Pharmacology: Statins and Beta Blockers
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Questions and Answers

Which of the following best describes the primary action of anticoagulants?

  • Enhance fibrin formation.
  • Inhibit the action of various clotting factors. (correct)
  • Increase the viscosity of blood.
  • Stimulate platelet aggregation.

What effect do antiplatelet drugs like aspirin have on platelets?

  • Increase platelet count.
  • Shorten platelet lifespan.
  • Alter platelet shape.
  • Inhibit platelet aggregation. (correct)

What is the primary adverse effect associated with anticoagulants?

  • Bleeding. (correct)
  • Nausea.
  • Dizziness.
  • Hypertension.

Which of the following statements about statin medications is accurate?

<p>They can lead to muscle pain and weakness. (A)</p> Signup and view all the answers

What is the primary role of loop diuretics in patient treatment?

<p>Remove excess fluid from the body. (A)</p> Signup and view all the answers

Angioedema is a known adverse effect of which drug class?

<p>Angiotensin-converting enzyme (ACE) inhibitors. (B)</p> Signup and view all the answers

How do nitrates alleviate angina pain?

<p>By dilating blood vessels. (A)</p> Signup and view all the answers

What is the mechanism of action for calcineurin inhibitors?

<p>Act as an immunomodulator (D)</p> Signup and view all the answers

Which suffix is commonly associated with angiotensin-converting enzyme (ACE) inhibitors?

<p>-pril (D)</p> Signup and view all the answers

What is a significant adverse effect of retinoids?

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

Which class of drug uses aPTT for monitoring?

<p>Anticoagulants (B)</p> Signup and view all the answers

What is the primary therapeutic use of vitamin D analogues?

<p>Plaque psoriasis (B)</p> Signup and view all the answers

Which of the following is a characteristic of steroids used in dermatology?

<p>They should be used sparingly (C)</p> Signup and view all the answers

What is the primary action of antifungal medications?

<p>Acting as antimycotic agents (D)</p> Signup and view all the answers

What adverse effect is common with calcineurin inhibitors?

<p>Skin irritation (C)</p> Signup and view all the answers

Which drug class does NOT use aPTT for monitoring?

<p>Antiplatelets (D)</p> Signup and view all the answers

What is the primary mechanism of action for cholinergic drugs used to treat glaucoma?

<p>Stimulate parasympathetic nervous system (D)</p> Signup and view all the answers

What is a common adverse effect associated with the use of topical anesthetics for eye pain?

<p>Burning (D)</p> Signup and view all the answers

Which class of drugs primarily reduces the formation of aqueous humor in the treatment of glaucoma?

<p>B-adrenergic blockers (C)</p> Signup and view all the answers

What type of medications should not be used for minor abrasions or wounds due to their immunosuppressant effect?

<p>Corticosteroids (B)</p> Signup and view all the answers

Which of the following drugs is NOT an ocular anti-inflammatory medication?

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

What is a potential adverse effect associated with prolonged use of corticosteroids?

<p>Cataracts (D)</p> Signup and view all the answers

Which ocular drug class specifically targets increased intraocular pressure by improving fluid drainage?

<p>Prostaglandin agonists (C)</p> Signup and view all the answers

What is a common mechanism of action for ocular antibiotics?

<p>Prevent antibiotic resistance from systemic use (A)</p> Signup and view all the answers

What condition do anti-inflammatory drugs treat in the ocular system?

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

Which adverse effect is NOT typically associated with antihistamines used in the ocular system?

<p>Nausea (B)</p> Signup and view all the answers

Which of the following medications is classified as a statin?

<p>Simvastatin (B)</p> Signup and view all the answers

What is a common side effect of beta blockers?

<p>Wheezing (C)</p> Signup and view all the answers

Which of the following conditions is a contraindication for ACE inhibitors?

<p>Pregnancy (C)</p> Signup and view all the answers

Angioedema is associated with which class of drugs?

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

What is the main action of angiotensin 2 receptor blockers?

