Systemic Pharmacology Review: Cardiovascular, Respiratory, Nervous, GI, Renal, Endocrine, Hematologic, and Immune Systems (150 Flashcards)

150 Q&A style flashcards covering major pharmacology concepts across cardiovascular, respiratory, nervous, GI, renal, endocrine, hematologic, and immune systems based on the provided notes.

What does the A in the ABCD mnemonic for antihypertensive agents stand for?

ACE inhibitors and ARBs.

What does the B in the ABCD mnemonic for antihypertensive agents stand for?

Beta blockers.

What does the C in the ABCD mnemonic for antihypertensive agents stand for?

Calcium channel blockers.

What does the D in the ABCD mnemonic for antihypertensive agents stand for?

Diuretics.

What enzyme do ACE inhibitors target and what is the downstream effect on blood pressure?

ACE inhibitors block angiotensin-converting enzyme, reducing angiotensin II, leading to vasodilation and lower blood pressure.

What is a common suffix for ACE inhibitors?

-pril.

Name two common ACE inhibitors.

Enalapril and Lisinopril.

What is a major adverse effect of ACE inhibitors besides cough?

Angioedema.

Why are ACE inhibitors contraindicated in pregnancy?

They cause fetal harm and birth defects.

Do ARBs cause a dry cough like ACE inhibitors?

No; ARBs do not typically cause a dry cough.

What is a common suffix for ARBs?

-sartan.

What receptor do ARBs block to lower blood pressure?

Angiotensin II AT1 receptors.

Name a commonly used ARB.

Losartan.

What should be monitored when patients are on ACE inhibitors or ARBs?

Blood pressure, renal function, hepatic status, and fluid status.

What is the suffix for beta-blockers?

-lol.

Which patient condition makes nonselective beta-blockers particularly risky?

Asthma or COPD due to potential bronchospasm.

Why should diabetics be cautious with beta blockers?

Beta blockers can mask signs of hypoglycemia.

Name two selective beta-1 blockers.

Metoprolol and Atenolol.

What is reflex tachycardia and with which drug class is it commonly seen?

A compensatory increase in heart rate after vasodilation; commonly seen with calcium channel blockers that vasodilate.

What is the difference between verapamil/diltiazem and dihydropyridine CCBs like nifedipine?

Verapamil/diltiazem affect heart and vessels; dihydropyridines mainly affect vessels.

Name a dihydropyridine calcium channel blocker.

Nifedipine.

Which calcium channel blockers are more likely to cause constipation?

Verapamil and diltiazem.

What is a common side effect due to vasodilation from calcium channel blockers?

Edema.

Why should calcium channel blockers be used with caution with beta blockers or digoxin?

Because of additive bradycardia effects.

Which CCBs are safer in heart failure and AV block because they act mainly on vessels?

Nifedipine, Amlodipine, Nicardipine (dihydropyridines).

What is hydralazine primarily used for?

Hypertensive crisis (rapid BP reduction through arterial dilation).

What do nitrates (e.g., nitroprusside, nitroglycerin) do in terms of vascular action?

Cause dilation of arteries and veins, reducing preload and increasing coronary perfusion.

What is a common side effect of arterial and venous dilators?

Headache, dizziness, flushing, edema.

Why might a beta blocker be combined with a calcium channel blocker?

To offset reflex tachycardia and excessive heart-rate slowing.

What is the primary use of short-acting beta-2 agonists (SABA) like albuterol?

Rapid relief of bronchoconstriction in asthma or COPD.

What is a common long-acting beta-agonist (LABA) used for maintenance in asthma/COPD?

Salmeterol.

What is a key instruction when using adenosine for SVT?

Administer rapidly with a 10 mL saline flush; very short half-life.

What is the primary action of adenosine in treating SVT?

Briefly blocks conduction through the AV node to reset the rhythm.

What is digoxin primarily used for, and what are its two main cardiac effects?

Heart failure and atrial fibrillation; increases contractility and decreases heart rate.

