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what MET is it when a person can dress, eat or use toilet. walk indoors around the hous, complete light housework and wak a block on level ground at 2 to 3 mph

> or eaqual to 1 MET
what MET is it when a person can climb a flight of stairs, walk up a hill. walk on level ground at 4 mph. run a short distance. complete heavy housework and participate in moderate recreational activitie?

> or equal to 4 METs
what MET is it when a person can participate in strenuous sprts

> or equal to 10 METs
what is the mechanism of diuretics?

cause body to eliminate excess fluids and sodium through urination
what drugs cause the body to eliminate excess fluids and sodium through urination

diuretics
what drugs end in olols

beta-blockers
what is the mechanism of beta blockers?

decrease the heart rate and output of blood from the heart by blocking beta-sympathetic stimulation in the heart?
what drug decreases the heart rate and output of blood from the heart by blocking beta-sympathetic stimulation in the heart?

beta-blockers
what drugs end in prils?

ACE inhibitors
what drug expands blood vessles (vasodilation) and decreases resistance to blood flow?

ACE inhibitors
what is the mechanism of ACE inhibitors?

expand blood vessles (vasodilation) and decrease resistance to blood flow
what is the mechanism of calcium channel blockers?

interrupt the movement of calcium into the cells of the heart and blood vessels to produce vasodilation
what drugs end in pines

calcium channel blockers
what drug interrupts the movemnt of calcium into the cells of the heart and blood vessels to produce vasodilation

calcium channel blockers
what drug inhibits vasoconstriction by blocking angiotensin binding, resulting in vasodilation

angiotensin-receptor blockers
what is the mechanism of angiotensin receptor blockers

inhibt vasoconstriction by blocking angiotensin binding, resulting in vasodilation
what drug prevents sympathetic innervation to alpah-receptors, therby blocking vasoconstriction and tachycardia

alpha blockers
what is the mechanism of alpha blockers?

prevent sympathetic innervation to alpha receptors thereby blocking vasoconstriction and tachycardia
what is the prototype for thiazide diuretics?

hydrochlorothiazide (HCTZ)
what are the three main types of diuretics?
- thiazide
- loop
- potassium sparing
what is the mechanism of action for hydrochlorothiazide?

interfere with sodium reabsorption in the distal tubule of the kidney and promote diuresis
what is the most common adverse reaction with hydrochlorothiazide?

hypokalemia
what is the dental drug interaction with hydrochlorothiazide?

COX inhibitor analgesics-reduce the antihypertensive effect of agent
what is the most common loop diuretic?

furosemide (lasix)
what is the mechanism of action of furosemide?

inhibit reabsorption of sodium and promote diuresis (loop diuretic)
what is an adverse effect of furosemide?

hyperkalemia
what is a dental drug interaction with furosemide?

COX inhibitor
what are two examples of potassium sparing diuretics?

spironolactone and triamterene
what is the mechanism of action of potassium sparing diuretics (spironolactone and triamterene)

interfere with the potassium/sodium exchange in the collecting tubules and collecting duct to conserve potassium that is reabsorbed at the expense of sodium in the exchange system
a potassium sparing and thiazide combination therapy is common. what are the drugs used in combination?

Triamterene and hydrochlorothiazide
what are thre three types of beta blocking agents?
- nonselective beta blockers
- selective agents that block B1 more than B2
- agents that block both alpha and beta
what type of beta blocker has an increased risk of hypertension if a vasoconstrictor is used?

nonselective
what are the side effects of beta blockers? 5
- bradycardia
- dizziness
- fatigue
- nausea
- mild xerostomia
what are the drug interactions with beta blockers?

COX inhibitors-antagonize antihypertensive effects
what is the prototype for nonseletive beta blockers?

propranolol (inderal)
t/f vasoconstrictors can be used with nonselective beta blockers

true-low concentrations and aspirating technique used
what is the agent of choice for conditions of bronchospasm?

selective beta blockers
t/f vasoconstrictors are safe to use with selective beta blockers

true
what is alpah and beta adrenergic blocking agent?

labetalol (Normodyne)
t/f labetalol is a alpha and beta adrenergic blocking agent. It may be prescribed in comination with diuretics.

both statements are true
what drugs are effective for hypertension, arrhythmia and angina pectoris

calcium channel blockers CCB
what are ADEs associated with calcium channel blockers?

gingival hyperplasia, xerostomia and dysguesia (nifedipine)
what CCB drugs are less lidkley to produce gingival hyperplasia?

amlodipine and isradipine
what are three examples of CCB drugs?
- nifedipine
- amlodipine
- isradipine
t/f cox inhibitors can be used for analgesia with calcium channel blockers

TRUE no drug interactions
what drug blocks vasoconstriction of coronary arteries (angiotensin inhibitor)

lisinopril
what is a drug to drug interaction with ACE inhibitors?

COX inhibitors
what are the side effects of ACE inhibitors?

dry hacking cough (worsen with supine position)
what is the prototype for angiotensin 2 receptor inhibitors?

