pharm exam 5

  1. Name an ACE inhibitor 

    what is it for 
    how to take
    adverse effects
    Captopril  ( -pril) 

    • For hypertension, CHF, Post MI 
    • PO with food 

    • Not for... 
    • -pregnant
    • -hyperkalemia ( avoid high K+, salt sub) 
    • -black people 

    AE: angioedema ( lips, eyes) ,cough, dizzy 

    • Dont stop abruptly 
    • Iron makes it go down, digoxin, and lithium increase
  2. ARB 
    Whats it for
    Losartan (sartans)

    For Hypertension, CH, DM neuropathy 

    • PO with food 
    • Not for black people, pregnant 

    AE: angioedema, hypot, dizzy, heartburn, diarrhea
  3. Ca+ channel blocker
    Whats it for 
    How to give
    Amlodipine ( -pine)

    For Hypertension, CAD, A fib, 1st for black people

    • PO, IV 
    • Not for systolic heart fail 

    AE: peripheral edema, headache, dizzy 

    other: dilitazem, verapamil, nifedipin ( crisis)
  4. Alpha 1- adrenergic receptor blockers 

    whats it for
    Doxazosin ( zosin) 

    • For HTN give at bed time ( 1st dose phenom)
    • AE: ortho, dizzy, syncope
    • Na+, fluid retent--> monitor weight
  5. Alpha 2 
    whats it for
    how to give
    • Clonidine 
    • For HTN
    • PO/transdermal patch - rotate sites dont cut
    • - first dose phenom
  6. Beta adrenergic blocker 

    How to give 
    whos it not for 
    Adverse effects
    Metroproplol ( lol) 

    • PO, IVP, IV gtt 
    • Best for 50+ w tachy, HTN, MI

    • Not for asthma, smaller doses in asians 
    • AE: bronchospasm, bradycardia
  7. Beta 1 adrenic agonist  ( name 3)
    - whats it for 
    - how to give
    Norepinephrine: IV gtt severe hypotension 

    • Epinephrine: IVP- MI 
    •                    IV gtt-shock
    •                    Topical- decongest
    •                    IM: anaphylaxis 
    •                   For asystole, PEA
    • Dopamine: IV gtt ( low dose enhance renal) 

    All not for : hypertension, hyperthyroid, narrow angle gluacoma 

    IV check: extravasation, peripheral ischemia, liver, renal 

    AE: restless, htn, palpitation, blurred vison
  8. Class 1 : Sodium channel block 
    Name 3 
    what to avoid
    • 1a: Quinidine 
    • - Reduces automaticity, slows conduction, and prolongs refractory
    • - take it with food ( gi) 

    • 1b: Lidocaine 
    • -IVgtt for post card surg, cath, digital v dysr

    • 1c: Flecainide 
    • -not for recent MI

    Avoid OTC cold/allergy, appetite supp, antisleep

    NOT for heart block, mysathenia gravis
  9. Name Class 2 Beta-adrenergic blocker 

    whats it for 
    Propranolol (lol) , metroprolol 

    Afib, tach, after MI, CHF

    • has 1st pass effect, masks hypoglycemia
    • dont give to brady, asthma, or stop abruptly
  10. III Potassium channel blocker 
    - when to use 
    - whats it not for

    • for life-threatening dysrhythmia 
    • no pulse: 300, pulse: 150

    • not for heart block/ thyroid 
    • routine chest x ray
  11. IV Ca+ channel block
    not for
    Diltiazem , verapamil

    • Only for SVT, afib/aflutter
    • Not for kids
    • digoxin toxicity makes it worse
  12. Nitroglycerin 
    whats it for 

    what to be aware of ( tablet, ointment) 

    what not to take it with
    For Angina 

    • Tablet: slowly dissolve 3-5hr
    • Ointment: cover area w plastic/tape after 

    • Can cause hypotension
    • No sildenafil, vardenfil ( eretile dysfu), no phenothiazine
  13. Cardiac glycoside 
    what for
    serum level 

    • For afib, aflutter, chr 
    • 0.5-2mg/ml , levels drawn 6hr after
    • antidote: digibind

    can cause: hypokalemia, limit Na 

    brady, yellow, green, purple halo
  14. Human B type natriuretic peptide 

    whats it for 
    • Acute heart failure 
    • check BNP

    • 74+ : 125, younger than 74: 450+ 
    • Critical care administers, hemodyn monitor 

