Cardiovascular Drugs Flashcards
1
Q
Types of drugs used to improve cardiovascular function include:
A
- inotropic drugs
- antiarrhythmic drugs
- antianginal drugs
- antihypertensive drugs
- diuretics
- antilipemic drugs
2
Q
influence the strength or contractility of muscle tissue
A
inotropic drugs
3
Q
they increase the force of the heart’s contractions
A
inotropic drugs
4
Q
Inotropic drugs influence the strength or contractility of muscle tissue. As a result, they increase the force of the heart’s contractions (this is known as a ___________________________)
A
positive inotropic effect
5
Q
are two types of inotropic drugs
A
glycosides and phosphodiesterase (PDE) inhibitors
6
Q
slow the heart rate (a negative chrono- tropic effect) and slow electrical impulse conduction through the atrioventricular (AV) node (a negative dromotropic effect).
A
Cardiac glycosides
7
Q
This action is useful for patients who have atrial fibrillation
A
Cardiac glycosides
8
Q
it can help to control their heart rate and to prevent the heart rate from becoming too fast.
A
Cardiac glycosides
9
Q
Inhibits sodium-potassium-activated adenosine triphosphase, an enzyme that regulates the amount of sodium and potassium inside the cell, resulting in increased intracellular levels of sodium and calcium.
A
Digoxin
10
Q
Promotes movement of calcium from extracellular to intracellular cytoplasm and strengthens myocardial contraction
A
Digoxin
11
Q
Acts on the central nervous system to enhance vagal tone, slowing contractions through the sinoatrial and atrioventricular nodes and providing an antiarrhythmic effect
A
Digoxin
12
Q
Indications for Digoxin
A
Heart failure
Atrial fibrillation and flutter
Supraventricular tachycardia
13
Q
Digoxin is excreted by the?
A
kidneys
14
Q
Withhold the Digoxin if the apical pulse is ___________________________, and notify the prescriber
A
less than 60 beats/minute
15
Q
Periodically monitor ____________________ and ______________ levels in patients taking Digoxin
A
serum potassium; digoxin
16
Q
Because cardiac glycosides have a narrow therapeutic index (margin of safety), they may produce ____________________.
A
digoxin toxicity
17
Q
Before giving digoxin, take the patient’s ______________ for ____________________
A
apical pulse; 1 full minute
18
Q
what happens to the vission of patients taking Digoxin?
A
blurred or yellow vision
19
Q
an enzyme that regulates the amount of sodium and potassium inside the cell
A
Sodium-potassium-activated adenosine triphosphase
20
Q
Signs and symptoms of digoxin toxicity include:
A
- vision changes (blurred or yellow vision)
- arrhythmias (bradycardia)
- complete heart block
21
Q
treat angina by reducing myocardial oxygen demand (reducing the amount of oxygen the heart needs to do its work), by increasing the supply of oxygen to the heart or both
A
Antianginal Drugs
22
Q
for treating acute angina
A
nitrates
23
Q
for long-term prevention of angina
A
beta-adrenergic blockers
24
Q
used when other drugs fail to prevent angina
A
calcium channel blockers
25
Types of Antianginal drugs:
- nitrates
- beta-adrenergic blockers
- calcium channel blockers
26
occurs when the coronary arteries supply insufficient oxygen to the myocardium
Angina
27
blood volume in the ventricles at the end of diastole
preload
28
pressure in the arteries leading from the ventricles
afterload
29
afterload is decreased by
calcium channel blockers and nitrates
30
Heart rate is decreased by
beta-adrenergic blockers and some calcium channel blockers
31
Preload is decreased by
nitrates
32
Contractility is decreased by
beta-adrenergic blockers and calcium channel blockers
33
Relaxes vascular smooth muscle
NITROGLYCERIN
34
Causes general vasodilation
NITROGLYCERIN
35
Indications for Nitroglycerin:
Acute or chronic anginal attacks
36
Beta-adrenergic antagonists is used for?
- used for long-term prevention of angina
- one of the main types of drugs used to treat hypertension.
