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Pharmacology > Drugs Acting on the Cardiovascular System > Flashcards

Drugs Acting on the Cardiovascular System Flashcards

1
Q

Drugs acting on the cardiovascular system

A
  1. Drugs affecting blood pressure
  2. Cardio tonic agents
  3. Antiarrhythmic agents
  4. Antianginal agents
  5. Lipid-lowering agents
  6. Drugs affecting blood coagulation
  7. Drugs used to treat anemias
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2
Q 
Antihypertensive Agents 
(List classes)
A
  1. Angiotensin-Converting-Enzyme (ACE) Inhibitors
  2. Angiotensin II-Receptor Blockers
  3. Calcium Channel Blockers
  4. Vasodilators
  5. Other:
    a. Diuretic agents
    b. Ganglionic blocker
    c. Renin inhibitor
    d. Sympathetic Nervous System Blockers
    i. Beta-blockers
    ii. Alpha-and beta-blockers
    iii. Alpha-adrenergic blockers
    iv. Alpha 1-blockers
    v. Alpha 2-agonists
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3
Q 
Antihypotensive Agents
(List classes)
A
  1. Sympathetic adrenergic agonists or vasopressors

2. Alpha-specific adrenergic agents

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4
Q

Cardiotonic (Inotropic) Agents

List classes

A
  1. Cardiac glycosides

2. Phosphodiesterase inhibitors

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5
Q 
Antiarrhythmic Agents
(List classes)
A
  1. Class I antiarrhythmics
    • class Ia
    • class Ib
    • class Ic
  2. Class II antiarrhythmics
  3. Class IV antiarrhythmics
  4. Other antiarrhthmics
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6
Q 
Antianginal Agents
(List classes)
A
  1. Nitrates
  2. Beta-blockers
  3. Calcium channel blockers
  4. Piperazineazetamide
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7
Q

Lipid-lowering agents

List classes

A
  1. Bile acid sequestrants
  2. HMG-CoA reductase inhibitors
  3. Cholesterol absorption inhibitor
  4. Other:
    a. Fibrates
    b. Vitamin B
    c. Perixisome proliferator receptor alpha activator
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8
Q

Drugs Affecting Blood Coagulation

List classes

A
  1. Antiplatelet agents
  2. Anticoagulants
  3. Thrombolytic agents
  4. Other:
    a. Low-molecular-weight heparins
    b. Anticoagulant adjunctive therapy
    c. Hemorrheologic agent
    d. C-reactive protein
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9
Q

Drugs used to treat anemias

List classes

A
  1. Erythropoiesis-stimulating agents
  2. Agents used for iron-deficiency anemia
  3. Agents used for other anemias
    a. Agents for megaloblastic anemias
    i. Folic acid derivatives
    ii. Vitamin B-12
    b. Agent for sickle cell anemia
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10
Q

Angiotensin-Converting-Enzyme (ACE) Inhibitors

Definition

A

(Antihypertensive agent)

  • Act in the lungs to prevent ACE from converting angiotensin I to angiotensin II (a powerful vasoconstrictor and simulator of aldosterone release).
  • Action leads to a decrease in BP and decrease aldosterone secretion, with resultant slight increase in serum K+ and a loss of serum Na+ and fluid.
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11
Q

Angiotensin-Converting-Enzyme (ACE) Inhibitors

List medications

A
  1. Benazepril (Lotensin)
  2. Captopril (Capoten) P
  3. Enalapril (Vasotec)
  4. Enalaprilat (Vasotec IV)
  5. Fosinopril (Monopril)
  6. Lisinopril (Prinivil, Zestril)
  7. Moexipril (Univasc)
  8. Perindopril (Aceon)
  9. Quinapril (Accupril)
  10. Ramipril (Altace)
  11. Trandolapril (Mavik)
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12
Q

Angiotensin II-Receptor Blockers

Definition

A

(Antihypertensive agent)

  • ARBs selectively bind with angiotensin II receptors in vascular smooth muscle and in adrenal cortex to block vasoconstriction and the release of aldosterone.
  • Actions block the BP-raising effects of renin-angiotensin system and lower BP.
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13
Q

Angiotensin II-Receptor Blockers

List medications

A

(Antihypertensive agent)

  1. Candesartan (Atacand)
  2. Eprosartan (Teveten)
  3. Irbesartan (Avapro)
  4. Iosartan (Cozaar) P
  5. Olmesartan (Benicar)
  6. Telmisartan (Micardis)
  7. Valsartan (Diovan)
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14
Q

