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Pharmacology I > Cardiovascular Pharmacology (Jensen's video lecture) > Flashcards

Cardiovascular Pharmacology (Jensen's video lecture) Flashcards

1
Q

Hypertension - disorders

A
  • Excessive cardiac output
  • Excessive peripheral resistance
  • Excessive fluid volume
  • Combination of above
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2
Q

Hypertension - mitigation possibilities

A
  • Decrease cardiac output via negative inotropism or negative chronotropism
  • Decrease peripheral resistance via vasodilation
  • Decrease fluid volume via fluid and electrolyte reduction
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3
Q

Normal BP

A

< 120/80

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4
Q

Prehypertension

A

120-135/80-89

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5
Q

Hypertension

A

Greater than or equal to 140/90

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6
Q

Stage 1 hypertension

A

140-159/90-99

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7
Q

Stage 2 hypertension

A

Greater than or equal to 160/100

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8
Q

BP =

A

BP = CO x PR

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9
Q

CO =

A

CO = HR x SV

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10
Q

Angina pectoris - disorder

A
  • Cardiac oxygen demand exceeds oxygen supply
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11
Q

Angina pectoris - mitigation possibilities

A
  • Increase the myocardial oxygen supply via coronary dilation
  • Decrease the myocardial oxygen demand via negative inotropism or chronotropism or peripheral vascular dilation
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12
Q

Cardiac arrhythmias - disorder

A
  • Abnormal pacemaker

- Abnormal impulse propagation

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13
Q

Cardiac arrhythmias - mitigation possibilities

A
  • Decrease ectopic foci via negative chronotropism
  • Decrease cardiac conduction rate via negative chronotropism
  • Increase the refractory period
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14
Q

Antiarrhythmic class 1

A
  • Sodicum channel blockers (local anesthetics)
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15
Q

Antiarrhythmics class 2

A
  • Beta blockers
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16
Q

Antiarrhthmics class 3

A
  • Prolong action potential duration (ADP) and effective refractory period
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17
Q

Antiarrhythmics class 4

A
  • Calcium channel blockers
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18
Q

Congestive Heart Failure (edema) - disorder

A
  • Excessive fluid volume
  • Excessive cardiac afterload
  • Inefficient cardiac work
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19
Q

CHF - mitigation possibilities

A
  • Decrease fluid volume and afterload via fluid and electrolyte reduction
  • Decrease cardiac energy consumption
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20
Q

Propranolol - trade name

A
  • Inderal??
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21
Q

Propranolol - categories

A
  • Sympatholytic
  • Antihypertensive
  • Anti-angina
  • Anti-arrhythmic
  • Anti-CHF
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22
Q

Propranolol - MOA

A
  • Beta 1 and Beta 2 antagonist
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23
Q

Propranolol - distinguishing characterisitics

A
  • Highly lipid soluble and protein bound (crosses BBB)
  • Paradoxical use in migraines
  • Diminishes renin release via beta 2 antagonism
  • Category C in pregnancy
  • First pass metabolism in liver by CYP2D6
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24
Q

Propranolol - predictable actions

A
  • Negative inotropic and chronotropic effect
  • Decrease cardiac output
  • Decrease blood pressure
  • Enters CNS, where it may cause side effects
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25
Q

Propranolol - interactions/contraindications

A
  • Contraindicated in asthma
  • Caution with diabetes
  • Avoid use in pregnancy
  • Duration prolonged in patients with liver disease
  • Many pharmacodynamic and pharmacokinetic interactions
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26
Q

Atenolol - trade name

A
  • Tenormin
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27
Q

Atenolol - categories

A
  • Sympatholytic
  • Antihypertensive
  • Anti-angina
  • Anti-arrhythmic
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28
Q

Atenolol - MOA

A
  • Selective beta 1 antagonist
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29
Q

Atenolol - distinguishing characteristics

A
  • Modest beta 2 activity
  • Hydrophilic
  • Excreted unchanged in urine
30
Q

Atenolol - predictable actions

A
  • Negative inotropic and chronotropic effects
  • Decreases cardiac output
  • Decreases blood pressure
  • No CNS effects (doesn’t cross BBB)
31
Q

Atenolol - contraindications

A
  • Caution with asthma

- Discouraged in diabetic patients

32
Q

Atenolol - general notes

A
  • Single daily oral use
  • Easy outpatient medication
  • Largely replaced propranolol for CV therapies
33
Q

Prazosin - trade name

A
  • Minipress
34
Q

Prazosin - categories

A
  • Sympatholytic
  • Antihypertensive
  • Anti-CHF
35
Q

Prazosin - MOA

A
  • Alpha 1 receptor antagonist
36
Q

Prazosin - distinguishing characterisitics

A
  • Effective orally
  • Highly lipid soluble and protein bound (only 5% free)
  • Phase 2 metabolites excreted in bile, little renal excretion
37
Q

Prazosin - predictable actions

A
  • Decreases peripheral resistance to reduce BP
  • Hypotension, especially orthostatic
  • Syncope
  • Reflex tachycardia
  • Treats urinary hesitancy in BPH (other alpha blockers are better)
38
Q