37
one of the main types of drugs used to treat hypertension
Beta-adrenergic antagonists
38
Beta-adrenergic blockers include:
- atenolol
- carvedilol
- metoprolol tartrate
- nadolol
- propranolol hydrochloride
39
Beta1 - and beta2 - adrenergic blockers:
PROPRANOLOL
40
reduces cardiac oxygen demand by blocking catecholamine-induced increases in heart rate, blood pressure, and force of myocardial contraction
PROPRANOLOL
41
depresses renin secretion and prevents vasodilation of cerebral arteries
PROPRANOLOL
42
relieves anginal and migraine pain, lowers blood pressure, restores normal sinus rhythm, and helps limit myocardial infarction (MI) damage
PROPRANOLOL
43
Check the patient's _________________ before giving Propranolol
apical pulse
44
Give Propranolol with _________
meals
45
Before any surgical procedure, notify the ______________________ that the patient is receiving propranolol
anesthesiologist
46
commonly used to prevent angina that doesn't respond to drugs in either of the other antianginal classes.
Calcium Channel Blockers
47
are also used as antiarrhythmics and in the treatment of hypertension
Calcium Channel Blockers
48
Calcium Channel Blockers is used to?
- prevent angina
- used as antiarrhythmics
- treatment of hypertension
49
Calcium Channel Blockers used to treat angina include:
- amlodipine besylate
- diltiazem
- nicardipine
- nifedipine
- verapamil
50
prevent the passage of calcium ions across the myocardial cell membrane and vascular smooth-muscle cells
Calcium Channel Blockers
51
this causes dilation of the coronary and peripheral arteries, which decreases the force of the heart's contractions and reduces the workload of the heart
Calcium Channel Blockers
52
reduce afterload, resulting in a decreased oxygen demand of the heart
calcium channel blockers
53
increase myocardial oxygen supply and slow cardiac impulse formation.
Calcium channel blockers
54
inhibits the influx of extracellular calcium ions across both myocardial and vascular smoothmuscle cell membranes
Calcium channel blockers
55
No calcium =
dilation
56
reduce blood pressure by interrupting the reninangiotensin activating system (RAAS).
Angiotensin-Converting Enzyme Inhibitors
57
Commonly prescribed ACE inhibitors include:
- benazepril
- captopril
- enalapril
- enalaprilat
- fosinopril sodium
- lisinopril
- moexipril
58
ACE Inhibitors:
CAPTOPRIL
59
Thought to inhibit angiotensin-converting enzyme (ACE), preventing conversion of angiotensin I to angiotensin II
CAPTOPRIL
60
Indications for Captopril:
- Sodium and water retention
- High blood pressure
- Impaired renal function in patients with diabetes
61
For patients taking Captopril:
Monitor _____________ and _________________ before therapy, every _______________ for the ______________ of therapy, and _____________ thereafter
white blood cell; differential counts; 2 weeks; first 3 months; periodically
62
For patients taking Captopril:
Give the drug _________________ because food may reduce drug absorption.
1 hour before meals
63
work by preventing the conversion of angiotensin I to angiotensin II.
ACE inhibitors
64
promote the excretion of sodium and water, reducing the amount of blood the heart needs to pump and reducing blood pressure.
ACE inhibitors
65
is a potent vasoconstrictor that increases peripheral resistance and promotes the excretion of aldosterone
Angiotensin II
66
Be sure to monitor the ______________ of a patient taking ACE
inhibitors
weight
67
lower blood pressure by blocking the vasoconstrictive effects of angiotensin II.
Angiotensin II Receptor Blocking Agents
68
Available ARBs include:
- candesartan cilexetil
- eprosartan
- irbesartan
- losartan
- Olmesartan
- Telmisartan
- valsartan
69
ARBS shouldn't be used during the ___________________________ because of the risk of injury or death to the fetus
second and third trimesters
70
ARBs have varying pharmacokinetic properties, and all are highly bound to
plasma proteins
71
act by interfering with the RAAS
Angiotensin II Receptor Blocking Agents (ARBs)
72
they selectively block the binding of angiotensin II to the angiotensin II receptor. This prevents the vasoconstricting and aldosterone-secreting effects of angiotensin II (a potent vasoconstrictor), resulting in a blood pressure decrease.
