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Pharmacology > Cardiovasular Drugs > Flashcards

Cardiovasular Drugs Flashcards

1
Q

Stages of hypertension

A

Stage 1- sustained systolic bp of 130-139 or sustained diastolic of 80-89

Stage 2- sustained systolic > 139 or sustained diastolic of > 89

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2
Q

What is the Renin-angiotensin-aldosterone system

A

Hormone system within body that is essential for the regulation of blood pressure and fluid balance
Primarily regulated by rate of of renal blood flow

Slide time 7:00

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3
Q

Examples of ACE inhibitors

A
  • Lisinopril
  • Enalapril
  • Benzaperil
  • Perindopril
  • Ramipril
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4
Q

Indications of lisinopril

A

(ACE inhibitor- inhibits conversion of Angiotensin 1 into angiotensin 2 which causes increased BP, vasoconstriction)

  • Hypertension
  • Acute myocardial infarction
  • Congestive heart failure
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5
Q

Mechanism of action of lisinopril(ACE inhibitor)

A
  • Suppress RAA (renin-angiotensin aldosterone) system and simultaneously inhibits bradykinin degradation

Bradikinin is a a compound released in the blood in some circumstances which causes contraction of smooth muscle and dilation of blood vessels

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6
Q

Adverse effects of lisinopril

A

Common:

  • Photosensitivity
  • Reduced vision
  • Headache
  • Hypotension
  • Conjunctivitis

Distinguishing side effects:

  • cough,
  • taste disturbance

Serious side effects:

  • Hypersensitivity: angioedema, eyelid edema

Ocular side effects:

  • Blur,
  • dry eye,
  • conjunctival/retinal hemorrhage,
  • diplopia

Angioedema:

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7
Q

Topical opthalmic interactions with lisinopril (ACE inhibitor)

A
  • Betaxolol, levobunolol, timolol: additive hypotension risk
  • Brimonidine(glaucoma): additive hypotension risk
  • Oxymetasoline: antagonizes antihypertensive effects

Caution: Connective tissue disease: Sjorgen’s syndrome( A chronic autoimmune disease affecting salivary glands and tear glands)

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8
Q

Angiotensin 2 blockers examples

A
  • Losartan
  • Valsartan
  • Irbesartan
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9
Q

Indications of losartan

A

(Angiotensin 2 blocker)

  • Hypertension
  • Congestive heart failure
  • Stroke prevention
  • Diabetic nephropathy
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10
Q

Mechanism of action of losartan

A

Selective antagonist of angiotensin 2 AT1 receptor

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11
Q

Adverse effects to Losartan

A
  • Dizziness
  • Cough
  • Hypotension
  • Angioedema

Topical interactions:

  • Betaxolol, levobunonol, timolol: additive hypotension risk
  • Brimonidine for glaucoma: additive hypotension risk
  • Oxymetazoline: antagonises antihypertensive effects
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12
Q

Examples of Calcium channel blockers

A
  • Amlodipine
  • Nifedipine
  • Diltiazem
  • Verapamil

Calcium causes muscle contraction, in arteries it causes contraction and a rise in BP

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13
Q

Indications of Amlodipine

A
  • Hypertension
  • Coronaty artery disease
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14
Q

Mechanism of action of Amlodipine

A

(Calcium channel blocker)

Inhibits trans-membrane Ca++ current into vascular smooth muscle more than cardiac muscle

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15
Q

Adverse effects of Amlodipine

A

(Calcium channel blocker)

Headache

Dizziness

Conjunctivitis

Diplopia

Ocular pain

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16
Q

Drugs that can cause conjunctivitis

A
  • Amlodipine
  • Lisinopril
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17
Q

Topical opthalmic interactions of amlodipine

A

Topical interactions:

Betaxolol, levobunonol, timolol: additive hypotension risk

Brimonidine for glaucoma: additive hypotension risk

Oxymetazoline, naphazoline, terahydrazoline, phenylephrine: antagonises antihypertensive effects

Atropine: antagonises antihypertensive effects

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18
Q

Examples of Alpha 1 blockers

A
  • Prazosin
  • Terazosin
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19
Q

Mechanism of action of Terazosin

A

Antagonises peripheral alpha1 adrenergic receptors

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20
Q

Indications of Terazosin

A

(Alpha1 blocker)

Hypertension

Benign prosatic hypertrophy

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21
Q

Adverse reactions of Terazosin

A
  • Headache
  • Dizziness
  • Pain
  • Paresthesia(tinghling of extremeties)
  • Intraoperative floppy iris syndrome
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22
Q

What class of drugs can cause floppy iris syndrome

A
  • Alpha 1 blockers
    • Terazosin
    • Tamsulosin
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23
Q

