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cardiovascular > CV127 &128 > Flashcards

CV127 &128 Flashcards

1
Q

What type of drug is enalapril?

A

angiotensin converting enzyme inhibitor (ACEI)

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2
Q

What type of drug is losortan?

A

angiotensin receptor blocker

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3
Q

What type of drug is amlodipine ?

A

CCB (calcium channel blocker) dihydropyridine

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4
Q

What type of drug is verapamil ?

A

CCC non-dihydropyridine

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5
Q

What type of drug is diltiazem ?

A

CCB non-dihydropyridine

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6
Q

What type of drug is hydralazine?

A

arteriolar dilator - may involve NO

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7
Q

What type of drug is minoxidil ?

A

arteriolar dilator

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8
Q

What type of drug is sodium nitroprusside?

A

venous/arterial dilator - NO from parent compound

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9
Q

What type of drug is thiosulfate?

A

sulfur donor

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10
Q

What type of drug is nitroglycerin?

A

venous dilator - NO from parent compound

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11
Q

What type of drug is sildenafil

A

type 5 (not 4) phosphodiesterase inhibitor

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12
Q

under what conditions does the renin angiotensin aldosterone system (RAAS) system become activated?

A

when there is a need to increase the blood pressure and/or blood volume (sodium retention)

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13
Q

what is the juxtaglomerular apparatus?

A

cells in the kidney that synthesize, store, and secrete the enzyme renin

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14
Q

when is renin released?

A

when the body senses a decrease in blood pressure or a need for sodium

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15
Q

what happens to vasoconstriction and after load and preload when the RAAS system is blocked?

A

vasoconstriction is decreased. Afterload and preload are also decreased significantly.

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16
Q

what effect does blocking the RAAS system have on K ions?

A

decreases potassium loss

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17
Q

Where does chymase come from and what action does it have?

A

chymase comes from the heart and it converts angiotensin I to angiotensin II. Therefore it acts as an ACE (angiotensin converting enzyme)

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18
Q

blocking chymase and the resting action is analogous to what kind of drugs?

A

ACEIs

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19
Q

what does ARB stand for?

A

angiotensin receptor blocker

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20
Q

what does ACEI stand for?

A

angiotensin converting enzyme inhibitor

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21
Q

how do ACEIs and ARBs decrease blood pressure?

A

1) decrease TPR by decrease angiotensin II
2) decrease Na reabsorption
3) increasing bradykinin (which vasodilator by increasing NO and prostaglandins)

22
Q

at what levels of renin are ACEIs and ARBs used with caution and why?

A

at very high renin levels because ACEIs and ARBs may produce a dangerous fall in BP since it removes all Angiotensin II

1) during hypervolemia when angiotensin II is already increased because of the existing condition
2) during renal artery stenosis in which Angiotensin II is produced to correct renal perfusion pressure due to stenosis.

23
Q

what does blocking the RAAS system do to sodium retention?

A

It decreases sodium retention

24
Q

when the angiotension receptor is activated, what are the resulting effects?

A

1) vasoconstriction
2) increase in aldosterone and increase in Na retention
3) increase in sympathetic activity
4) increased tropic effect (ventricular remodelling)

25
Q

how are ARBs excreted?

A

Through the hepatic pathway (i.e the liver). Therefore decrease the dose in patients with liver disease

26
Q

How are ACEIs excreted?

A

through the kidney. Therefore, decrease does in those with renal failure.

27
Q

in which cardiovascular conditions are ARBs and ACEIs the first line treatment ?

A

1) hypertension

2) heart failure

28
Q

What is the first line treatment for congestive heart failure?

A

ACEIs and ARBs

29
Q

What are the benefits of using ACEIs and ARBs in Post Myocardial Infarction?

A

1) decreases post infarction myocardial remodelling

2) may decrease mortality following an MI

30
Q

What are the benefits of using ACEis and ARBs in diabetic nephropathy?

A

1) prevent/delay diabetic nephropathy
2) decreases protein excretion and decreases renal deterioration
3) effective at doses that do not decrease blood pressure

31
Q

How does aldosterone work?

A

increases reabsorption of ions and water in the kidney, to cause the conservation of sodium, secretion of potassium,

32
Q

What is the first line treatment for preventing or delaying diabetic nephropathy?

A

ACEIs and ARBs

33
Q

What is proteinuria?

A

the presence of abnormal quantities of protein in the urine, which may indicate damage to the kidneys.

34
Q

When should ACEIs and ARBs be used with caution?

A

1) in pregnancy b/c harmful to the fetus
2) when combining with K sparing drugs
3) in renal artery stenosis because renin levels are high
4) diabetes type 4 renal tubular acidosis

35
Q

What class of calcium channel blockers are vascular?

A

dihydropyridines

36
Q

What class of calcium channel blockers are cardiac and vascular?

A

non-dihydrophyridines

37
Q

What type of channels do CCB block? What does this result in?

A

L-type voltage gated calcium channels; decreases calcium available for contraction

38
Q

what conditions are nifedipine and amlodipine used for ?

A

angina, raynaud’s phenomenon, hypertension, hypertensive crisis

39
Q

describe diltiazem (type and uses)

A

non-dihydropyridine CCB with both cardiac and vascular effects. used to treat angina and hypertension

40
Q

describe verapamil (type and uses)

A

non-dihydropyridine CCB that blocks mainly in the heart (limited vascular tissue)

41
Q

TRUE OR FALSE: Verapamil should not be used in combination with a beta receptor blocker

A

TRUE; this has the potential to cause severe or total AV nodal block.

42
Q

Which CCB of those discussed would be most preferentially used to decrease the contractility of the heart?

A

verapamil

43
Q

Which CCB of those discussed would be most preferentially used for vasodilation of the vessels?

A

amlodipine

44
Q

Which CCB would you use to treat supra ventricular tachycardia?

A

verapamil/diltiazem - this decreases condition velocity, and increases AV node refractory period

45
Q

which vasodilator is the one which may cause lupus like syndrome?

A

hydralazine

46
Q

which vasodilator is effective even if one has renal failure?

A

minoxidil

47
Q

What kind of drug is sodium nitroprusside?

A

venous and arteriolar dilator

48
Q

What drug would you administer in hypertensive emergencies and why?

A

sodium nitroprusside because it is potent and very fast acting.

49
Q

How does sildenafil work ?

A

it is a type 5 phosphodiesterase inhibitor. Since phosphodiesterase breaks down cGMP, inhibiting it allows for cGMP to be preserved and to continue vasodilation/relaxation of the vessels

50
Q

Why can chronic use of sodium nitroprusside lead to toxicity?

A

when nitroprusside is broken down, it is broken down into nitric oxide (vasodilator) and cyanide which is converted to thiocyanate in the liver and excreted in the kidneys. Chronic use can lead to cyanide accumulating

cardiovascular (6 decks)

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