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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
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2
Q

influence the strength or contractility of muscle tissue

A

inotropic drugs

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3
Q

they increase the force of the heart’s contractions

A

inotropic drugs

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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

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5
Q

are two types of inotropic drugs

A

glycosides and phosphodiesterase (PDE) inhibitors

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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

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7
Q

This action is useful for patients who have atrial fibrillation

A

Cardiac glycosides

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8
Q

it can help to control their heart rate and to prevent the heart rate from becoming too fast.

A

Cardiac glycosides

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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

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10
Q

Promotes movement of calcium from extracellular to intracellular cytoplasm and strengthens myocardial contraction

A

Digoxin

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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

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12
Q

Indications for Digoxin

A

Heart failure
Atrial fibrillation and flutter
Supraventricular tachycardia

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13
Q

Digoxin is excreted by the?

A

kidneys

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14
Q

Withhold the Digoxin if the apical pulse is ___________________________, and notify the prescriber

A

less than 60 beats/minute

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15
Q

Periodically monitor ____________________ and ______________ levels in patients taking Digoxin

A

serum potassium; digoxin

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16
Q

Because cardiac glycosides have a narrow therapeutic index (margin of safety), they may produce ____________________.

A

digoxin toxicity

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17
Q

Before giving digoxin, take the patient’s ______________ for ____________________

A

apical pulse; 1 full minute

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18
Q

what happens to the vission of patients taking Digoxin?

A

blurred or yellow vision

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19
Q

an enzyme that regulates the amount of sodium and potassium inside the cell

A

Sodium-potassium-activated adenosine triphosphase

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20
Q

Signs and symptoms of digoxin toxicity include:

A
  • vision changes (blurred or yellow vision)
  • arrhythmias (bradycardia)
  • complete heart block
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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

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22
Q

for treating acute angina

A

nitrates

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23
Q

for long-term prevention of angina

A

beta-adrenergic blockers

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24
Q

used when other drugs fail to prevent angina

A

calcium channel blockers

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25
Q

Types of Antianginal drugs:

A
  • nitrates
  • beta-adrenergic blockers
  • calcium channel blockers
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26
Q

occurs when the coronary arteries supply insufficient oxygen to the myocardium

A

Angina

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27
Q

blood volume in the ventricles at the end of diastole

A

preload

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28
Q

pressure in the arteries leading from the ventricles

A

afterload

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29
Q

afterload is decreased by

A

calcium channel blockers and nitrates

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30
Q

Heart rate is decreased by

A

beta-adrenergic blockers and some calcium channel blockers

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31
Q

Preload is decreased by

A

nitrates

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32
Q

Contractility is decreased by

A

beta-adrenergic blockers and calcium channel blockers

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33
Q

Relaxes vascular smooth muscle

A

NITROGLYCERIN

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34
Q

Causes general vasodilation

A

NITROGLYCERIN

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35
Q

Indications for Nitroglycerin:

A

Acute or chronic anginal attacks

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36
Q

Beta-adrenergic antagonists is used for?

A
  • used for long-term prevention of angina
  • one of the main types of drugs used to treat hypertension.
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37
Q

one of the main types of drugs used to treat hypertension

A

Beta-adrenergic antagonists

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38
Q

Beta-adrenergic blockers include:

A
  • atenolol
  • carvedilol
  • metoprolol tartrate
  • nadolol
  • propranolol hydrochloride
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39
Q

Beta1 - and beta2 - adrenergic blockers:

A

PROPRANOLOL

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40
Q

reduces cardiac oxygen demand by blocking catecholamine-induced increases in heart rate, blood pressure, and force of myocardial contraction

A

PROPRANOLOL

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41
Q

depresses renin secretion and prevents vasodilation of cerebral arteries

A

PROPRANOLOL

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42
Q

relieves anginal and migraine pain, lowers blood pressure, restores normal sinus rhythm, and helps limit myocardial infarction (MI) damage

A

PROPRANOLOL

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43
Q

Check the patient’s _________________ before giving Propranolol

A

apical pulse

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44
Q

Give Propranolol with _________

A

meals

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45
Q

Before any surgical procedure, notify the ______________________ that the patient is receiving propranolol

A

anesthesiologist

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46
Q

commonly used to prevent angina that doesn’t respond to drugs in either of the other antianginal classes.