    SOB, numb, ting,
  15. Phosphodiesterase inhibitor 
    reacts with

    • critical care nurse, IV drip 
    • short term hf that doesnt respond to digoxin 

    creatine clearance observes dose
  16. K+ wasting loop diuretic 
    Furosemide : PE, ascites 

    not for sulfo allergy

    restrict Na, K+ 

    ear ringing
  17. Thiazide 
    not for 

    • HTN 1st 
    • Not for sulfo allergy
    • hold before surgery

    less na, take K+, photosen
  18. K+ Sparing 
    what for 
    bad with
    • Aldosterone 
    • HF, ascites 
    • no K+, or salt 

    bad with digoxin, lithium
  19. Heparin 
    whats it for 
    what to check 
    reduces effects
    Prevents DVT, PE 

    • Give IV, SubQ dose based on aPTT ( 45-70 sec) 
    • - Get aPTT 1 hr before dose 

    Antidote: protamine sulfate 

    effects go down: nicotine, nitroglycerine, antihistamine, digoxin
  20. Vit K anticoagulant 
    what to base dose on 
    • Warfarin 
    • dose based on PT/ INR
    • - pt: 18 sec - INR: 2-3
    • - hold med INR 3+ 

    • Antidote vit k+ 
    • avoid walking barefoot
  21. Dabigatran 
    whats it for
    • Direct thrombin inhibitor 
    • stroke prevention ( prevent thrombus, afib )

    - less risk of thrombocytopenia

    Bivalirudin: critical care IV, dabigatron PO ( not good w antacid, statin, proton pump inhib) 

    - no coag monitor
  22. Rivaroxaban
    • Direct factor XAinhibit
    • for CVA, Afib
    • no antidote,, not removed w dialysis 
    • no coagu monitoring
  23. Anti-platelets
    name some
    - how to give
    -what to be aware of
    • Clopidogrel  
    • other... prasugrel, ticagrelor, aspirin, cilostazol 

    • MI, Stoke, prevent w atherosclerosis post stent 
    • PO dual antiplatelet post PCI, PTA

    clopidogrel: loading dose

    - need to be help 5-7 days before surgery 

    AE: rash, TTP
  24. Thrombolytic 
    whens it used
    -what must be ruled out 
    - what to check

    • 1st in stroke lysis 
    • must rule out cerebral hemm, only critical care 
    • check INR, aPTT, check levels 2-3 hrs post
  25. Name a statin 

    ae: myopathy

    take at night, routine leaflets
  26. Cholestyramine 

    how to give
    what it interacts with
    Bile acid sequest. 

    • lowers LDL ( powder), added with statin, niacin 
    • decrease fat sol vit
    • mix with fluid

    dont take any other drugs 1hr before, 4-6hr post 

    dental hygiene
  27. Fenofibrate
    whats it good for 

    be aware of
    • lowers serum triglyc
    • good for low HDL

    • need to lower warfarin dose
    • dont take with statin
  28. Alirocumbab, evolocumab 

    whats it good for 
    for people with a family hist of high cholest 

    ae: nasopharyngitis, inject pain
  29. Epotein alpha
    whats it for 
    when not to give

    • Erythrocyte hematopoeitic 
    • makes rbc , hmg, hct 

    dont give if hemoglobin 12+ ( check 2x week)

    Iron needs to be normal

    • AE: DVT, HTN
    • Dont shake vial
  30. Filgrastim

    how to give 
    Granulocyte colony stim

    • Dont shake
    • wait 24 hr after chemo
    • take wit acetaminophen

    not for kids

    flu symp, bone pain
  31. Interferon alfa, beta gamma 
    what does it do
    what to be aware of
    • suppress cancer growth 
    • dont shake
    • kids, 3x week

    bc 6 months post
  32. Aldesleukin
    whats it for 
    • metostatic kidn, melanomas
    • norm heart and lung

    ae: capillary leak
  33. Mycophendate mofetil
    whens it for
    how to give
    after org transplant

    give on empty stomach, use gloves

    ae: fever, sore thraot ( avoid mucus mem)
  34. Antirejection drug Cyclosporin 
    what not to give
    • no live vaccine
    • prevents drug rejections
    • dose is by weight
  35. Antiestrogen 

    whens it for 
    how long to take
    • Breast cancer
    • PO 2-5post
  36. Gonadotropin rel agonist 

    Leuprolide acetate
Card Set
pharm exam 5
cardiac hemo