Cardio Drugs 2

Question 0

Diuretics indication

Answer 0

To correct fluid retention
Monitor JvD
WOF: orthostatic hypotension, hypotension, electrolyte imba
Can use iv, dopamine to inc renal bf, or salt retaining agents(nsaids)

Question 1

Classes of diuretics

Answer 1

Osmotic- mannitol, urea, glycerin
Carbonic anhydrase inhibitor- acetazolamide
Thiazide- hydrochlorthiazide
Loop- furosemide, bumetanide, ethacrynic acid
K-sparing- triamterene, amiloride

Question 2

Site of action of diff diuretics

Answer 2

CAI- PCT
LD- Thick ascending LH
TD- DCT
Ksparing- DCT, CD
OD- all

Question 3

Diuretics cardio effects

Answer 3

Dec blood vol and venous pressure-
dec hydrostatic pressure, capillary fluid filtration, edema
Dec cardiac filling
Dec SV, CO, Arterial pressure

Question 4

Osmotic diuretics

Answer 4

Inc in osmolarity in filtrate
Treat oliguria- reduce cerebral edema, dec icp
Reduce intraocular
Ae- headache, blurred vision

Question 5

Carbonic anhydrase inhibitors

Answer 5

Reduce formation of h ion, thus less na is reabsorbed
Reduce edema, intraocular pressure, alkalinize urine
Ae: cns depresion, bone marrow depression,
For anti convulsant, mountain sickness

Question 6

Thiazide diuretics

Answer 6

Inhibits na, cl reabsorption
Inc excretion of na, k, cl, hco3, water
For chronic edema, htn, chf
Ae: ortho hypo, metabolic alkalosis, dm, hyperuricemia, hypercholesterolemia

Question 7

Loop diuretics

Answer 7

Inhibits co transport of na, k, cl, in the thick ascending loop of henle
Ae hypokalemia hyponatremia, metabolic alkalosis, dose related hearing loss

Question 8

Ksparing diuretics

Answer 8

Aldosterone antag- spirinolactone and elplerenone
Cause na and fluid excretion, Dec K secretion
Triamterene- prevents na reabsorption, inc uric acid levels
Ae- hyperkalemia, metabolic acidosis, git upset

Question 9

Arterial vasodilators

Answer 9

Reduces arterial pressure
Dec peri vasc resist, dec MAP
Inc stroke vol, CO; dec ventricular period, venous pressure

Question 10

Venous vasodilators

Answer 10

Dec preload, CO, proximal capillary hydrostatic pressure, edema

Question 11

Mixed vasodilators

Answer 11

Dec systemic vasc resist, Arterial pressure

Could lead to baroreceptor mediatedreflex stimulation, orthostatic hypotension

Question 12

Hydralazine

Answer 12

PREGNANT
May cause SLE-Like syndrome at doses > 400mg/day
Arthralgia, fever, myalgia, skin rash

Question 13

Minoxidil

Answer 13

Opens Kchannels, stabilizing the membrane

Ae: tachy, palpitations, angina, HYPERTRICHOSIS

Question 14

Nitroprusside

Answer 14

Inc cGMP, mixed dilator, for hypertensive emergencies
Rapid onset, short acting
Ae- cyanide accumulation, PROPHYLAXIS

Question 15

Diazoxide

Answer 15

Arterial vasodilator, opens k channels, for hypertensive emergencies
Ae- excessive hypotension, reflex tachy
Precaution for ischemic heart disease

Question 16

Nitrates

Answer 16

Activates guanylyl cyclase, inc cGMP
Indications- hypertension, heart failure, angina and myocardial infarction
Ae- headache, cutaneous flushing, postural hypotension

Question 17

Endothelin receptor antagonist

Answer 17

Very potent vasoconstrictor ung receptor
Admin of receptor causes transient vasodilation and hypotension
Bosentan- non selective antag, for pulmonary hypertension

Question 18

cAMP-PDE inhibitors

Answer 18

Camp plays an impt second messenger role

Activate sympathetic adrenergic nerves to the heart

Question 19

PDe- inhibitors

Answer 19

cAMP is broken down by an enzyme called camp dependent PdE
Target is PDE3- backdoor approach- for acute heart f, NOT for chronic
Inc cardiac inotropy, chronotrpoy, dromotropy

Question 20

cGMP pde inhibitors

Answer 20

Pde5 is found inc orpus cavernosum
Break down cGMP that forms in response to inc NO
For erectile dysfunction
Causes headache and flushing

Question 21

Ace inhibitors

Answer 21

-prils
Dec angiotensin 2, stimulates kallikrenin-kinin,
Inhibits bradykinin metab

Question 22

Ace inhibitor effects

Answer 22

Vasodilation
Down regulation of sympathetic adrenergic pathway
Promotion of renal excretion of Na and water

Question 23

Classification of ace inhib

Answer 23

Sulfhydryl containing- capto, zofeno
Dicarboxylate- enala, quina, benaze, rami, lisino
Phosphate- fosino
Others- alce, rentia, trandola, imida, spira

Question 24

Angiotensin receptor inhibitor

Answer 24

Clocks angiotensi2 mediated vasoconstriction
Losartan
Blocks aldosterone secreting effects

Question 25

Renin inhib

Answer 25

Inhibit raas
Ae: dizziness, flu like, diarrhea
Reduces furosemide, interaction with cyclosporine