Cardiovascular Medications Flashcards
What are the two types of innervation within the heart?
Sympathetic and parasympathetic.
Which part of the brain innervates the heart?
Medulla oblongata.
What are the three types of cardiac muscle effects?
Chronotropic, inotropic, dromotropic.
What are the two types of sympathetic receptors?
Alpha and beta.
What are catecholamines associated with?
Vascular and glandular effects.
What is the role of the vagus nerve in the parasympathetic system?
Stimulation of the heart.
What receptors are involved in cardiac function?
Chemoreceptors, baroreceptors, and other receptors.
What are the classes of anti-arrhythmics based on?
Their predominant effects on action potential.
What is the Vaughan Williams classification system?
A system that classifies all anti-arrhythmics.
What is Class I of anti-arrhythmics?
Sodium channel blockers.
What is Class II of anti-arrhythmics?
Beta blockers (BB).
What is Class III of anti-arrhythmics?
Potassium channel blockers (K+ CB).
What is Class IV of anti-arrhythmics?
Calcium channel blockers (CCB).
What do beta blockers do?
Block the effects of the hormone epinephrine.
What are common conditions treated with beta blockers?
Chest pain, hypertension, post STEMI, cardiomyopathy, arrhythmias.
What are some adverse effects of beta blockers?
Dizziness, weakness, drowsiness, cold hands, dry mouth, headache.
What is atenolol?
A cardioselective beta blocker.
What is esmolol used for?
Cardioselective for supraventricular tachycardias (SVT’s).
What is the indication for atropine?
Symptomatic bradycardia.
What are potassium channel blockers used for?
Treatment of refractory V-FIB and VT.
What are the adverse reactions of potassium channel blockers?
Arrhythmia worsening, slower heart rates, chest pains.
What do calcium channel blockers prevent?
Calcium from entering the cells of the heart and blood vessel walls.
What is the family name for calcium channel blockers?
DIPINE.
What are the conditions treated by Calcium Channel Blockers (CCB)?
High blood pressure, rapid heart rhythms, and decreasing the excitability of heart muscles.
What are common adverse effects of Calcium Channel Blockers?
Headache, flushing, edema, drowsiness, low blood pressure, constipation, rash, and nausea.
Name some examples of Calcium Channel Blockers.
Amlodipine, Felodipine, Isradipine, Nicardipine, Nifedipine, Verapamil, and Diltiazem.
What is Adenosine used for?
Emergency treatment of SVT arrhythmias.
What is a key characteristic of Adenosine?
It is a naturally occurring nucleoside.
What should Adenosine not be used for?
Irregular rhythms.
What is the function of ACE inhibitors?
They dilate blood vessels and lower blood pressure.
What conditions are treated with ACE inhibitors?
Heart failure, hypertension (HTN), prevention of kidney damage from diabetes mellitus (DM), and prevention of continuous damage after myocardial infarction (MI).
What is the role of Angiotensin Converting Enzyme (ACE) in the body?
It converts Angiotensin 1 to the active vasoconstrictor Angiotensin 2.
What is a common adverse effect of ACE inhibitors?
Dry tickly cough.
What is the family name for ACE inhibitors?
PRIL.
What are ACE Inhibitors?
ACE Inhibitors are medications that help treat heart failure, hypertension (HTN), prevent kidney damage from diabetes mellitus (DM), and prevent continuous damage after a myocardial infarction (MI).
What are common adverse effects of ACE Inhibitors?
Common adverse effects include dry cough, hyperkalemia, fatigue, dizziness, headaches, and loss of taste.
Name some ACE Inhibitors.
Captopril, Enalapril, Fosinopril, Lisinopril, Quinapril, Ramipril.
What are ARBs?
Angiotensin Receptor Blockers (ARBs) help lower blood pressure and work similarly to ACE Inhibitors but without causing a cough.
What are the conditions treated by ARBs?
Conditions include controlling blood pressure, treating heart failure, preventing kidney failure from DM, and reducing the risk of cerebrovascular accidents (CVA) in patients with abnormal HTN or an enlarged heart.
What are common adverse effects of ARBs?
Common adverse effects include dizziness, headache, drowsiness, nausea/vomiting/diarrhea (N/V/D), elevated potassium levels, lower blood pressure, muscle or bone pain, and rash.
Name some ARBs.
Candesartan, Irbesartan, Losartan, Telmisartan, Valsartan.
What are nitrates?
Nitrates are vasodilators that help dilate the arteries to the heart, increase blood flow to the heart, and relieve angina symptoms or chest pain.
What is the function of nitroglycerin (NTG)?
Nitroglycerin (NTG) is used as a vasodilator to treat angina symptoms, reducing the workload on the heart by dilating veins.