A

Calcium Channel Blockers

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47
Q

are also used as antiarrhythmics and in the treatment of hypertension

A

Calcium Channel Blockers

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48
Q

Calcium Channel Blockers is used to?

A
  • prevent angina
  • used as antiarrhythmics
  • treatment of hypertension
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49
Q

Calcium Channel Blockers used to treat angina include:

A
  • amlodipine besylate
  • diltiazem
  • nicardipine
  • nifedipine
  • verapamil
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50
Q

prevent the passage of calcium ions across the myocardial cell membrane and vascular smooth-muscle cells

A

Calcium Channel Blockers

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51
Q

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

A

Calcium Channel Blockers

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52
Q

reduce afterload, resulting in a decreased oxygen demand of the heart

A

calcium channel blockers

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53
Q

increase myocardial oxygen supply and slow cardiac impulse formation.

A

Calcium channel blockers

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54
Q

inhibits the influx of extracellular calcium ions across both myocardial and vascular smoothmuscle cell membranes

A

Calcium channel blockers

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55
Q

No calcium =

A

dilation

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56
Q

reduce blood pressure by interrupting the reninangiotensin activating system (RAAS).

A

Angiotensin-Converting Enzyme Inhibitors

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57
Q

Commonly prescribed ACE inhibitors include:

A
  • benazepril
  • captopril
  • enalapril
  • enalaprilat
  • fosinopril sodium
  • lisinopril
  • moexipril
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58
Q

ACE Inhibitors:

A

CAPTOPRIL

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59
Q

Thought to inhibit angiotensin-converting enzyme (ACE), preventing conversion of angiotensin I to angiotensin II

A

CAPTOPRIL

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60
Q

Indications for Captopril:

A
  • Sodium and water retention
  • High blood pressure
  • Impaired renal function in patients with diabetes
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61
Q

For patients taking Captopril:
Monitor _____________ and _________________ before therapy, every _______________ for the ______________ of therapy, and _____________ thereafter

A

white blood cell; differential counts; 2 weeks; first 3 months; periodically

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62
Q

For patients taking Captopril:
Give the drug _________________ because food may reduce drug absorption.

A

1 hour before meals

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63
Q

work by preventing the conversion of angiotensin I to angiotensin II.

A

ACE inhibitors

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64
Q

promote the excretion of sodium and water, reducing the amount of blood the heart needs to pump and reducing blood pressure.

A

ACE inhibitors

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65
Q

is a potent vasoconstrictor that increases peripheral resistance and promotes the excretion of aldosterone

A

Angiotensin II

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66
Q

Be sure to monitor the ______________ of a patient taking ACE
inhibitors

A

weight

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67
Q

lower blood pressure by blocking the vasoconstrictive effects of angiotensin II.

A

Angiotensin II Receptor Blocking Agents

68
Q

Available ARBs include:

A
  • candesartan cilexetil
  • eprosartan
  • irbesartan
  • losartan
  • Olmesartan
  • Telmisartan
  • valsartan
69
Q

ARBS shouldn’t be used during the ___________________________ because of the risk of injury or death to the fetus

A

second and third trimesters

70
Q

ARBs have varying pharmacokinetic properties, and all are highly bound to

A

plasma proteins

71
Q

act by interfering with the RAAS

A

Angiotensin II Receptor Blocking Agents (ARBs)

72
Q

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.

A

Angiotensin II Receptor Blocking Agents (ARBs)

73
Q

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

A

Angiotensin II Receptor Blocking Agents (ARBs)

74
Q

Indications for Angiotensin II Receptor Blocking Agents (ARBs):

A

High blood pressure

75
Q

are one of the main types of drugs used to treat hypertension, including ocular hypertension.

