Key Drug Exam - P2 Fall

Benazepril brand?

Lotensin

Lotensin generic?

Benazepril

Benazepril / Lotensin pharmacological category?

ACE inhibitor

ACE inhibitor box warning

fetal toxicity

Benazepril / Lotensin MOA?

Prevents conversion of angiotensin I to angiotensin II, resulting in lower levels of angiotensin II, which causes and increase in plasma renin activity and a reduction in aldosterone secretion

ACE inhibitor key counseling

Cough, Hypotension, Dizziness, Headache, increases potassium (monitor)

Benazepril / Lotensin primary therapeutic uses?

Hypertension

Benazepril / Lotensin dose adjustments in renal dysfunction?

Yes

Enalapril maleate brand?

Vasotec

Vasotec generic?

Enalapril maleate

Enalapril maleate / Vasotec pharmacologic category?

ACE inhibitor

Enalapril maleate / Vasotec MOA?

A pro-drug that is converted to its active metabolite

Prevents conversion of angiotensin I to angiotensin II, resulting in lower levels of angiotensin II, which causes and increase in plasma renin activity and a reduction in aldosterone secretion

Enalapril maleate / Vasotec primary therapeutic uses?

HF

HTN

Kidney disease(non- diabetes related)

Diabetic neuropathy

MI

Proteinuric CKD

Enalapril maleate / Vasotec dose adjustments in renal dysfunction?

yes

Lisinopril brand name?

Zestril

Prinivil

Zestril / Prinivil generic?

Lisinopril

Lisinopril / Zestril / Prinivil pharmacological category?

ACE inhibitor

Lisinopril / Zestril / Prinivil MOA?

Prevents conversion of angiotensin I to angiotensin II, resulting in lower levels of angiotensin II, which causes and increase in plasma renin activity and a reduction in aldosterone secretion

Lisinopril / Zestril / Prinivil primary therapeutic uses?

HFrEF

Hypertension

ST-elevated Myocardial Infraction

Lisinopril / Zestril / Prinivil dose adjustments in renal dysfunction?

Yes

Lisinopril-HCTZ brand?

Prinzide

Zestoretic

Prinzide / Zestoretic generic?

Lisinopril-HCTZ

Lisinopril-HCTZ / Prinzide / Zestoretic pharmacologic category?

ACE inhibitor and thiazide diuretic combo

Lisinopril-HCTZ / Prinzide / Zestoretic MOA?

HCTZ → Inhibits sodium reabsorption in the distal tubules causing increased excretion of sodium and water as well as potassium and hydrogen ion

Lisinopril → competitive inhibitor of ACE; prevents conversion of angiotensin I to angiotensin II, results in lower levels of angiotensin II which causes an increase in plasma renin activity and a reduction in aldosterone secretion

Lisinopril-HCTZ / Prinzide / Zestoretic key counseling?

Cough, Hypotension, Dizziness, Headache, increases potassium (monitor)

HCTZ → reduces potassium (monitor); dizziness, take in morning to avoid frequent urination at night

Lisinopril-HCTZ / Prinzide / Zestoretic primary therapeutic uses?

Hypertension

Lisinopril-HCTZ / Prinzide / Zestoretic dose adjustments in renal dysfunction?

Yes

Norepinephrine bitartrate brand?

Levophed

Levophed generic?

Norepinephrine bitartrate

Norepinephrine bitartrate / Levophed pharmacologic category?

Alpha-1 and 2 agonist, beta-1 catecholamine (inotrope)

Norepinephrine bitartrate / Levophed MOA?

Action on alpha receptors causes peripheral vasoconstriction of blood vessels to maintain blood pressure and heart function

Norepinephrine bitartrate / Levophed key counseling info

Bradycardia

Arrhythmia

Anxiety
Transient headache

Norepinephrine bitartrate / Levophed therapeutic uses?

used primarily to increase or maintain blood pressure during acute medical situations

Epinephrine pharmacologic category?

Alpha-1 and 2 agonist, beta-1 and 2 agonist (catecholamine)

Epinephrine MOA?

Action on alpha receptors causes peripheral vasoconstriction of blood vessels to maintain blood pressure and heart function

Action on beta receptors, it increases heart rate and contractility & also relaxes smooth muscles in the lungs to relieve SOB and wheezing → during anaphylaxis

Epinephrine key counseling info?

Anxiety

Disorientation

Headache

Restlessness

Epinephrine primary therapeutic uses?

Acute treatment of allergic reactions

Treats low BP during septic shock

Use in eye surgery to maintain pupil dilation

Dopamine hydrochloride pharmacologic category?

Alpha-1 agonist, beta-1 agonist, dopamine agonist catecholamine (Inotrope)

Dopamine HCl MOA?

Dose dependent pharmacology →

Lower doses → used for renal perfusion in AKI and HF

Intermediate doses → it activates beta-1 receptors enhancing HR and contractility. used in shock for inotropic effect

High doses → primarily impacts alpha-1 receptors causing vasoconstriction. used for hypotension in shock

Dopamine HCl key counseling info?

Monitor for tachycardia, arrhythmias, and excessive vasoconstriction (can compromise organ function)

Dopamine HCl primary therapeutic uses?

Used primarily to increase or maintain BP during acute medical situations

Doxazosin brand?

Cardura

Cardura XL

Cardura / Cardura XL generic?

Doxazosin

Doxazosin / Cardura / Cardura XL pharmacologic category?

Alpha 1 antagonist

Doxazosin / Cardura / Cardura XL MOA?

