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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
Indications of Guanfacine
(Alpha 2 agonist) * Hypertension * Opoid withdrawal * Migraine headache prophylaxis * Tourette syndrome * ADHD
26
Mechanism of action of Guanfacine
Centrally acting alpha 2 adrenergic receptor agonist
27
Adverse reactions of guanfacine
* Headache * Dizziness * Hypotension (Extended Release form) * Syncope
28
Topical opthalmic drug interactions with guanfacine
* Betaxolol, carteolol, levobunolol, timolol: additive hypotension risk * Brimonidine for glaucoma, apraclonidine: additive CNS depression & hypotension * Oxymetazoline, naphazoline, tetrahydrozyline, phenylephrine: antagonise antihypertensive effect
29
Examples of Beta blockers
Beta 1 selective * Metoprolol * Atenolol * Nevivolol Beta non-selective * Propranalol Beta non selective / with Alpha selectivity * Labetalol * Carvedilol
30
Indications of metoprolol
(Beta blocker) * Hypertension * Angina pectoris * Post MI
31
Mechanism of action of Metoprolol
* 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
32
Adverse reactions of Metoprolol
(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
33
What medication class can cause dry eye syndrome
Beta blockers - Metoprolol
34
Topical opthalmic drug interactions with metpolol(B-blocker)
* Betaxolol, carteolol, levobunolol, timolol: additive hypotension risk * Brimonidine for glaucoma, apraclonidine: additive CNS depression & hypotension * Oxymetazoline, naphazoline, tetrahydrozyline, phenylephrine: antagonise antihypertensive effect
35
Cautions with the use of Metoptolol(B-blocker)
* Diabetes mellitus * Myasthenia gravis
36
Examples of loop diuretics
Furosemide
37
Indications of Furosemide
* Hypertension * Acute pulmonary oedema * Hypercalcemia Calcium and potasium depleting
38
Mechanism of action of furosemide
Loop diuretic - Calcium and potasium depleting Inhibits reabsorption of NaCl at proximal/distal convulated tubule & loop of henle
39
Adverse reactions of furosemide
(Loop diuretic) * Hypotension * Pruritus(itch) * Blured vision(dehydrating of crystalne lens)
40
Topical opthalmic drug interactios with furosemide
* Brimonidine for glaucoma: additive hypotension risk * Oxymetazoline: antagomises antihypertensive effects
41
Caution for the use of furosemide
Hypersensitivity to **sulfonamides**
42
Examples of thiazide diuretics
* Hydrochlorthiazide (HCTZ) * Chlorthalidone * Chlorthiazide
43
Indications of hydrochlorthiazide
* Hypertension * Peripheral edema (Calcium sparing)
44
Topical opthalmic drug interactions of Hydrochlorthiazide
* Betaxolol, levobunolol, timolol:additive hypotension risk * Brimonidine for glaucoma: additive CNS depression & hypotension * Oxymetazoline: antagonises antihypertensive effect
45
Caution for the use of hydrochlorthiazide
Hypersensitivity to sulphonamides
46
Examples of Potasium sparing diuretics
* Sipirinolactone * Triamterene
47
Indications of spirinolactone
* Hypertension * Cardiac heart failure * Hyperaldosteronism * Hypokalemia * Acne vulgaris
48
Mechanism of action of Spirinolactone
Antagonises aldosterone receptors in distal convoluted tubule resulting in sodium/water loss and potasium retention
49
Adverse reactions of spirinolactone
Common: * Headache Distinguishing: * **Gynecomastia (swelling of breast tissue in men)** * **Menstrual irregularities**
50
Topical opthalmic drug interactions with spirinolactone
* Betaxolol, levobunolol, timolol:additive hypotension risk * Brimonidine for glaucoma: additivie hypotension risk * Oxymetazoline: antagonises antihypertensive effect
51
Indications of clonidine
* Hypertension * Tourette syndrome * Severe cancer related pain
52
Indications of hydralazine
* Hypertension * Congestive heart failure * Hypertensive crisis
53
Mechanism of action of Clonidine
(Alpha agonist) * Stimulates central and spinal alpha 2 adrenergic receptors (pre and post synaptic)
54
Adverse reactions of clonidine
(Alpha agonist) * Headache * Dizziness * **Angioedema**
55
Topical opthalmic drug interactions with clonidine
* Betaxolol, carteolol, levobunolol, timolol: additive hypotension risk * Brimonidine for glaucoma, apraclonidine: additive CNS depression & hypotension * Oxymetazoline, naphazoline, tetrahydrozyline, phenylephrine: antagonise antihypertensive effect
56
Which drug can cause gynecomastia
Spirinolactone
57
Mechanism of action of hydralazine
Directly dilates peripheral vessels via hyperpolarization of vascular smooth musche which then inhibits Ca++ influx (depolarization)
58
Adverse reactions of hydralazine
(Vasodilator) * * Headache * Lupus erythematosis
59
Topical opthalmic drug interactions with hydralazine
* Brimonidine for glaucoma- additive hypotension risk * Oxymethazoline- antagonises antihypertensive effects
60
What is angina
Painfull result of decreased blood flow in myocardium Caused by obstruction/spasm of cardiac arteries, anemia, arrhythmia, heart failure
61
Trearment options for Angina
* Nitroglycerine * Isosorbide
62
Indications of nitroglycerine
(potent vasodilator) * Angina prophylaxis * Acute angina * Hypertension or heart failure
63
Mechanism of action of nitroglycerine
Donor of nitric oxide that stimulates intracellular cGMP production which leads to smooth muscle relaxation
64
Adverse effects of nitroglycerine
* Headache(vasodilation) * Dizziness * Orthostatic hypotension * Hypotension * Syncope
65
Topical opthalmic drug interactions with nitroglycerine
Brimondine for glaucoma: additive hypotension risk
66
What other indication does lidocaine have except for anesthesia
Cardiac arrythmia
67
Antiarrthythmic drugs
Just take note:
68
Indications of amiodarone
* Advanced life support * Ventricular arrhythmias * Artrial fibrillation
69
Mechanism of action of amiodarone(antyarrhythmic)
Blocks K+ channel efflux resluting in prolonged phase 3 action potential
70
Adverse reactions of amiodarone
* Blue-grey skin discoloration(long term) * Corneal deposits (\> 6 month use) * Visual disturbance * Hallucinations * Optic neuritis * Optic neuropathy Cautions for use * surgery
71
What drug can cause corneal deposits
Amiodarone
72
Which drug can cause optic neuritis
Amiodarone
73
Which drug can cause optic neuropathy
Amiodarone
74
Indication of digoxin
* Congestive heart failure * Atrial fibrillation * Paroxysmal supraventricular tachycardia
75
Mechanism of action of digoxin
Inhibits Na-K ATPase ATPase-enzyme responsible for breaking down ATP and libiration energy required to move ions against concentration gradient
76
Adverse reactions of digoxin
* Headache * Confusion * Visual disturbance * Hallucinations
77
Topical opthalmic drug interactions with digoxin
* Apraclonidine: additive risk of hypotension, bradycardia, AV block * Betaxolol,carteolol, Levobunolol: additive risk of bradykardia and AV block *
78
Which drug can cause diplopia
Lisinopril( ACE inhibitor) Amlodipine (calcium channel blocker)
79
Which % of americans have hypertension
15%
80

Pharmacology (19 decks)

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