cardio meds Flashcards
what is mild HTN BP
140-149/90-99
FIRST LINE tx for most HTN
thiazide
thiazide MOA
Lower plasma volume by dec Na resorption at distal convuluted tubule by inhibiting Na/Cl transporter
Diuretics MOA
remove excess water and Na; dec amt of fluid flowing through blood vessels to reduce pressure on vessel walls
first line medications list tx for htn
thiazide, ccb, ace/arbs
thiazide and calcium
increase Ca reabsorption and lower urinary Ca excretion(good for kidney stones)
Electrolyte effect of thiazide
hypokalemic metabolic alkalosis, hyponatremia, decreased Mg;
HYPER(G-L-U-C): glycemina, lipidemia, uricemia, calcemia)
FIRST LINE tx for mild HTN
Diuretics
Contraindications to thiazides(5)
HypoTN, Sulfur allergy, gout, renal failure, hypokalemina, careful in diabetics
loop MOA
act on ascending loop of henle inhibiting Na/K++/Cl transporter
where is most of the Na reabsorbed
loop of henle
Electrolyte effect of Loops
hyperuricemia, decrease K++, Mg, Ca
good and bad side of using Loops
Powerful but short acting
Good med for acute pulm edema with renal failure
loop
SE of loops
ototoxicity but it is reversible
2 MOA of K++ sparing diuretics
Block Na exchange sites; and aldosterone antagonists which prevent specific proteins from being created that are part of the Na K++ exchange pump
when to use K++ sparing diuretics
SECOND line with another med for acute pulm edema or CHF
Electrolyte effect of K++ sparing diuretics
hyperuricemia and dec Mg
FIRST line treatment as monotherapy or with thiazides, ACE/ARB for HTN regardless of age or race
CCB
CCB MOA
Block Ca channels in blood vessels and cardiac muscle; this prevents Ca from entering the cells reducing muscle contractility–leading to vasodilation and decreased cardiac contractility
What reduces AV node conduction therefore HR; and also reduces aldosterone production
CCB
Dihydropyridine
CCB(Nifedipine and Amlodipine)
Dihydropyridine MOA
Peripheral Vasodilation w/out affecting HR or rate control.
Danger of Dihydropyridines
Reflex Tachycardia
Danger of Nifedipine
Reduce ventricular contractility, worsening angina, avoid in HF
Nondihydropyridines
Diltiazem and Verapamil
3 uses for CCB
HTN, angina, Arrhythmia(supraventricular tachyarrhythmias)
CCB less effective on cardiac tissue
dihydropyridines(amlodipine and nifedipine), it works more on the peripheral system
SE of CCB
HA, peripheral edema, leg edema, bradycardia(due to AV node)
which CCB can cause AV block and worsening heart failure
NonDihydropyridines(diltiazem and verapamil)
which CCB causes flushing and which ones cause constipation
nifedipine. diltiazam and verapamil
SE of K++ sparing diuretics
hypokalemia, gynecomastia, sexual dysfunction
hydralazine MOA and SE
causes release of nitric oxide and increases HR
lupus like syndrome, pericarditis
inotropes
MOA and meds
increase cardiac output by increasing contractility and it also increases BP.
-dobutamine, dopamine, epi
chronotropes MOA and meds
alter HR.
- positive: adrenaline
- neg: digoxin