Angiotensin II Receptor Blocking Agents (ARBs)
73
inhibits vasoconstricting and aldosteronesecreting effects of angiotensin lI by selectively blocking binding of angiotensin II to receptor sites in many tissues, including vascular smooth muscle and adrenal glands
Angiotensin II Receptor Blocking Agents (ARBs)
74
Indications for Angiotensin II Receptor Blocking Agents (ARBs):
High blood pressure
75
are one of the main types of drugs used to treat hypertension, including ocular hypertension.
Beta-adrenergic Antagonists
76
Beta-adrenergic blockers used for hypertension include:
- acebutolol
- atenolol
- betaxolol
- bisoprolol
- carteolol
- metoprolol tartrate
- nadolol
- pindolol
- propranolol hydrochloride
- timolol
77
decrease blood pressure and block betaadrenergic receptor sites in the heart muscle and conduction system. This decreases heart rate and reduces the force of the heart's contractions, resulting in a lower demand for oxygen.
Beta-adrenergic Blockers
78
are used as first-line therapy for treating hypertension and are also indicated for the longterm prevention of angina
Beta-adrenergic Blockers
79
Suddenly stopping a beta-adrenergic blocker may trigger
angina, hypertension, arrhythmias, and acute MI
80
inhibits central vasomotor centers, decreasing sympathetic outflow to the heart, kidneys, and peripheral vasculature
Centrally Acting Sympatholytics: CLONIDINE
81
Centrally Acting Sympatholytics:
CLONIDINE
82
Decreases peripheral vascular resistance, systolic and diastolic blood pressure, heart rate
Centrally Acting Sympatholytics: CLONIDINE
83
Indications for Centrally Acting Sympatholytics: CLONIDINE:
High blood pressure
84
When stopping therapy in a patient receiving both clonidine and a beta-adrenergic blocker, gradually withdraw the ___________________________ first to minimize adverse reactions
beta-adrenergic blocker
85
trigger the excretion of water and electrolytes from the kidneys
Diuretics
86
a primary choice in the treatment of renal disease, edema, hypertension, and heart failure.
Diuretics
87
Thiazide and Thiazide-like Diuretics are derived from
sulfonamides
88
are used to treat edema and to prevent the development and recurrence of renal calculi
Thiazide and Thiazide-like Diuretics
89
are used to treat edema and to prevent the development and recurrence of renal calculi
Thiazide and Thiazide-like Diuretics
90
Thiazide diuretics include:
- bendroflumethiazide
- chlorothiazide
- hydrochlorothiazide
- hydroflumethiazide
- methyclothiazide
- polythiazide
91
Thiazide-like diuretics include:
- chlorthalidone
- indapamide
- metolazone
92
promote the excretion of water by preventing the reabsorption of sodium in the kidneys. As the kidneys excrete the excess sodium, they excrete water along with it.
Thiazide and Thiazide-like Diuretics
93
increase the excretion of chloride, potassium, and bicarbonate, which can result in electrolyte imbalances.
Thiazide and Thiazide-like Diuretics
94
With long-term use, thiazide diuretics also _______________________ by causing arteriolar vasodilation.
lower blood pressure
95
Thiazide Diuretics:
HYDROCHLOROTHIAZIDE
96
interferes with sodium transport across tubules of the cortical diluting segment of the nephron
HYDROCHLOROTHIAZIDE
97
increases renal excretion of sodium, chloride, water, potassium, and calcium
HYDROCHLOROTHIAZIDE
98
increases bicarbonate, magnesium, phosphate, bromide, and iodide excretion
HYDROCHLOROTHIAZIDE
99
decreases excretion of ammonia, causing increased serum ammonia levels
HYDROCHLOROTHIAZIDE
100
Indications for HYDROCHLOROTHIAZIDE
- Edema
- Hypertension
101
for patients taking HYDROCHLOROTHIAZIDE:
Monitor for adverse effects, such as pancreatitis, hematologic disorders, and electrolyte imbalances, especially ___________________
hypokalemia
102
symptoms of hypokalemia include
leg cramps and muscle aches
103
for patients taking HYDROCHLOROTHIAZIDE:
Frequently monitor _______________________________________.
