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Drugs > Cardiac Week and Noche > Flashcards

Cardiac Week and Noche Flashcards

1
Q

Furosemide Trade name

A

Lasix

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2
Q

Furosemide drug class

A

Diuretic

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3
Q

Furosemide mechanism of action

A

Loop diuretic - main location of action is thick ascending limb of loop of Henle - Block Na+-K+-2Cl transporter in luminal membrane of loop of Henle preventing reabsorption of Na+ from tubular lumen -> decrease Na+ in medullary interstitial -> decreased osmolary gradient -> decreased urine concentration -> decreased H2O retention -> decreased blood volume -> decreased blood pressure

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4
Q

furosemide fx

A
  • diuretic activity SA treat -congestive cardiomyopathy - pulmonary edema -hypercalcuric nephropathy - uremia - adjunct therapy in hyperkalemia - occasionally used as antihypertensive agent Cattle - udder edema Racehorses - reduce EIPH (exercise-induced pulmonary hemorrhage)
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5
Q

furosemide side effects

A
  • fluid and electrolyte abnormalities - prerenal azoetemia - hyponatremia - hypocalcemia -hypokalemia -hypomagnesmia
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6
Q

enalapril trade name

A

Vasotec

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7
Q

enalapril drug class

A

ACE inhibitior

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8
Q

enalapril mechanism of action

A
  • converted by liver to active compound enalprilat which competes with angiotensin I for ACE (angiotensin converting enzyme) (ACE has higher affinity for Enalaprilat than angiotensin I) -> prevents formation angiotensin-II which is a vasoconstrictor - decreased angiotensin-II [] -> decreased aldosterone secretion and plasma renin activity increased - decreases total peripheral resistance, pulmonary vascular resistance, mean arterial and R atrial pressures, and pulmonary capillary wedge pressure - increase renal blood flow and decrease glomerular efferent arteriole resistance
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9
Q

enalapril fx

A
  • adjunctive therapy of heart failure (CHF) - decrease efferent glomerular resistance, reduce proteinuria and have renoprotective effects, can use for adjunct treatment idiopathic glomerular nephritis - CRF (chronic renal failure) - protein-losing nephropathy - hypertension accompanying kindey dx
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10
Q

enalapril side effects

A
  • GI distress - weakness - hypotension - renal dysfx - hyperkalemia - can cause coughs
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11
Q

Diltiazem trade name

A

Cardizem, Dilt-cd

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12
Q

Diltiazem Drug class

A

Ca2+ channel blocker

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13
Q

Diltiazem Mechanism of Action

A

binds to L-type Ca2+ channels preventing Ca2+ entry into cell -> inhibit cardiac and vascular smooth muscle contractility dilating main systemic and coronary artieries; TPR, BP, cardiac afterload all = reduced - Slows AV node conduction and prolongs refractory time

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14
Q

Diltiazem fx

A
  • termination for supra ventricular(atrial) tachycardia - suppress atrial premature complexes -> a-fib - decrease ventricular rate associated with atrial fibrillation
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15
Q

Diltiazem side effects

A
  • bradycardia - hypotension - GI disturbances
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16
Q

Pimobendan trade name

A

Vetmedin

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17
Q

Pimobendan drug class

A

inodilator

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18
Q

pimobendan mechanism of action

A
  • inhibition of phosphodiesterase III (PDE III) -> increased inotropy and arteriodilation - increases intracellular Ca2+ sensitivity on troponin C making -> enhancement cardiac contractility w/o inc in myocardial O2 consumption bc does not increase intracellular Ca2+ levels (Ca2+ sensitization -> increased ionotrophy)
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19
Q

pimobendan fx

A
  • treat CHF secondary to DCM or chronic mitral valve insufficiency in dogs or myxomatous/ degernative mitral valve dx
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20
Q

pimobendan side effects

A
  • GI - may inc development of arrhtymias
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21
Q

Spironolactone trade name

A

aldactone

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22
Q

spironolactone drug class

A

Mineralocorticoid antagonist

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23
Q

spironolactone mechanism of action

A

competitively binds mineralocorticoid receptor -> release heat shock protein 90 -> inhibits production of aldosterone-induced proteins and blocks effects of aldosterone ie -> dec Na+ uptake b/c aldosterone normally increases synthesis of lumina Na+ channels and increases K+ channels increasing K+ secretion driving force secondary to Na+ secretion so if inhibit aldosterone inhibit the luminal Na+ channels and in turn inhibit that secondary K+ secretion ** At low doses does not have diuretic effects**

