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Pharm Exam 2 > Cardiac Pharm > Flashcards

Cardiac Pharm Flashcards

1
Q

an example of thiazide diuretics

A

hydrochlorothiazide

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2
Q

MOA of thiazide diuretics

A

Blocks Na+APTase pumps in upper end of ascending loop of Henle and first segment distal tubule. This will prevent sodium from being pumped out of the filtrate. Water will follow the sodium and be excreted as urine. **may cause hypokalemia.

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3
Q

an example of loop diuretics

A

furosemide

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4
Q

MOA of loop diuretics

A

Blocks NA+ATPase pumps along the entire length of ascending loop of Henle; most powerful class of diuretics. **may cause hypokalemia

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5
Q

an example of potassium-sparing diuretic

A

amiloride and/or eplerenone

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6
Q

MOA of potassium-sparing diuretics

A

inhibits the Na+ATPase pumps that are indirectly linked to K+/H+ exchange in the distal tubule

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7
Q

MOA of eplerenone

A

An aldosterone receptor ANTAGONIST. Aldosterone promotes water and Na retention. Blocking an aldosterone receptor leads to diuresis.

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8
Q

an example of an osmotic diuretic

A

mannitol

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9
Q

MOA of osmotic diuretic

A

Pulls water into vasculature for elimination via osmosis. Does not depend on BP.

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10
Q

an example of a carbonic anhydrase inhibitor

A

acetazolamide

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11
Q

Examples of vasodilators (hint: there are 4)

A

Verapamil
Hydralazine
Nitric Oxide
Nitroprusside

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12
Q

MOA of verapamil

A

calcium channel blocker

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13
Q

MOA of hydralazine

A

K+ channel blocker and myosin light chain phosphatase activator

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14
Q

MOA of Nitric Oxide

A

guanylyl cyclase, myosin light chain phosphatase activator

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15
Q

What is myosin light chain phosphatase?

A

A substance that DEPHOSPHORALATES the cardiac cell, causing it to relax

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16
Q

What medications are specifically effective in African American patients with htn and HF

A

hydralazine and nitrates

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17
Q

ACE Inhibitor examples

A

Aliskiren, captopril and lisinopril

18
Q

Example of an Angiotensin II receptor blocker (ARB)

A

losartan

19
Q

How do ACE inhibitors and ARBs work?

A

By interfering with the RAAS, causing the body to excrete more urine and decrease blood volume to assist in BP management

20
Q

Advantage of ACE inhibitors

A

inhibition of ACE reduces the risk of cardiovascular mortality in hypertensive patients. Are NOT contraindicated with patients who have asthma. Will not cause orthostatic hypotension

21
Q

examples of antianginal drugs

A

propranolol and nitroglycerin

22
Q

MOA of nitroglycerin

A

Nitroglycerine gets converted to nitric oxide which is a potent vasodilator in the coronary arteries which increases the supply of oxygen.

23
Q

two medications that can be used in the treatment of cardiac arrest

A

epinephrine and isoproterenol

24
Q

How do epinephrine and isoproterenol act to treat cardiac arrest

A

they act as beta1 agonists in cardiac tissue, increase the SNS activity of the sinoatrial node that can induce myocardial systole (contractions)

25
Q

what medication prevents the spread of necrosis during an MI

A

propranolol

26
Q

how does propranolol prevent spread of necrosis in an MI

A

propranolol acts as a beta1 antagonist which reduces heart rate, reduces work of the heart, reduces anoxia, and reduces the spread of necrosis

27
Q

Another treatment to prevent necrosis, other than propranolol?

A

treat with fibrolytic drugs that dissolve blood clots (ex. TPA)

28
Q

Examples of fibrolytic drugs

A

TPA, streptokinase and urokinase

29
Q

MOA of TPA, streptokinase and urokinase

A

enzymes that catalyze plasmin formation within a clot that leads to fibrolysis… puts pt at risk for widespread bleeding

30
Q

What medication is used to treat dysrhythmias?

A

amiodarone

31
Q

MOA of amiodarone

A

amiodarone is a class III potassium channel blocker that is used to control atrial fibrillation and ventricular tachycardia caused by ectopic foci; its effects are also mediated by inhibition of sodium and calcium channels

32
Q

Why is amiodarone a short term treatment?

A

AMIODARONE CAN CAUSE TOXIC LUNG, HEART, AND LIVER DAMAGE

33
Q

Major negative side effect to ace inhibitors and the causation of it

A

ACE inhibitors also inhibit the enzyme that metabolizes the inflammatory mediator bradykinin > bradykinin along the respiratory airway stimulates an inflammatory condition > stimulates mucous secretion > stimulates a chronic cough

34
Q

Pro to bradykinin metabolization

A

bradykinin is beneficial to the heart because it stimulates fibrolysis that reduces the progression of cardiac remodeling > prolonged life in pts with cardiac failure

35
Q

What is the first line of treatment of patients with fluid overload

A

diuretics combines with ace inhibitors and/or arbs

36
Q

MOA of eplerenone

A

aldosterone receptor antagonist

37
Q

Usage of eplerenone

A

reduces symptoms of edema and blocks aldosterone’s role in promoting cardiac remodeling

38
Q

MOA of tolvaptan

A

an oral vasopressin antidiuretic hormone receptor antagonist

39
Q

What does tolvaptan used for

A

it is used to treat hyponatremia/hypervolemia that is secondary to end-stage HF.

40
Q

what drug has a positive inotropic effect on the myocardium

A

digoxin

41
Q

MOA of digoxin

A

it blocks the Sodium-Potassium ATPase pump > more sodium in the cell > Sodium-Calcium ATPase pump to work in overtime, excreting sodium from the cell > more calcium inside of the cell > stronger cardiac contractions

Pharm Exam 2 (3 decks)

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