3A: Cardiac Meds Flashcards
What is pharmokinetics?
How the drug is absorbed, delivered to the target site, metabolized, and excreted
What is pharmacodynamics?
Drug specific actions and clinical effects
What is a parenteral distribution route, and what are some examples?
Non-GI absorption, fast acting. Injection, sublingual, inhalation, transdermal
What is an enteral distribution route, and what are some examples?
GI system absorption, convenient and most common. Oral and rectal
What are the three locations of drug receptors?
- ANS
- Kidneys
- Smooth muscles
What is major site of excretion for CV drugs?
Kidneys, some liver involvement
What population metabolizes drugs at a faster rate?
Children
How does metabolism change with age?
Slows, makes them more susceptible to overdose toxicity
What is the general description of Class I Antiarrhythmics - Sodium Channel Blockers?
Decrease excitability
What are the two uses of Lidocaine?
- Acute PVC
- Ventricular arrhythmias with MI
What is the action of Lidocaine?
Slow myocardial conduction by decreasing the refractory period
What are the adverse effects of Lidocaine?
Key: dizziness, CNS disturbances
Other: aggravation of some arrhythmias, visual disturbances, nausea
What are the two uses of Rhythmol?
- VT
- PVCs
What is the action of Rhythmol?
Slow repolarization
What are the adverse effects of Rhythmol?
Arrhythmogenic (bradycardia) during exercise and defibrillation problems
Describe Class II Anti-Arrhythmics
Beta Blockers
What are Beta1 receptors?
Sympathetic, have affinity for epi and norepi
What patient should you not use beta blockers for?
Decreased LV function, if their EF is < 35% because you don’t want their HR to drop even lower
What are the non-selective beta blockers?
Propranolol, Inderol, Carvedilol
What do non-selective beta blockers block?
Both Beta1 and Beta2 receptors
What is the use of non-selective beta blockers?
Angina, HTN, and arrhythmias
What is the action of non-selective beta blockers?
Slow down conduction through the myocardium, cause smooth muscle relaxation
What are the adverse effects of non-selective beta blockers?
Decrease CO, cause bradycardiac dysrhythmias, bronchospasm, cold extremities, fatigue, insomnia, making of hypoglycemia. Can decrease HDL levels
What are examples of selective beta blockers?
Lopressor and Atenolol
What is the use of selective beta blockers?
Same as non-selective beta blockers. Angina, HTN, arrhythmias
What is the action of selective beta blockers?
Same as non-selective beta blockers. Slow down conduction through myocardium, cause smooth muscle relaxation
What are the adverse effects of selective beta blockers?
Same as non-seletive, but will have fewer peripheral side effects because are only active at Beta1 receptors
What are Class III Antiarrhythmics used for?
Ventricular arrhythmias
What is Amiodarone used for?
Ventricular arrythmias
What is the action of Amiodarone?
Prolong repolarization to slow and stabilize HR
What are adverse effects of Amiodarone?
Pulmonary toxicity and liver damage
What are examples of oral nitrates?
Sublingual nitroglucerine, nitrolingual spray
What is the use of oral nitrates?
Acute chest pain, rescue med
What is the action of oral nitrates?
Smooth muscle relaxation and vasodilation
What are the adverse effects of oral nitrates?
Ischemic headache, hypotension, may induce bronchospasm
What are examples of nitro patches?
Transderm nitro, Nitrodisc, Nitrodur
What are examples of nitro ointments?
Nitrol
What is the use of topical nitros?
Prevention of CP and angina
What is the action of topical nitros?
Smooth muscle relaxation and vasodilation
What are the adverse effects of nitro topicals?
Hypotension, drug tolerance with continued use
