CV Pharmacology Flashcards
What are 4 specific agents to treat hypertension?
- Diuretics
- sympatholytic drugs
- angiotensin inhibitors
- vasodilators
What are 3 diuretics used to treat hypertension?
- thiazides
- K sparing diuretics (aldosterone antagonists)
- loop diuretics
What are the 3 sympatholytic drugs used to treat hypertension?
- beta blockers
- centrally acting
- alpha 1 blockers
What are the 3 angiotensin inhibitors used to treat hypertension?
- ACE inhibitors
- all antagonists
- direct renin inhibiter
What are the 2 vasodilators used to treat hypertension?
- Ca channel blockers: Nifedipine, diltiazem, verapamil
- other vasodilators
What are 4 drugs used in the treatment of MI?
- aspirin
- statins
- beta-blockers
- ACE inhibitors
What are 3 ways to treat angina?
- decrease risk factors/alter lifestyle
- bypass surgery, angioplasty, stent
- drug therapy-aims to improve the balance between O2 supply and demand
What are 4 drug therapies for angina?
- Organic nitrates (nitroglycerine)
- Ca channel blockers
- Beta adrenergic blockers
- drugs that modify myocardial metabolism
What are 3 ways that nitrates treat angina?
- decrease preload
- improve ischemic areas of the heart
- prevent coronary spasms
Nifedipine
-Ca channel blocker
-acts ONLY on vsm cells
Reduces O2 demand by:
-decreasing after load
Increases O2 supply by:
-decreasing vasospasms
-increases coronary flow via vasodilation
Verapamil and Diltiazem
- Ca channel blockers
- act on heart and vsm cells
- causes relaxation and decreased contractility in heart
What are adverse effects of Verapamil and Diltiazem
- hypotension (headache)
- not good for angina and CHF
How do beta adrenergic R blockers treat angina?
- block Beta R in SNS
- causes decreases HR, contractility and after load –> decreases demand for O2
- the decreased force can cause an issue in CHF
How do drugs that modify myocardial metabolism treat angina
- inhibit fatty acid oxidation in the heart and shift metabolism to glucose oxidation
- reduced O2 consumption in the ischemic heart
What are 4 key points about hyperlipoproteinemias- elevation in the levels of certain lipoproteins?
- Monogenic and polygenic (multiple genes interacting with changes in the environment) cases
- Different lipoproteins affected-elevation in LDL, VLDL or combo
- Disorders differ in their incidence-polygenic is more common
- disorders associated with LDL have greater associations with cardiovascular disease
What are 5 characteristics of remodelling in CHF?
- hypertrophy
- abnormal heart cells
- apoptosis
- fibrosis-increased collagen, stiffness of the heart
- dilation-increased ventricle volume
What are 5 drugs used to treat CHF?
- positive inotropic drugs
- Angiotensin Inhibitors
- Sympatholytic drugs
- Aldosterone antagonists
- vasodilators
Why do Angiotensin inhibitors work to treat CHF?
- decrease PR
- decrease aldosterone secretion from adrenal gland, decreased retention of Na and water–> decreased preload
- decrease remodeling
- increase bradykinin, causes vasodilation (ACE inhibitors)
Explain Digoxin
see notes
Explain carvedilol
-non selective adrenergic blocker (beta1, beta2, alpha1)
What are the types of arrhythmias.
- supraventricular
- ventricular
- bradychardia
- tachycardia
What are non pharmacological treatments of cardiac arrhythmias?
- pacemaker (esp if SA node is damaged)
- remove abnormal tissue (use radio waves to heat the tissue and destroy it)
- Implantable cardioverter defibrillator
What are 3 ways to get abnormal impulse formation?
- enhanced automaticity
- afterdepolarizations
- reentry
What are the 4 classes of antiarrhythmia drugs?
- Na channel blockers
- Beta blockers
- K channel blockers (APD prolonging)
- Ca channel blockers