<p>Block vasoconstriction (B)</p> Signup and view all the answers

Which diuretic is most commonly associated with potassium-wasting?

<p>Furosemide (C)</p> Signup and view all the answers

Which conditions are CNS stimulants primarily used to treat?

<p>ADD, ADHD, narcolepsy, obesity (C)</p> Signup and view all the answers

What should be monitored closely in children taking thiazide diuretics?

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

What is a significant consideration for prescribing CNS stimulants?

<p>They should not be prescribed to individuals with cardiac abnormalities (A)</p> Signup and view all the answers

What mechanism do CNS stimulants use to increase norepinephrine and dopamine levels?

<p>They increase their release and block their reuptake (B)</p> Signup and view all the answers

Which suffix indicates a drug belongs to the class of ACE inhibitors?

<p>'pril' (B)</p> Signup and view all the answers

Which side effect is commonly associated with diuretics?

<p>Hypokalemia (D)</p> Signup and view all the answers

Which adverse effect is associated with the use of phenytoin?

<p>Hepatic failure (B)</p> Signup and view all the answers

Which of the following medications is a calcium channel blocker?

<p>Verapamil (B)</p> Signup and view all the answers

What should be avoided when administering anti-epileptic drugs?

<p>Suddenly stopping the medication (A)</p> Signup and view all the answers

What is a potential risk of prolonged use of loop diuretics?

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

What is a correct definition of a seizure?

<p>Excessive discharge of neurons in the brain (A)</p> Signup and view all the answers

Which of the following best describes a convulsion?

<p>Involuntary spasmodic muscle contractions (A)</p> Signup and view all the answers

What mechanism do vasodilators like hydralazine primarily utilize?

<p>Vascular smooth muscle relaxation (A)</p> Signup and view all the answers

Which of the following is NOT a way that antiepileptic drugs work?

<p>Enhance the reuptake of neurotransmitters (A)</p> Signup and view all the answers

Which is a potential effect of beta blockers that may mask a clinical sign?

<p>Tachycardia (B)</p> Signup and view all the answers

What is the primary treatment use for ARBs?

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

What is the primary mechanism of action of opioid drugs?

<p>Bind to opioid receptors in the central nervous system (C)</p> Signup and view all the answers

What side effect is most commonly associated with opioid use?

<p>Respiratory depression (B)</p> Signup and view all the answers

Which of the following drugs is categorized as an NSAID?

<p>Ibuprofen (D)</p> Signup and view all the answers

How does aspirin differ from other NSAIDs?

<p>It irreversibly inhibits COX receptors in platelets. (A)</p> Signup and view all the answers

What is a significant concern when using acetaminophen in older adults?

<p>Reduced hepatic and renal clearance leading to toxicity (B)</p> Signup and view all the answers

What common effect do benzodiazepines have?

<p>Reduce anxiety and excitability (B)</p> Signup and view all the answers

Which suffix is typically associated with benzodiazepines?

<p>pam (B)</p> Signup and view all the answers

What is a potential consequence of mixing different CNS depressants?

<p>Potential for overdose and respiratory failure (D)</p> Signup and view all the answers

Why is codeine contraindicated in children?

<p>Children are often under-dosed, leading to ineffective treatment. (D)</p> Signup and view all the answers

Which of the following statements is true regarding muscle relaxants?

<p>They primarily exert their action at the spinal cord level. (B)</p> Signup and view all the answers

Flashcards

Statins

HMG-CoA reductase inhibitors that reduce cholesterol production.

Simvastatin/Atorvastatin/Rosuvastatin

Examples of statins

Beta Blockers

Drugs that slow heart rate and reduce contractility.

Atenolol/Lebetaolol/Metoprolol

Examples of beta blockers

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ACE Inhibitors

Angiotensin-converting enzyme inhibitors that lower blood pressure.

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Captopril/Lisinopril/Ramipril

Examples of ACE inhibitors

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Angiotensin II Receptor Blockers (ARBs)

Drugs that block angiotensin II receptors, lowering blood pressure

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Losartan/Candesartan/Telmisartan

Examples of Angiotensin II Receptor Blockers (ARBs)

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Calcium Channel Blockers

Relax smooth muscle and slow heart rate lowering blood pressure.

