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Systemic Pharmacology OPTM 5133 > Cardiovascular > Flashcards

Cardiovascular Flashcards

Know the type, MOA, and side effects of Cardiovascular drugs

1
Q

How is the INtrinsic thrombus pathway activated?

A

Foreign body or collagen

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2
Q

How is the EXTRINSIC thrombus pathway activated?

A

Injury to endothelial tissue, exposing tissue factor to blood

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3
Q

How is the extrinsic thrombus pathway activated?

A

Injury to endothelial tissue, exposing tissue factor to blood

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4
Q

What does plasminogen do Once a clot forms?

A

Becomes plasmin, which breaks down fibrin and fibrinogen to BREAK the CLOT/thrombus

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5
Q

What types of drugs prevent blood clots?

A

Blood thinners: antiplatelets anticoagulants

Clot busters: thrombol

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6
Q

Define blood pressure & it’s major factors

A

BP=CO×PVR

Affected by blood volume, heart contractility, heart rate & blood vessels diameter

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7
Q

Side effects of hydralazine

A 
Peripheral edema 
Headache
Flushing
Reflex tachycardia 
Orthostatic HYPOtension
Drug induced lupus/like syndrome
Conjunctivitis & tearing
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8
Q

How do diuretics help decrease BP

A

Help body rid Na (&H2O), increase urine output & cardiac output

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9
Q

What are the 4 main types of diuretics

A

Thiazide
Loop
Potassium Sparing
Osmotic

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10
Q

3 Thiazide diuretics

A

Hydrochlorothiazide
Chlorothiazide
Chlorthalidone

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11
Q

Side effects of thiazide diuretics

A

Hypokalemia
Hyponatremia
Metabolic alkalosis

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12
Q

The most effective (loop) diuretic. Why? What is it common for?

A

Furosemide, blocks more sodium reabsorption.

common to improve edema seen in congestive heart failure

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13
Q

Side effects of loop diuretics

A

Hypokalemia
Hyponatremia
Metabolic alkalosis

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14
Q

What drug interaction causes an idiosyncratic reaction in the eyes?

A

Thiazide & loop diuretics

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15
Q

(2)common potassium sparing diuretics

A

Spironolactone

Triamterene

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16
Q

Side effects of spironolactone & triamterene

A

Hyperkalemia
Hyponitremia
Metabolic acidosis

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17
Q

Common osmotic diuretic

A

Mannitol

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18
Q

Mannitol MOA

What is its IV use?

A

Filtered at glomerulus, not reabsorbed in tubules, brings in water all throughout to lower blood volume
IV- reduces cerebral edema & eye pressure

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19
Q

Mannitol side effect

A

Excessive plasma volume expansion
If given too fast/with 2 much IV fluid, draws in too much water into plasma which leads to heart failure & pulmonary congestion
Contraindicated in heart failure & pulmonary edema

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20
Q

Side effects of all diuretics

A

Dehydration/dizziness leads to hypotension & fainting
Dry eyes
Electrolyte imbalances & muscle cramps
Frequent urination

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21
Q

Which classes of drugs inhibit RAAS?

A

Angiotensin Converting Enzyme (ACE) Inhibitors

Angiotensin Receptor Blockers (ARBs)

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22
Q

What is the function of the Renin-Angiotensin-Aldpsterone System?

A

Increases BP by sensing low BP, kidneys release renin into bloodstream, which converts angiotensinogen from liver –> Angiotensin I +ACE->Angiotensin II

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23
Q

How does Angiotensin II increase BP?

A

2 ways

24
Q

How do drugs inhibit effects of angiotensin II

A

Inhibit ACE or angiotensin II from binding to its receptors

25
Q

What is the function of ACE?

A

Aids conversion of Angiotensin 1–>2

Breaks down bradykinin, a vasodilator

26
Q

Name 5 common ACE inhibitors

-pril

A 
Quinapril 
Captopril 
Benazepril 
Lisinopril 
Enalapril
Any w/suffix -pril
27
Q

Name 5 common ACE inhibitors

A 
Quinapril 
Captopril 
Benazepril 
Lisinopril 
Enalapril
Any w/suffix -pril
28
Q

Adverse effects of ACE inhibitors & ARBs

Why?

A

Hyperkalemia

Angioedema

29
Q

What is a unique side effect of ACE inhibitors?

Due to what?