Clonidine - trade name

A
  • Catapress
39
Q

Clonidine - category

A
  • Sympathomimetic (sorta)
40
Q

Clonidine - MOA

A
  • Alpha 2 receptor agonist
41
Q

Clonidine - distinguishing characteristics

A
  • Effective orally
  • Crosses BBB
  • Prefers alpha receptors in the brainstem
  • Long half-life and duration of action
  • Diminish discharge from medullary vasomotor center
42
Q

Clonidine - predictable actions

A
  • Antihypertensive
  • Xerostomia is common side effect
  • Sedation
  • Used to treat ADHD
  • Can cause erectile dysfunction
43
Q

Metoprolol - trade name

A
  • Lopressor
44
Q

Metoprolol - category

A
  • Sympatholytic
  • Antihypertensive
  • Anti-arrhythmic
  • Anti-angina
  • Anti-CHF
45
Q

Metoprolol - MOA

A
  • Selective beta 1 receptor antagonist
46
Q

Metoprolol - distinguishing characterisitics

A
  • Highly lipid soluble
  • Phase 1 metabolism by CYP2D6
  • Often used after myocardial infarction for protection
47
Q

Metoprolol - predictable actions

A
  • CNS benefits and adverse reactions
  • Bradycardia
  • Reduced blood pressure
48
Q

Verapamil - category

A
  • Calcium channel blocker
49
Q

Verapamil - MOA

A
  • Prevents calcium ion from penetrating membranes
  • Slows biochemical conduction
  • Inhibits muscle contraction (esp smooth and cardiac)
50
Q

Verapamil - distinguishing characteristics

A
  • Oral administration

- Blocks both cardiac and peripheral receptors

51
Q

Verapamil - predictable actions

A
  • Reduces cardiac arrhythmias by slowing conduction
  • Decreases blood pressure by relaxing arterioles
  • Reduces angina by reducing myocardial O2 demands
  • Causes headaches by causing vasodilation
  • Causes dizziness by causing hypotension
  • Causes constipation by relaxing smooth muscle of gut
  • Causes muscle weakness by reducing skeletal muscle contraction
52
Q

Lisinopril - category

A
  • Antihypertensive

- Possibly anti-CHF

53
Q

Lisinopril - MOA

A
  • Angiotensin Converting Enzyme (ACE) Inhibitor
54
Q

Lisinopril - distinguishing characteristics

A
  • Causes coughing

- Causes skin rash

55
Q

Lisinopril - predictable actions

A
  • Vasodilation
  • Decreased blood pressure
  • Orthostatic hypotension
  • Reflex tachycardia
56
Q

Nitroglycerine - category

A
  • Anti-angina
57
Q

Nitroglycerine - MOA

A
  • Vasodilation in coronary and peripheral circulation
58
Q

Nitroglycerine - distinguishing characteristics

A
  • 1st pass hepatic metabolism
59
Q

Nitroglycerine - predictable actions

A
  • Increase coronary blood flow –> increased myocardial oxygen supply
  • Decrease systemic blood pressure –> decreased myocardial oxygen demand
  • Ineffective orally
    > Prescribe sublingual or percutaneous
  • Causes bad headaches
  • Causes hypotension (esp orthostatic)
  • Causes reflex tachycardia
  • Short duration of action
60
Q

Procainamide - category

A
  • Local anesthetic

- Antiarrhythmic

61
Q

Procainamide - MOA

A
  • Sodium channel blocker
62
Q

Procainamide - distinguishing characteristics

A 
- Parent compound is Procaine
     > Has an increased half-life
- Short half-life requires dosing every 3-4 hours
- Used to treat supraventricular and ventricular arrhythmias
- Numerous side effects
     > Ventricular dysrhythmias
     > Bradycardia
     > Hypotension
     > Hypersensitivity
- Effective orally
- Low margin of safety
63
Q

Procainamide - predictable actions

A
  • Slows action potential transmission

- Prolongs refractory period

64
Q

Digoxin - category

A
  • Cardiac glycoside
  • Anti-CHF
  • Antiarrhythmic (selective)
65
Q

Digoxin - MOA

A
  • Inhibits sodium pump
  • Reduces energy consumption
  • Increases force of contraction
66
Q

Digoxin - distinguishing characteristics

A
  • Stimulates chemoreceptor trigger zone
  • Visual disturbances
  • Low margin of safety
  • Slows conduction in AV node
67
Q

Digoxin - predictable actions

A
  • Increases cardiac efficiency
  • Increases renal perfusion and diuresis in edematous patients
  • Prevents ventricular fibrillation during atrial fibrillation
  • Often monitored via clinical lab
68
Q

Reserpine - category

A
  • Sympatholytic
69
Q

Reserpine - MOA

A
  • Promotes release of NE and reduces reuptake, resulting in depletion of NE stores
70
Q

Reserpine - distinguishing characteristics

A
  • Derived from a plant
  • Transitory sympathomimetic, followed by prolonged sympatholytic effect
  • Antiquated for therapeutic use, but extensive research use
71
Q

Reserpine - predictable uses

A
  • Antihypertensive
72
Q

Reserpine - predictable side effects

A
  • Prolonged paralysis of sympathetic nervous system

Pharmacology I (4 decks)

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