Calcium Channel Blockers

Definition

A

(Antihypertensive agent)

  • Decrease BP, cardiac workload, and myocardial oxygen consumption.
  • Inhibit movement of Ca+ ions across the membranes of myocardial and arterial muscle cells, altering the action potential and blocking muscle cell contraction.
  • Action depresses myocardial contractility, slows cardiac impulse formation in connective tissues, and relaxes and dilates arteries–causing a fall in BP and decrease in venous return.
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15
Q

Calcium Channel Blockers

List medications

A

(Antihypertensive agent)

  1. Amlodipine (Norvasc)
  2. Diltiazem (Cardizem, Dilacor CR) P
  3. Felodipine (Plendil)
  4. Isradipine (DynaCirc)
  5. Nicardipine (Cardene)
  6. Nifedipine (Procardia XL)
  7. Nisoldipine (Sular)
  8. Varapamil (Calan SR)
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16
Q

Vasodilators

Definition

A

(Antihypertensive agent)

  • Act directly on vascular smooth muscle to cause muscle relaxation, leading to vasodilation and drop in BP.
  • Do no block reflex tachycardia that occurs when BP drops.
  • Indicated for treatment of severe hypertension that has not responded to other therapy.
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17
Q

Vasodilators

List medications

A

(Antihypertensive agent)

  1. Diazoxide (Hyperstat)
  2. Hydralazine (Apresoline)
  3. Minoxidil (Loniten)
  4. Nitroprusside (Nitropress) P
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18
Q

Other: Diuretic Agents

Definition

A

(Antihypertensive agent)

-Increase excretion of Na+ and H2O from kidney–often first agents tried in mild hypertension.

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19
Q

Other: Diuretic Agents
Thiazide and thiazide-like diuretics
(List medications)

A

(Antihypertensive agent)

  1. Bendroflumethiazide (Naturetin)
  2. Chlorothiazide (Diuril)
  3. Hydrochlorothiazide (HydroDIURIL)
  4. Hydroflumethiazide (Saluron)
  5. Methyclothiazide (Enduron)
  6. Trichlormethiazide (GENERIC)
  7. Chlorthalidone (Hygroton)
  8. Indapamide (Lozol)
  9. Metolazone (Mykrox, Zaroxolyn)
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20
Q

Other: Diuretic Agents
Potassium-sparing diuretics
(List medications)

A

(Antihypertensive agent)

  1. Amiloride (Midamor)
  2. Spironolactone (Aldactone)
  3. Triamterene (Dyrenium)
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21
Q

Other: Ganglionic Blocker

Definition

A

(Antihypertensive agent)

  • Occupies cholinergic receptor sites of autonomic neurons, blocking effects of acetylcholine at sympathetic and parasympathetic ganglia.
  • Blocking sympathetic system leads to vasodilation, decreased BP, blocking of reflex tachycardia, and release of catecholamines from adrenal gland.
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22
Q

Other: Ganglionic Blocker

List Medications

A

(Antihypertensive agent)

1. Mecamylamine (Inversine)

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23
Q

Other: Renin Inhibitor

Defninition

A

(Antihypertensive agent)

  • Aliskiren directly inhibits renin, leading to decreased plasma renin activity and inhibiting the conversion of angiotensinogen to angiotensin I.
  • This leads to decreased BP, decreased aldosterone release, and decreased Na+ reabsorption.
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24
Q

Other: Renin Inhibitor

List Medications

A

(Antihypertensive agent)

1. Aliskiren (Tekurna)

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25
Q

Other: Sympathetic Nervous System Blockers
Beta-blockers
(Definition)

A

(Antihypertensive agent)
-Block vasoconstriction, decrease HR, decrease cardiac muscle contraction, and tend to increase blood flow to kidneys, leading to decrease in release of renin.

26
Q

Other: Sympathetic Nervous System Blockers
Beta-blockers
(List Medications)

A

(Antihypertensive agent)

  1. Acebutolol (Sectral)
  2. Atenolol (Tenormin)
  3. Betaxolol (Kerlone)
  4. Bisoprolol (Zebeta)
  5. Careolol (Cartrol)
  6. Metoprolol (Lopressor)
  7. Nadolol (Corgard)
  8. Nebivolol (Bystolic)
  9. Penbutolol (Levator)
  10. Pindolol (Visken)
  11. Propranolol (Inderal)
  12. Timolol (Blocadren)
27
Q

Other: Sympathetic Nervous System Blockers
Alpha-and beta-blockers
(Definition)

A

(Antihypertensive agent)
-Useful in conjunction with other agents, and tend to be somewhat more powerful, blocking all receptors in sympathetic nervous system.

