Cardiovascual System Flashcards
What are the u/e of ACE inhibitors?
HA, dizziness, abdo pain, confusion, renal failure and impotence. Also a DRY IRRITATING COUGH
What is the MOA of ACE inhibitors?
block the synthesis of angiotensin II (a potent vasoconstrictor) -
reduce aldosterone secretion from adrenal cortex (resulting in net water loss)
What is the MOA of Thiazide Diuretics?
Inhibit sodium and chloride reabsorption in the thick ascending loop and early distal tubule. Loss of Ions increases urine volume.
Name two ACE inhibitors?
Captopril -
Enalapril
What are the U/E of Thiazide Diuretics?
can cause hypokalemia
Name a Thiazide diuretic?
Chlorthiazide
What Thiazide diuretic can cause u/e hyponatremia, hypokalemia, hyperglycemia, hyperuricemia, hypercalcemia?
Chlorthiazide
What is the MOA of Loop Diuretics?
inhibit chloride reabsorption in the ascending loop of Henly.
(also treat pulmonary edema b/c potent rapid action)
Name two Loop Diuretics?
Furosemide, Ethacrynic Acid
What are the U/E of loop Diuretics?
hyponatremia, hypokalemia, hypocalcemia, hypomagnesemia, hyperglycemia, hyperuricemia, OTOTOXICITY
What drugs are cause hyponatremia, hypocalcemia, hypomagnesemia, hyperglycemia, hyperuricemia, ototoxicity?
Furosemide, Ethacrynic Acid (most ototoxic)
What is the MOA of Cardia Glycosides?
inhibit Na+K+ATPase.
causing an increase in the level of sodium ions in the myocytes, leading to a rise in the level of intracellular Ca+. Sodium/calcium exchanger on the plasma membrane depends on a constant inward Sodium gradient to pump out calcium. Cardiac Glycosides decreases sodium concentration gradient and the subsequent calcium outflow, thus raising the Ca+ concentration in myocardiocytes and increasing the force of myocardial contraction.
Name a Cardiac Glycoside?
Digoxin
What is the precaution with Digoxin-Cardiac Glycosides?
narrow therapeutic margin
What are the U/E of Digoxin - Cardiac Glycosides toxicity?
arrhythmias, anorexia, nausea, diarrhea, drowsiness, fatigue, visual disturbances
What is the MOA of class I antiarrythmic drugs?
Na+ channel blockers.
block ssodium entry into the cell during depolarization. This decreases the rate of rise of phase 0 of the action potential.
What is the MOA of Class III antiarrythmic drugs?
K+ channel blockers -
prolong re-polarization. Useful in treating intractable ventricular arrhythmias
What is the MOA of class IV antiarrythmic drugs?
CA++ channel blockers -
slowing the inward calcium current to slow conduction and prolong the effective refractory period, especially in the AV node. Most effective against atrial arrhythmias.
What is a Class I Anti-arrhythmic drug?
Lidocaine - used for ventricular ;
Procainamide - used for atrial and ventricular
What is a Class III Anti-arrhythmic drug?
Amiodarone - effective preventative for ventricular fibrillation and tachychardia
What is MOA for organic nitrates in relieving angina?
dilate the large myocardial arteries to increase the blood supply of the heart.
Also reduces cardia preload by reducing venous tone.
nitrAtes ^ -> ^ nitrItes -> ^ nitric oxide -> ^ cGMP -> ^ dephosphorylation of myosin light chain -> vascular smooth muscle relaxation
What is the organic nitrate and drug of choice for acute coronary spasm?
Nitroglycerine - administered SV for rapid onset of action (2 minutes)- can be administered transdermally for a longer duration of action
What is the MOA of ß-blockers in relieving angina?
decrease the oxygen demands of the myocardium by lowering both the rate and force of contraction of the heart
What are the contraindications when using ß-blockers for angina?
contraindicated in patients with COPD, asthma, diabetes, severe bradycardia, peripheral vascular disease.
How should the use of ß-blockers be discontinued?
dose should be gradually tapered off over 5-10 days to avoid reboudn angina or hypotension.
Which group of antihypertensive drugs useful in treating diabetes patients?
ACE inhibitors do not affect glucose levels so are good for diabetes patients.
ACE inhibitors useful in hypertension that is a result of increased rennin levels.
Which group of antihypertensive drugs is useful in patients of African American decent?
Calcium Channel Blockers
Which group of antihypertensive drugs is useful for patients with angina?
ß-blockers
Which group of antihypertensive drugs are used for pregnant women?
central acting adrenergic drugs like METHYLDOPA .
What are the important antiplatelet drugs?
Aspirin, Clopidegrol, Abciximab
What is the MOA of aspirin?
inhibits platelet aggregation by inhibiting thromboxane A2 synthesis in the platelets and thus prolongs bleeding time.
What is the MOA of Clopidegrol?
blocks platelet aggregation by irreversibly inhibiting the binding of ADP to its receptor on platelets. This inhibits the activation of GP IIb/IIIa receptors required for platelets to bind to fibrinogen.
What is the action of Heparin?
interferes w the clotting factor activation in both the intrinsic and extrinsic pathways, principally by binding to antithrombin III w the subsequent rapid inactivation of coagulation factors especially thrombin and factor Xa.
What is the main u/e of Heparin?
hemorrhage
What is the antidote to a heparin-induced hemorrhage?
protamine
What is the MOA of oral anticoagulants?
they antagonize vitamin K, interfere w the synthesis of vitamin K dependent clotting factors (II, VII, IX, X) - intrinsic clotting pathway is vitamin K dependent
Name an oral anticoagulant?
warferin
What does a thrombolytic drug do?
they lyse already formed clots
What is the MOA of Thrombolytic drugs?
activate plasminogen to plasmin. Plasmin digests fibrin forming degradation products. most effective if initiated early after clot formation.
Name two thrombolytic drugs?
streptokinase -
tissue plasminogen activator (t-PA)
What drug is used to treat anemia from end-stage renal failure?
erythropoietin -
synthesized in the KD in response to hypoxia or anemia to stimulate erythropoiesis
What drug is used in megaloblastic anemia?
Cyanocobalamin aka Vitamin B 12 -
lacking intrinsic factor and unable to absorb vit b12
What is the MOA of HMG-CoA reductase inhibitors? What does it treat?
Antihyperlipidemic; first choice for Tx of patients with hypercholesterolemia.
HMG-CoA reductase is a precursor of cholesterol - the inhibitor prevents the reductase enzyme from rate-limiting cholesterol synthesis.
HMG-CoA reductase inhibitor decrease LDL, VLDL and TG.
Increases HDL.
Name two kinds of HMG-CoA reductase inhibitors and their U/E.
Simvastatin ; Atrovastatin ; Rosuvastatin -
LV Fx abnormalities, myopathy, rhabdomyolysis.
cannnot be taken w grapefruit juice
What is the MOA of Niacin? What category of drug is this?
antihyperlipidemic drug ;
MOA: strongly inhibist lipolysis in adipose tissue.
Decreases LDL, VLDL, TG
increases HDL
What are the U/E of Niacin?
flush and pruritus
What is the MOA and drug category of Ezetimibe?
Anithyperlipidemia - cholesterol absorption inhibitor ;
MOA: inhibit intestinal absorption of dietary and biliary cholesterol.
decrease LDL and TG
increase HDL
