Cardio pharm Flashcards
what is considered elevated BP
systolic 120-129 AND diastolic <80
what is normal BP
<120/80
what are the two stages of Hypertension
Stage 1: S-130-139 or D: 80-89
Stage 2: S >140 or D >90
What are the ACC/AHA goals
decrease systolic pressure <130
Tx for Elevated BP
3-6 months
First tier HTN medications
ACEI/ARB
DHP CCB
Thiazide-like diuretics
What does Aldosterone do in the urine
Na reabsorption and K excretion as well as H2O retention
ACEI mechanism
inhibit conversion of ANg I to II
blocks ACE
and decrease afterload
endings of ACEI and the most common drug here
“pril”
Lasonopril
endings for ARBs and the main drug here
“sartan”
Losartan
ACEI/ARBS main adverse drug effects
Dry COUGH and Angioedema (most comon on first week, AfroAmerican ppl at riskk here)
Hypotention (1st dose)
HYPERKALEMIA
Contraindication of ACEI/ARBS
Pregnancy X
renal artery stenosis
Ccalcium channel blockers DHP ending and the main drug
dipines
-Amlodipine
CCB non-DHP are better compared to CCB-DHP for the heart, yes or no ?
who are they ?
*hint this is what dad takes
yes b/c it works on the heart specifically
VERAPIMIL and Diltiazem
what is the ending of a alpa 1 blocker that is second line for HTN?
sozin
Doxazosin , Prazosn
alpha 1 blocker (2nd line HTN) MOA
-antagonize alpha 1 receptor on vasculature of SM
-vasodoalate peripheral sm
-DECREASE afterload
alpha 1 blocker (2nd line HTN) ADR
postural hypotension (drops when you stand up)
Dizziness
what is an alpha 2 non selective agonist
clonidine
beta block main MOA
reduce cardiac contractility and increase preload (ammt of blood ejected)
beta blocker ADR
BRADYcardia, heart block , fatigue, depression, bronchospasm
what are two mixed Beta with alpha-blocking medicines mostly used for HTN
“Leba el carvet” aka wash the corvet in Spanish
Lebatolol and carvedilol
Direct-acting vasodialators MOA
-direcly realx vascular smooth muscle
- ↓ afterload
what two medications decrease afterload
alpha 1 blockers and direct vasodialators
Name a vasopressin antagonist (ADH antagonist)
*collect the last toll” - works at the end of collecting tube
Tolvaptan
between Thiazide diuretics and Loop, who looses the most K+
Loop
ARDS of Thiazides and channel they block
hypoK, hypoNa, Hyperglycemiam Hyperuremia
-block Na/Cl channel
Which channel does the Loop diuretic block and ARDS
Na/2CL/K channel
-HYPOKALEMIA, cramping and hearing decrements
(pssst this is mainly used for CHF)
Name the most common loop diuretic
“ides”
Furosemide
primary manifestation of Heart failure
Dyspnea, fatigue, and fluid retention
HErEF (heart failure w reduced ejection fraction) LVEF
LVEF <40 %
previously systolic HF
HFpEF what is the LVEF
> 50%
-reviously diastolc HF
most common cause of HFpEF
HTN
1 horpitalizationipn in people >65
Heart failure
Is HTN asymtomatic?
yes hence why its called the silent killer
current guidelines for HTN
JNC 8
can fish oil and garlic increase bleeding risk ?”
yes
Can you use ACEI and ARBS togther?
never!! can cause Angioedema (emergency) due to ACEI
ACEI main side effect
dry cough, if so change to ARBs
pt seeing yellow green after taking his medicatins
think Digoxin toxicity
vasodialators BBW
BBW: pericardial effusion, angina exacerbation , drug induced lupus erythmatous
WHat to avoid with Statins
Grapefuid=t
Protease inhb
Aazoles
Cyclosporins
Macrlides
Amiodarone
Non DHP CCB
Ranolazine MOA
anti-ischemic and anti-angina effects
non selective alpha 2 that comes in a patch
clonidine
ACEI hepatically cleared
Fisonopril
ACEI/ ARBS CI
dont use with Aleskerin in diabetes
-Dont use together
-Pregnanc
where do MRAs work on (location on the nephron)
distal tubule and collecting duct
