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Clin Med III > Cardiac Medications > Flashcards

Cardiac Medications Flashcards

1
Q

What are pharmacokinetics?

A
  • how drug is absorbed
  • how it is delivered to target site
  • how it is metabolized
  • how it is excreted
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2
Q

What are pharmacodynamics?

A
  • drugs specific action
  • clinical effects
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3
Q

What are parenteral routes?

A
  • injection
  • sublingual
  • inhalation
  • transdermal
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4
Q

What is parenteral distribution route?

A
  • non gastrointestinal absorption
  • fast acting
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5
Q

What are the enteral routes?

A
  • oral
  • rectal
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6
Q

What are enteral distribution routes?

A
  • gastrointestinal system
  • convenient & most common
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7
Q

Where can drug receptors be located?

A
  • ANS
  • kidney
  • smooth muscle
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8
Q

What organ provides the major excretory function for cardiovascular drugs?

A

kidneys

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9
Q

Do children or adults metabolize drugs quicker?

A

children

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10
Q

Why are the elderly more susceptible to overdose toxicity?

A

metabolism in elderly is slower

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11
Q

What medications are included in Class I Antiarrhytmics: Sodium Channel Blockers?

A
  • Lidocaine
  • Rhythmol
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12
Q

What class of medications does Lidocaine belong in?

A

Class I Antiarrhythmics: Sodium Channel Blockers

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13
Q

What is the action of Lidocaine?

A

slow myocardial conduction (shorter refractory period)

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14
Q

What are the adverse effects of Lidocaine?

A
  • Dizziness*
  • CNS disturbances*
  • aggravation of some arrhythmias
  • visual disturbances
  • nausea
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15
Q

When is Lidocaine used?

A
  • Acute PVC
  • Ventricular arrhythmia with MI
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16
Q

What is the action of Rhythmol?

A

slow repolarization

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17
Q

What are the adverse effects of Rhythmol?

A
  • arrhythmogenic during exercise
  • defibrillation problems
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18
Q

When is Rhythmol used?

A
  • VT
  • PVC
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19
Q

What class of drugs does Rhythmol belong to?

A

Class I Antiarrhythmics: Sodium Channel Blockers

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20
Q

What doe Beta 1 receptors have an affinity for?

A
  • Epinephrine
  • Norepinephrine
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21
Q

What does it mean if a beta blocker is non-selective?

A

Will block beta 1 & beta 2 receptors

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22
Q

Are the medications, Propranolol (Propranolol, Inderol), Carvedilol selective or non-selective beta blockers?

A

Nonselective

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23
Q

What class of drugs does Propranolol (Propranolol, Inderol), Carvedilol belong to?

A

Class II Anti-arrhythmics: Beta Blockers

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24
Q

When are Propranolol (Propranolol, Inderol), Carvedilol used?

A
  • angina
  • HTN
  • arrhythmias
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25
Q

What is the action of Propranolol (Propranolol, Inderol), Carvedilol?

A

slow down conduction through the myocardium, and cause smooth muscle relaxation

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26
Q

What are the adverse effects of Propranolol (Propranolol, Inderol), Carvedilol?

A
  • may decrease CO*
  • bradycardic dysrhythmias*
  • bronchospasm *
  • cold extremities *
  • masking of hypoglycemia *
  • fatigue
  • insomnia
  • shown to decrease HDL levels
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27
Q

What class of drugs does Metoprolol (Lopressor), Atenolol belong to?

A

Class II Anti-arrhytmics: Beta Blockers

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28
Q

When is Metoprolol (Lopressor), Atenolol used?

A
  • angine
  • HTN
  • arrhythmias
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29
Q

Are Metoprolol (Lopressor), Atenolol selective or nonselective?

A

Selective

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30
Q

What is the action of Metoprolol (Lopressor), Atenolol?

A

slow down conduction through the myocardium, and cause smooth muscle relaxation

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31
Q

What are the adverse effects of Metoprolol (Lopressor), Atenolol?

A
  • same as nonselective, but fewer peripheral side effects because only active at beta 1 receptors
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32
Q

Which receptor are selective beta blockers active at?

A

Beta 1 receptors

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33
Q

What class of drugs does Amiodarone belong to?

A

Class III Antiarrhythmics

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34
Q

When is Amiodarone used?

A

ventricular arrhythmias

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35
Q

What is the action of Amiodarone?

A

prolong repolarization to slow and stabilize HR

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36
Q

What are the adverse effects of Amiodarone?

A
  • Pulmonary toxicity
  • liver damage
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37
Q

When is Sublingual Nitroglycerine, Nitrolingual Spray used?

A

acute chest pain/rescue

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38
Q

What is the action of Sublingual Nitroglycerine, Nitrolingual Spray?

A

smooth muscle relaxation

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39
Q

What are the adverse effects of Sublingual Nitroglycerine, Nitrolingual Spray?