A

Beta-adrenergic Antagonists

76
Q

Beta-adrenergic blockers used for hypertension include:

A
  • acebutolol
  • atenolol
  • betaxolol
  • bisoprolol
  • carteolol
  • metoprolol tartrate
  • nadolol
  • pindolol
  • propranolol hydrochloride
  • timolol
77
Q

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.

A

Beta-adrenergic Blockers

78
Q

are used as first-line therapy for treating hypertension and are also indicated for the longterm prevention of angina

A

Beta-adrenergic Blockers

79
Q

Suddenly stopping a beta-adrenergic blocker may trigger

A

angina, hypertension, arrhythmias, and acute MI

80
Q

inhibits central vasomotor centers, decreasing sympathetic outflow to the heart, kidneys, and peripheral vasculature

A

Centrally Acting Sympatholytics: CLONIDINE

81
Q

Centrally Acting Sympatholytics:

82
Q

Decreases peripheral vascular resistance, systolic and diastolic blood pressure, heart rate

A

Centrally Acting Sympatholytics: CLONIDINE

83
Q

Indications for Centrally Acting Sympatholytics: CLONIDINE:

A

High blood pressure

84
Q

When stopping therapy in a patient receiving both clonidine and a beta-adrenergic blocker, gradually withdraw the ___________________________ first to minimize adverse reactions

A

beta-adrenergic blocker

85
Q

trigger the excretion of water and electrolytes from the kidneys

86
Q

a primary choice in the treatment of renal disease, edema, hypertension, and heart failure.

87
Q

Thiazide and Thiazide-like Diuretics are derived from

A

sulfonamides

88
Q

are used to treat edema and to prevent the development and recurrence of renal calculi

A

Thiazide and Thiazide-like Diuretics

89
Q

are used to treat edema and to prevent the development and recurrence of renal calculi

A

Thiazide and Thiazide-like Diuretics

90
Q

Thiazide diuretics include:

A
  • bendroflumethiazide
  • chlorothiazide
  • hydrochlorothiazide
  • hydroflumethiazide
  • methyclothiazide
  • polythiazide
91
Q

Thiazide-like diuretics include:

A
  • chlorthalidone
  • indapamide
  • metolazone
92
Q

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.

A

Thiazide and Thiazide-like Diuretics

93
Q

increase the excretion of chloride, potassium, and bicarbonate, which can result in electrolyte imbalances.

A

Thiazide and Thiazide-like Diuretics

94
Q

With long-term use, thiazide diuretics also _______________________ by causing arteriolar vasodilation.

A

lower blood pressure

95
Q

Thiazide Diuretics:

A

HYDROCHLOROTHIAZIDE

96
Q

interferes with sodium transport across tubules of the cortical diluting segment of the nephron

A

HYDROCHLOROTHIAZIDE

97
Q

increases renal excretion of sodium, chloride, water, potassium, and calcium

A

HYDROCHLOROTHIAZIDE

98
Q

increases bicarbonate, magnesium, phosphate, bromide, and iodide excretion

A

HYDROCHLOROTHIAZIDE

99
Q

decreases excretion of ammonia, causing increased serum ammonia levels

A

HYDROCHLOROTHIAZIDE

100
Q

Indications for HYDROCHLOROTHIAZIDE

A
  • Edema
  • Hypertension
101
Q

for patients taking HYDROCHLOROTHIAZIDE:
Monitor for adverse effects, such as pancreatitis, hematologic disorders, and electrolyte imbalances, especially ___________________

A

hypokalemia

102
Q

symptoms of hypokalemia include

A

leg cramps and muscle aches

103
Q

for patients taking HYDROCHLOROTHIAZIDE:
Frequently monitor _______________________________________.

A

weight and blood pressure

104
Q

Initially, diuretic drugs ____________ circulating blood volume, leading to __________ cardiac output. However, if therapy is maintained, cardiac output ____________ but plasma fluid volume ______________.

