NSG 222 Focused on PHARM
CARDIAC/ENDOCRINE Test Exam Review
Questions with all Answers verified for
accuracy Updated 2024/2025
Pioglitazone - correct answer anti-diabetic (type ii)/thiazolisinediones
*never w/ hf or pulmonary edema*
Decreases insulin resistance and inhibits hepatic gluconeogenesis.
Adverse effects: fluid retention, headache and weight gain (not hypoglycemia).
*monitor lft's (hepatotoxicity)*
Acarbose - correct answer anti-diabetic (type ii)/alpha-glucosidase inhibitor
Slows down cho breakdown in small intestine to help establish a stable glucose level.
*very well tolerated*
Sitagliptin (januvia) - correct answer anti-diabetic (type ii)/gliptins
Incretin enhancer (intestinal hormone) slows glucose absorption and reduces action of
glucagon. No hypoglycemia risk.
Dulaglutide (trulicity) - correct answer anti-diabetic (type ii)/incretin enhancers
Mimics incretin hormone secreted in intestines: increases insulin secretion, slows
glucose absorption and reduces action of glucagon.
Diruetics (htn) - correct answer increase urine output and decrease fluid volume to
decrease preload and increase co.
Rarely used alone.
Indicated only with evidence of fluid retention.
Thiazide, potassium-sparing and loop.
Always take in morning.
Renin angiotensin and aldosterone (raas) system - correct answer renin (secreted by
kidney with decreased bp and decrease is na+) → converts inactive liver protein
angiotensin to angiotensin i → angiotensin i passes through lungs → converts to
angiotensin ii → causes vasoconstriction = increased bp → signals aldosterone
secretion from adrenal cortex → aldosterone = na+ reabsorption (+ water) in kidneys =
increased bp.
, Ace inhibitors - correct answer antihypertensive/symptomatic heart failure
Blocks angiotensin i → angiotensin ii conversion.
Lower angiotensin ii = decreased peripheral resistance (vasodilation), and decreased
blood volume (decreased aldosterone).
Angiotensin ii receptor blockers (arbs) - correct answer antihypertensive
Blocks action of angiotensin ii = decreased peripheral resistance (vasodilation), and
decreased blood volume (decreased aldosterone).
Calcium channel blockers - correct answer block calcium ion channels in arterial
smooth muscle (limiting muscular contraction) causing vasodilation = decreased
peripheral resistance (afterload) and thus decreased bp.
Good for certain populations who are less responsive to other drug classes.
Adrenergic antagonists - correct answer block effects of norepinephrine (cns) at
adrenergic receptors to inhibit fight or flight response.
Beta1: cardioselective - decrease hr/contractility/co/bp.
Alpha1: blocks receptors in arterioles causing vasodilation.
Direct vasodilators - correct answer cause direct relaxation of vascular smooth muscle.
*reflex tachycardia risk*
*bp drop activates raas* (sodium and water retention risks = blood volume increase).
Use with diuretic (to decrease fluid retention)/beta blocker (to decrease risk of reflex
tachycardia).
Cardiac glycosides - correct answer used in more advanced stages of hf and
combined with other drugs.
Positive inotropic effect (cause the heart to beat more forcefully), improves co.
Narrow safety margin
Severe adverse effects
Requires frequent serum levels
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