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Pharmacology > Cardiology Part 1 > Flashcards

Cardiology Part 1 Flashcards

1
Q

Alpha - 1

A

Vascular Smooth Muscle (vasoconstriction), use as an agonist for hypotension. Use as antagonist for hypertension and benign prostatic hyperplasia (BPH)

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2
Q

Alpha - 2

A

CNS synapses (inhibitory effects), agonist use is for hypertension and spasticity while antagonistic has no clinical use

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3
Q

Beta - 1

A

Heart (increased HR and force of contraction),
agonist use for cardiac decompensation and antagonistic use for HTN, arrhythmia, angina pectoris, heart failure, prevention of reinfarction

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4
Q

Beta - 2

A

Lungs (bronchodilation), agonist use to prevent bronchospasms and no clinical use for antagonist

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5
Q

Alpha 1 Epinephrine

A

Topically or Intradermal
Local effects
Control bleeding
Intravenously
Vasoconstriction
Hypotension (vasopressor)

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6
Q

Beta 1 epinephrine

A

Intravenously
Myocardium
Cardiac arrest

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7
Q

Beta 2 epinephrine

A

Inhalation/IM
Target lungs
Anti-Asthmatic / Anaphylaxis

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8
Q

Midodrine

A

Alpha-1 agonist -> vasoconstriction of vascular smooth muscle, used for OH and prevention of hypotension, well tolerated

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9
Q

Orthostatic Hypotension

A

Also known as postural hypotension
Abnormal drop in BP when changing positions
-≥20 mm Hg systolic and/or≥10 mm Hg diastolic
Due to delayed/inadequate baroreceptor reflex

Risk factors:
Age >60, Parkinson’s disease, medications

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10
Q

Diuretics

A

MOA: Increase renal excretion of water and sodium, decreased plasma volume
↓ Blood volume =↓ SV =↓ CO

3 groups based on where they act in nephron:
-Thiazides(First line therapy)
-Loop
-Potassium-sparing

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11
Q

Diuretics: Adverse Effects

A

electrolyte imbalances, increased urination, orthostatic hypotension

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12
Q

Sympatholytics

A

In general work to decrease sympathetic drive
Classified based on where they work:
-Beta blockers
-Alpha blockers
-Centrally acting agents

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13
Q

Beta-blockers

A

MOA: Bind toβ receptors in heart/lung blocking binding of catecholamines

↓Contractility =↓SV = ↓ CO
↓HR = ↓CO

Adjunct therapy – need compelling indication – not first line

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14
Q

Cardioselective beta blockers

A

Atenolol
Metoprolol
Nebivolol (Bystolic)

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15
Q

Mixed alpha/beta beta blockers

A

Carvedilol
Labetalol

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16
Q

Nonselective beta blockers

A

Propranolol

17
Q

Beta-blockers adverse effects

A

Generally well-tolerated, after adjusting to ADE
Bronchoconstriction
Orthostatic hypotension
Mask hypoglycemia
Exercise intolerance

18
Q

Alpha blockers

A

MOA: Bind to α1 receptorson vascular smooth muscle, blocking binding of catecholamines
↓Vasoconstriction =↓ TPR
Adjunct therapy

19
Q

Alpha Blockers: Adverse Effects

A

Reflex tachycardia (Caution in patients with cardiac disease)
Orthostatic hypotension (Take at night to lower risk)
Dizziness

20
Q

Centrally Acting Agents

A

MOA: Alpha 2 agonist: Stimulate α2 receptors in brainstem which decreases sympathetic activity

↓HR/SV = ↓ CO
Adjunct therapy
Exception: methyldopa in pregnancy

21
Q

Centrally Acting Agents: Adverse Effects

A

Dry mouth
Dizziness
Sedation
Rebound hypertension/tachycardia with abrupt withdrawal
-Due to rebound sympathetic activity

22
Q

Vasodilators

A

MOA: Vasodilate the peripheral vasculature directly at cell
IncreasedcGMP = ↓contractility of smooth muscle cells =↓TPR
Adjunct therapy

23
Q

Vasodilators: Adverse Effects

A

Reflex tachycardia
-Baroreceptor reflex compensation
Orthostatic hypotension
-Warm pool will worsen

24
Q

Angiotensin Converting Enzyme Inhibitors (ACE-I)

A

Lisinopril
Ramipril
Benazepril
Captopril

25
Q

Angiotensin II Receptor Blockers (ARBs)

A

Losartan
Olmesartan (Benicar)
Valsartan (Diovan)

26
Q

RAS Inhibitors MOA

A

↓Fluid/Sodium Retention =↓SV =↓CO
↓Angiotensin II =↓Vasoconstriction =↓TPR
First line therapy (ACE inhibitors/ARBs)

27
Q

ACE-I/ARBs: Adverse Effects

A

Generally well-tolerated
Hyperkalemia
Dry cough (ACE-I)
Angioedema (ACE-I)
Kidney injury

28
Q

CCBs MOA

A

Blocks calcium entry into vascular smooth muscle, First line therapy

Vasculature: ↓SVR  Vasodilation
Heart: ↓HR/SV =↓CO

29
Q

CCBs Adverse effects

A

Peripheral edema
Orthostatic hypotension
Reflex tachycardia (dihydropyridine only)

30
Q

CCB (dihydropyridine)

A

Amlodipine
Nifedipine
Nicardipine

31
Q

CCB (nondihydropyridine)

A

Diltiazem
Verapamil

Pharmacology (10 decks)

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