Cardio Pharm Flashcards
what is the MOA of 1st gen B-blockers
non-selective B1, B2, and alpha receptor blockers
what is the MOA of 2nd gen B-blockers
B1 receptor blockers
what is the MOA of 3rd gen B-blockers
vasodilating - act on blood vessels; may produce non selective or cardioselective B-blockade
what occurs from B1 receptors being blocked in the treatment of A-fib
reduction of sympathetic stimulation of the heart - decreases myocardial conductivity and sympathetic tone
what are major AEs of B-blockers
sinus bradycardia/arrest, bronchospasm in asthmatic patients
what is the MOA of non-dihydropyridine Ca channel blockers
identical to B-blockers (reduces conductivity and contractility of heart)
what is MOA of digoxin
cardiac glycoside, positive inotropic action (increases contractility & force of ventricular contraction –> increases CO), decrease cardiac conduction
what are major side effects of digoxin
dysrhythmias, drug interaction +++
*caution with loop diuretics & hypokalemia, predisposes patients to dysrhythmias
what drugs control heart rate for the treatment of afib
b-blockers, ND-CCBs, & digoxin
what antiarrhythmic drugs are used for afib
sotalol (B-blocker), propafenone, amiodarone
What is the MOA for sotalol
blocks K channels at higher doses; acts like non selective B-blocker at lower doses
what is an adverse event of sotalol
dysrhythmias (inc torsades do pointes & QT prolongation)
what are contraindications for sotalol
pre-existing dysrhythmias, conduction disorders, renal impairment, HFrEF, CHF
what is the MOA for propafenone
Na channel blocker, also weakly inhibits B-adrenergic receptors and inhibits Ca influx
what are AEs of propafenone
hypotension, bradycardia, ventricular proarrhythmia
what are CIs of propafenone
severe hepatic or renal failure, ischemic CAD/hx MI, HFrEF
what is the MOA for amiodarone
blocks K and Na channels to delay repolarization
what are the black box warnings for amiodarone
pulmonary and liver toxicity
CI in pregnancy
what are the three rate control drugs used for afib
- B blockers
- non-dihydropyridine CCBs
- digoxin
what are some examples of non-dihydropyridine CCBs
diltiazem, verapamil
what is the MOA of B-blockers for the treatment of afib
decrease automaticity of SA node, decrease velocity of conduction through AV node, decrease myocardial contractility
what is the MOA of ND-CCBs in the treatment of afib
slow SA node automaticity, delay AV nodal conduction, reduce myocardial contractility
what is a CI for ND-CCBs
LVED<40% (B-blocker preferred)
what is the MOA of digoxin in the treatment of afib
decrease conduction through AV node adn automaticity of SA node