weight and blood pressure
104
Initially, diuretic drugs ____________ circulating blood volume, leading to __________ cardiac output. However, if therapy is maintained, cardiac output ____________ but plasma fluid volume ______________.
decrease; reduced; stabilizes; decreases
105
used for the long-term treatment of hypertension
Thiazides
106
used to treat edema caused by kidney or liver disease, mild or moderate heart failure, and corticosteroid and estrogen therapy
Thiazides
107
Because these drugs decrease the level of calcium in urine, they may be used alone or with other drugs to prevent the development and recurrence of renal calculi.
Thiazides
108
For patient taking Thiazides:
Give the drug in the _____________ to prevent __________ from disrupting the patient's sleep
morning; nocturia
109
inhibits sodium and chloride reabsorption in the ascending loop of Henle, thus increasing renal excretion of sodium, chloride, and water
Loop Diuretics: FUROSEMIDE
110
Loop Diuretics:
FUROSEMIDE
111
increases excretion of potassium
Loop Diuretics: FUROSEMIDE
112
produces greater maximum diuresis and electrolyte loss than a thiazide diuretic
Loop Diuretics: FUROSEMIDE
113
For patiebts taking Furosemide:
Monitor for adverse effects, such as pancreatitis, hematologic disorders, and electrolyte imbalances (especially _____________).
hypokalemia
114
Indications for Loop Diuretics: FUROSEMIDE :
- Acute pulmonary edema
- Edema
- Hypertension
115
the part of the nephron responsible for concentrating urine
ascending loop of Henle
116
Loop Diuretics received their name because they act primarily on the thick ______________________
ascending loop of Henle
117
also inhibit sodium, chloride, and water reabsorption in the proximal tubule.
Loop Diuretics
118
activate renal prostaglandins, which result in dilation of the blood vessels of the kidneys, lungs, and the rest of the body.
Loop Diuretics
119
are used to treat edema associated with renal disease, hepatic cirrhosis, and heart failure,
Loop Diuretics
120
Loop Diuretics is used to treat hypertension (usually with a ______________________________________ to
prevent _________________).
potassium-sparing diuretic or potassium supplement; hypokalemia
121
may also be used for the short-term management of ascites due to malignancy, idiopathic edema, or lymph-edema.
Ethacrynic acid
122
- may be used with mannitol to treat cerebral edema
- is also used to treat hypercalcemia.
Furosemide
123
increase the renal excretion of calcium.
Loop diuretics
124
Potassium-Sparing Diuretics a.k.a
Aldosterone-Inhibiting Diuretics
125
have weaker diuretic and antihypertensive effects than other diuretics but provide the advantage of conserving potassium
Aldosterone-Inhibiting Diuretics (Aldosterone-Inhibiting Diuretics)
126
Potassium-Sparing Diuretics (Aldosterone-Inhibiting Diuretics) drugs include:
- amiloride
- spironolactone
- triamterene
127
The direct action of potassium-sparing diuretics on the collecting ducts and distal tubule of the kidneys results in
urinary excretion of sodium, water, bicarbonate, and
calcium.
128
The drug also decreases the excretion of potassium and hydrogen ions. These effects lead to reduced blood pressure and increased serum potassium levels
Potassium-Sparing Diuretics (Aldosterone-Inhibiting Diuretics)
129
Giving potassium-sparing diuretics with potassium supplements or angiotensinconverting enzyme inhibitors increases the risk of _________________.
hyperkalemia
130
are used to reduce the ability of the blood to clot
Anticoagulant DrugsMajor categories of anticoagulant drugs include:
131
Major categories of anticoagulant drugs include:
- heparin
- oral anticoagulants
- antiplatelet drugs
- direct thrombin inhibitors
- factor Xa inhibitors
132
commercially from animal tissue
Heparin
133
is an anti-thrombolytic agent used to prevent clot formation
Heparin
134
low-molecular-weight heparins
Dalteparin Sodium and Enoxaparin Sodium
135
are derived by decomposing unfractionated heparin into simpler compounds.