A
  • ischemic headache*
  • hypotension*
  • may induce bronchospasm in some people
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40
Q

What type of medication is Transderm Nitro, Nitrodisc, Nitrodur?

A

Nitro Patch

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41
Q

What type of medication is Nitrol?

A

Nitro Ointment

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42
Q

What is the use Nitro patches of Ointment?

A

prevention of CP/angina

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43
Q

What is the action of Nitro patches of ointment?

A

smooth muscle relaxation

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44
Q

What are the adverse effects of Nitro Patches of Ointments?

A
  • hypotension*
  • Drug tolerance may occur with continuous use*
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45
Q

What medications are thrombolytic agents?

A
  • Streptokinase
  • Recombinant tPA
  • Retovase
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46
Q

What class of drugs does Streptokinase, Recombinant tPA, Retovase belong to?

A

Thrombolytic agents

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47
Q

What is the action of Streptokinase?

A

cause clot dissolution

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48
Q

What are the adverse effects of Streptokinase?

A

Hemorrhage

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49
Q

When is Streptokinase used?

A

acute MI to re-establish coronary blood flow

50
Q

What is the action of Recombinant tPA, Retovase?

A

Cause clot dissolution

51
Q

What is the adverse effect of Recombinant tPA, Retovase?

A

hemorrhage

52
Q

When is Recombinant tPA, Retovase used?

53
Q

What class does Heparin belong to?

A

Anticoagulants

54
Q

What is Heparin used for?

A

prevent & treat thromboembolism

55
Q

What is the action of Heparin?

A

inhibit clot formation

56
Q

What are the adverse effects of Heparin?

A
  • Hemorrhage*
  • hemarthosis
57
Q

Is Heparin used long or short term? How is it administered?

A
  • Used short term
  • Given via IV or subcutaneous shot
58
Q

What is the use of Coumadin?

A

prevent & treat thromboembolism

59
Q

What is the action of Coumadin?

A

blocks vitamin K & other clotting agents

60
Q

What class of drugs does Coumadin belong to?

A

Anticoagulants

61
Q

What are the adverse effects of Coumadin?

A
  • Hemorrhage*
  • hemarthosis
62
Q

Is Coumadin used long or short term?

A

Long term instead of Heparin

63
Q

What is the normal value of Prothrombin time (PT)?

A

12-15 seconds

64
Q

What does Prothrombin time (PT) measure?

A

extrinsic & pathway means of clotting

65
Q

What is the normal value of Partial thromboplastin time (PTT)?

A

30-70 seconds

66
Q

What does Partial thromboplastin time measure?

A

intrinsic & pathway means of clotting

67
Q

What is the normal value of International normalized ration (INR) for prophylactic treatment?

68
Q

What does International normalized ratio measure?

A

difference between PTT & PT

69
Q

With what medications must clotting times be measured to insure proper dosing?

A
  • Heparin
  • Coumadin
70
Q

What is the action of Lovenox, Xarelto, Eliquis?

A

de-activates thrombin to prevent fibrin clot

71
Q

What are the adverse effects of Lovenox, Xarelto, Eliquis?

A

small chance of hemorrhage

72
Q

When is Lovenox, Xarelto, Eliquis used?

A

prevent & treat thromboembolism

73
Q

Why is PT & INR not needed with Lovenox, Xarelto, Eliquis?

A

the medication does not affect clotting times

74
Q

When is Aspirin (ASA), Plavix, Effient used?

A

prevent clot formation

75
Q

What is the action of Aspirin (ASA), Plavix, Effient?

A

prohibit platelet induced thrombus

76
Q

What is the adverse effects of Aspirin (ASA), Plavix, Effient?

A

mild gastric irritation

77
Q

What class of drugs does Cardizem, Procardia, Cardene, Verapimil belong to?

A

Calcium Channel Blockers

78
Q

When are Cardizem, Procardia, Cardene, Verapimil used?

A
  • HTN*
  • Myocardial ischemia*
  • Coronary artery spasm*
  • angina
  • atrial tachycardia
  • diastolic dysfunction
79
Q

What is the action of Cardizem, Procardia, Cardene, Verapimil?

A

inhibit calcium influx into cardiac & smooth muscle, prevents vasoconstriction, reduces myocardial contractility, and slows conduction

80
Q

What are the adverse effects of Cardizem, Procardia, Cardene, Verapimil?

A
  • bradycardia*
  • orthostatic hypotension*
  • peripheral edema
81
Q

What class of drugs does the medication Lasix belong to?

82
Q

When is Lasix used?

A
  • CHF
  • Hypertension
  • Other peripheral edema
83
Q

What is the action of Lasix?

A

increase renal excretion of fluid & electrolytes

84
Q

What are the adverse effects of Lasix?

