UNIT 4
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Questions and Answers

Match

Coumadin (warfarin) = Anticoagulant HCTZ = Used to lower blood pressure Diltiazem = Class IV anti-arrhythmic Alirocumab = Used to lower cholesterol

?

Benazepril = Used to lower blood pressure Sotalol = Class III anti-arrhythmic NTG = Part of the MONA (Morphine, Oxygen, NTG, ASA) protocol for heart attack treatment Minoxidil = Causes hirsutism (excessive hair growth)

Where are the anatomic sites for BP control?

Resistance in arterioles Capacitance venules Heart: pump output Kidney volume= RAAS

match

<p>Heparin = Indirect thrombin inhibitor Pradaxa (dabigatran) = Direct thrombin inhibitor Xarelto (rivaroxaban) = Factor Xa inhibitor Arixtra (fondaparinux) = Factor Xa inhibitor</p> Signup and view all the answers

/?

<p>Eliquis (apixaban) = Factor Xa inhibitor Brillinta (ticagrelor) = Anti-platelet Lovenox (enoxaparin) = Indirect thrombin inhibitor Lomitapide = Newer agent used to lower cholesterol</p> Signup and view all the answers

Match Me

<p>Lovastatin = Avoid grapefruit with this cholesterol agent Lisinopril = Causes coughing Propafenone = Used to treat arrhythmia Spironolactone = Causes gynecomastia</p> Signup and view all the answers

Ciraparantag (formerly known as PER977) is a universal antidote designed to reverse the effects of a broad range of anticoagulants, including direct oral anticoagulants (DOACs) like dabigatran and factor Xa inhibitors.

Match the others

<p>Vitamin K: = Antidote for Warfarin Protamine Sulfate: = Antidote for Heparin Praxbind = Antidote for Pradaxa, is specific to dabigatran. (neutralizes affects) Andexanet Alfa: = Antidote for Factor Xa Inhibitors (e.g., Xarelto, Eliquis): Andexanet alfa is designed to reverse the effects of factor Xa inhibitors.</p> Signup and view all the answers

CLOTS & stuff

<p>Coagulation = liguid to solid plug, norm. clot formation following injury platlets/thrombocytes = cells in the blood that migrate to tissue innjury that are necessary for clot formation thrombus = clot formation thrombnoembolism = clots are jammed in a blood vessel (i.e. a moving clot)</p> Signup and view all the answers

Match em up

<p>Lisinopril = ACE inhibitor Losartan = ARB (Angiotensin II Receptor Blocker) Simvastatin = Used to lower cholesterol Metoprolol = Beta-1 blocker</p> Signup and view all the answers

Coagulation pathway

<p>Stage 1 = Thromboplastin is produced via intrinsic or extrinsic pathway stage 2 = thromboplastin converts prothrombin to thrombin stage 3 = thrombin converts fibrinogen to fibrin, also activates other clotting factors stage 4 = plasmin is formed, an enzyme that acts on fibrin to produce a more soluble product</p> Signup and view all the answers

match em up

<p>Hydralazine = Vasodilator HCTZ (Hydrochlorothiazide) = Diuretic Lopid (gemfibrozil) = Used to lower cholesterol Hytrin (terazosin) = Alpha-1 blocker</p> Signup and view all the answers

Match some more

<p>Catapres (clonidine) = Alpha-2 agonist Tekturna (aliskiren) = Renin inhibitor Norvasc (amlodipine) = Calcium channel blocker Mipomersen = Used to lower cholesterol</p> Signup and view all the answers

Whats what?

<p>Valsartan = ARB (Angiotensin II Receptor Blocker) Lasix (furosemide) = Diuretic Verapamil = Calcium channel blocker Spironolactone = Diuretic</p> Signup and view all the answers

???

<p>Niacin (Vitamin B3) = Used to lower cholesterol Welchol (colesevelam) = Used to lower cholesterol Zetia (ezetimibe) = Used to lower cholesterol Omega-3 = cholesterol lower LDL</p> Signup and view all the answers

what do Niacin (Vitamin B3): Welchol (colesevelam): Zetia (ezetimibe) Omega-3 have in common?

<p>Used to lower cholesterol</p> Signup and view all the answers

Describe the clinical pearls for oral Iron preparations.

