cardiac meds

Question 1

Ischemic HD -anti ischemic drugs

goals

Answer 1

physio- heart is O2 dependent
patho: myocardium can only func w/o adequte O2 for short period

Pharm: restore balance

Question 2

drugs that decrease myocardial O2 demand

Answer 2

Beta blockers
CCBs
Nitrates

Question 3

Angina (vasodilators)

Answer 3

Nitroglycerin tablets (1-3mins)(first pass effect- bypass liver)
nitro ointmeny (30mins)
patch (30mins)
infusion(immediate)

oral isorbide tablets (60mins)
chewable isorbide tablets (2-5mins)

AEs: HA, dizzy, hypotention -esp w/ sublingual

Question 4

Drugs that increase myocardial O2 supply

Answer 4

-thrombolytic agents
-antiplatelet agents
-anticoags
-CCBs

Question 5

Anti-clotting drugs

Answer 5

-antithrombotics (anti-platelet activity): aspirin, plavix, ticlid

-anticoags(inhibit blood clotting process): IM:Heparin, SQ:Lovenox, PO:Warfarin(INR monitoring)

-thrombolytics(dissolve clot and reopen vessels): need to be admined within 3hrs from occlusion: streptase, eminase, alteplase

AEs: bruising. bleeding

Question 6

HF

Answer 6

physio: positive ionotropes(drugs that increase contractility), negative ionotropes(drugs that decrease contractility)

pharm: diuretics, B blockers, ACE inhibitors, vasodilators, CCBs,
digitalis glycosides-increase Na in heart(TOXIC-monitor pt carefully)
phosphodiesterase-increases Ca in heart

*drugs can only improve QOL

Question 7

Cardiac arrhythmias

types
warning
AEs

Answer 7

Na channel blockers
CCBs
B blockers
drugs that prolong repolarization

warning: monitor when exercising

AEs: triggers different forms of arrhythmia

Question 8

HTN

Answer 8

Diuretics
drugs acting on SNS
vasodilators
drugs acting on RAS
centrally acting drugs

Question 9

Diuretics

Answer 9

-thiazide diuretics (HCTZ)
-loop (furosemide, torsemide)
-K sparing diuretics (amiloride, spirolactones)

Question 10

Vasodilators

Answer 10

-peripheral alpha 1-blockers- ZOSIN
-ACE inhibs -PRIL
-ARBS -AN
-CCBs
-K channel openers
-renin inhibs

Question 11

Cardioinhibitory drugs

Answer 11

BBs -OLOL
CCBs -DIPINE

Question 12

AEs anti-hypertensive drugs

Answer 12

can cause drop BP- results in OH, dizziness, fainting, falls

Question 13

AEs BBs

Answer 13

fatigue, weakness, decreased libido. Respond different during exercise

Question 14

AEs CCBs

Answer 14

swollen ankles, arrhythmias, MI

Question 15

ACE inhibs AEs

Answer 15

persistent dry cough (this is due to them having an allergic reaction to it)

Question 16

Diuretics AEs

Answer 16

electrolyte imbalance -confusion, dizziness, unreasonably fatigue and dehydration

Question 17

OH

Answer 17

more fx in older HTN pts with DM, taking diuretics, vasodilators, and some psychotropic drugs

Question 18

HTN women

Answer 18

oral contras- increase BP, HRT does not raise BP
pregnant women- a lot of meds cannot be given if ACEI or ARBs

Question 19

Lipid disorders

Answer 19

-elevated cholesterol levels- esp LDL are associated w/ premature coronary disease

TLC

drugs for this disorder- many AEs
Statins*, bile sequestrants

Question 20

Statins

Answer 20

mechan: inhibit LDL synthesis, increase LDL catabolism

AEs: constip, diarrhea, heartburn, stomach pain, dizzy, HA, hapetotox, myopathy/renal dysfunc, neuropathy, liver failure

Question 21

Lower cholesterol natural products

Answer 21

fish oils
flaxseed
garlic
oat bran
psyllium
red yeast (very effective)
soy

Question 22

DM mx

Answer 22

safe exercise program (avoid hypoglycemia)
knowledge of insulin
remind not to inject insulin into muscle related to exercise

SQ, PO
AEs: hypoglycemia, coma, death

Question 23

DM sxs, classification

Answer 23

sxs: polyuria, polydipsia, polyphagia

class: 1,2, gestational