What is the therapeutic drug range for digoxin?

0.5 to 2 ng/mL.

What is a classic early sign of digoxin toxicity?

Nausea and visual changes (yellow-green halos).

What is the antidote for digoxin toxicity?

Digoxin immune FAB.

What dietary factor can increase digoxin toxicity?

Licorice (glycyrrhizin) and electrolyte shifts—especially hypokalemia.

What should be checked before giving digoxin and what HR threshold prompts holding the dose?

Check pulse; hold if heart rate is below 60 bpm in adults.

What is a key adverse effect of amiodarone besides risk of thyroid issues?

Blue-gray skin discoloration and photosensitivity.

Which antiarrhythmic is well known for causing thyroid, liver, and lung toxicity?

Amiodarone.

Which antiarrhythmic is primarily a sodium channel blocker (Class I) and is associated with lupus-like syndrome?

Procainamide.

What is a major adverse effect associated with procainamide besides GI upset?

SLE-like syndrome.

Which antiarrhythmic is used to keep patients in normal sinus rhythm and is a potassium channel blocker?

Amiodarone.

What safety concern is associated with IV push of ondansetron?

Can prolong the QT interval and risk torsades de pointes; push slowly.

Which antiemetic class is typically first-line for severe nausea and vomiting by blocking serotonin receptors?

Serotonin antagonists (e.g., ondansetron).

What is the major risk with using promethazine for antiemesis in young children?

Respiratory depression and CNS effects; contraindicated under 2 years.

What is the primary nursing concern when giving vancomycin?

Nephrotoxicity; must infuse slowly (at least 60 minutes) to avoid red man syndrome; monitor trough levels.

What is the antidote for red man syndrome?

Stop infusion and treat the symptoms; typically doesn’t have a specific antidote.

Which TB drugs are commonly used and what are their major adverse effects?

Isoniazid (hepatotoxicity, peripheral neuropathy); Rifampin (orange body fluids, drug interactions).

What unique effect does rifampin have on body fluids?

Turns body fluids (tears, urine, sweat) orange-red.

Why must rifampin be used cautiously in patients on HIV therapy?

It induces hepatic enzymes and can reduce levels of HIV drugs.

Which antibiotic class inhibits bacterial cell wall synthesis and often ends with -cillin?

Penicillins.

What is the major risk associated with penicillin allergies?

All penicillins may be cross-reactive; watch for hypersensitivity reactions.

What is a common beta-lactamase inhibitor combination product name?

Augmentin (amoxicillin-clavulanate) with clavulanate.

What is a key adverse effect to monitor with cephalosporins?

Risk of C. diff with prolonged use; cross-sensitivity with penicillins.

Why should penicillins be used cautiously in patients with renal impairment?

Renal clearance may be reduced, increasing levels and risk of toxicity.

What is a major adverse effect of tetracyclines in children and pregnancy?

Teeth discoloration and enamel hypoplasia; avoid in pregnancy and children under 8.

What should be avoided when taking tetracyclines to ensure absorption?

Calcium, magnesium, dairy products, and antacids.

Which antibiotic is commonly used for Rocky Mountain spotted fever and Lyme disease and has notable photosensitivity?

Doxycycline (tetracycline class).

What is a notable interaction concern with macrolides like erythromycin and azithromycin?

Can prolong QT interval; can inhibit hepatic metabolism of other drugs.

What is the key toxicity concern with aminoglycosides like gentamicin?

Ototoxicity and nephrotoxicity.

What is a common sulfonamide combination antibiotic and its common use?

Sulfamethoxazole-trimethoprim (Bactrim); common for UTIs.

What is a major serious hypersensitivity syndrome associated with sulfonamides?

Stevens-Johnson syndrome.

Why should sulfonamides be avoided in late pregnancy or in very young infants?

Can cause kernicterus and bilirubin disruption.

What is a key consideration when giving fluoroquinolones to pediatric patients?