<p>Take on an Empty Stomach or with vitamin C (enhances absorption), can cause constipation, take seperate from other meds, toxic to children,</p> Signup and view all the answers

Identify the baseline exams for amiodarone

<p>LFT (liver function test) EKG, Thyroid function test</p> Signup and view all the answers

Coumadin Interactions

<p>Adverse Reaction = Skin necrosis, purple toe syndrome, Increase response = Ginkgo, ginseng, garlic, green tea increase response = sulfamethoxazole/trimethoprim decrease response = st. johns wort, green leafy vegetables</p> Signup and view all the answers

Matchy matchy

<p>Folic acid = Women have an increased need during pregnancy to prevent neural tube defects in newborns. Vitamin B12 deficiency = Also called 'extrinsic factor, absorbed with the help of intrinsic factor Activase (alteplase-tPA) = A clotbuster Andexanet alfa = Reverses the effects of Factor Xa inhibitors</p> Signup and view all the answers

Match

<p>Vitamin K = Decreases the effect of Coumadin (warfarin). Protamine sulfate = Antidote for heparin toxicity. Aspirin (ASA) = An anti-platelet medication. Pradaxa (dabigatran) = A prodrug that requires conversion to its active form in the body.</p> Signup and view all the answers

ANTI-platletes

<p>Aspirin (ASA) = inhibits Thromboxane A2, no platlet aggregation Dipyridamole = increase adennsoine interferes with platl;et aggregation. Plavix (clopidogrel &amp; effient (prasugrel) = Blocks ADP from activating COAG-cascade brilinta (ticasgrelor) = blocks ADP</p> Signup and view all the answers

Differentiate the two clinical trials for HTN

ONTARGET vs ACCOMPLISH

<p>On target = ACE+ ARB= no Increase in effectiveness ON Target = telmisartan was non-inferior to ramipril but did not show a significant benefit of the combination therapy over ramipril alone. Accomplish = found that the benazepril-amlodipine combination was superior to the benazepril-hydrochlorothiazide combination in reducing cardiovascular events. Accomplish = benazepril (an ACE inhibitor) and amlodipine (a calcium channel blocker)</p> Signup and view all the answers

Blood thinners prevention measure for bleeding

<p>gentl;y nose blows, use of electric razor, soft bristle tooth brush, ID card or band indicating, counseling on OTC meds</p> Signup and view all the answers

MATCH!

<p>Quinaglute (quinidine) = blocks potassium, sodium, calcium, and adrenergic channels that results in prolongation of AP, is a Class I antiarrhythmic drug Esmolol = decreases heart rate by blocking sympathetic stimulation, beta blocker Cardarone (amiodarone) = Blocks potassium, sodium, and calcium channels. is a Class III antiarrhythmic drug Diltiazem = Inhibits calcium entry to slow conduction. Diltiazem is a calcium channel blocker used as a Class IV antiarrhythmic</p> Signup and view all the answers

Propafenone, MOA?

<p>Blocks sodium channels. Propafenone is another Class I antiarrhythmic drug</p> Signup and view all the answers

?

<p>Lanoxin (digoxin) = can lead to QT interval prolongation Entresto (sacubitril and valsartan) = A-fib (Atrial Fibrillation) INR = warfarin PTT = Heparin</p> Signup and view all the answers

Heparin patient

<p>20-35 seconds = normal 12-15 seconds = increase dose 5-10 seconds = increase dose 40-45 seconds = lower dose</p> Signup and view all the answers

coumadin patient

<p>INR 2-3 = Normal value INR 4-5 = Lower dose, too thick, increase DOSE INR 2.5 = normal INR 1.7 = thin, decrease</p> Signup and view all the answers

matchy matchy

<p>Diuretics = are medications that increase the excretion of sodium and water through the kidneys, reducing the volume of fluid in the bloodstream Sympatholytics (Sympathoplegics) = Sympatholytic agents, also known as sympathoplegic drugs, work by inhibiting the sympathetic nervous system, Direct Vasodilators = medications that relax and dilate blood vessels directly, which decreases vascular resistance and reduces blood pressure. Agents that Block Production and Action of Angiotensin = block actions of angiotensin which Angiotensin is a hormone that constricts blood vessels and raises blood pressure.</p> Signup and view all the answers

Mtach em

<p>Agents that Block Production and Action of Angiotensin = angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs). direct vasodilators = Hydralazine and minoxidil Sympatholytics (Sympathoplegics) = metoprolol, doxazosin, clonidine Diuretics = HCTZ</p> Signup and view all the answers

what medication require : ECG and serum potassium levels. liver function tests. thyroid function tests. ophthalmological examination if there is pre-existing visual impairment.

