Cardiovascular drugs Flashcards
dec. blood supply
Decrease heart rate in cardiovascular disorders
SFF, no exercises
Ischemia
Oral, sublingual (fastest at home 3 times, 5 mins. Interval; after 2 mins before it takes effect), IV (fastest in hospital), patch (doesn’t matter where you place it; do not touch; headache – say it is normal but give analgesic)
Vasodilator; increases blood supply
Potency is decreased when exposed to sunlight
Tolerance (Ceiling effect) – inc. dosage
Never give nitrate in patients who had Viagra and other drugs for ED
Antidote to Viagra is epinephrine
If erection lasts for 4 hours, go to Emergency Room
All drugs in a patch are placed on 12 hours only to prevent tolerance
Patch are needed in the morning
Nitrates
dec. heart rate/ check HR
also vasodilators/ monitor BP
the more the calcium, the more contraction, the more HR and oxygen
Verapamil
Nifedipine
Diltiazem
dipine
Calcium channel blockers
dec. heart rate
olol
Beta-blockers
Drugs depend on type of arrhythmia
Rate problem
Symptomatic bradycardia – atropine sulfate
Tachycardia – beta blocker, calcium channel blockers
Rhythm problem
Atrial - quinidine
Ventricular tachycardia – 200-300bpm - Lidocaine
P – atrial depolarization (stimulates muscles) – made by SA node – initial pacemaker
Atrial arrhythmia
SA-AV node – PR interval (0.12-0.20 secs)- to allow filling Bundle of His Purkinje Fibers – QRS – Ventricular depolarization (0.04-0.12 secs)
Ventricular arrhythmia
ANTIARRHYTHMICS
P – atrial depolarization (stimulates muscles) – made by SA node – initial pacemaker
Atrial arrhythmia
SA-AV node – PR interval (0.12-0.20 secs)- to allow filling Bundle of His Purkinje Fibers – QRS – Ventricular depolarization (0.04-0.12 secs)
Ventricular arrhythmia
supraventricular tachycardia
Half life is 6 seconds – time it take for half of the drug to be excreted
Follow with bolus 10-20 cc NSS
Adenosine
M - Morphine
O - Oxygen
N – Nitroglycerin – patch/IV
A – aspirin (ANTIPLATELET) Ticlobidine – alternative if with allergy
Must have maintenance aspirin or anticoagulant (Heparin & Warfarin
IV, SQ while the other one is oral)
Enoxaparin (Lovenox) – low molecular weight, less systemic bleeding, anticoagulant
Monitor for bleeding
Myocardial Infarct
– PT (Control value = 10-15 secs; therapeutic value = 1.5-2.5xCV) and INR = 2-3; must be checked every 2 weeks for the rest of your life to maintain the level
Potent drugs; prone to bleeding
Warfarin
– aPTT (Control value = 30-45 secs)
Warfarin - If high therapeutic value, give Vit K
Heparin – protamine sulfate
Heparin
Electric razon, soft bristled toothbrush
Antidote is Vit K
Prone to bleeding, do not do IM, SQ instead!
Warfarin takes 2-3 days before it can take effect so Heparin and Warfarin can both be used
Mas matagal, mas matigas Mas matigas, mas mahirap tunawin
Given as soon as possible; 4-6 hours from the onset of symptoms of MI
Ischemic Stroke – must be given 3-4 hours. NOT HEMORRHAGIC STROKE
CT Scan without contrast
Tissue Plasminogen Activator (Alteplase), Streptokinase,
ER Door-to-Drug – 90 mins but still must conform to the 4-6 hours limit
THROMBOLYTICS
Digoxin
increase force of contraction; the more you squeeze the more ineffective the contraction; dec. heart rate
0.5-2ng/ml
Given to patients with diuretic
Hypokalemia predisposes you to digoxin toxicity
BANDAV – bradycardia, Anorexia, Nausea, Diarrhea, Abdominal pain, visual illusions , males (gynecomastia)
Antidote: digibind
CARDIAC GLYCOSIDES
Diamox/Mannitol – open angle glaucoma; not given as antihypertensives
Mannitol – ICP
Furosemide (Lasix)-fast acting drug (oral – 30 mins, venous
5 mins) for CHF; not given as antihypertensives since it will trigger the RAAS system -> rebound hypertension
Thiazides – antihypertensives; gradual diuretics
Spironolactone – potassium sparing diuretic (Aldactone);
mild
Liver cirrhosis
Ascites – high Na, low K – so potassium sparing
Monitor for orthostatic hypertension
DIURETICS