A

decrease; reduced; stabilizes; decreases

105
Q

used for the long-term treatment of hypertension

106
Q

used to treat edema caused by kidney or liver disease, mild or moderate heart failure, and corticosteroid and estrogen therapy

107
Q

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.

108
Q

For patient taking Thiazides:
Give the drug in the _____________ to prevent __________ from disrupting the patient’s sleep

A

morning; nocturia

109
Q

inhibits sodium and chloride reabsorption in the ascending loop of Henle, thus increasing renal excretion of sodium, chloride, and water

A

Loop Diuretics: FUROSEMIDE

110
Q

Loop Diuretics:

A

FUROSEMIDE

111
Q

increases excretion of potassium

A

Loop Diuretics: FUROSEMIDE

112
Q

produces greater maximum diuresis and electrolyte loss than a thiazide diuretic

A

Loop Diuretics: FUROSEMIDE

113
Q

For patiebts taking Furosemide:
Monitor for adverse effects, such as pancreatitis, hematologic disorders, and electrolyte imbalances (especially _____________).

A

hypokalemia

114
Q

Indications for Loop Diuretics: FUROSEMIDE :

A
  • Acute pulmonary edema
  • Edema
  • Hypertension
115
Q

the part of the nephron responsible for concentrating urine

A

ascending loop of Henle

116
Q

Loop Diuretics received their name because they act primarily on the thick ______________________

A

ascending loop of Henle

117
Q

also inhibit sodium, chloride, and water reabsorption in the proximal tubule.

A

Loop Diuretics

118
Q

activate renal prostaglandins, which result in dilation of the blood vessels of the kidneys, lungs, and the rest of the body.

A

Loop Diuretics

119
Q

are used to treat edema associated with renal disease, hepatic cirrhosis, and heart failure,

A

Loop Diuretics

120
Q

Loop Diuretics is used to treat hypertension (usually with a ______________________________________ to
prevent _________________).

A

potassium-sparing diuretic or potassium supplement; hypokalemia

121
Q

may also be used for the short-term management of ascites due to malignancy, idiopathic edema, or lymph-edema.

A

Ethacrynic acid

122
Q
  • may be used with mannitol to treat cerebral edema
  • is also used to treat hypercalcemia.
A

Furosemide

123
Q

increase the renal excretion of calcium.

A

Loop diuretics

124
Q

Potassium-Sparing Diuretics a.k.a

A

Aldosterone-Inhibiting Diuretics

125
Q

have weaker diuretic and antihypertensive effects than other diuretics but provide the advantage of conserving potassium

A

Aldosterone-Inhibiting Diuretics (Aldosterone-Inhibiting Diuretics)

126
Q

Potassium-Sparing Diuretics (Aldosterone-Inhibiting Diuretics) drugs include:

A
  • amiloride
  • spironolactone
  • triamterene
127
Q

The direct action of potassium-sparing diuretics on the collecting ducts and distal tubule of the kidneys results in

A

urinary excretion of sodium, water, bicarbonate, and
calcium.

128
Q

The drug also decreases the excretion of potassium and hydrogen ions. These effects lead to reduced blood pressure and increased serum potassium levels

A

Potassium-Sparing Diuretics (Aldosterone-Inhibiting Diuretics)

129
Q

Giving potassium-sparing diuretics with potassium supplements or angiotensinconverting enzyme inhibitors increases the risk of _________________.

A

hyperkalemia

130
Q

are used to reduce the ability of the blood to clot

A

Anticoagulant DrugsMajor categories of anticoagulant drugs include:

131
Q

Major categories of anticoagulant drugs include:

A
  • heparin
  • oral anticoagulants
  • antiplatelet drugs
  • direct thrombin inhibitors
  • factor Xa inhibitors
132
Q

commercially from animal tissue

133
Q

is an anti-thrombolytic agent used to prevent clot formation

134
Q

low-molecular-weight heparins

A

Dalteparin Sodium and Enoxaparin Sodium

135
Q

are derived by decomposing unfractionated heparin into simpler compounds.