<p>amnioderone</p> Signup and view all the answers

match

<p>Atrial Fibrillation (A-fib) = Common Arrhythmia Digoxin = Inhibits the Na/K ATPase Pump Which Increases Intracellular Na/Ca++ Exchange to Increase Intracellular Calcium Entresto (Sacubitril and Valsartan) = Newer Agent Used to Treat Heart Failure Ranexa (Ranolazine) = Treatment of Chronic Angina</p> Signup and view all the answers

Aspirin allergy

Name an anti-platelet alternative

<p>dipyridamole</p> Signup and view all the answers

W/ OF INR 6 You should: decrease MED, Correct the lab value blood is thin coagulating slow decrease MED

<p>True (A)</p> Signup and view all the answers

Match the rest

  1. tissue injury

<ol start="2"> <li>= thromboplastin is produced</li> <li>= thromboplastin converts prothrombin to thrombin</li> <li>= thromboplastin fibrinogen to fibrin, activates CF</li> <li>= plasmin is formed, an enzyme that acts on fibrin to produce a more soluble product</li> </ol> Signup and view all the answers

Qt prolongation is common drug interaction seenn by professor valdez

<p>True (A)</p> Signup and view all the answers

Here are the anti-arrhythmic drugs matched to their Vaughan Williams class

<p>Amiodarone = Class III idocaine = Class I Acebutolol = Class II Propafenone = Class I</p> Signup and view all the answers

Here are the anti-arrhythmic drugs matched to their Vaughan Williams class:

<p>Amiodarone = Class III Acebutolol = Class II Quinidine = Class I Cardizem (diltiazem) = Class IV</p> Signup and view all the answers

Indications to meds

<p>Aspirin (ASA = antiplatelet Tenormin (atenolol) = treats hypertension Plavix (clopidogrel) = antiplatelet Zesteril (lisinopril) = treats hypertension</p> Signup and view all the answers

A PTT (Partial Thromboplastin Time) of 5 seconds is significantly lower than the normal range, which indicates that the blood is not appropriately anticoagulated. Is the blood thin or thick? should you increase or decrease?

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D.V. is to start Coumadin (warfarin) 5mg. After the first week, the INR is 7.5. Apply what you know regarding INR monitoring. Is the blood thick or thin? Increase or decrease the dose?

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Here are the anti-hypertensive drugs matched to their mechanisms of action:

<p>Norvasc (amlodipine) = blocks vascular calcium channels Hydrochlorothiazide = inhibits Na reabsorption in the distal tubules causing an increased excretion of Na, water, K, and H Lasix (furosemide) = inhibition of NA and CL in the ascending Loop of Henle and distal renal tubules Zesteril (lisinopril) = block the conversion of angiotensin I to angiotensin II through competitive inhibition of the angiotensin-converting enzyme</p> Signup and view all the answers

Here are the anti-hypertensive drugs matched to their mechanisms of action

<p>Cozaar (losartan) = blocks the ATII receptor Spirinolactone = blocks the aldosterone receptor and results in K retention Norvasc (amlodipine) = blocks vascular calcium channels Zesteril (lisinopril) = block the conversion of angiotensin I to angiotensin II through competitive inhibition of the angiotensin-converting enzyme</p> Signup and view all the answers

Here are the drugs matched to their respective indications or clinical uses:

<p>Lovenox (enoxaparin) = indirect thrombin inhibitor Heparin = direct thrombin inhibitor Pradaxa (dabigatran) = direct thrombin inhibitor Plavix (clopidogrel) = antiplatelet</p> Signup and view all the answers

coagulation pathway

<p>1 = Thromboplastin is produced. 2 = Thromboplastin converts prothrombin to thrombin. 3 = Thrombin converts fibrinogen to fibrin. 4 = Plasmin is formed.</p> Signup and view all the answers

MATCH

<h1>ACE = -PRIL ARB = -SARTAN Statins are drugs that can lower your cholesterol = -STATIN</h1> Signup and view all the answers

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