Nifedipine (Procardia), amlopidine (Norvasc), felodipine (Plendil)
Verapamil has strongest
negative inotropic effect
and should be avoided
in patients with
HF.
Using CCB/ACE combination decreases
peripheral edema by 50
% vs.
those on CCB high dose alone.
Glycosides
Digoxin: highly selective inhibitors of the ATPase system
Inhibition of this pump results in
sodium and calcium buildup inside the cell
, which
leads to increased contractility of heart muscle.
Amiodarone can cause blue skin discoloration
b.
Understand positive and negative chronotropism and inotropism and which drugs
exhibit which
Negative chronotropic effect lowering conduction through AV node fix
tachycardia. Non-dihydropyridines CCB
CCB Block the influx of calcium, reduction in contractility (negative inotropism),
c.
Know recommended fiber intake
Increased soluble fiber intake (10 to 25 gm/day)
Dietary fiber of 20 to 30 gm/day
d.
Signs/symptoms to look out for side effects of statins; rank relative statin potency
Common statin adverse effects: HA
, myalgia
, fatigue, GI intolerance, flu-like
symptoms
Myopathy: occurs in
0.2% to 0.4%
of patients, some agents more likely
Reduced by using lowest effective dose

Cautiously combining statins with fibrates
Avoiding drug interactions
Increase in liver enzymes
not enough
to warrant frequent labs
5.
Gastrointestinal/Gentourinary
a.
Chapter 20 Drugs Affecting the Gastrointestinal System
i.
Precautions for using antacids
Precautions and contraindications
b.
Abdominal pain of unknown cause
c.
Calcium-based antacids contraindicated if patient is
hypercalcemic or has renal
calculi.
d.
Magnesium-based antacids contraindicated in patients with renal failure or renal
insufficiency.
e.
Aluminum-based antacids should not be used in patients with renal failure on
dialysis.
f.
Sodium content may affect patients with hypertension, congestive heart failure, or
renal failure.
i.
Antidiarrheals, MOA of loperamide
Loperamide (Imodium) binds to opioid receptors and slows gastric
motility.
ii.
Antiemetics (which to use in pediatrics)
Dimenhydrinate (Dramamine) and
diphenhydramine
(Benadryl) can be used to treat nausea in children
over 2 years old
Ranitidine (zantac)and famotidine (Pepcid) use approved in children
(H2RAS) for ulcers
g.
Chapter 34 Gastroesophageal Reflux and Peptic Ulcer Disease

i.
MOA of drugs, side effects, , steps in therapy
Step 1
h.
Lifestyle modifications and over-the-counter antacids or
H
2
blockers
Step 2
i.
H. pylori
testing
j.
Treatment with PPIs
Step 3
k.
Treatment for
H. pylori
All regimens include a PPI plus antibiotics to treat H. pylori.
Triple therapy: PPI plus
Clarithromycin: 500 mg twice daily, or
Metronidazole: 500 mg twice daily
Amoxicillin: 1 gm twice daily
Treat for 10 to 14 days.
Quadruple therapy: PPI plus
Metronidazole: 250 mg four times/day
Tetracycline: 500 mg four times/day
Bismuth subsalicylate: 525 mg four times/day
Treat for 14 days.


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- Fall '16
- Christy McCall
- Pharmacology, Pregnancy category, partial agonist, long-acting beta agonists, long-acting beta agonist, NSG 6005 , Nursing Pharmacology Antibiotic Exam