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Pharmacology > CHF, HTN, Angina > Flashcards

CHF, HTN, Angina Flashcards

1
Q

Resepine

A

Interferes with vesicle storage. DA, 5HT, NE central and peripheral

  • decrease CO, TPR (NE periphery)

Oral. t1/2 24hrs with 6wks of effect

TX. HTN

ADV. depression (severe), edema, increase GI secretions

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2
Q

Guanethidine

A

interferes with storage vessicles by binding inhibit NE release

  • decreases TPR and CO

TX. HTN

ADV. diarrhea, edema

DI: TCAs block reuptake thus block action of the drug

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3
Q

Nitroprusside

A

Nitric Oxide

decrease TPR dilating arterioles and venules

TX. HTN emergencies (IV)

ADV. cyanide toxicity (coadminister with nitrites and thiosulfate)

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4
Q

Hydralazine

A

Nitric Oxide

decrease TPR dilating arterioles

TX. moderate to severe HTN

ADV. SLE-like symptoms, slow acetylators, edema, reflex tachycardia

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5
Q

Minoxidil

A

open K+ channels hyperpolarizing smooth muscle

arteriolar vasodilation

TX. severe HTN, baldness (topical)

ADV. hypertrichosis (hair), edema, reflex tachycardia

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6
Q

Diazoxide

A

open K+ channels hyperpolarizing smooth muscle

arteriolar vasodilation

TX. HTN emergency

ADV. hyperglycemia (decrease insuline release), edema, reflex tachycardia

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7
Q

dihydropyridines

A

Ca+ channel blocker (arteriolar blood vessels - decrease TPR)

TX. HTN, angina

ADV, reflex tachycardia, gingival hyperplasia

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8
Q

Nifedipine

A

Ca+ channel blocker (arteriolar blood vessels - decrease TPR)

TX. HTN, angina

ADV, reflex tachycardia, gingival hyperplasia

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9
Q

Captopril

A

~pril. ACE Inhibitor (inhibit Angio II formation preventing AT1 resecptor stimulation)

decrease aldosterone and vasodilation, prevent bradykinin degradation.

TX. mild to moderate HTN, CHF, protective of diabetic neuropathy

ADV. dry cough, hyperkalemia, acute renal failure in renal artery stenosis, angioedema.

CI. pregnancy

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10
Q

Losartan

A

~sartan. AT1 receptor blocker.

decrease aldosterone and vasodilation

TX. mild to moderate HTN, CHF, protective of diabetic neuropathy

ADV. hyperkalemia, acute renal failure in renal artery stenosis, angioedema.

CI. pregnancy

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11
Q

antiHTN drugs used in comorbid conditions

A

HTN comorbid

Angina (Beta blockers, Ca channel blockers)

Diabetes (ACE inhibitor, AT1 receptor blockers)

Heart Failure (ACE inhibitors, AT1 receptor inhibitors, beta blockers)

Post-MI (beta blockers)

BPH (alpha blockers)

Dyslipidemias (alpha blocker, Ca+ channel blockers, ACE inhibitor, AT1 receptor inhibitor)

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12
Q

Bosentan

A

Endothelin receptor A antagonist.

oral

TX. pulmonary HTN

ADV. vasodilation (flushing, headache, hypotension).

CI. pregnanacy

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13
Q

Epoprostenol

A

PGI2 prostacyclin

infusion pp administration

TX. pulmonary HTN

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14
Q

Sildenafil

A

PDE type V inhibitor

increases cGMP (relax pulm artery)

TX. pulmonary HTN

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15
Q

Nitroglycerin

A

Nitrate (NO prodrug)

venodilator (decrease preload)

sublingual, transdermal, IV

TX. Angina

ADV. flushing, headache, orthostatic hypotension, reflex tachycardia, fluid retention

CI: tachyphylaxis with repeated use. Cadio tox with sildenafil (PDE inhiitor to increase cGMP)

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16
Q

Isosorbide

A

Nitrate (NO prodrug)

venodilator (decrease preload)

oral, extended release for chronic use

TX. Angina

ADV. flushing, headache, orthostatic hypotension, reflex tachycardia, fluid retention

CI: tachyphylaxis with repeated use. Cadio tox with sildenafil (PDE inhiitor to increase cGMP)

17
Q

Ranolazine

A

Cardiac myocyte: Na+ channel blocker on late inward to decrease buildup in ishemia (in order to decrease associated intracellular Ca+)

  • decrease end diastolic pressure improving diastolic coronary flow

ADV. constipation, nausea, increased QT.

18
Q

Digoxin

A

inhibit cardiac NA/K ATPase pp (and neuronal tereby increasing vagal tone)

  • increased intracellular Ca+, increased contractility (inotropic)

T1/2 long (requires loading dose), renal clearance (caurion renal failure), tissue protein binding (large Vd) and displaced by verapamil/quinidine

TX. CHF, supreventricular tacycardia (except Wolff-PArkinson-White AV node accessory pathway syndrome)

ADV. anorexia, nausea, ECG changes, disorientation, visual effects (halos), and cardiac arrythmias.

CI: hypoK, hypoMg, hyperCa.

Tox Tx: Fab Abs to dig, supportive with electrolytes and class Ib antiarrythmics.

19
Q

Inamrinone

A

Phosphodiesterase inhibitor

  • increase cAMP in heart (inotropic)
  • increase cAMP in smooth muscle (decrease TPR)

TX. CHF

20
Q

Milrinone

A

Phosphodiesterase inhibitor

increase cAMP in heart (inotropic)
 increase cAMP in smooth muscle (decrease TPR)

TX. CHF

21
Q

Nesiritide

A

Natriuretic peptide recombinant (rh BNP)

increases cGMP causing vasodilation

TX. CHF

Pharmacology (18 decks)

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