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24
Q

spironolactone fx

A
  • CHF patients not responding to furosemide and ACE inhibitors adequately - K+ sparing diuretic (use in CHF if hypokalemic) - treatment of ascites
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25
Q

spironolactone side effects

A

-GI - dehydration - hyperkalemia

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26
Q

albuterol trade name

A

proventil, accuneb

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27
Q

albuterol drug class

A

beta 2 adrenergic agonist

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28
Q

albuterol mechanism of action

A

stimulates production of cAMP by activation of adenyl cyclase via Gs -> relaxation bronchial, uterine, and vascular smooth muscle; beta 2 adrenergic agonist

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29
Q

albuterol fx

A

alleviate brochospasm or cough

30
Q

albuterol side effects

A
  • inc HR - tremors - CNS excitement (nervousness) - dizziness - decreased serum K+ values possible
31
Q

epinephrine trade name

A

Adrenaclick, EpiPen, Twinject, Medihaler-Epi

32
Q

epinephrine drug class

A

hormone and adrenergic agonist

33
Q

epinephrine mechanism of action

A

endogenous adrenergic agent w/ alpha and beta activity -> - relaxation smooth muscle in bonchi and iris - antagonizes effects histamine - inc glycogenolysis - raise blood sugar - give rapidly IV -> inc systolic BP - give slow IV -> modest rise systolic pressure and dec diastolic pressure - dec TPR bc beta effects

34
Q

epinephrine fx

A

From notes: - cardiac arrest/ heart block - acute anaphylactic reactions (counteract hypotension and bronchospasm) - combine with local anesthetics to retard removal of anesthetics - control bleeding (apply topically) -treatment for anaphylaxis or cardiac resuscitation - can add to local anestetics to retard systemic absorption and prolong effect

35
Q

epinephrine side effects

A
  • anxiety - tremor - excitablity - V+ - hypertension (overdose) - arrhythmias - hyperuricemia (excess of uric acid in blood) - lactic acidosis (buildup of lactate in body) - EPINEPHRINE REVERSAL IF GIVEN W/ ALPHA ADRENERGIC ANTAGONISTS (will -> dec BP not inc)
36
Q

isoproterenol trade name

A

isuprel, medihaler-iso

37
Q

isoproterenol drug class

A

beta adrenergic agonist

38
Q

isoproterenol mechanism of aciton

A

B1 and B2 adrenergic agonist; isoproterenol stimulates B-adrenergic receptors of intracellular adenyl cyclase which catalyzes conversion of adenosine triphosphate to cAMP -> inc cAMP levels-> -inc inotropism and chronotropism, - relax bronchial smooth muscle - peripheral vasodilation - +/- inc perfusion to skeletal muscle

39
Q

isoproterenol fx

A

From lecture: - cardiac arrest/ heart block From plumbs: - treat acute bronchial constriction - treat cardiac arrhythmias (complete AV block) - occasionally used as adjunctive therapy in shock of HF

40
Q

isoproterenol side effects

A
  • tachycardia - anxiety - tremors - excitablity - headache - weakness - V=
41
Q

norepinephrine trade name

A

levophed

42
Q

norepinephrine drug class

A

neurotransmitter and adrenergic agonist

43
Q

norepinephrine mechanism of action

A
  • directly stimulates adrenergic receptors strong affinity for alpha than beta receptors (GPCRs) - also some B1 activity - acts as peripheral vasoconstrictor (a) and inotropic cardiostimulant and coronary artery dilator (b) -> TPR inc -> inc BP - high doses can -> decreased perfusion to vital organs, skin, and skeletal muscle
44
Q

norepinephrine fx

A
  • treat profound hypotension (especially septic shock or post-cardiac arrest hypotension due to vasodilation) - cardiac stimulant, raise BP
45
Q

norepinephrine side effects

A
  • if used w/o blood volume replacement can -> dec renal perfusion and urine output, poor systemic blood flow despite “normal” pressure - arrhythmias - seizures
46
Q

phenylephrine trade name

A

phenylephrine

47
Q

phenylephrine drug class

A

alpha adrenergic agonist

48
Q

phenylephrine mechanism of action

A
  • a1 seletive - predominantly post-synaptic alpha-adrenergic effects at therapeutic doses Act through Gq which activates PLC -> formation IP3 and DAG -> increased cytosolic Ca2+ -> contraction -> - vasoconstriction -> inc in diastolic and systolic BP - small dec in cardiac output - increase in circulation time
49
Q

phenylephrine fx

A

decongestion fo mucous membranes (vasoconstriction to reduce nasal fluid in hay fever, sinusitis, rhinitis) treatment of hypotension w/o overt cardiostimulation