Topical opthalmic interactions with terazosin

A
  • Brimonidine(Alpha2 agonist) for glaucoma- aditive hypotension risk
  • Oxymethazoline: antagonisis antihypertensive effect

Cautions: cataract sugery

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24
Q

Example of an Alpha 2 agonist

A

Guanfacine

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25
Q

Indications of Guanfacine

A

(Alpha 2 agonist)

  • Hypertension
  • Opoid withdrawal
  • Migraine headache prophylaxis
  • Tourette syndrome
  • ADHD
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26
Q

Mechanism of action of Guanfacine

A

Centrally acting alpha 2 adrenergic receptor agonist

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27
Q

Adverse reactions of guanfacine

A
  • Headache
  • Dizziness
  • Hypotension (Extended Release form)
  • Syncope
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28
Q

Topical opthalmic drug interactions with guanfacine

A
  • Betaxolol, carteolol, levobunolol, timolol: additive hypotension risk
  • Brimonidine for glaucoma, apraclonidine: additive CNS depression & hypotension
  • Oxymetazoline, naphazoline, tetrahydrozyline, phenylephrine: antagonise antihypertensive effect
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29
Q

Examples of Beta blockers

A

Beta 1 selective

  • Metoprolol
  • Atenolol
  • Nevivolol

Beta non-selective

  • Propranalol

Beta non selective / with Alpha selectivity

  • Labetalol
  • Carvedilol
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30
Q

Indications of metoprolol

A

(Beta blocker)

  • Hypertension
  • Angina pectoris
  • Post MI
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31
Q

Mechanism of action of Metoprolol

A
  • Selective competative antagonism of Beta1 receptors reducing systolic BP and cardiac output via negative inotropic(force of the heart contracting) and chronotropic(Heart rate) effects
  • Central acting inhibition of sympathetic outflow
  • Supression of renin activity
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32
Q

Adverse reactions of Metoprolol

A

(Beta blocker)

  • Headache
  • Visual disturbances
  • Decreased tear secretion-can lead to dry eye syndrome

Distinguishing:

  • Depression
  • Short term memory loss

Ocular:

  • Increased migrainous scotomata
  • Reduced IOP
  • Glaucoma progression
  • Corneal anesthesia
  • Exacerbation of myasthenia gravis
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33
Q

What medication class can cause dry eye syndrome

A

Beta blockers - Metoprolol

34
Q

Topical opthalmic drug interactions with metpolol(B-blocker)

A
  • Betaxolol, carteolol, levobunolol, timolol: additive hypotension risk
  • Brimonidine for glaucoma, apraclonidine: additive CNS depression & hypotension
  • Oxymetazoline, naphazoline, tetrahydrozyline, phenylephrine: antagonise antihypertensive effect
35
Q

Cautions with the use of Metoptolol(B-blocker)

A
  • Diabetes mellitus
  • Myasthenia gravis
36
Q

Examples of loop diuretics

A

Furosemide

37
Q

Indications of Furosemide

A
  • Hypertension
  • Acute pulmonary oedema
  • Hypercalcemia

Calcium and potasium depleting

38
Q

Mechanism of action of furosemide

A

Loop diuretic - Calcium and potasium depleting

Inhibits reabsorption of NaCl at proximal/distal convulated tubule & loop of henle

39
Q

Adverse reactions of furosemide

A

(Loop diuretic)

  • Hypotension
  • Pruritus(itch)
  • Blured vision(dehydrating of crystalne lens)
40
Q

Topical opthalmic drug interactios with furosemide

A
  • Brimonidine for glaucoma: additive hypotension risk
  • Oxymetazoline: antagomises antihypertensive effects
41
Q

Caution for the use of furosemide

A

Hypersensitivity to sulfonamides

42
Q

Examples of thiazide diuretics

A
  • Hydrochlorthiazide (HCTZ)
  • Chlorthalidone
  • Chlorthiazide
43
Q

Indications of hydrochlorthiazide

A
  • Hypertension
  • Peripheral edema

(Calcium sparing)

44
Q

Topical opthalmic drug interactions of Hydrochlorthiazide

A
  • Betaxolol, levobunolol, timolol:additive hypotension risk
  • Brimonidine for glaucoma: additive CNS depression & hypotension
  • Oxymetazoline: antagonises antihypertensive effect
45
Q

Caution for the use of hydrochlorthiazide

A

Hypersensitivity to sulphonamides

46
Q

Examples of Potasium sparing diuretics

A
  • Sipirinolactone
  • Triamterene
47
Q

Indications of spirinolactone

A
  • Hypertension
  • Cardiac heart failure
  • Hyperaldosteronism
  • Hypokalemia
  • Acne vulgaris
48
Q