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Diltizem/Amlodipine/Verapamil

Examples of Calcium Channel Blockers

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Diuretics

Drugs that increase urine production to lower blood pressure.

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Loop Diuretics

Powerful diuretics, inhibit sodium and chloride reabsorption in loop of Henle.

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Hypokalemia

Low potassium levels, side effect of diuretics

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Vasodilators

Drugs that relax blood vessels, lowering blood pressure.

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Anticoagulants

Drugs that prevent blood clots by inhibiting clotting factors.

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Anticoagulant Example: Heparin

A blood thinner that measures how long blood takes to clot (aPTT).

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Antiplatelet Drugs

Drugs that prevent platelets from clumping together.

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Antiplatelet Example: Aspirin

A drug that prevents platelets from clumping, its effect lasts the life of a platelet.

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Statins

Drugs that lower cholesterol by inhibiting its production in the liver.

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Bile Acid Sequestrants

Drugs that bind bile acids in the intestines, increasing cholesterol excretion.

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Muscle Pain (Statins)

Possible side effect of statin medication.

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Diuretics at Night

Taking diuretics at night can cause sleep disturbances.

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Digoxin Serum Monitoring

Patients taking digoxin, a cardiac glycoside, still require regular serum drug monitoring due to its narrow therapeutic range.

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Millimoles vs. Milliequivalents

The relationship between millimoles (mmol) and milliequivalents (mEq) of potassium (or other electrolytes) depends on the ion's valence, not a fixed ratio.

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Anticoagulants vs. Antiplatelets

Anticoagulants (e.g., heparin) and antiplatelets (e.g., aspirin) are DIFFERENT classes of drugs and require DIFFERENT lab monitoring (aPTT for anticoagulants).

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Steroid MOA

Steroid drugs suppress inflammation and the immune response.

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Steroid AE

Adverse effects of steroids can include telangiectasia (small blood vessel dilation).

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Retinoid MOA

Retinoids suppress inflammation, help the skin produce collagen/elastin and regulate sebum production.

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Retinoid AE (Important)

Retinoids are teratogenic (cause birth defects); use with caution, especially in pregnant persons, and start low and go slow.

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Calcineurin Inhibitor MOA

Calcineurin inhibitors are immunomodulators that suppress the immune response.

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Topical Skin Agents

Medicines applied directly to the skin to treat various conditions like infections, inflammation, and pain.

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Ophthalmic Drugs

Medicines applied to the eye for eye conditions like glaucoma or infections.

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Glaucoma

A group of eye conditions that damages the optic nerve due to increased pressure within the eye.

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Cholinergics (eye drops)

Eye drops that stimulate the parasympathetic nervous system to lower eye pressure.

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Beta-blockers (eye drops)

Eye drops that reduce eye pressure by reducing aqueous humor formation.

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Prostaglandin agonist

Eye drops that increase outflow of aqueous fluid to lower eye pressure.

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Ocular antibiotics

Eye drops or ointments that fight bacterial eye infections.

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Topical Anesthetics

Eye drops reducing eye pain, used to numb the eye. Only used by healthcare professionals.

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Anti-inflammatories in eyes

NSAIDs and corticosteroids used to reduce inflammation in the eye.

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Otic Medications

Medicines for ear conditions like infections, inflammation or earwax removal.

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CNS Stimulants

Drugs that increase the effect of norepinephrine and dopamine in the central nervous system (CNS) by increasing their release and blocking their reuptake.

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Opioid Analgesics

Synthetic or partially synthetic drugs that bind to opioid receptors in the central nervous system (CNS) to alter pain perception and response.

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Opioid Analgesic Side Effects

Includes slowed bodily functions (e.g., nausea, vomiting), tolerance, dependence, withdrawal, toxicity, and overdose, but most seriously respiratory depression (stopping breathing).

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CNS Stimulant Use

Used for conditions like ADHD, narcolepsy, obesity, respiratory depression, post-anesthesia, and migraines.