28
Q

Other: Sympathetic Nervous System Blockers
Alpha-and beta-blockers
(List Medications)

A

(Antihypertensive agent)

  1. Carvedilol (Coreg)
  2. Guanabenz (Wytensin)
  3. Labetalol (Normodyne, Trandate)
29
Q

Other: Sympathetic Nervous System Blockers
Alpha-adrenergic blockers
(Definition)

A

(Antihypertenisve agent)

  • Inhibit postsynaptic alpha1-adrenergic receptors, decreasing sympathetic tone in vasculature and causing vasodilation, leads to lower BP.
  • Also block presynaptic alpha2-receptors, preventing feedback control of norepinephrine release. Resulting in an increase in reflex tachycardia that occurs when BP decreases.
30
Q

Other: Sympathetic Nervous System Blockers
Alpha-adrenergic blockers
(List medications)

A

(Antihypertenisve agent)

  1. Phenoxybenxamine (Dibenzyline)
  2. Phentolamine (Regitine)
31
Q

Other: Sympathetic Nervous System Blockers
Alpha1-blockers
(Definition)

A

(Antihypertenisve agent)

  • Block postsynaptic alpha1-receptor sites–decreasing vascular tone and promoting vasodilation, leading to fall in BP.
  • (They do not block presynaptic alpha2-receptor sites, and therefore the reflex tachycardia that accompanies fall in BP does not occur).
32
Q

Other: Sympathetic Nervous System Blockers
Alpha1-blockers
(List Medications)

A

(Antihypertenisve agent)

  1. Doxazosin (Cardura)
  2. Prazosin (Minipress)
  3. Terazosin (Hytrin)
33
Q

Other: Sympathetic Nervous System Blockers
Alpha2-agonists
(Definition)

A

(Antihypertenisve agent)

  • Stimulate alpha2-receptors in CNS and inhibit cardiovascular centers, leading to decrease in sympathetic outflow from CNS and resultant drop in BP.
  • Associated with many adverse CNS and GI effects.
34
Q

Other: Sympathetic Nervous System Blockers
Alpha2-agonists
(List Medications)

A

(Antihypertenisve agent)

  1. Clonidine (Catapres)
  2. Guanfacine (Tenex)
  3. Methyldopa (GENERIC)
35
Q

Sympathetic Adrenergic Agonists or Vasopressors

definition

A

(antihypotensive)

  • used to treat severe hypotension or shock.
  • sympathomimetic drugs react with sympathetic adrenergic receptors to cause effects of a sympathetic stress response: increased BP, increased blood volume, and increased strength of cardiac muscle contraction.
  • actions increase BP and may restore balance to cardiovascular system.
36
Q

Sympathetic Adrenergic Agonists or Vasopressors

list medications

A

(antihypotensive)

  1. Dobutamine (Dobutrex)
  2. Dopamine (Intropin)
  3. Ephedrine (GENERIC)
  4. Epinephrine (Adrenalin, Epi-Pen)
  5. Isoproterenol (Isuprel)
  6. Metaraminol (Aramine)
  7. Norepinephrine (Levophed)
  8. Phenylephrine (Neo-Synephrine)
37
Q

Alpha-Specific Adrenergic Agents

definition

A

(antihypotensive)
-midodrine activates alpha-receptors in arteries and veins to produce an increase in vascular tone and an increase in BP.

38
Q

Alpha-Specific Adrenergic Agents

list medications

A

(antihypotensive)

1. Midodrine (ProAmatine)

39
Q 
Cardiotonic Agents
(definition)
A
  • affect intracellular Ca+ levels in heart muscle, leading to increased contractility.
  • increased contraction strength leads to increased cardiac output, which causes increased renal blood flow and increased urine production.
  • increased renal blood flow decreases renin release, interfering with effect of renin-angiotensin-aldosterone system, and increases urine output, leading to decreased blood volume.—Result is decrease in heart’s workload and relief of HF.
40
Q 
Cardiotonic Agents
(classes)
A
  1. Cardiac glycosides

2. Phosphodiesterase Inhibitors

41
Q 
Cardiac Glycosides
(definition)
A

(cardiotonic agent)
-digoxin increases intracellular Ca+ and allows more Ca+ to enter myocardial cells during depolarization–causing the following effects:
-increased force of myocardial contraction (+ inotropic
effect)
-increased cardiac output and renal perfusion
-slowed HR
-decreased conduction velocity through atrioventricular
node