What are vasodilators also called?
Anti-anginal medications.
What are common medications classified as vasodilators?
Nitroglycerin, Diltiazem, Felodipine, Nifedipine, and Verapamil.
What conditions do vasodilators treat?
Heart failure, angina pains, and high blood pressure (HBP).
What are common adverse reactions of vasodilators?
Headache, dizziness, lightheadedness, nausea, flushing, and burning or tingling under the tongue for sublingual forms.
What are anti-coagulants?
Drugs that slow down the body’s process of making clots.
What are anti-platelets?
Drugs that prevent blood cells from clumping together to form a clot.
What is the generalized term for anti-coagulants and anti-platelets?
Blood thinners.
What conditions require the use of blood thinners?
Heart disease, poor blood circulation, recent surgeries, abnormal heartbeats (a-fib), and congenital heart defects.
What do anti-coagulants prevent?
Ischemic strokes and TIAs, and they prevent blood clots from forming or getting larger.
Who are often prescribed anti-coagulants?
People with artificial heart valves, irregular heartbeats, or those who have had a heart attack or stroke.
What do anti-platelets help prevent?
Blood clots by making it difficult for platelets to stick together.
What are some examples of anti-coagulants?
Heparin, Warfarin, Rivaroxaban, and Apixaban.
What are some examples of anti-platelets?
Clopidogrel, Aggrenox, and ASA (Acetylsalicylic Acid).
What are common adverse effects of blood thinners?
Increased bruising, red or pink urine, coffee ground stools, increased menstrual bleeding, and purple toes.
What is the mechanism of action of Acetylsalicylic Acid (ASA)?
Blocks the enzyme cyclooxygenase, crucial for the creation of prostaglandins.
What is the purpose of enteric-coated ASA?
To pass through the stomach intact and dissolve in the small intestine, minimizing irritation.
What are the uses of ASA?
To treat pain, fever, inflammation, as an anti-clotting agent, and to prevent second heart attacks or CVAs.
What medications are used in cardiac ischemia and arrest?
Nitroglycerine (vasodilator) and ASA (anti-clotting agent).
What are advanced care medications for cardiac arrest?
Nitroglycerine, ASA, Epinephrine, Adenosine, Atropine, Amiodarone, and Lidocaine.
What part of the nervous system innervates the sympathetic and parasympathetic systems within the heart?
Both are innervated by the medulla oblongata and act on cardiac muscle.
What are the three types of effects the sympathetic nervous system has on the heart?
The sympathetic nervous system affects the heart in chronotropic (heart rate), inotropic (force of contraction), and dromotropic (conduction velocity) ways.
What are the two types of receptors found in the sympathetic nervous system, and where do they primarily act?
Alpha receptors: Primarily in vascular areas.
Beta receptors:
Beta-1: In the heart.
Beta-2: In the lungs.
Which receptors are involved in the parasympathetic nervous system, and where do they act?
The parasympathetic system involves the vagus nerve and has chemoreceptors, baroreceptors, and other receptors such as Kappa, Mu, Sigma, and Delta.
What is the Vaughan Williams classification system used for?
It classifies anti-arrhythmic medications based on their predominant effects on the action potential.
What is the mechanism of action for Beta Blockers?
Beta blockers block the effects of epinephrine on the Beta-1 receptors in the heart, causing a slower heart rate and less forceful contraction, which helps reduce blood pressure.
What are some conditions that Beta Blockers are used to treat?
Conditions like chest pain, hypertension, post-STEMI, arrhythmias (e.g., A-fib), and cardiomyopathy.
What are some common adverse effects of Beta Blockers?
Dizziness, weakness, cold hands/feet, dry mouth/skin/eyes, headache, upset stomach, and changes in bowel movements.
What condition is treated with Atropine and how does it work?
Atropine is used for symptomatic bradycardia (heart rate <50 beats/min), especially when there is structural disease of the infra-nodal system.
What are Potassium Channel Blockers used for, and what is a potential adverse effect?
These drugs are used to treat refractory V-Fib, V-Tach, and atrial dysrhythmias. They can sometimes worsen arrhythmias or cause dangerously slow heart rates.
How do Calcium Channel Blockers (CCB) work, and what conditions are they used for?
CCBs prevent calcium from entering the heart and blood vessel walls, reducing electrical conduction and the force of contraction. They are used for supraventricular arrhythmias and high blood pressure.
What are common adverse effects of Calcium Channel Blockers?
Headache, flushing, edema, low blood pressure, constipation, rash, and nausea.
What is Adenosine used for, and what is an important contraindication?