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CNS Stimulant Precautions

Avoid in individuals with cardiac abnormalities (e.g., cardiomyopathy, dysrhythmias, coronary artery disease).

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Non-Opioid Analgesics (Tylenol)

Pain relievers that do not treat inflammation, but do treat fever (antipyretic).

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Anti-epileptic Drugs (AEDs)

Medications that reduce seizure activity; cannot be stopped suddenly.

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NSAID Analgesics

Pain relievers that reduce inflammation (anti-inflammatory), treat pain (analgesic), and reduce fever (antipyretic) by inhibiting prostaglandin synthesis.

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Antiepileptic Drug Action

Interrupts sodium channels in the brain, preventing excessive neuron firing.

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COX enzyme inhibition

Mechanism by which NSAIDs reduce inflammation and pain by interfering with the synthesis of prostaglandins.

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Aspirin's unique action

Aspirin is an irreversible inhibitor of COX receptors in platelets; therefore, it decreases platelet aggregation and reduces blood clot formation.

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Seizure

Excessive and uncontrolled neuron firing in the brain; sudden depolarization.

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Convulsion

Involuntary muscle spasms caused by seizures.

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CNS Depressants

Reduce nerve impulses; examples include sedatives (to reduce anxiety), hypnotics (to induce sleep), and sedative-hypnotics (that may act as either depending on the dose).

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Antiepileptic Drug Goals

Reduce seizures while minimizing side effects. Aim for a balance between treatment and patient wellbeing.

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CNS depressant lifespan considerations

Older adults, due to reduced liver and kidney function, are more sensitive to the effects of CNS depressants and should be monitored carefully.

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Benzodiazepines

A common class of sedative-hypnotics often used for anxiety or seizures. Characterized by the suffix "pam".

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Drug Interactions

Mixing CNS depressants can have dangerous consequences. Avoid combining these drugs.

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Study Notes

Statins

  • Hydroxymethylglutaryl-coenzyme (HMG-CoA) reductase inhibitors
  • Examples: Simvastatin, atorvastatin, rosuvastatin
  • Notice the "statin" suffix
  • Reduce the production of cholesterol
  • Common side effects: headache, dizziness, blurred vision, constipation, diarrhea, nausea, myopathy (muscle weakness), skin rashes, myalgia (muscle pain)
  • Lifespan considerations: Contraindicated in pregnant or breastfeeding women or those under 10 years of age.
  • Use caution with older adults: Increased risk of myopathy (muscle weakness)

Beta Blockers

  • Used for hypertension, angina, myocardial infarction (MI), and dysrhythmias
  • Block beta1 receptors in the heart, slowing conduction and reducing myocardial contractility
  • Contraindicated in decompensated heart failure and serious conduction disturbances; can cause block of beta 2 blockers
  • Used with caution in patients with asthma
  • Can mask tachycardia
  • Side effects: hypotension, bradycardia, dizziness, fatigue, wheezing, dyspnea
  • Examples: Atenolol, labetalol, metoprolol
  • Notice the "olol" suffix

ACE inhibitors

  • Angiotensin-converting enzyme inhibitors
  • Blocks the production of salt and water in the nephron
  • Blocks the conversion of Angiotensin I into Angiotensin II
  • Prevents/stops the vasoconstriction of Angiotensin and the absorption of sodium and water by inhibiting aldosterone secretion
  • Used in hypertension, heart failure, and post-myocardial infarction (MI)
  • Also protective of the kidney
  • Examples: captopril, lisinopril, ramipril (all end in "pril")
  • CANNOT GIVE IV
  • Suffix: "pril"
  • Most ACE inhibitors are prodrugs
  • Side effects: fatigue, dizziness, headaches, dry cough, hypotension, hyperkalemia, angioedema
  • Angioedema: rare but potentially fatal side effect (swelling beneath the skin, unlike hives, which are on the top of the skin)

ARB (Angiotensin II receptor blocker)

