UNIT 4

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46 Questions

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

Heparin = Indirect thrombin inhibitor Pradaxa (dabigatran) = Direct thrombin inhibitor Xarelto (rivaroxaban) = Factor Xa inhibitor Arixtra (fondaparinux) = Factor Xa inhibitor

/?

Eliquis (apixaban) = Factor Xa inhibitor Brillinta (ticagrelor) = Anti-platelet Lovenox (enoxaparin) = Indirect thrombin inhibitor Lomitapide = Newer agent used to lower cholesterol

Match Me

Lovastatin = Avoid grapefruit with this cholesterol agent Lisinopril = Causes coughing Propafenone = Used to treat arrhythmia Spironolactone = Causes gynecomastia

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

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.

CLOTS & stuff

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)

Match em up

Lisinopril = ACE inhibitor Losartan = ARB (Angiotensin II Receptor Blocker) Simvastatin = Used to lower cholesterol Metoprolol = Beta-1 blocker

Coagulation pathway

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

match em up

Hydralazine = Vasodilator HCTZ (Hydrochlorothiazide) = Diuretic Lopid (gemfibrozil) = Used to lower cholesterol Hytrin (terazosin) = Alpha-1 blocker

Match some more

Catapres (clonidine) = Alpha-2 agonist Tekturna (aliskiren) = Renin inhibitor Norvasc (amlodipine) = Calcium channel blocker Mipomersen = Used to lower cholesterol

Whats what?

Valsartan = ARB (Angiotensin II Receptor Blocker) Lasix (furosemide) = Diuretic Verapamil = Calcium channel blocker Spironolactone = Diuretic

???

Niacin (Vitamin B3) = Used to lower cholesterol Welchol (colesevelam) = Used to lower cholesterol Zetia (ezetimibe) = Used to lower cholesterol Omega-3 = cholesterol lower LDL

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

Used to lower cholesterol

Describe the clinical pearls for oral Iron preparations.

Take on an Empty Stomach or with vitamin C (enhances absorption), can cause constipation, take seperate from other meds, toxic to children,

Identify the baseline exams for amiodarone

LFT (liver function test) EKG, Thyroid function test

Coumadin Interactions

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

Matchy matchy

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

Match

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.

ANTI-platletes

Aspirin (ASA) = inhibits Thromboxane A2, no platlet aggregation Dipyridamole = increase adennsoine interferes with platl;et aggregation. Plavix (clopidogrel & effient (prasugrel) = Blocks ADP from activating COAG-cascade brilinta (ticasgrelor) = blocks ADP

Differentiate the two clinical trials for HTN

ONTARGET vs ACCOMPLISH

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)

Blood thinners prevention measure for bleeding

gentl;y nose blows, use of electric razor, soft bristle tooth brush, ID card or band indicating, counseling on OTC meds

MATCH!

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

Propafenone, MOA?

Blocks sodium channels. Propafenone is another Class I antiarrhythmic drug

?

Lanoxin (digoxin) = can lead to QT interval prolongation Entresto (sacubitril and valsartan) = A-fib (Atrial Fibrillation) INR = warfarin PTT = Heparin

Heparin patient

20-35 seconds = normal 12-15 seconds = increase dose 5-10 seconds = increase dose 40-45 seconds = lower dose

coumadin patient

INR 2-3 = Normal value INR 4-5 = Lower dose, too thick, increase DOSE INR 2.5 = normal INR 1.7 = thin, decrease

matchy matchy

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.

Mtach em

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

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

amnioderone

match

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

Aspirin allergy

Name an anti-platelet alternative

dipyridamole

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

True

Match the rest

  1. tissue injury

  1. = thromboplastin is produced
  2. = thromboplastin converts prothrombin to thrombin
  3. = thromboplastin fibrinogen to fibrin, activates CF
  4. = plasmin is formed, an enzyme that acts on fibrin to produce a more soluble product

Qt prolongation is common drug interaction seenn by professor valdez

True

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

Amiodarone = Class III idocaine = Class I Acebutolol = Class II Propafenone = Class I

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

Amiodarone = Class III Acebutolol = Class II Quinidine = Class I Cardizem (diltiazem) = Class IV

Indications to meds

Aspirin (ASA = antiplatelet Tenormin (atenolol) = treats hypertension Plavix (clopidogrel) = antiplatelet Zesteril (lisinopril) = treats hypertension

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?

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?

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

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

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

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

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

Lovenox (enoxaparin) = indirect thrombin inhibitor Heparin = direct thrombin inhibitor Pradaxa (dabigatran) = direct thrombin inhibitor Plavix (clopidogrel) = antiplatelet

coagulation pathway

1 = Thromboplastin is produced. 2 = Thromboplastin converts prothrombin to thrombin. 3 = Thrombin converts fibrinogen to fibrin. 4 = Plasmin is formed.

MATCH

ACE = -PRIL ARB = -SARTAN Statins are drugs that can lower your cholesterol = -STATIN

Test your knowledge about the anatomic sites related to blood pressure control. Match the anatomic sites to their respective roles in regulating blood pressure.

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