Adenosine is used for SVT arrhythmias, but should not be used for irregular rhythms. It works by slowing or stopping conduction through the AV node.
What is the main function of ACE Inhibitors?
ACE inhibitors dilate blood vessels, lower blood pressure, and reduce the heart’s workload by inhibiting the enzyme that converts Angiotensin I to Angiotensin II.
What are some common adverse effects of ACE Inhibitors?
Dry cough, hyperkalemia, dizziness, fatigue, headaches, and loss of taste.
What is the difference between ACE Inhibitors and Angiotensin Receptor Blockers (ARBs)?
ARBs work similarly to ACE inhibitors by dilating blood vessels and lowering blood pressure, but without causing the dry cough associated with ACE inhibitors.
What conditions are Nitrates/Vasodilators used to treat?
They are used to treat angina, heart failure, and high blood pressure, by increasing blood flow to the heart and reducing its workload.
What is the primary role of Blood Thinners (anticoagulants and antiplatelets)?
Blood thinners prevent blood clots by either slowing the clotting process (anticoagulants) or preventing platelets from sticking together (antiplatelets).
What are some examples of anticoagulants?
Heparin, Warfarin, Rivaroxaban, and Apixaban.
What is the mechanism of action of Acetylsalicylic Acid (ASA), and what is its primary use?
ASA blocks cyclooxygenase to reduce inflammation, pain, and fever. It is also used as an anti-clotting agent to prevent heart attacks or strokes.
What medication could be administered to reduce the work on the heart and relieve chest pain in a patient with chest pain, shortness of breath, and dizziness?
Nitroglycerin – A vasodilator that helps reduce the heart’s workload and increases blood flow to the heart.
What medication would you administer to increase the heart rate in a patient with symptomatic bradycardia (heart rate of 40 bpm) showing signs of hypotension and altered mental status?
Atropine – Used for symptomatic bradycardia to increase heart rate, especially when the cause is not reversible.
What should you monitor for after administering Adenosine to a patient with a history of A-fib presenting with dizziness and palpitations?
Adenosine can cause a brief sinus pause or asystole (flatline), so monitor for any signs of cardiac arrest or rhythm changes.
What is a common side effect of Lisinopril that you should be aware of in a patient on this medication for blood pressure management?
A common side effect of Lisinopril is a dry cough. Ensure the patient has not recently experienced this symptom.
Which medication would you avoid in a patient suspected to have aortic dissection with acute severe back pain?
Beta-blockers (e.g., Metoprolol) – While they lower heart rate and blood pressure, they may not be effective in aortic dissection, and the rapid reduction in heart rate could worsen the condition.
What is a potential risk of administering Propranolol to a patient with a history of asthma presenting with shortness of breath and wheezing?
Propranolol is a non-selective beta-blocker and can cause bronchoconstriction in patients with asthma, worsening respiratory symptoms.
Which class of medication would be appropriate to manage V-Tach in a patient presenting with rapid heart rate, shortness of breath, and dizziness?
Amiodarone – A Class III potassium channel blocker that is used to treat V-Tach and V-Fib by prolonging phase 3 of the action potential.
What class of medications would you likely see prescribed for a patient with heart failure presenting with edema, shortness of breath, and jugular venous distention?
ACE inhibitors (e.g., Lisinopril) or ARBs (e.g., Losartan) – These medications dilate blood vessels, reduce blood pressure, and decrease the heart’s workload, improving symptoms of heart failure.
What complication should you be vigilant for in a patient with a history of A-fib and recent MI being treated with Warfarin?
Bleeding complications, such as bruising, hemorrhaging, or hematoma, as anticoagulants increase the risk of excessive bleeding.
What is the primary effect of Furosemide (Lasix) in a patient in acute heart failure, and what side effect should you monitor for?
Furosemide is a diuretic that helps reduce fluid retention by increasing urine output. Monitor for signs of hypokalemia (low potassium), dehydration, and low blood pressure.
What is the primary action of Aspirin (ASA) in a 60-year-old diabetic patient with a history of heart failure presenting with severe chest pain?
Aspirin inhibits cyclooxygenase and prevents platelet aggregation, helping to reduce the risk of myocardial infarction (MI) or further clotting in the coronary arteries.
What initial treatments would you administer to a patient presenting with severe chest pain found to be in STEMI?
Aspirin (ASA) to prevent clotting and Nitroglycerin to relieve chest pain and dilate coronary arteries. Consider morphine if pain is not relieved, and oxygen if needed.
What is the action of Lidocaine when administered to a patient in V-Fib who is unresponsive and undergoing CPR?
Lidocaine is an antiarrhythmic used to suppress abnormal heart rhythms by stabilizing the heart’s electrical activity during V-Fib.
