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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
What is the action of Propranolol (Propranolol, Inderol), Carvedilol?
slow down conduction through the myocardium, and cause smooth muscle relaxation
26
What are the adverse effects of Propranolol (Propranolol, Inderol), Carvedilol?
- may decrease CO* - bradycardic dysrhythmias* - bronchospasm * - cold extremities * - masking of hypoglycemia * - fatigue - insomnia - shown to decrease HDL levels
27
What class of drugs does Metoprolol (Lopressor), Atenolol belong to?
Class II Anti-arrhytmics: Beta Blockers
28
When is Metoprolol (Lopressor), Atenolol used?
- angine - HTN - arrhythmias
29
Are Metoprolol (Lopressor), Atenolol selective or nonselective?
Selective
30
What is the action of Metoprolol (Lopressor), Atenolol?
slow down conduction through the myocardium, and cause smooth muscle relaxation
31
What are the adverse effects of Metoprolol (Lopressor), Atenolol?
- same as nonselective, but fewer peripheral side effects because only active at beta 1 receptors
32
Which receptor are selective beta blockers active at?
Beta 1 receptors
33
What class of drugs does Amiodarone belong to?
Class III Antiarrhythmics
34
When is Amiodarone used?
ventricular arrhythmias
35
What is the action of Amiodarone?
prolong repolarization to slow and stabilize HR
36
What are the adverse effects of Amiodarone?
- Pulmonary toxicity - liver damage
37
When is Sublingual Nitroglycerine, Nitrolingual Spray used?
acute chest pain/rescue
38
What is the action of Sublingual Nitroglycerine, Nitrolingual Spray?
smooth muscle relaxation
39
What are the adverse effects of Sublingual Nitroglycerine, Nitrolingual Spray?
- ischemic headache* - hypotension* - may induce bronchospasm in some people
40
What type of medication is Transderm Nitro, Nitrodisc, Nitrodur?
Nitro Patch
41
What type of medication is Nitrol?
Nitro Ointment
42
What is the use Nitro patches of Ointment?
prevention of CP/angina
43
What is the action of Nitro patches of ointment?
smooth muscle relaxation
44
What are the adverse effects of Nitro Patches of Ointments?
- hypotension* - Drug tolerance may occur with continuous use*
45
What medications are thrombolytic agents?
- Streptokinase - Recombinant tPA - Retovase
46
What class of drugs does Streptokinase, Recombinant tPA, Retovase belong to?
Thrombolytic agents
47
What is the action of Streptokinase?
cause clot dissolution
48
What are the adverse effects of Streptokinase?
Hemorrhage
49
When is Streptokinase used?
acute MI to re-establish coronary blood flow
50
What is the action of Recombinant tPA, Retovase?
Cause clot dissolution
51
What is the adverse effect of Recombinant tPA, Retovase?
hemorrhage
52
When is Recombinant tPA, Retovase used?
acute MI
53
What class does Heparin belong to?
Anticoagulants
54
What is Heparin used for?
prevent & treat thromboembolism
55
What is the action of Heparin?
inhibit clot formation
56
What are the adverse effects of Heparin?
- Hemorrhage* - hemarthosis
57
Is Heparin used long or short term? How is it administered?
- Used short term - Given via IV or subcutaneous shot
58
What is the use of Coumadin?
prevent & treat thromboembolism
59
What is the action of Coumadin?
blocks vitamin K & other clotting agents
60
What class of drugs does Coumadin belong to?
Anticoagulants
61
What are the adverse effects of Coumadin?
- Hemorrhage* - hemarthosis
62
Is Coumadin used long or short term?
Long term instead of Heparin
63
What is the normal value of Prothrombin time (PT)?
12-15 seconds
64
What does Prothrombin time (PT) measure?
extrinsic & pathway means of clotting
65
What is the normal value of Partial thromboplastin time (PTT)?
30-70 seconds
66
What does Partial thromboplastin time measure?
intrinsic & pathway means of clotting
67
What is the normal value of International normalized ration (INR) for prophylactic treatment?
2-3 ng/L
68
What does International normalized ratio measure?
difference between PTT & PT
69
With what medications must clotting times be measured to insure proper dosing?
- Heparin - Coumadin
70
What is the action of Lovenox, Xarelto, Eliquis?
de-activates thrombin to prevent fibrin clot
71
What are the adverse effects of Lovenox, Xarelto, Eliquis?
small chance of hemorrhage
72
When is Lovenox, Xarelto, Eliquis used?
prevent & treat thromboembolism
73
Why is PT & INR not needed with Lovenox, Xarelto, Eliquis?
the medication does not affect clotting times
74
When is Aspirin (ASA), Plavix, Effient used?
prevent clot formation
75
What is the action of Aspirin (ASA), Plavix, Effient?
prohibit platelet induced thrombus
76
What is the adverse effects of Aspirin (ASA), Plavix, Effient?
mild gastric irritation
77
What class of drugs does Cardizem, Procardia, Cardene, Verapimil belong to?