  • Also works on the Renin-Angiotensin-Aldosterone System (RAAS)
  • MOA: Blocks angiotensin II at the receptor site
  • Examples: losartan, candesartan, telmisartan
  • Notice the "sartan" suffix
  • Blocks vasoconstriction and the release of aldosterone
  • Does not cause cough
  • Indications: hypertension; adjunctive for heart failure
  • Contraindications: pregnancy and lactation; caution in older adults and renal dysfunction
  • Side effects: headache, dizziness, fatigue; hyperkalemia much less likely

Calcium Channel Blockers

  • 3 classes within
  • Calcium is used in the process of triggering heart and vascular smooth muscle cells
  • Blocking calcium channels prevents muscle contraction and relaxes smooth muscle; causes arterial dilation
  • Slows the SA node, decreases conduction through the AV node
  • Indications: angina, hypertension, some dysrhythmias, migraine headaches, and Raynaud's disease
  • Contraindications: acute MI, some heart blocks
  • Side effects: peripheral edema, Stevens-Johnson Syndrome, arrhythmias
  • Examples: Diltizem (benzothiazepine), amlodipine (dihydropyridine), verapamil (phenylalkylamine)

Diuretics

  • Used for the treatment of heart failure, hypertension, and fluid overload
  • Different categories within this class: carbonic anhydrase inhibitors
  • Loop diuretics: most common is furosemide; blocks water and sodium resorption; thought to activate kidney prostaglandins which cause vasodilation systemically; prolonged use can cause ototoxicity (tinnitus, hearing loss); side effects: hypokalemia (potassium wasting), dizziness, dehydration, and other electrolyte imbalances; gives off potassium.
  • Potassium-sparing diuretics: spironolactone most common; competitively binds with aldosterone receptors, blocks sodium and water resorption; not as strong as thiazide and loop diuretics; Side effects: dizziness, headaches, cramps, hyperkalemia, urinary frequency, and weakness.
  • Thiazide and thiazide-like diuretics: hydrochlorothiazide most common; inhibits reabsorption of sodium, potassium, and chloride; also relaxes arterioles; efficacy of the drug decreases with decreasing kidney function —contraindicated in severe kidney failure; side effects: dizziness, headache, blurred vision, nausea, vomiting, diarrhea.

Vasodilators

  • Work directly on vascular smooth muscle to cause relaxation
  • Most common is hydralazine

Angina

  • Nitroglycerin is the most common
  • Dilates all blood vessels by relaxing vascular smooth muscle cells
  • Very potent effect on coronary arteries
  • Contraindicated in severe head injury, hypotension, severe anemia, inferior myocardial infarction, and simultaneous use of ED medications
  • Vasodilation that occurs too rapidly can cause reflex tachycardia (overcompensation)

Heart Failure

  • Heart is unable to effectively pump blood (right sided, left sided, both)
  • Common symptoms include peripheral edema and shortness of breath
  • Common treatment classes include diuretics, ACE inhibitors, ARBs, beta blockers, and nitroglycerin

Cardiac Glycosides (Digoxin)

  • Some of the oldest drugs; synthesized from foxglove (digitalis) – digoxin
  • Reduces heart rate and increases contractility (positive inotropic, negative chronotropic)
  • Prolonged rest between beats
  • Side effects: bradycardia, tachycardia, hypotension, arrhythmia
  • Signs of toxicity: headache, confusion, colored vision, halo vision, anorexia, nausea, vomiting
  • Low therapeutic index; drug levels need to be monitored

Dysrhythmias

  • Many different heart rhythms
  • Huge category
  • Most common: atrial fibrillation (a-fib)
  • You will most commonly see beta blockers, calcium channel blockers, and blood thinners

Electrolytes

  • Chemical compounds that dissociate into ions in water
  • Conduct electrical current
  • Electrolytes include sodium, chloride, potassium, calcium, magnesium, and phosphate

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This quiz covers key concepts related to statins and beta blockers, including their mechanisms of action, common side effects, and contraindications. Test your knowledge on these essential pharmacological agents used in cardiovascular health.

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