A
  • hypokalemia*
  • fluid depletion that may cause ectopic arrhythmias*
  • hypotension*
  • gastric disturbances
85
Q

What does a positive inotropic effect do?

A

increase myocardial contraction force

86
Q

What does a dromotropic effect do?

A

slows conduction at AV node to allow increased filling time

87
Q

What class of drugs does Digitalis, Digoxin belong to?

A

Cardiac glycosides

88
Q

When is Digitalis, Digoxin used?

A
  • CHF
  • Atrial arrhythmia
  • a - fib secondary to AV node delay
89
Q

What is the action of Digitalis, Digoxin?

A

improve myocardial contractility by increase calcium concentrations, reducing end diastolic pressure, decrease AV nodal conduction to allow greater filling time

90
Q

What are the adverse effects of Digitalis, Digoxin?

A
  • digitalis toxicity*
91
Q

What is digitalis toxicity?

A
  • GI disturbances
  • CNS disturbances
  • fatigue
  • ST segment depression
  • arrhythmia*
  • PVCs*
  • VT
  • bradycardia
92
Q

What class of drugs does the medication Dobutamine, Dopamine belong to?

A

sympathetic stimulators

93
Q

When is Dobutamin, Dopamine used?

A

post cardiac event

94
Q

What is the action of Dobutamin, Dopamine?

A
  • prolong the effect of sympathetic action
  • increase myocardial contraction & BP
95
Q

What is the adverse effects of Dobutamin, Dopamine?

A
  • CP
  • Feelings of dyspnea*
96
Q

What is the specific action of Dopamine?

A
  • increase CO & BP
  • good for CHF with resultant hypotension
97
Q

What is the specific action of Dobutamine?

A
  • increases Ca+ in cell
  • increases SA node firing, AV node conduction & contractility
98
Q

Why is it important to wean patients off Dopamine, Dobutamine quickly?

A

they cause receptor desensitization

99
Q

What do venodilators do?

A
  • reduce preload by decreasing volume to increase length tension relationships
  • nitrates
100
Q

What do arteriodilators do?

A
  • reduce afterload
  • hydralazine
101
Q

What class of drugs does the medication Hydralazine belong to?

A

vasodilators

102
Q

When is Hydralazine used?

103
Q

What is the action of Hydralazine?

A

direct vasodilation to decrease peripheral resistance

104
Q

What are the adverse effects of Hydralazine?

A
  • orthostatic hypotension*
  • increase HR
105
Q

What do ACE Inhibitors do?

A
  • Angiotensin converting enzyme inhibitors
  • in CHF, blood flow to kidneys stimulates release of renin
  • Renin initiates a chain of events, which ultimately results in the body absorbing increasing amounts of fluid
  • the fluid overloads just exacerbated CHF
  • Ace Inhibitors block this process
106
Q

What class of drugs does Vasotec, Accupril, Lisinopril belong to?

A

ACE Inhibitors

107
Q

When is Vasotec, Accupril, Lisinopril used?

A
  • CHF*
  • HTN*
  • ventricular remodeling (after acute event)
  • patients w/o failure but have low EF (<40%)
108
Q

what is the action of Vasotec, Accupril, Lisinopril?

A

inhibit vasoconstriction and water and Na+ retention

109
Q

What are the adverse effects of Vasotec, Accupril, Lisinopril?

A
  • minor GI disturbances*
  • Minor skin rashes*
  • Minor dry mouth*
110
Q

What class of drugs does the medication Avapro, Cozar belong to?

A

Angiotensin II Receptor Blockers (ARBS)

111
Q

When is Avapro, Cozar used?

A
  • HTN*
  • CHF*
  • can prevent kidney failure in patients with DM
112
Q

What is the action of Avapro, Cozar?

A
  • angiotensin II causes blood vessels to constrict
  • ARBS block binding at those receptors so vessel will dilate or at least not constrict
113
Q

What are the adverse effects of Avapro, Cozar ?

A
  • cough
  • hyperkalemia
  • low BP
  • dizziness
  • headache
  • drowsiness
114
Q

What must a patient on Angiotensin II Receptor Blockers need to be cautious of?

A

Potassium intake so they do not end up hyperkalemic

115
Q

What class of drugs does the medications Niacin, Pravastatin, Atorvastatin belong to?

A

Reductase inhibitors

116
Q

When is Niacin used?

A

to lower LDL’s & triglycerides

117
Q

What is the action of Niacin?

A

decreases LDL synthesis

118
Q

What are the adverse effects of Niacin?

A

cutaneous vasodilation

119
Q

When is Pravastatin, Atorvastatin used?

A

To lower cholesterol

120
Q

What is the action of Pravastatin, Atorvastatin?

A

decrease production of LDL

121
Q

What are the adverse effects of Pravastatin, Atorvastatin?

A
  • mild GI disturbance*
  • Mino myalgia

Clin Med III (5 decks)

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