Dalteparin Sodium and Enoxaparin Sodium
136
developed to prevent deep vein thrombosis
(DVT)
Dalteparin Sodium and Enoxaparin Sodium
137
their use is preferred because they can be given subcut and don't require as much monitoring as unfractionated heparin.
Dalteparin Sodium and Enoxaparin Sodium
138
a blood clot in the deep veins (usually of the legs), in surgical patients
Deep Vein Thrombosis
139
Anticoagulant Drugs:
HEPARIN AND HEPARIN DERIVATIVES
WARFARIN
140
accelerates formation of an antithrombin Illthrombin complex
Anticoagulant Drugs: HEPARIN AND HEPARIN DERIVATIVES
141
inactivates thrombin
Anticoagulant Drugs: HEPARIN AND HEPARIN DERIVATIVES
142
prevents the conversion of fibrinogen to fibrin
Anticoagulant Drugs: HEPARIN AND HEPARIN DERIVATIVES
143
Effects of HEPARIN AND HEPARIN DERIVATIVES can be neutralized by
protamine sulfate
144
For patients taking Heparin:
Monitor ________________________ regularly.
partial thromboplastin time
145
inhibits vitamin K-dependent activation of clotting factors II (pro-thrombin), VII, IX, and X formed in the liver
WARFARIN
146
Indications of WARFARIN:
Prevention of pulmonary embolism
147
Warfarin's effects can be neutralized by
vitamin K
148
For patients taking Warfarin:
Monitor _________________________ regularly
prothrombin time
149
are used to prevent arterial thromboembolism, particularly in patients at risk for Ml, stroke, and arteriosclerosis (hardening of the arteries).
Antiplatelet Drugs
150
Antiplatelet drugs include:
- aspirin
- clopidogrel
- dipyridamole
- ticlopidine
151
are used in the treatment of acute coronary syndromes
IV antiplatelet drugs
152
IV antiplatelet drugs include the medications:
- abciximab
- eptifibatide
- tirofiban
153
___________________ drugs are absorbed very quickly and reach peak concentration _______________________ after administration. Aspirin maintains its antiplatelet effect for approximately 10 days, or as long as platelets normally survive. The effects of clopidogrel last about 5 days.
Oral antiplatelet; between 1 and 2 hours
154
Aspirin maintains its antiplatelet effect for approximately ____________________, or as long as platelets normally survive.
10 days
155
The effects of clopidogrel last about __________________.
5 days
156
are used to lower abnormally high blood levels of lipids, such as cholesterol, triglycerides, and phospholipids. The risk of developing coronary artery disease increases when serum lipid levels are elevated
Antilipemic Drugs
157
Antilipemic drug classes include:
- bile-sequestering drugs
- fibric acid derivatives
- HMG-CoA reductase inhibitors
- nicotinic acid
- cholesterol absorption inhibitors
158
HMG-CoA reductase inhibitors
3-hydroxy-3- methylglutaryl coenzyme A reductase inhibitors
159
HMG-CoA reductase inhibitors also known as the
statins
160
lower lipid levels by interfering with cholesterol synthesis.
HMG-CoA Reductase Inhibitors (statins)
161
HMG-CoA Reductase Inhibitors (statins) drugs include:
- atorvastatin calcium
- fluvastatin sodium
- lovastatin
- pitavastatin
- pravastatin sodium
- rosuvastatin
- simvastatin
162
inhibit the enzyme that's responsible for the conversion of HMG-CoA to mevalonate, an early rate-limiting step in the biosynthesis of cholesterol.
HMG-CoA reductase inhibitors
163
an early rate-limiting step in the biosynthesis of cholesterol
conversion of HMG-CoA to mevalonate
164
used primarily to reduce LDL cholesterol levels and to reduce total blood cholesterol levels
Statin drugs
165
produce a mild increase in HDL cholesterol levels
Statin drugs
166
Because of their ability to lower cholesterol levels, statins are indicated for the treatment of __________________________________
primary hypercholesterolemia