Increased risk of tendonitis and tendon rupture; avoid in under 18 years.

What is a major adverse effect of fluoroquinolones related to the eyes and sun exposure?

Photosensitivity and potential exacerbation of myasthenia gravis symptoms.

What should be avoided when taking fluoroquinolones due to absorption issues?

Cations like calcium, iron, zinc, and aluminum-containing antacids.

What is a major safety warning for rifampin in patients taking contraception?

It reduces effectiveness of hormonal birth control; use backup methods.

Which antifungal is highly nephrotoxic and typically given IV with saline Bos?

Amphotericin B.

What are the two main antifungal classes used systemically?

Azoles (e.g., fluconazole) and polyenes (e.g., amphotericin B); echinocandins (fungins) are another class.

What is a key monitoring consideration for azole antifungals like fluconazole?

Liver function tests (potential hepatotoxicity) and drug interactions (CYP450).

What warning should patients know about body fluids when taking rifampin?

Fluids (tears, urine, sweat) can turn orange-red.

What is the main action of anti-infectives in general?

To damage or inhibit growth of pathogens (bacteria, viruses, fungi).

What does the acronym M-E-D-C-A-T stand for in antibiotic teaching?

M: monitor for superinfections; E: evaluate renal and liver function; D: diarrhea management; C: culture before first dose; A: avoid alcohol; T: take the entire course.

Why is it important to culture before the first antibiotic dose?

To identify the organism and choose the most effective antibiotic; avoid contaminating results.

What is a major consequence of using broad-spectrum antibiotics long-term?

Superinfections and resistance development.

What is the mechanism of action for penicillins?

Weakens bacterial cell wall, causing bacterial death.

What is a common side effect of penicillins?

Rash and diarrhea.

What is the primary management step if a patient develops a key antibiotic allergy?

Discontinue the offending antibiotic and assess alternatives.

Which class of diuretics is typically first-line for primary hypertension?

Thiazide diuretics (e.g., hydrochlorothiazide).

Which diuretic is often used in heart failure to reduce edema and preload?

Loop diuretics (e.g., furosemide).

Which diuretic class acts at the collecting duct and helps spare potassium?

Potassium-sparing diuretics (e.g., spironolactone).

What is a key safety consideration when using ACE inhibitors in kidney disease?

Renal impairment can raise drug levels; monitor renal function.

Which class of hypertension drugs does the cough and angioedema risk pertain to most?

ACE inhibitors.

What is a major pregnancy-related contraindication for both ACE inhibitors and ARBs?

Known fetal harm and birth defects.

What are the two main opioid-based cough suppressants?

Codeine and hydrocodone.

What non-opioid cough suppressant is commonly used over the counter?

Dextromethorphan.

What is a common expectorant used to loosen mucus?

Guaifenesin.

What is a mucolytic used in cystic fibrosis to break up thick secretions and its notable odor?

Acetylcysteine; smells like rotten eggs.

Why should acetylcysteine not be given with a cough suppressant?

To avoid inhibiting coughing needed to clear mucus.

What is total parenteral nutrition (TPN) and when is it used?

IV nutrition for patients unable to use enteral feeding due to GI issues or obstruction.

What major risk is associated with TPN?

Infection, fluid overload, electrolyte disturbances; high glucose load.

How often are TPN bags typically changed?

Every 24 hours.

What should you do if a TPN bag spills?

Hang dextrose 10% at the same rate to prevent hypoglycemia and then replace the bag.

Where do loop diuretics act in the nephron?

Loop of Henle.

Which electrolyte is most at risk with loop diuretics leading to arrhythmias if low?

Potassium (hypokalemia).

Which diuretic is first-line for edema and hypertension with less potassium loss than loops?

Thiazide diuretics (e.g., hydrochlorothiazide).

Which diuretic is best for preserving potassium?

Potassium-sparing diuretics (e.g., spironolactone).

What is the main adverse effect of loop diuretics related to hydration status?

Dehydration and hypotension.