pharm final 2

• Class III K+ blocker
• DOC for ANY dysrhythmias

Tx Angina

N= dialte veins and decrease preload

B=decrease rate and force of contrction

C= Dilate arteriole, decrease afterload

• 1st drug given for Angina
• Acts directly on vascular smooth mucsle
• Dilates veins and pulls fluid from heart, DECREASING Preload
• -Give Tylenol to prevent Nitro headache

• SE= Dec. BP
• = drug interaction with Viagra

Highly lipid soluble

Sublingual - 3 doses, 5 min apart

• Oral - sustained release (Prophylaxis ONLY)
•   - Isosorbide/Imdur

Transdermal - off at night

• IV fusion - short term only
•  - 5-50 ug/min

IV Nitro needs special tubing b/c it sticks to plastic

increase urine output

• -Tx of HTN
• -Mobilization of edematous fluid
• -Prevent renal failure
•   =when fluids are low on this pt. we give fluids and diuretics to flush kindeys out

• Hypovolemia
• -dehydration, orthostatic hypoTN, thirst
• Acid/Base imbalance
• Disturbances of electrolyte levels

• Loop (high ceiling) Diuretic
• Works in the Ascending loop of Henle
• -depends on prostaglandin availability (which dec. with ibuprofen use)
• Blocks Na+ and Cl- reabsoprtion
• DOC for fluid overload

SE= Hypokalemia

• Blocks Na and CL reabsorption
•  ->much LESS h2o and electrolyte loss than loops
• Doesn't work well with low GFR rate, so not given for Renal Failure
• Used for HTN and Edema
• BAD for Gout (uric acid build up)

Paradoxical (reverse) effects on Diabetes Insipidus (decreases urine in a disease that increases urine

-used with other diurs.

• Aldosterone Antagonist
• Inc. Na+ excretion so Kidney saves K+

Limited urine production but dec. K+ loss

• Creates an osmotic effect in the nephron
• -inhibits passive reabsorption of h2o
• NO Metab effect, just a big molecule that attracts h2o
• Moves fuild from tissue into vascular space
• MUST be given IV and use a filter needle
• Given mainly to Dec. ICP, also used for edema

a= Epi

HTN= Nitroprusside / Nipride

SVT= Adenosine  (Cardizem ?)

• anti-coag
• Inactivates Thrombin and Factor 10a
• -fibrin production is reduced, clotting suppressed
• -short 1/2
• First pass effect

Used for PE, Embolic stroke, MI, DIC

Monitor aPTT (22-34 sec.)

Risk for Bleeding

Antidote for heparin induced bleeding

• oral anti-coag
• Vit K antagonist

Monnitor PT and INR

• risk for bleeding
• many drug reactions

• Anti-platelet
• prevent platelet aggregation
• prevent thromboses in arteries

• Interrupts clotting by interfering with Thromboxane
• SE= GI bleed

Anti-platelet

-reversible blocking of receptor to prevent agg

Given IV short term for ACS

Anti-platelet

Platelet inhibitor and vasodilator

DOC for intermittent Claudication

HMG reductase provides for cholest product

Inhibitors sterols  --> are called Statins -> DOC for dec. LDL and inc. HDL

• Dec. LDL
• INc. HDL
• Promote plaque stability
• Also, an Inc in Hepatic LDL receptors

take drug at night b/c most chol production is done at night

create risk for liver failure and muscle breakdown

Headache, rash, GI

Hepatotoxicity major SE, monitor every 6 months

Muscle inflamm and breakdown

Grapefruit juice

inflammtion and bronchospasms

glucocorticoids

• ***Most effective anti-asthma (anti-inflamm) drugs available
• Prophylaxis of chronic asthma
• Beneficial effects develope OVER TIME (will not help in middle of attack)
• Used on a regular schedule

must be weened off to avoid adrenal suppression

• for acute-short term use only
• toxicity risk increases with long term

• O= Adrenal suppression, bone loss
•  = nl cortisol production stops by body
•  = pts must be weaned off so adrenal glands pick up production

• I= oropharyngeal candidiasis and dysphonia
•  = little inhaled meds reaches systemic circulation
•  = changing from oral to inhale must include weaning, even if using both

inhaled Beta 2 agonist

• bronchodilators
• inhibit bronchospasm by relaxing smooth ms
• suppress histamine release in the lungs

• combo inhalers
• long term Beta agonists and inflamm agents
• Have good asthma control

• traditional ulcer bland diet not effective
• avoiding caffeine not effective

• eat 5-6 small meals daily
• Avoid NSAIDS and ASA

• anti-acid secretion drug
• = reduce volume and acidity of secretions

recept= parietal cells of stomach

Pneumonia b/c Dec. acid means Inc. bacteria growth

• most effective acid suppresion b/c it shuts everything down
• prevents basal and stimulated acid production
• IRREVERSIBLE

• Cancer risk with long term use
• along with pneumonia, fractures, rebound hypersecretions, and for C-Diff

other anti-ulcer drug

• Inert-provides viscous protective barrier b/w acid and epithelium
• May impede absorption of some drugs

• Alkaline cmps that neutralize
• Stimulate production of prostaglandins
• Do not provide physical barrier
• poorly absorbed

Provide symptomatic relief for GERD

• to ease of stimulate defecation
• -soften
• -increase stool volume
• -hasten fecal passage
• -facilitate evacuation

L= mild leisurely results

C= Fast, intense effects

• watery stool in 2-6 hours
• Osmotics, Castor oil, Electrolyte solutions

used to clean bowels before surgery

• Semi-fluid stools in 6-12 hours
• Osmotics, stimulants

used for general constipation

• Soft stool in 1-3 DAYS
• Bulk, surfactant, lactulose

preventative

• group 3
• Like dietary fiber
• Stretch of intestinal wall stimulates peristalsis
• Absorbs water to soften stool

• group 3
• Lower surface tension - greater water absorption

• Stimulate instestinal motility
• Inc. water and electorlyte in intestinal lumen

• Laxative Salts
• Draw water into the gut
• Poorly absorbed systemically, but high doses can cause problems for cardiac pt.s

• made of fructose and galactose
• Enhances intestinal excretion of ammonia

used for liver failure pt.s to help rid ammonia in stool