Cardiovascular Pharm Flashcards by SamanthaJoan90 .

Digoxin

inhibit Na/K ATPase
increasing Na/Ca
increasing contractility

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ACE inhibitor

“pril”
prevent conversion of Ag I to Ag II
increase bradykinin

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Angiotensin II antagonist

“sartan”
block angiotensin II
do not cause cough

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What are the side effects of ACE inhibitors and ARBs

changes in renal function
contraindicated in pregnancy
contraindicated in bilateral renal artery stenosis

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Aliskiren

inhibits renin–> blocks angiotensinogen to Ag I

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What are the side effects of aliskerin

hyperkelemia
angioedema
contraindicated in pregnancy

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Acetozolamide

decrease Na/H antiport
increases water loss
tx: increase CSF, acute mountain sickness, decrease aqueous humour

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Mannitol

Increase permeability of PCT

tx: glaucoma

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What are the side effects of mannitol?

increase Heart failure

pulmonary edema

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What are the side effects of acetozolamide ?

renal tubule acidosis type 2
hypokalemia
sulfa allergy

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Hypothermia

slow shallow breathing

hypoventilation–> increased CO2

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Hyperthermia

kussmal breathing

hyperventilation –> decreased CO2

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Furosemide

inhibit Na. K. 2 Cl

increases excretion of Na, Cl ,Ca, Mg

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Ethacrynic acid

inhibit Na, K, 2 Cl

does not cause sulf allergies

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What are the side effects of loop diuretics

hypokalemia 
metabolic alkalosis 
hyperurecemia 
interstitial nephritis 
Hyp Mg &amp; Ca
ototoxcity

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What is the effect of NSAIDs on loop diuretics

decrease efficacy

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Thiazides

Block the Na/Cl cotransport

increase the reabsorption of Ca

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Triamterne & Amiloride

Block eNac pumps
decrease Na reabsorption
K spairing

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Spironolactone & Eplerenone

bind mineralocorticoids receptors

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What are the side effects of K pairing drugs ?

hyperkalemia

renal tubule acidosis

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What are the side effects of spirnalactone ?

gynecomastia
block of 17-OH
decrease libido
is beneficial in PCOS

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Dihyropyridine -CCB

“dipine”

block Ca channel in vascular smooth muscle

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Non- dihydropyridine -CCB

diltiazem -medium effect
verapamil- strong effect
block Ca channel in cardiac muscle

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What are the side effects of Calcium channel blockers ?

headache, flushing, lightheadness, peripheral edema, reflex tachycardia, gingival hyperplasia ( dihydropyridine )

constipation - verapamil

contraindicated in heart block & heart failure

Hydralazine

Safe in pregnancy may cause SLE can exacerbate hypotension decrease mortality

Nitrorusside

causes vasodilation of arteries and veins | when metabolized causes cyanide--> toxicity especially with renal insufficiency ( almond smell)

Fenoldopam

selective dopamine 1 receptor agonist --> increased cAMP dilates renal arteries increases naturesis

Nitrates

TX: heart failure

Quinidine

block Na channel prolong phase 2 & 3 tx: SvT & ventricular arrhythmia

What are the side effects of quinidine ?

Thrombocytopenia Cinchonism (tinnitus, headache, dizziness) Torsade de pointe

Procainamide

block Na channels | can prolong phase 2 & 3

What is the side effects of procainamide ?

drug induced lupus

Disopyramide

block Na channels | strong anticholinergic

What is the side effect os disopyramide ?

exacerbate heart failure

What is a side effect of Class IA drugs?

Torsade de pointes

What are the characteristics of Class IB?

low binding affinity shortened phase 3 tx: arrhythmia with ischemic damage

What are the class IB drugs?

Lidocaine Phenytoin Mexiletine

What is the side effect of class IB?

Seizures paresthesia convulsions

What are the characteristics of class IC

``` greater binding affinity decrease phase 0 Prolong QRS do not affect the AP used to tx SVT & ventricular arrhythmia tx:atrial fibrillation & flutter ```

Who cannot receive class IC drugs ?

those with structural or ischemic heart disease

Class II - beta blockers

decrease SA node firing & AV node conduction decrease cAMP-->closure of Ca channels --> decrease contractility Tx: atrial fibrillation & flutter

What are the side effects of Class II?

can exacerbate heart block | prolong PR interval

What are the class II drugs given IV ?

Esmolol- IV only Metoprolol Propanolol

Class III antiarrythmics?

block K channel & delay repolarization prolong AP--> prolonged QT tx: SVT & ventricular arrhythmia , atrial fibrillation & flutter

Amiodarone

``` acts as a class I, II, III, IV very long half life increased tissue protein binding ```

What are the side effects of amiodarone

``` neurologic effects blue grey deposits in the skin and cornea thyroid dysfunction exacerbate heart block & HF hypersensitivity hepatitis torsade de pointes P450 inhibitor pulmonary fibrosis ```

not including amiodarone what other class III drugs are there ?

dofetilide & ibutilide | sotalol

Class IV drugs

decrease phase 0 & phase 4 --> SA & AV node conduction decreased tx: SVT , atrial fibrillation & flutter increase PR interval

What are the side effects of Class IV drugs

``` reduced BP reduced cardiac output lower extremity deem constipation increases heart block ```

Class IV drug interaction

verapamil displaces digoxin

What does digoxin treat?

SVT & fibrillation & flutter

How does digoxin work?

Vagal innervation | parasympathetic

What is the benefit of using magnesium in arrhythmia?

tx : torsades de pointes

What can induce arrhythmia?

HyperKalemia | HypoKalemia

Adenosine

rapid acting tx: PSVTs half life is less than 30 sec increase coronary dilation by A2 receptors

What are adenosine receptors

A1- Gi coupled , decrease SA, AV rate A2: Gs coupled , vasodilator A2B: Gq coupled , bronchoconstriction

What are the side effects of adenosine ?

flushing shortness of breath chest pain--> sense of impending doom

What are the drug interactions of adenosine ?

Theophylline (caffeine) antagonize adenosine receptors