Iosartan (Cozaar)
t/f angiotensin 2 receptor inhibitors are safe to use during pregancy

FALSE-category D in 2nd and 3rd trimester. They should NOT be used during pregnancy
what are two examples of alpha1-adrenergic blockers

doxazosin and terazosin
what are three CNS mediated action drugs? (-INE)

clonidine, guanethidine and reserpine
what is the potential drug interaction with alpha adrenergic blockers?
- epinephrine (reduceds duration of local anesthetic)
- COX inhibitors reduce antihypertensive effect
what is the drug of choice for hypertension associated with pregnancy?

hydralazine
what are the side effects affecting DH of hydralazine?

orthostatic hypotension and cardiac palpitation
what are the common adverse drug effects?
- Urination-diuretics
- fatigue-beta blockers
- chronic dry cough - ACE inhibitors
- Gingival hyperplasia-some CCBs
- postural hypotension and xerostomia-several classes
what class of drugs has a common effect of urination?

diuretics
what class of drugs has a common effect of fatigue

beta blockers
what class of drugs has a common effect of chronic dry cough

ACE inhibitors
what class of drugs has a common effect of gingival hyperplasia?

some CCBs
what class of drugs has a common effect of postural hypotension and xerostomia?

several classes
what effect does COX-1 inhibitors have on antihypertensive agents?

reduce efficacy
what effect does sympathomimetic amines have on bata adrenergic blockers?

decreases effect
nonselective beta blockers have interactions with what to cause hypertensive reactions caused by unopposed alpha adrenergic stimulation?

epinephrine
what effect does pilocarpine have on antihypertensives?

may ave additive effect leading to hypotension
what are the five therapeutic goals of CAD?
- inhibit progression atherosclerosis
- improve circulation in coronary arteries
- reduce workload
- prevent thrombus formation
- prevent coagulation (warfarin)
what is the pharm strategy for inhibiting progression of atherosclerosis? 4
- lipid lowering agents
- HMG-Co-A reductase inhibitors
- bile acid sequestrants
- Niacin
what is the Parm strategy for improving circulation in coronary arteries? 2
- nitrates
- calcium channel blocking agents
what is the pharm strategy for reducing workload?

B1-adreneergic receptor antagonist
what is the pharm strategy for preventing thrombus formation?

antithrombotic agents
what is the pharm strategy for prevention of coagulation?

anticoagulants (warfarin)
what ist he recommendation for total cholesterol levels? what about LDL levels?
- total cholesterol <200 mg/dl
- LDL <130 mg/dl
what are the agents used to lower cholesterol?
- HMG-CoA reductase inhibitors (STATIN)
- bile acid sequestrants
- fibric acid derivaties
- Niacin
- ezetimibe, ezetimibe and simvastatin
t/f HMG-CoA has many ADEs and they affect dentaly hygiene treatment

false usually mild and do not affect DH tx
what are three examples of bile acid sequestrants?

cholestryramine, colesevelam, colestipol
how must bile acid sequestrants be taken with other oral medications?

take drug 1 hour before or 4-6 hours after other drugs
what are two examples of fibric acid derivatives?
- gemfibrozil (lipid)
- fenofibrate (TriCor)
what are the drug interactions of fibric acid derivaties?

none
what are the tree effects of Niacin?
- reduces 10-20% reduction in total and LDL
- reduces 30-70% reduction in triglycerides
- increase 20-35% in HDL
what are the fast acting vasodilating agents used for angina pectoris?

amyl nitrate, nitroglycerin
what are the long acting agents for prevention and treatment of angina pectoris?
- isosorbide dinitrate
- isosorbide mononitrate
- calcium channel blocking agents
what is used to MANAGE anginal pain?

nitroglycerin
what is used to PREVENT and TREAT angina?

isosorbide mononitrate or dinitrate
what MET does a pt with CAD have to be to recieve care?

4 MET
what do you as DH do for an angina attack?

provide 100% oxygen
what are the 10 class I antiarrhythmic drugs
- disopyramide
- procainamide
- quinidine
- lidocaine
- tocainide
- mexiletine
- flecainide
- moricizine
- propafenone
- phenytoin
what are the three class II antiarrhythmic drugs? olol
- propranolo
- esmolol
- acebutolol
what are the three class III antiarrhythmic drugs
- amiodarone
- bretylium
- sotalol
what is the class IV antiarrhythmic drug?

verapamil
what are the two miscellaneous antiarrhytmic drugs?
- digoxin
- adenosine
what antiarrhythmic agent has a drug interaction with local anesthetics-increased CNS effects

propafenone
t/f vasoconstrictors may interact adversely with digoxin and nonselective beta adrenergic blocking drugs

true
when are vasoconstrictors contraindicated wtih arrhythmias?

with intractable arrhythmias
what are the four complications of arterial thrombi?
- blood clots in brain (stroke)
- mural thrombosis
- occlusion of coronary artery grafts
- transient ischemic attack
what are the two main classes of antithrombotic agents?
- aspirin
- clopidogrel
when is clopidogrel prescribed

when a pt cannot take aspirin (antithrombotic agents)
what are the two main groups of anticoagulants?

heparin and warfarin
what are two low molecular weight heparin agents available for home use?
- dalteparin
- enoxaparin
what is the mechanism of action of warfarin?

interferes with the synthesis of several vitamin K clottin factors including thrombin (factors II, VII, IX and X) in the liver
what drug interferes with the synthesis of several vitamin K clotting factors including thrombin (factors II, VII, IX, X) in the liver

warfarin
what are the drug interactions of COX 1 inhibitors and antibiotics?

increase INR level
______ (a drug) increases metabolism and reduces anticoagulant effect

phenobarbital
what shouldbe be used for analgesic with warfarin?

short term acetaminophen or opiod analgesics WITHOUT aspirin
what anticoagulant drug is used after replacement of prosthetic heart valves?

dipyridamole (Persantine)
with warfarin what levels do you need to monitor and what should the number be?

INR levels LESS THAN 3.5
what are the agents used in heart failure?

cardiac glycosides
what are three examples of cardiac glycosides used for heart failure?
- digitalis
- digitoxin
- digoxin
what is the most common cardiac glycoside used for heart failure?

digoxin (lanoxin)
what is the vasoconstrictor formulation usd for digoxin?

1:200,000
how many cartridges of 1:100,000 epi can be given to a pt of 4 METs

2

Author

cassiedh

78758

Card Set

Pharm

Description

drugs drugs and all those dang boxes

Updated

2011-04-11T03:26:09Z

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