Pharmacology Reviewer for Finals
Heart Failure: Inotropes (Inotropy, chronotropy, dromotorpy
· Ace inhib 1st, and BB, pluc thiazide diuretic – Ace prevents L-V remodelling
o The spironolactone
o Digoxin
o Late stage: Inodilator milrinone
· Cardiac glycoside Digoxin:
o Inotrope Digosin (Lanoxin)
o Narrow therp index
o Hypokal = risk for digoxin toxicity
o Antidote digibind
o Bran food binds to digoxin
Antianginals
· Nitrates and nitrites
o High first-pass effect, interact with sildenafil (Viagra), contraindication in
anemia, need to protect from sunlight, angina-lie d0wn, take 1q 5 min and
if no relief, call 911, po isosorbide dinitrate, s/e headache, tolerance with
transdermal patches
· B-blockers
· CCB
o Dihydropines and non-dihydropines
o Eg. Amlopidine, diltiazem, verapamil
o CYT P450, grapefruit juice
· Angina = cardiac hypoxemia
· MI = cardiac cells die
Antihypertensives
· CHEP target
o Less than 140/90 mm Hg
o Less than 130/80 mm Hg in those with diabetes or CKD
o Research support treatment for first-line, elderly, the black population
· Adrenegics = Prazosin (Minipress), Clonidine, methyldopa
o Prazosin and tamsulosin are alpha-blockers that lower blood pressure
o Tamsulin is for BPH
o Clonidine and methyldopa = alpha 2 agonist, methyldopa is given to
pregnant, clonidine is for adhd and on rehab
o Alpha 2 is PRE-Synapthetic
· Ace inhibitor (Captopril)
· CCB “AVND”
· BB
· Diuretic-thiazide eg, hydrocholorothiazide
, · Vasodilators – eg. Hydralazine, nitroprusside
· Olol/HCTZ is the first line drug – combined – for newly diagnosed uncomplicated
cases
· ACE – first line for diabetic patient
o Causes hyperkalemia
o Is pt develops kidney failure – they given diff drugs
· Prodrug vs not
· Tyramine containing food and MAOI can cause a hypertensive crisis
· Thyropchyotcosis
Diuretics
· Loop diuretic eg. Furosemide – risk of hypotension and hypokalemia
· P-S diuretics eg., spironolactone (Aldactone) – the risk of hyperkalemia –
interacts with ACE because ACE causes hyperkalemia
· Thiazide eg. Hydrochlorothiazed and indapamide
· Osmotic diuretics eg. Mannitol (osmitrol)
Electrolytes
· K +3.5-5mmol/L
o Hypokal = weakness, late dysrhythmia, increased risk of digoxin toxicity; a
side effect of furosemide loop diuretic
o Hyperkal treat with BIG K, salbutamol (Ventolin)
o Side effects of S-P, potassium-sparing diuretic
o Foods high in K: banana, oranges, dates
o Insulin and Sodium Bicarb = push potassium into the cells (Ventolin pushes
the Potassium as well)
o Kayexalate causes you to poop
· Na 132-145 mmol/L
o Hypernatremia dry sticky membranes, correct slowly no more than 10
mmol/L per day
o Hyponatremia – can be seen in fluid overload
o Very careful correcting sodium can cause brain dead
Coag Modif
· Anticoagulants
o Heparin monitor a PTT, antidote is protamine silfate
o LMWG – “parin” – no labs
o Warfarin – contraindication in preg, monitor INR, antidote is vit K
o Xa inhib – apixaban – no labs
o Thrombin inhibitor – dabigatran – no labs
· Antiplatelets
o ASA, Aspirin
o Clopidogrel
· Thrombolytics “clot blusters”
Heart Failure: Inotropes (Inotropy, chronotropy, dromotorpy
· Ace inhib 1st, and BB, pluc thiazide diuretic – Ace prevents L-V remodelling
o The spironolactone
o Digoxin
o Late stage: Inodilator milrinone
· Cardiac glycoside Digoxin:
o Inotrope Digosin (Lanoxin)
o Narrow therp index
o Hypokal = risk for digoxin toxicity
o Antidote digibind
o Bran food binds to digoxin
Antianginals
· Nitrates and nitrites
o High first-pass effect, interact with sildenafil (Viagra), contraindication in
anemia, need to protect from sunlight, angina-lie d0wn, take 1q 5 min and
if no relief, call 911, po isosorbide dinitrate, s/e headache, tolerance with
transdermal patches
· B-blockers
· CCB
o Dihydropines and non-dihydropines
o Eg. Amlopidine, diltiazem, verapamil
o CYT P450, grapefruit juice
· Angina = cardiac hypoxemia
· MI = cardiac cells die
Antihypertensives
· CHEP target
o Less than 140/90 mm Hg
o Less than 130/80 mm Hg in those with diabetes or CKD
o Research support treatment for first-line, elderly, the black population
· Adrenegics = Prazosin (Minipress), Clonidine, methyldopa
o Prazosin and tamsulosin are alpha-blockers that lower blood pressure
o Tamsulin is for BPH
o Clonidine and methyldopa = alpha 2 agonist, methyldopa is given to
pregnant, clonidine is for adhd and on rehab
o Alpha 2 is PRE-Synapthetic
· Ace inhibitor (Captopril)
· CCB “AVND”
· BB
· Diuretic-thiazide eg, hydrocholorothiazide
, · Vasodilators – eg. Hydralazine, nitroprusside
· Olol/HCTZ is the first line drug – combined – for newly diagnosed uncomplicated
cases
· ACE – first line for diabetic patient
o Causes hyperkalemia
o Is pt develops kidney failure – they given diff drugs
· Prodrug vs not
· Tyramine containing food and MAOI can cause a hypertensive crisis
· Thyropchyotcosis
Diuretics
· Loop diuretic eg. Furosemide – risk of hypotension and hypokalemia
· P-S diuretics eg., spironolactone (Aldactone) – the risk of hyperkalemia –
interacts with ACE because ACE causes hyperkalemia
· Thiazide eg. Hydrochlorothiazed and indapamide
· Osmotic diuretics eg. Mannitol (osmitrol)
Electrolytes
· K +3.5-5mmol/L
o Hypokal = weakness, late dysrhythmia, increased risk of digoxin toxicity; a
side effect of furosemide loop diuretic
o Hyperkal treat with BIG K, salbutamol (Ventolin)
o Side effects of S-P, potassium-sparing diuretic
o Foods high in K: banana, oranges, dates
o Insulin and Sodium Bicarb = push potassium into the cells (Ventolin pushes
the Potassium as well)
o Kayexalate causes you to poop
· Na 132-145 mmol/L
o Hypernatremia dry sticky membranes, correct slowly no more than 10
mmol/L per day
o Hyponatremia – can be seen in fluid overload
o Very careful correcting sodium can cause brain dead
Coag Modif
· Anticoagulants
o Heparin monitor a PTT, antidote is protamine silfate
o LMWG – “parin” – no labs
o Warfarin – contraindication in preg, monitor INR, antidote is vit K
o Xa inhib – apixaban – no labs
o Thrombin inhibitor – dabigatran – no labs
· Antiplatelets
o ASA, Aspirin
o Clopidogrel
· Thrombolytics “clot blusters”
