Pharm.4

• cardiac glycoside
• inc CO by inc myocardial contractility via Ca²⁺

• cardiac glycoside
• inc CO by inc myocardial contractility via Ca2+

• acute MI
• cardiac arrythmia
• valve issues
• end stage chronic heart failure

• B1 agonist
• = inc CO
• tx. of acute heart failure

• converted to epi and norepi
• sustains blood flow to kidneys via dopamine receptors
• inc CO
• tx AHF

• phophodiexterase 3 inh
• tx. AHF
• inc cAMP, inc contract, inc CO

• musc rec antag
• blocks effects of para n.s. on heart
• inc CO
• Tx. AHF

tx glycoside overdose

• ace inh
• chf

• ace inhib
• chf

• angiotension receptor blocker
• only used when pt.'s cannot tollerate ace inh
• chf

• administration w/ an ace inhib reduces morbidity and moratlity > an ace inhib alone
• antag at aldosterone rec
• K+ sparing
• weakest diruetic

• thiazide diruetic
• moderate efficacy
• produced hypokalemia

• thiazide diruetic
• moderate efficacy
• produced hypokalemia

• loop diuretic
• high efficacy
• produced hypokalemia

• loop diuretic
• high efficacy
• produced hypokalemia

• arterial dilator
• dec afterload
• good for fatigue symptoms

• venous dilator
• dec preload
• good for pulmonary edema

• one of 3 B-blockers that work for chf
• also a1 antage = vasodilator

• one of 3 B-blockers that work for chf
• selective

• one of 3 B-blockers that work for chf
• selective

• reduced congest symptoms and improved exercise tolerance
• reduce lethality from PROGRESSIVE damage but inc SUDDEN death
• margin of safety is VERY LOW: RISK of caridac arrhythmias
• overdose tx w/ antibodies

• ultra-short acting
• 4-6

• ultra-short acting
• 4-6

• ultra-short acting
• 4-6

• short acting
• 6-8h

• intermediate acting
• 14-18
• good for twice a day inj for basal level reg

• long acting
• 24
• good basal reg

• long acting
• 24 hr
• good basal reg

• synthetic AMYLIN analog
• dec gastric emptying
• reduces glucagon secretion
• suppresses appetite

• 2nd gen sulfonylurea
• short acting and safer
• a secretagogue

• 3rd gen sulfonylurea
• longer acting
• more efficacious due to effect in the liver
• secretagogue

• Meglitinide
• quick onset and short duraction
• used in combination
• secretagogue

• biguanide
• first-choice drug
• weight loss!!
• enhances insulin effects
• glucose to lactic acid

• tzd
• Avandia
• reg at PPAR
• inc insulin response to muscle and fat glucose uptake
• weeks to begin working
• Euglycemic

• tzd
• Actos
• reg at PPAR
• inc insulin response to muscle and fat glucose uptake
• weeks to begin working
• Euglycemic

• liver toxicity
• weight gain
• altered lipid profile
• bone fracture in post-menopausal women
• fluid retention/edema resulting in weight gain & CHF (Avandia)

• synthetic incretin
• GLP-1 receptor agonist

• inhibit enzyme DPP-4
• taken ORALLY!
• prevent incretin metabolism

• alpha glucosidase inhibitor
• prevent breakdown and therefore absorption of monosaccharides = reduce absorption of glucose precursors

• synthetic T4
• tx. chronic hypothyroidism
• delayed onset

• synthetic T3
• short half-life
• acute insufficiency
• risk of cardiotoxicity

• tx hyperthyroidism
• young pt.
• mild ht
• - inh thyroid peroxidase

• tx hyperthyroidism
• young pt.mild ht
• first choice w/ pregnant women
• - inh thyroid peroxidase

• brings t3 down
• inhibits t3 and t4 release
• may result in latent hyperthyroid
• prevents uptake of radioiodine

• not used as monotherapy
• tx hyperthroidism esp prevent storm
• quick acting b-blocker blocks T3 effect on heart and t4 to t3

• radioactive iodine
• tx hyperthyroidism

• tx bipolar disorder
• precipitates hypothyroid conditions
• may be goitrogen

• tx cardiac arrhythmias
• produce hypothyroidism
• goitrogen

endogenous corticoid

• physiological minearlocorticoid
• transcription effects which upregulate na/k pump
• inc na reabsorption = inc water retention = inc bp

greater mineralocorticoid action

• synthetic mineralocorticoid
• same effects as aldosterone
• greater mineralocorticoid action

• synthetic cortisol
• slightly less activity than hydrocortisone
• equal m and g actions

• syn cortisol which all others are based off of for activity
• equal m and g actions

greater glucocorticoid action

greater gluco action

greater gluco action

great gluco action

great gluco action

glucocorticoid synthesis inh

glucocorticoid rec antagonist

• aminoglutethamide: glucocorticoid synthesis inhibitor
• mifepristone: glucocorticoid receptor antagonist (also terminates pregnancy)
• spirinolactone: mineralocorticoid receptor antag

estrogen used in hormonal contraceptive

synthetic progestin used for part of hormonal contraceptive

synthetic progstrin for hormonal contraceptive

91 day, 7 day off extended preparation hormonal contraceptive that is newer

91 day, 7 day off extended hormonal contraceptive that is newer

• continuous hormonal contraceptive 365 days
• eliminates periods

• RU-486
• abortion pill
• antag on progest and blucocort rec
• luteolytic

• contraceptive pill "morning after"
• high dose levonorgestrel

• Selective estrogen receptor modulator (SERM)
• blocks negative feedback
• stimulates gonadotropin release

• fertility drug
• synthetic GnRH
• stimulates gonadotropin release

• fertility drug
• gonadotropins (LH and /or FSH)

• conjugated estrogen
• HRT for menopause

estrogen + progestin combination HRT therapy for menapause

• active form of vit D
• increase Ca2+ release from bone
• reduced Ca elim from kidney
• increased Ca absorption in intestine

• Vit D3
• promotes vit D responses

directly promotes bone resorption, it indirectly promotes bone growth through its effects on systemic calcium levels

• parathyroid hormone
• released in response to low systemic calcium
• inc bone resorpt
• inc renal reabsorpt
• inc intest calcium absopt

• prevents bone resorption
• less effective long term vs estrogen & bisphos

calcium supplements for tx osteoporosis

• recombinant PTH
• anabolic = stimulate new bone formation!!
• SC admin

bisphosphonate drug for osteoporosis

bisphosphonate for osteoporosis