50
Q

phenylephrine side effeects

A
  • can have B effects at high doses (bradycardia) - CNS effects (excitement, restlessness, headache) - arrhythmia - hypertension
51
Q

prazosin trade name

A

minipress

52
Q

prazosin drug class

A

alpha adrenergic antagonist

53
Q

prazosin mechanism of action

A

competitive inhibition of a1-adrenergic receptors -> no stim PLC via Gq so no formation IP3 and DAG so no increase in cytosolic Ca2+ so no contraction -> decrease BP and peripheral vascular resistance; has dilatory effects on arterial and venous side also decreases RA pressure; CO increased in patients with CHF

54
Q

prazosin fx

A
  • treatment CHF (reduce peripheral resistance w/ decrease after load) - treatment of hypertension - pheochromocytoma (catecholamine secreting tumor of adrenal medulla; overcome hypertensive attacks and counteract effects of manipulation of tumor during sx removal usually combine with B blocker) - cardiovascular shock (overcome compensatory vasoconstriction -> decreased tissue perfusion must use in conjunction with adequate fluid therapy) not in notes: - reduce symp tone when treating uretheral obstruction
55
Q

prazosin side effect

A
  • hypotension - CNS (lethargy, dizziness ect.), GI effects
56
Q

propranolol trade name

A

inderal

57
Q

propranolol drug class

A

beta adrenergic antagonist

58
Q

propranolol mechanism of action

A

blocks B1 and B2 receptors in myocardium, bronchi, and vascular smooth m muscle - B1 block -> dec HR dec force contraction and dec AV nodal conduction velocity and dec renin secretion - B2 block -> constriction smooth muscle (vascular, bronchial ect.)

59
Q

propranolol fx

A

-anti arrhythmic agent (supra ventricular and ventricular arrhythmias, v useful w/ v fib) - photochromocytoma (use to manage tachycardia and arrhythmias during sx) - control symptoms hyperthyroidism - treat CHF (not severe or acute) - short term treatment of hypertension

60
Q

propranolol side effects

A
  • bradycardia - lethargy - depression - impaired AV conduction - CHF or worsening HF - hypotension - syncope - diarrhea - hypoglycemia - bronchoconstriction
61
Q

Metoprolol trade name

A

lopressor

62
Q

metoprolol drug class

A

beta 1 adrenergic antagonist

63
Q

metoprolol mechanism of action

A

B1 adrenergic antagonist can block B2 at high dose - negative inotropic and chronotropic actions

64
Q

metoprolol fx

A
  • cardiac arrhythmias (supra ventricular and ventricular) - v fib (type of arrhythmia) - Pheochromatocytoma (manage tachycardia and arrhythmias during sx along w/ a blocker) - Hyperthryroidism - Congestive heart failure (milld to moderate only)
65
Q

metoprolol side effects

A
  • bradycardia - lethargy - depression - impaired AV conduction - CHF - worsening heart failure - hypotension - hypoglycemia - bronchoconstriction - syncope - D+
66
Q

atropine trade name

A

atropine

67
Q

atropine drug class

A

muscarinic antagonist

68
Q

atropine mechanism of action

A

-inhibits acetylcholine and other cholinergic stimulants at postganglionic parasympathetic neuroeffector sites - high dose can block nicotinic receptors at autonomic ganglia and NMJ

69
Q

atropine side effects

A
  • dry mount - increased viscosity of secretions - dysphagia - constipation - V+ - thirst - urinary retention or hesitancy - CNS effects (stimulation, drowsiness, ataxia, seizures, respiratory depression) - Opthamic effects (blurred vision, pupil dilation, cycloplegia, photophobia) - Cardiovascular effects (sinus tachycardia, increased myocardial work, O2 consumption, bradycardia, hypertension, hypotension, arrhythmias, circulatory failure)
70
Q

atropine function

A
  • antidote for organophosphate intoxication - preanesthetic prevent or reduce secretions of respiratory tract - treat sinus bradycardia, sinoatrial arrest, incomplete AV block - differentiate vagally-mediated bradycardia for other causes - antidote for OD cholinergic agents

Drugs (9 decks)

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