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BIOM3210 - PHARM > CardioV Drugs > Flashcards

CardioV Drugs Flashcards

1
Q

Clonidine

A

a2 agonist
- CNS sympatholytic
- inhibitory in CNS –> decr NE (decr SNS, incr PSNS)
= decr. BP

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2
Q

Propranolol

A 
Beta blocker: b1 b2 antagonist
- PNS sympatholytic
- block b1 receptor in heart
- class II anti-arrhythmatics 
= decr. CO (decr. HR = decr. O2 requirement - treat CHF)
= decr. BP (treat hypertension)

careful with asthma and bradycardia

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3
Q

Metoprolol

A 
Beta blocker: b1 antagonist
- PNS sympatholytic
- block b1 receptor in heart
- class II anti-arrhythmatics 
= decr. CO (decr. HF = decr. O2 requirement - treat CHF)
= decr. BP (treat hypertension)

= treat tachycardia in CHF, but be careful
careful with bradycardia

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4
Q

Prazosin

A

Alpha blocker: a1 antagonist
- PNS sympatholytic
- block NE release at a1 from vasoconstriction in arterioles and venules
= vasodilation and decr. BP

administer with diuretic to prevent salt and water retension

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5
Q

Sodium nitroprusside

A

Vasodilator (short acting)
- nitric oxide donor
- NO –> cGMP –> dephosphorylate myosin –> cannot contract –>
= vasodilate

toxicity: hypotension and cyanide accumulation

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6
Q

Verapamil

A 
Vasodilator (long acting)
- calcium channel blocker
- long term and emergency
- class IV anti-arrhythamatics
- inhibit Ca++ influx
    relax arterial smooth muscle 
= vasodilate
    prevent calcium calmodulin formation and contraction 
= decr. HR (decr O2 requirement)
  • treat hypotension and CHF
    (treat CHF with edema cuz long acting)
    toxicity: hypotension, bradycardia
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7
Q

Enalapril

A

ACE inhibitor

  • prodrug (metabolized in liver)
  • prevent conversion of angiotensin 1 –>2
  • prevents inactivation of bradykinin (vasodilator)

= decr. BP (treat hypertension and mild CHF)

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8
Q

Losartan

A

Angiotensin 1 Receptor Blocker (ARB)
- similar effect to ACE inhibitors
= vasodilation and decr. BP

= treat mild CHF

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9
Q

Hydrochlorothiazide

A 
Thiazide Diuretics
- mild hypotension
- inhibits NaCl transport 
- DCT
- increase salt and water excretion
= decr. BP

= treat CHF with edema
(used with ACE inhibitors)

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10
Q

Furosemide

A 
Loop Diuretics
- severe hypotension/pulmonary edema
- inhibits Na+, K+, Cl- transport
- loop of henle
- increase salt and water excretion
= decr. BP

= treat CHF with edema

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11
Q

What is the order of drugs given for severe hypertension in combination therapy?

A
  1. diuretic
  2. ACE inhibitors/ARB
  3. Ca2+ blocker
  4. sympatholytics/vasodilators
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12
Q

Digoxin

A

Cardiac glycoside

  • Na+/K+ inhibitor
  • for patients: still symptomatic after treatment, atrial fibr. enlarged/LV dysfunction
  • absorbed and distributed well -> heart (direct) and baroreceptor (indirect)

Net effect:
= increase force
= decr rate of contraction

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13
Q

What are the mechanisms of Digoxin?

A 
Direct (Heart)
- Na+/K+ pump inhibitor
= more Na+ Ca++ inside, K+ outside
- more Ca++ inside for improved contractility (actin and myosin)
= incr. contractility

Indirect (baroreceptors)
- better circulation
- incr. PSNS, decr. SNS
= decr. rate of contraction

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14
Q

What are the toxicities and the harmful drug interaction with digoxin?

A

Toxicity:
- arrhythmias, tachycardia, and fibrillation
Quinidine
- anti-arrhythmatic drug
- potentiates digoxin because it is also a Na+ blocker
- decr. clearance of digoxin = more Na+ inside cell

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15
Q

Nitroglycerin

A

Vasodilator
- NO –> cGMP –> relax smooth muscle

  • also a bronchodilator because it relaxes smooth muscle
  • decr. venous return (decr. O2 requirement)
  • dilate coronary arteries (incr. O2 delivery)
  • compensation to incr. HR (SNS reflex)

Toxicities:

  • hypotension
  • tachycardia
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16
Q

What is the harmful drug interaction with Nitroglycerin?

A

Sildenafil/Viagra
- inhibits phosphodiesterase
- prevents breakdown of cGMP
- therefore do NOT take with nitroglycerin
- potentiates effects
= hypotension (+ alter green/blue vision)

17
Q

Quinidine

A

Class I anti-arrhythmic

  • Na+ channel blocker
  • toxicity with Digoxin
  • not common
  • dont take if you have HF
18
Q

Lidocaine

A

Class 1 anti-arrhythmic

  • Na+ channel blocker (reduce excitation)
  • commonly used IV in emergency
19
Q

Amiodarone

A

Class III anti-arrhythmatic

  • K+ channel blocker
  • prolongs action potential
  • used for severe ventricular fibrillation
20
Q

What are the cardiovascular compensatory mechanisms to a failing heart?

A
  • increases SNS
  • increase RAAS
  • increase force of contraction
  • v. hypertrophy

BIOM3210 - PHARM (2 decks)

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