A

Dalteparin Sodium and Enoxaparin Sodium

136
Q

developed to prevent deep vein thrombosis
(DVT)

A

Dalteparin Sodium and Enoxaparin Sodium

137
Q

their use is preferred because they can be given subcut and don’t require as much monitoring as unfractionated heparin.

A

Dalteparin Sodium and Enoxaparin Sodium

138
Q

a blood clot in the deep veins (usually of the legs), in surgical patients

A

Deep Vein Thrombosis

139
Q

Anticoagulant Drugs:

A

HEPARIN AND HEPARIN DERIVATIVES
WARFARIN

140
Q

accelerates formation of an antithrombin Illthrombin complex

A

Anticoagulant Drugs: HEPARIN AND HEPARIN DERIVATIVES

141
Q

inactivates thrombin

A

Anticoagulant Drugs: HEPARIN AND HEPARIN DERIVATIVES

142
Q

prevents the conversion of fibrinogen to fibrin

A

Anticoagulant Drugs: HEPARIN AND HEPARIN DERIVATIVES

143
Q

Effects of HEPARIN AND HEPARIN DERIVATIVES can be neutralized by

A

protamine sulfate

144
Q

For patients taking Heparin:
Monitor ________________________ regularly.

A

partial thromboplastin time

145
Q

inhibits vitamin K-dependent activation of clotting factors II (pro-thrombin), VII, IX, and X formed in the liver

146
Q

Indications of WARFARIN:

A

Prevention of pulmonary embolism

147
Q

Warfarin’s effects can be neutralized by

148
Q

For patients taking Warfarin:
Monitor _________________________ regularly

A

prothrombin time

149
Q

are used to prevent arterial thromboembolism, particularly in patients at risk for Ml, stroke, and arteriosclerosis (hardening of the arteries).

A

Antiplatelet Drugs

150
Q

Antiplatelet drugs include:

A
  • aspirin
  • clopidogrel
  • dipyridamole
  • ticlopidine
151
Q

are used in the treatment of acute coronary syndromes

A

IV antiplatelet drugs

152
Q

IV antiplatelet drugs include the medications:

A
  • abciximab
  • eptifibatide
  • tirofiban
153
Q

___________________ 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.

A

Oral antiplatelet; between 1 and 2 hours

154
Q

Aspirin maintains its antiplatelet effect for approximately ____________________, or as long as platelets normally survive.

155
Q

The effects of clopidogrel last about __________________.

156
Q

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

A

Antilipemic Drugs

157
Q

Antilipemic drug classes include:

A
  • bile-sequestering drugs
  • fibric acid derivatives
  • HMG-CoA reductase inhibitors
  • nicotinic acid
  • cholesterol absorption inhibitors
158
Q

HMG-CoA reductase inhibitors

A

3-hydroxy-3- methylglutaryl coenzyme A reductase inhibitors

159
Q

HMG-CoA reductase inhibitors also known as the

160
Q

lower lipid levels by interfering with cholesterol synthesis.

A

HMG-CoA Reductase Inhibitors (statins)

161
Q

HMG-CoA Reductase Inhibitors (statins) drugs include:

A
  • atorvastatin calcium
  • fluvastatin sodium
  • lovastatin
  • pitavastatin
  • pravastatin sodium
  • rosuvastatin
  • simvastatin
162
Q

inhibit the enzyme that’s responsible for the conversion of HMG-CoA to mevalonate, an early rate-limiting step in the biosynthesis of cholesterol.

A

HMG-CoA reductase inhibitors

163
Q

an early rate-limiting step in the biosynthesis of cholesterol

A

conversion of HMG-CoA to mevalonate

164
Q

used primarily to reduce LDL cholesterol levels and to reduce total blood cholesterol levels

A

Statin drugs

165
Q

produce a mild increase in HDL cholesterol levels

A

Statin drugs

166
Q

Because of their ability to lower cholesterol levels, statins are indicated for the treatment of __________________________________

A

primary hypercholesterolemia

Pharmacology (24 decks)

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