sources: organges and broccli

Iron use/ at risk/antidote/ adverse

USe: makes hemoglobin and myoglobin=anemia

PO: take with orange juice on an empty stomach

Adverse: Blocks aborption of meds, take 1 hour before or 2 hours after, black stools, stains teeth

Antidote: Deferasirox

Potassium admin

IV ONLY: SLOWWW PUSH

ANTIDOTE: Sodium BICarb

Magnisium admin

Mag relaxes muscles, used in labor and torsads adn anti convulsant

ANTIDOTE: Ca gluconateeee tape it to the wall