Mechanism of action of Spirinolactone

A

Antagonises aldosterone receptors in distal convoluted tubule resulting in sodium/water loss and potasium retention

49
Q

Adverse reactions of spirinolactone

A

Common:

  • Headache

Distinguishing:

  • Gynecomastia (swelling of breast tissue in men)
  • Menstrual irregularities
50
Q

Topical opthalmic drug interactions with spirinolactone

A
  • Betaxolol, levobunolol, timolol:additive hypotension risk
  • Brimonidine for glaucoma: additivie hypotension risk
  • Oxymetazoline: antagonises antihypertensive effect
51
Q

Indications of clonidine

A
  • Hypertension
  • Tourette syndrome
  • Severe cancer related pain
52
Q

Indications of hydralazine

A
  • Hypertension
  • Congestive heart failure
  • Hypertensive crisis
53
Q

Mechanism of action of Clonidine

A

(Alpha agonist)

  • Stimulates central and spinal alpha 2 adrenergic receptors (pre and post synaptic)
54
Q

Adverse reactions of clonidine

A

(Alpha agonist)

  • Headache
  • Dizziness
  • Angioedema
55
Q

Topical opthalmic drug interactions with clonidine

A
  • Betaxolol, carteolol, levobunolol, timolol: additive hypotension risk
  • Brimonidine for glaucoma, apraclonidine: additive CNS depression & hypotension
  • Oxymetazoline, naphazoline, tetrahydrozyline, phenylephrine: antagonise antihypertensive effect
56
Q

Which drug can cause gynecomastia

A

Spirinolactone

57
Q

Mechanism of action of hydralazine

A

Directly dilates peripheral vessels via hyperpolarization of vascular smooth musche which then inhibits Ca++ influx (depolarization)

58
Q

Adverse reactions of hydralazine

A

(Vasodilator)

    • Headache
  • Lupus erythematosis
59
Q

Topical opthalmic drug interactions with hydralazine

A
  • Brimonidine for glaucoma- additive hypotension risk
  • Oxymethazoline- antagonises antihypertensive effects
60
Q

What is angina

A

Painfull result of decreased blood flow in myocardium

Caused by obstruction/spasm of cardiac arteries, anemia, arrhythmia, heart failure

61
Q

Trearment options for Angina

A
  • Nitroglycerine
  • Isosorbide
62
Q

Indications of nitroglycerine

A

(potent vasodilator)

  • Angina prophylaxis
  • Acute angina
  • Hypertension or heart failure
63
Q

Mechanism of action of nitroglycerine

A

Donor of nitric oxide that stimulates intracellular cGMP production which leads to smooth muscle relaxation

64
Q

Adverse effects of nitroglycerine

A
  • Headache(vasodilation)
  • Dizziness
  • Orthostatic hypotension
  • Hypotension
  • Syncope
65
Q

Topical opthalmic drug interactions with nitroglycerine

A

Brimondine for glaucoma: additive hypotension risk

66
Q

What other indication does lidocaine have except for anesthesia

A

Cardiac arrythmia

67
Q

Antiarrthythmic drugs

A

Just take note:

68
Q

Indications of amiodarone

A
  • Advanced life support
  • Ventricular arrhythmias
  • Artrial fibrillation
69
Q

Mechanism of action of amiodarone(antyarrhythmic)

A

Blocks K+ channel efflux resluting in prolonged phase 3 action potential

70
Q

Adverse reactions of amiodarone

A
  • Blue-grey skin discoloration(long term)
  • Corneal deposits (> 6 month use)
  • Visual disturbance
  • Hallucinations
  • Optic neuritis
  • Optic neuropathy

Cautions for use

  • surgery
71
Q

What drug can cause corneal deposits

A

Amiodarone

72
Q

Which drug can cause optic neuritis

A

Amiodarone

73
Q

Which drug can cause optic neuropathy

A

Amiodarone

74
Q

Indication of digoxin

A
  • Congestive heart failure
  • Atrial fibrillation
  • Paroxysmal supraventricular tachycardia
75
Q

Mechanism of action of digoxin

A

Inhibits Na-K ATPase

ATPase-enzyme responsible for breaking down ATP and libiration energy required to move ions against concentration gradient

76
Q

Adverse reactions of digoxin

A
  • Headache
  • Confusion
  • Visual disturbance
  • Hallucinations
77
Q

Topical opthalmic drug interactions with digoxin

A
  • Apraclonidine: additive risk of hypotension, bradycardia, AV block
  • Betaxolol,carteolol, Levobunolol: additive risk of bradykardia and AV block
    *
78
Q

Which drug can cause diplopia

A

Lisinopril( ACE inhibitor)

Amlodipine (calcium channel blocker)

79
Q

Which % of americans have hypertension

A

15%

80
Q
A

Pharmacology (19 decks)

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