A

Dry Cough

Due to increased bradykinin in lungs

30
Q

4 Common antihypertensive drug combinations

A

Hydrochlorothiazide-triamterene
Metoprolol-hydrochlorothiazide
Hydrochlorothiazide-lisinopril
Atenolol-chlorthalidone

31
Q

What are 3 classes of drugs for angina?

A

B-blockers

Non-dihydropyridine Ca-channel blockerorhanic Organic nitrates aka nitrodilators

32
Q

What’s the MOA of B-blockers and non-dihydropyridine Ca-channel blockers for angina?

A

Decrease heart rate/contractility–> reduce work of heart & its oxygen demand

33
Q

What’s the MOA of organic nitrates/nitrodilators for angina?

A

Strong vasodilator, improve coronary blood flow by reversing coronary artery vasospasm

34
Q

Distinguish between sublingual & topical nitroglycerin.

A

Sublingual is for acute angina

Topical/transdermal patch is to prevent it

35
Q

What’s the MOA of nitroglycerin?

(It is an organic nitrate “nitrodilators”

A

Becomes nitric oxide-> activates cGMP in blood vessel wall-> blocks Ca entry –> vasodilation
Plus: In coronary arteries this increases O2 delivery to <3

36
Q

Common Side effects of all diuretcs

A

Dry eyes

Frequent urination, dehydration, electrolyte imbalances, muscle cramps, hyperkalemia & hyponatremia

37
Q

3 thiazide diuretics for hypertension

A

Hydrochlorothiazide (HCTZ)
Chlorothiazide
Chlorthalidone

38
Q

FUROSEMIDE

A

Loop diuretic for hypertension

39
Q

2 POTASSIUM SPARING DIURETICS

A

Spironolactone

Triamterene

40
Q

Classes of HTN drugs that inhibit RAAS

A 
ACE inhibitors (-pril)
ARBs (-sartan)
41
Q

Common side effects of RAAS inhibitors (ACEI & ARBS)

A

Hyperkalemia

Angioedema

42
Q

Alpha-1 blockers for HTN

3, ending -osin

A

Doxazosin
Terazosin
Prazosin

43
Q

How do alpha-1 blockers lower blood pressure? (MOA)

A

Inhibit a1 receptors on blood vessels causing vasodilation

44
Q

Side effects of all alpha-1 blockers

A 
Intraoperative floppy iris syndrome 
Reflex tachycardia 
Orthostatic hypotension 
Headache
Flushing
peripheral edema
45
Q

What is CLONIDINE?

Class, MOA, side effects

A

Centrally acting sympathetic agonist for HTN
Stimulates alpha2 receptors in 🧠 decreasing sym. outflow to ❤️ (decrease ❤️ rate/contractions, & blood vessels (vasodilation)
Bradycardia, impotence/erectile dysfunction, tiredness/ sedation, lower IOP

Sudden discontinuation can cause severe rebound hypertension

46
Q

Common MOA of all diuretucs

A

Increase excretion of Na/H2O to lower blood volume thereby lowering BP

47
Q

Side effects of nitroglycerine (for angina)

A

peripheral edema, headache, flushing, reflex tachycardia, orthostatic hypotension

48
Q

Name (5) NONSELECTIVE B-blockers for hypertension and angina (B1,B2 inhibition)

A

Labetalol & carvedilol which also have a1 blocking effects, and propranolol

49
Q

Name (2) SELECTIVE B-blockers for hypertension and angina

A

Metoprolol & atenolol

50
Q

Side effects of ALL B-blockers

A

Bradycardia, fatigue, depression, impotence, may mask hypoglycemia symptoms, decrease IOP (aq. humor production)

51
Q

Unique side effect of NONSELECTUVE B-blockers

A

Bronchoconstriction, not used in asthma/COPD

52
Q

Name the direct acting vasodilator & its MOA

A

hydralazine; MOA unknown, unpredictable actions

53
Q

Name (2) non-dihydropyridine calcium channel blockers for ANGINA & HTN

A

diltiazem, verapamil

54
Q

MOA of non-dihydropyridine CCBs

A

inhibit L-type Ca-channels in cardiac myocytes & SA/AV node of heart, reducing heart rate

55
Q

Side effects of diltiazem & verapamil (NCCBs)

A

bradycardia, riskier with B-blocker

56
Q

classes of drugs used for angina

A

B-blockers, , Non-dihydropyridine CCBs, and 1 nitrodilator

Systemic Pharmacology OPTM 5133 (8 decks)

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