42
Q

Cardiac Glycosides

list medications

A

(cardiotonic agent)

1. Digoxin (Lanoxin)

43
Q 
Phosphodiesterase Inhibitors
(definition)
A

(cardiotonic agent)

  • blocks the enzyme phosphodiesterase—leads to an increase in myocardial cell cyclic adenosine monophosphate (cAMP), which increases Ca+ levels in the cell.
  • increased cellular Ca+ causes stronger contraction and prolongs effects of sympathetic stimulations.
  • indicated for short-term treatment of HF that has not responded to digoxin, diuretics, and vasodilators.
44
Q

Phosphodiesterase Inhibitors

list medications

A

(cardiotonic agent)

  1. Inamrinone (Inocor)
  2. Milrinone (Primacor)
45
Q 
ANTIARRHYTHMIC AGENTS
(definition)
A
  • affect the action potential of the cardiac cells by altering their automaticity, conductivity, or both.
  • as a result, the can also produce new arrhythmias (proarrhythmic).
46
Q 
ANTIARRHYTHMIC AGENTS
(list classes)
A
  1. Class I antiarrhythmics
    • class Ia
    • class Ib
    • class Ic
  2. Class II antiarrhythmics
  3. Class IV antiarrhythmics
  4. Other antiarrhthmics
47
Q

Class I Antiarrhythmics

definition

A

(antiarrhythmic)

  • drugs that block the Na+ channels in the cell membrane during action potential—stabilize the cell membrane by binding to Na+ channels, depressing phase 0 of the action potential and changing the duration of the action potential.
  • They are local anesthetics or membrane-stabilizing agents.
  • Indicated for treatment of potentially life-threatening ventricular arrhythmias.
  • Broken down into 3 subclasses, reflecting how their blockage of Na+ channels affects the action potential.
48
Q

Class Ia Antiarrhythmics

definition

A

-Depress phase 0 of action potential and prolong duration of action potential.

49
Q

Class Ib Antiarrhythmics

definition

A

-Depress phase 0 somewhat and shorten duration of action potential.

50
Q

Class Ic Antiarrhythmics

definition

A

-Markedly depress phase 0, with resultant extreme slowing of conduction—but have little effect on duration of action potential.

51
Q

Class Ia Antiarrhythmics

list medications

A
  1. Disopyramide (Norpace)
  2. Procainamide (Pronestyl)
  3. Quinidine (GENERIC)
52
Q

Class Ib Antiarrhythmics

list medications

A
  1. Lidocaine ((Xylocaine) P

2. Mexiletine (Mexitil)

53
Q

Class Ic Antiarrhythmics

list medications

A
  1. Flecainide (Tambocor)

2. Propafenone (Rythmol)

54
Q

Class II Antiarrhythmics

definition

A

-Beta-adrenergic blockers that block beta-receptors, causing a depression of phase 4 of the action potential.

55
Q

Class II Antiarrhythmics

list medications

A
  1. Acebutolol (Sectral)
  2. Esmolol (Brevibloc)
  3. Propranolol (Inderal) P
56
Q

Class III Antiarrhythmics

definition

A
  • Blocks K+ channels and slows the outward movement of K+ during phase 3 of action potential, prolonging it.
  • They are all proarrhythmic.
57
Q

Class III Antiarrhythmics

list medications

A
  1. Amiodarone (Cordarone) P
  2. Dofetilide (Tikosyn)
  3. Ibutilide (Corvert)
  4. Sotalol (Betapace)
  5. (Betapace AF)
58
Q

Class IV Antiarrhythmics

definition

A

-Blocks the movement of Ca+ ions across the cell membrane, depressing the generation of action potentials and delaying phases 1 and 2 of repolarization, which slows automaticity and conduction

59
Q

Class IV Antiarrhythmics

list medications

A
  1. Diltiazem (Cardizem) P

2. Verapamil (Calan, Covera-HS)

60
Q

Other Antiarrhythmics: Adenosine & Digoxin

definition

A

Adenosine: used to convert supraventricular tachycardia to sinus rhythm if vagal maneuvers have been ineffective.

Digoxin: slows calcium from leaving the cell, prolonging the action potential and slowing conduction and HR.
-Effective in treatment of atrial arrhythmias

Pharmacology (10 decks)

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