Calcium Channel Blockers
78
When are Cardizem, Procardia, Cardene, Verapimil used?
- HTN* - Myocardial ischemia* - Coronary artery spasm* - angina - atrial tachycardia - diastolic dysfunction
79
What is the action of Cardizem, Procardia, Cardene, Verapimil?
inhibit calcium influx into cardiac & smooth muscle, prevents vasoconstriction, reduces myocardial contractility, and slows conduction
80
What are the adverse effects of Cardizem, Procardia, Cardene, Verapimil?
- bradycardia* - orthostatic hypotension* - peripheral edema
81
What class of drugs does the medication Lasix belong to?
Diuretics
82
When is Lasix used?
- CHF - Hypertension - Other peripheral edema
83
What is the action of Lasix?
increase renal excretion of fluid & electrolytes
84
What are the adverse effects of Lasix?
- hypokalemia* - fluid depletion that may cause ectopic arrhythmias* - hypotension* - gastric disturbances
85
What does a positive inotropic effect do?
increase myocardial contraction force
86
What does a dromotropic effect do?
slows conduction at AV node to allow increased filling time
87
What class of drugs does Digitalis, Digoxin belong to?
Cardiac glycosides
88
When is Digitalis, Digoxin used?
- CHF - Atrial arrhythmia - a - fib secondary to AV node delay
89
What is the action of Digitalis, Digoxin?
improve myocardial contractility by increase calcium concentrations, reducing end diastolic pressure, decrease AV nodal conduction to allow greater filling time
90
What are the adverse effects of Digitalis, Digoxin?
- digitalis toxicity*
91
What is digitalis toxicity?
- GI disturbances - CNS disturbances - fatigue - ST segment depression - arrhythmia* - PVCs* - VT - bradycardia
92
What class of drugs does the medication Dobutamine, Dopamine belong to?
sympathetic stimulators
93
When is Dobutamin, Dopamine used?
post cardiac event
94
What is the action of Dobutamin, Dopamine?
- prolong the effect of sympathetic action - increase myocardial contraction & BP
95
What is the adverse effects of Dobutamin, Dopamine?
- CP - Feelings of dyspnea*
96
What is the specific action of Dopamine?
- increase CO & BP - good for CHF with resultant hypotension
97
What is the specific action of Dobutamine?
- increases Ca+ in cell - increases SA node firing, AV node conduction & contractility
98
Why is it important to wean patients off Dopamine, Dobutamine quickly?
they cause receptor desensitization
99
What do venodilators do?
- reduce preload by decreasing volume to increase length tension relationships - nitrates
100
What do arteriodilators do?
- reduce afterload - hydralazine
101
What class of drugs does the medication Hydralazine belong to?
vasodilators
102
When is Hydralazine used?
- HTN - CHF
103
What is the action of Hydralazine?
direct vasodilation to decrease peripheral resistance
104
What are the adverse effects of Hydralazine?
- orthostatic hypotension* - increase HR
105
What do ACE Inhibitors do?
- 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
What class of drugs does Vasotec, Accupril, Lisinopril belong to?
ACE Inhibitors
107
When is Vasotec, Accupril, Lisinopril used?
- CHF* - HTN* - ventricular remodeling (after acute event) - patients w/o failure but have low EF (<40%)
108
what is the action of Vasotec, Accupril, Lisinopril?
inhibit vasoconstriction and water and Na+ retention
109
What are the adverse effects of Vasotec, Accupril, Lisinopril?
- minor GI disturbances* - Minor skin rashes* - Minor dry mouth*
110
What class of drugs does the medication Avapro, Cozar belong to?
Angiotensin II Receptor Blockers (ARBS)
111
When is Avapro, Cozar used?
- HTN* - CHF* - can prevent kidney failure in patients with DM
112
What is the action of Avapro, Cozar?
- angiotensin II causes blood vessels to constrict - ARBS block binding at those receptors so vessel will dilate or at least not constrict
113
What are the adverse effects of Avapro, Cozar ?
- cough - hyperkalemia - low BP - dizziness - headache - drowsiness
114
What must a patient on Angiotensin II Receptor Blockers need to be cautious of?
Potassium intake so they do not end up hyperkalemic
115
What class of drugs does the medications Niacin, Pravastatin, Atorvastatin belong to?
Reductase inhibitors
116
When is Niacin used?
to lower LDL's & triglycerides
117
What is the action of Niacin?
decreases LDL synthesis
118
What are the adverse effects of Niacin?
cutaneous vasodilation
119
When is Pravastatin, Atorvastatin used?
To lower cholesterol
120
What is the action of Pravastatin, Atorvastatin?
decrease production of LDL
121
What are the adverse effects of Pravastatin, Atorvastatin?
- mild GI disturbance* - Mino myalgia

Clin Med III (5 decks)

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