Hypertension → competitively inhibits postsynaptic alpha-adrenergic receptors which results in vasodilation of veins and arterioles and a decrease in total peripheral resistance and blood pressure

BPH → antagonist of alpha(1A)-adrenoreceptors in the prostate, leads to relaxation of smooth muscle in the bladder neck and prostate causing an improvement of urine flow and decreased symptoms of BPH

Doxazosin / Cardura / Cardura XL key counseling info?

May cause low BP causing dizziness or fainting, tachycardia, sexual dysfunction, some weakness

Usually resolves within 2 weeks

Doxazosin / Cardura / Cardura XL primary therapeutic uses?

BPH

Hypertension

Clonidine brand?

Catapres

Catapres generic?

Clonidine

Clonidine / Catapres pharmacologic activity?

Alpha 2 agonist

Clonidine / Catapres box warnings?

Epidural use (500 mcg/mL should be diluted prior to use)

Clonidine / Catapres MOA?

Stimulates alpha-2 adrenoceptors in the brain stem, thus activating an inhibitory neuron, resulting in reduced sympathetic outflow from the CNS, producing a decrease in peripheral resistance, renal vascular resistance, heart rate, and blood pressure

Clonidine / Catapres key counseling info?

Drowsiness, headache, dizziness, rash, dry mouth

Clonidine / Catapres primary therapeutic uses?

ADHD

Hypertension

Irbesartan brand?

Avapro

Avapro generic?

Irbesartan

Irbesartan / Avapro pharmacologic category?

ARB

Irbesartan / Avapro MOA?

Block binding of angiotensin II to AT1 receptor on blood vessel walls - promotes vasodilation indirectly

ARB key counseling info?

dizziness, fatigue, hypotension, headache, can raise potassium

Irbesartan / Avapro primary therapeutic uses?

Diabetic neuropathy

Hypertension

Losartan brand?

Cozaar

Cozaar generic?

Losartan

Losartan / Cozaar pharmacologic category?

ARB

Losartan / Cozaar MOA?

Block binding of angiotensin II to AT1 receptor on blood vessel walls - promotes vasodilation indirectly

Losartan / Cozaar primary therapeutic uses?

Hypertension

Diabetic neuropathy

Olmesartan brand?

Benicar

Benicar generic?

Olmesartan

Olmesartan / Benicar pharmacologic category?

ARB

Olmesartan / Benicar MOA?

Block binding of angiotensin II to AT1 receptor on blood vessel walls - promotes vasodilation indirectly

Olmesartan / Benicar primary therapeutic uses?

Hypertension

Valsartan brand?

Diovan

Diovan generic?

Valsartan

Valsartan / Diovan pharmacologic category?

ARB

Valsartan / Diovan MOA?

Block binding of angiotensin II to AT1 receptor on blood vessel walls - promotes vasodilation indirectly

Valsartan / Diovan primary therapeutic uses?

HFrEF

Hypertension

Post-MI

Adenosine brand?

Adenocard

Adenocard generic?

Adenosine

Adenosine / Adenocard pharmacologic category?

Antiarrhythmic agent

Adenosine / Adenocard MOA?

Slows conduction time through AV node, vasodilation and increases blood flow in normal coronary arteries

Adenosine / Adenocard key counseling info?

Immediately after administration may experience sudden but transient chest pressure or sense of impending doom

Adenosine / Adenocard primary therapeutic uses?

Paroxysmal supraventricular tachycardia

Amiodarone brand?

Pacerone

Pacerone generic?

Amiodarone

Amiodarone / Pacerone pharmacologic category?

Antiarrhythmic agent (Class III)

Amiodarone / Pacerone box warnings?

Arrhythmias

Pulmonary toxicity

Hepatotoxicity

Amiodarone / Pacerone MOA?

Inhibits adrenergic stimulation, affects sodium, potassium, and calcium channels, prolongs the AP and refractory period in myocardial tissue; decreases AV conduction and sinus node function

Amiodarone / Pacerone key counseling info?

Epithelial keratopathy (Eyes), hypotension, nausea/vomiting

Amiodarone / Pacerone primary therapeutic uses?

Ventricular arrhythmias

Flecainide brand?

Tamboco

Tambocor generic?

Flecainide

Flecainide / Tambocor pharmacologic category?

Antiarrhythmic agent, class IC

Flecainide / Tambocor box warnings?

Excess mortality in patients with recent MI

Ventricular proarrhythmic events in patients with atrial fibrillation/flutter

Flecainide / Tambocor MOA?

Class IC antiarrhythmic → slows conduction in cardiac tissue by altering transport of ions across cell membranes; causes slight prolongation of refractory periods; decreases the rate of rise of the action potential without affecting its duration; increases electrical stimulation threshold of ventricle, His-Purkinje system

Flecainide / Tambocor key counseling info?

Dizziness, ventricular arrhythmia, visual disturbances

Flecainide / Tambocor primary therapeutic uses?

Paroxysmal AFib/flutter and SVT prevention, ventricular arrhythmias prevention

Flecainide / Tambocor dose adjustments in renal dysfunction ?

Yes

Atropine brand?

AtroPen

AtroPen generic?

Atropine

Atropine / AtroPen pharmacologic category?

Anticholinergic/antimuscarinic M1, M2, M3, M4, and M5

Atropine / AtroPen MOA?

Blocks action of acetylcholine at parasympathetic sites in smooth muscle, secretory glands, and the CNS; increases cardiac output, dries secretions