CV Pharm II Flashcards
How do Angiotensin II receptor antagonists ARB’s work?
Block type I angiotensin II receptors on blood vessels and the heart
What drugs are in the ARB class of anti hypertensives?
Valsartan, Irbessartan, Valsartan
When are ARBs indicated?
HTN, congestive heart failure
What is the MOA of ARBs?
i. Vasodilator
ii. Down regulate sympathetic adrenergic activity
iii. Promote renal excretion of sodium and water
iv. Inhibit cardiac and vascular remodeling
When are ARBs CI?
Pregnancy
Bilateral renal artery stenosis
how do ACE inhibitors work?
i. Vasodilator
ii. Down regulate sympathetic adrenergic activity
iii. Promote renal excretion of sodium and water
iv. Inhibit cardiac and vascular remodeling
What are ACEI used for?
HTN
Edema
CHF
What are some of the AEs of ACE inhibitors?
Dry cough
Angioedema
Hyperkalemia
Hypotension
Which drugs are from the class of ACE inhibitors?
Lisinopril, Ramipril
When are ACE inhibitors CI?
Pregnancy
Bilateral renal artery stenosis
Which drugs are in the Beta Blocker class of anti hypertensives?
Atenolol, Metoprolol, Carvedilol, Propranolol
Which beta blocker is B-1 selective?
Atenolol, Metoprolol
Which beta blockers affects B1 and B2 receptors?
Carvedilol
Propranolol
What drugs act as an alpha and beta adrenergic blocker?
Carvedilol
What is the advantage of using atenolol or metoprolol, a beta-1 blocker only?
Less bronchoconstriction than agents that bond to B-2 receptors
How do B-1 blockers work?
Selective sympatholytic agent
Causes decreased HR and output
Decreases renin release
What are the AEs of beta blockers?
May worsen CHF
Bradycardia
Cold extremities
Reduced exerces capacity
Fatigue
Hypotension
Impotence
What are the other uses for propranolol?
i. Migraine prophylaxis
ii. Hyperthyroidism
iii. Benign essential tremor
What is one of the SEs of propranolol?
Bronchoconstriction so CI in asthma or COPD pts
Which population should you be cautious of prescribing of beta blockers?
Diabetics, may mask the tachycardia associated with hypoglycemia
What are the CIs of beta blockers?
Sinus bradycardia
Partial AV block
What black box warning is associated with beta blockers?
Increased risk of angina pectoris and MI with abrupt discontinuation
Which drugs are Calcium Channel blockers?
Dihydropyridine : Amlodipine
Nondihyropyridine : Diltiazem, Verapamil
What is the MOA of CCBs?
i. Calcium channel antagonist which reduces calcium influx into cardiac cells
ii. Vascular smooth muscle relaxation : vasodilatioin
iii. Decreased myocardial force generation (negative inotropy)
iv. Decreased HR (negative chronotropy)
What are some of the uses for CCB?
HTN
Angina
Arrhythmias
What are some of the AEs of CCBs?
Dizziness
Peripheral edema
Hypotension
Nausea
Fatigue
What are CIs for prescribing CCBs?
Preexisting bradycardia
Conduction defects or systolic function HF
Which hypertensive drug class should not be given together with CCBs?
Beta Blockers
What is the MOA of Clonidine?
Centrally acting alpha-2 agonist
What are some of the AEs of Clonidine?
Sedation
Dry mouth
Bradycardia
Orthostatic hypotension
Impotence
Edema
What is the prototype anti-angina drug?
Nitroglycerine
How does nitroglycerin work?
Releases nitrous oxide into smoooth muscle causing relaxation
What situation is nitroglycerin best used in?
Acute angina due to its rapid onset