Module 1: Pharmatech

What are the main conditions affecting the cardiovascular system?

hypertension, heart failure, arrhythmias, congestive heart failure, angina, and myocardial infarction

What is myocardial infarction?

heart attack, when blood flow is blocked or reduced

What is the MOA of angiotensin-converting enzyme inhibitors?

treats hypertension by blocking the enzymes that activate angiotensin → widens arteries and lowers blood pressure

What are the side effects of angiotensin-converting enzyme inhibitors?

can cause a persistent dry cough due to the increased cytokine and bradycardia levels

persists as long as the medication is administered

Lisnopril

angiotensin-converting enzyme inhibitors

Zestril or Prinivil

Benazepril

angiotensin-converting enzyme inhibitors

Lotensin

Ramipril

angiotensin-converting enzyme inhibitors

Altace

Enalapril

angiotensin-converting enzyme inhibitors

Vasotec

What is the MOA of angiotensin receptor blockers?

used to treat hypertension, blocks angiotensin, which leads to vasodilation

What demographic of people should not take either angiotensin receptor blockers or angiotensin-converting enzyme inhibitors?

pregnant women

Losartan

an angiotensin receptor blocker

Cozaar

Olmesartan

an angiotensin receptor blocker

Benicar

Irbesartan

an angiotensin receptor blocker

Avapro

Valsartan

an angiotensin receptor blocker

Diovan

What are the MOA of beta blockers?

treats hypertension by blocking the stimulatory effects of adrenaline on the heart, decreasing heart rate and force of contraction

What is the difference between metoprolol tartrate and metoprolol succinate?

tartrate is the immediate release and is taken twice daily

succinate is the extended release and is taken once daily

What patients should not take any beta blockers?

patients with asthma, since beta blockers can block receptors in the lungs as well, causing bronchoconstriction

Metoprolol tartate

beta blockers

lopressor

Metoprolol succinate

beta blockers

Toprol XL

Carvedilol

beta blockers

Coreg

Atenolol

beta blockers

Tenormin

Labetalol

beta blockers

Trandate

Propranolol

beta blockers

Inderal

What is the MOA of calcium channel blockers?

inhibits the entry of inhibiting the entry of calcium, causes less muscle contraction which leads to vasodilation → reduced heart rate and weaker contraction

What are the 2 types of calcium channel blockers and how are they used?

dihydropyridine (treats high blood pressure) and non-dihydropyridine (treats other heart conditions such as arrhythmias)

Amalodipine

dihydropyridine calcium channel blockers

Norvasc

Nifedipine

dihydropyridine calcium channel blockers

Procardia and Adalat

Diltiazem

non-dihydropyridine calcium channel blockers

cardizem

Verapamil

non-dihydropyridine calcium channel blockers

Calan

What is the MOA for thiazide diuretics?

causes excess excretion of K and Na in the distal tubule which promotes more urine output

What are potential side effects of thiazide diuretics?

hyponatremia (not as concerning since people eat) and hypokalemia

What are the drug-drug interactions of hydrochlorothiazide?

HCTZ is often combined with other antihypertensive medications

Hydrochlorothiazide

thiazide diuretics

microzide

Chlorthalidone

thiazide diuretics

thalitone

Metolazone

thiazide diuretics

zaroxolyn

What are the MOA of loop diuretics?

increase excretion of potassium in the kidneys

What other medications must patients who take loop diuretics be prescribed?

potassium supplements

What must never be taken with loop diuretics?

thiazide diuretics, only prescribed during a fluid overload

Furosemide

loop diuretics

Lasix

Bumetanide

loop diuretics

Bumex

Toresmide

loop diuretics

Demadex

What is the MOA of potassium-sparing diuretics?

promotes the excretion of sodium in the collecting duct

What is the side effects to potassium-sparing diuretics?

hyperkalemia

What foods should not be eaten with potassium-sparing diuretics?

any salt substitutes or other potassium rich food

Spironolactone

potassium-sparring diuretics

Aldactone

Trianterene/HCTZ

Potassium-sparing diuretics

dyazide

What are the MOA of electrolytes?

replenishes nutrients of patients who take thiazide and loop diuretics

What are electrolytes dosed in?

mEq

What should patients who are taking electrolytes not eat?

salt substitutes

What must be done to oral solutions of electrolytes?

must be diluted

Potassium chloride

electrolyte

Klor-con, K-dur, K-Tab

What is the use of alpha-blockers?

hypertension and an enlarged prostate (benign hyperplasia)

What is the most common side effect of alpha blockers?

orthostatic hypotension, which drops BP when changing postions

Doxasin

alpha blocker for HTN/BPH

Candura

Terazosin

alpha blocker for HTN/BPH

Hyrtin

Prazosin

alpha blocker for HTN

Minipress

Tamsulosin

alpha blocker for BPH

Flomax

What are the MOA of peripheral vasodilators?

relax the smooth muscle, causing vasodilation and more blood flow

What is the side effect of peripheral vasodilators?

orthostatic hypotension

Hydralazine

peripheral vasodilators

Apresoline

What are the MOA of alpha agonist?

reduce heart rate and blood pressure by decreasing adrenaline

What are the side effects of alpha agonist?

drowsiness and fatigue

Clonidine

alpha agonist

Catapress

What are the MOA of blood thinners?

used to prevent clots, used with patients with arrythmias to reduce the risk of stroke, heart attack and other conditions

What could help prevent side effects of blood thinners?

combine different blood thinners of different classes

What is different about warfarin?

One of the oldest blood thinners, needs to have perfect blood and use NIR to look at blood

may take a different dose everyday

What should people who take warfarin not eat irregularly?

vitamin K, since this reverses the effects

Asprin

salicylate blood thinner

various

Clopidogrel

antiplatelet blood thinner

plavix

Ticagrelor

antiplatelet blood thinner

brilinta

Warfarin

anticoagulant blood thinner

coumadin

Apixaban

anticoagulant blood thinner

eliquis

Rivaroxaban

anticoagulant blood thinner

xarelto

Dabigatran

anticoagulant blood thinner

pradaxa

Enoxaparin

anticoagulant blood thinner

not taken orally

lovenox

What are the MOA of nitrates?

dilates the arteries in the heart, increases blood flow, and alleviates chest pain

How is nitroglycerin stored and administered?

because it is unstable, it is to be kept in a dark color bottle and must be discarded after 5 months

goes under tongue

What drugs should not be taken with nitroglycerin?

phosphodiesterase-5 (PDE-5) inhibitors

ex. viagra

Nitroglycerin sublingual tablets

nitro-quick, nitro-stat

What is the MOA of digoxin?

slows the heart rate and increases the force of each beat, used to treat heart failure and arrhythmias

minor dosage changes can cause significant affects

Digoxin

Digitec Lanoxin

What is OBRA-90 law?

requires pharmacists to give counseling, keep records, and evaluate prescription to all Medicare patients

some states have it for all patients

What is therapeutic subsitution?

replacing a prescribed medication with different drug that has a similar clinical effect

What is VAERS?

The Vaccine Adverse Event Reporting System