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Pharmacology > Drugs Affecting the Cardiovascular Systems > Flashcards

Drugs Affecting the Cardiovascular Systems Flashcards

1
Q

what are the 4 factors that regulate cardiovascular disease?

A
  1. Autonomic NS
  2. Kidneys
  3. Heart
  4. Blood volume & composition
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2
Q

how is the autonomic NS involved in regulation of cardiovascular disease?

A

from the innervations of the parasympathetic and sympathetic divisions to the heart, BV, kidneys, and adrenal glands

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3
Q

how are the kidneys involved in regulation of cardiovascular disease?

A

maintenance of cardiac output by excretion & reabsorption of ions and water

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4
Q

how is the heart involved in regulation of cardiovascular disease?

A

through its effects on rate & force of contraction through the intrinsic NS

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5
Q

how is blood volume and composition involved in regulation of cardiovascular disease?

A

water and electrolyte balance

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6
Q

hypertension =

A

systolic pressure > 140 mm Hg

diastolic pressure > 90 mm Hg

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7
Q

what type of hypertension composes up to 90% of cases?

A

primary hypertension

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7
Q

primary hypertension’s specific cause is

A

unknown

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7
Q

BP =

A

cardiac output (CO) X Peripheral Vascular Resistance (PVR)

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7
Q

what is the cause of secondary hypertension

A

causative basis for elevation in pressure

eclampsia of pregnancy, renal artery disease, pheochromocytoma

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7
Q

CO=

A

heart rate (HR) X stroke volume (SV)

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7
Q

there is a _________ relationship between vascular resistance and blood pressure

A

direct

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8
Q

vasoconstriction can be described as a

A

decrease in lumen size

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8
Q

vasoconstriction will __________ resistance to blood flow therefore increasing _____________ ____________

A
  • increase
  • blood pressure
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9
Q

vasodilation can be described as an

A

increase in lumen size

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10
Q

vasodilation decreases resistance to __________ _______ and in turn _______ BP

A
  • blood flow
  • decreases
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11
Q

what are the 6 categories of antihypertensive agents?

A
  1. adrenergic agents
  2. angiotensin-converting enzyme inhibitors
  3. angiotensin II receptor blockers
  4. calcium channel blockers
  5. diuretics
  6. vasodilators
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12
Q

alpha 1 blockers are peripheral acting agents that block the

adrenergic agents

A

vasoconstricting effects through alpha 1 receptors

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13
Q

beta 1 blockers are cardio selective agents that

adrenergic agents

A

decrease the force of contraction in the heart

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14
Q

What may be a consequence of given a “non-selective” beta blocker to a patient that may also have asthma?

A

BAD RESULT
- severe bronchospasm
- fatalitites
- bronchoconstriction
- asthma exacerbations

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15
Q

give an example of alpha 2 agonists

A

clonidine

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15
Q

alpha 2 agonists stimulate what? to decrease what?

adrenergic agents

A

stimulate: alpha 2 receptors
decrease: sympathetic outflow from the CNS

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16
Q

ACE inhibitors block

angiotensin converting enzyme

A

the conversion of angiotensin 1 to angiotensin II

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17
Q

angiotensin II is a potent

A

vasoconstrictor

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18
angiotensin II stimulates the release of
aldosterone
18
aldosterone is a vasoconstrictor that promotes the
reabsorption of H2O and Na in the renal tubules
18
what is the MOA of angiotensin II receptor blockers?
to block the receptors that receive AII inhibiting vasoconstriction and the release of aldosterone
19
calcium channel blockers cause
smooth muscle relaxation
20
how do calcium channel blockers cause smooth muscle relaxation?
by blocking the binding of calcium to its receptors
21
vasodilators are
rapid acting
21
how does calcium channel blockers affect PVR and BP?
decreases both of them
22
vasodilators are powerful
antihypertensives
23
vasodilators directly relaxes
smooth muscle
23
what are the 4 categories of diuretics based on their pharmacodynamics?
1. loop diuretics 2. osmotic diuretics 3. potassium-sparing diuretics 4. thiazide diuretics
24
diuretics decrease the
plasma and extracellular fluid volumes
24
how do diuretics decrease the plasma and extracellular fluid volumes?
by increasing the rate of urine formation
24
what is the result of diuretics?
decrease cardiac output and blood pressure
25
loop diuretics are aka
lasix
26
loop diuretics inhibit
sodium and chloride resorption
27
loop diuretics increase
renal prostaglandins
28
an increase in renal prostaglandins results in
- BV dilation - decreased PVR | peripheral vascular resistance
29
there is a tendency to loose _________ during excretion with loop diuretics.
calcium
30
what is an example of osmotic diuretics?
mannitol
31
osmotic diuretics do NOT
- interact w/ receptors - block renal transport mechanisms
32
osmotic diuretics produce an
osmotic gradient
33
how do osmotic diuretics increase urine output?
by pulling water into the tubule system of the nephrons
34
potassium-sparing diuretics prevent
potassium from being pumped into the tubules and excreted in the final urine product
35
potassium-sparing diuretics have a.... | this is why they are used in combination with other diuretics
weak overall effect
36
thiazide diuretics inhibit the
reabsorption of sodium and chloride
37
with thiazides there is a
decreased loss of calcium in the excretion
38
where sodium goes...
water follows
39
antiarrhythmic drugs are drugs used for the
treatment and prevention of cardiac rhythm disturbances
40
action potential pathway describes the flow of
depolarization through the intrinsic NS of the heart
41
describe the pathway known as action potential "Super Highway"
sinoatrial node -> atrioventricular node -> bundle of His -> L&R bundle branches -> purkinje network & papillary muscles
42
ALL antiarrhythmic drugs have the potential to they themselves...
produce arrhythmias
43
what are 4 common antiarrhythmic drugs
1. sodium channel blockers 2. beta blockers 3. drugs prolonging the AP from the SA to AV node 4. calcium channel blockers
43
sodium channel blockers MOA is to
decrease the AP or electrical conductance within the heart
44
beta blocker's MOA is to
reduce stimulation to the sympathetic NS
45
calcium channel blockers are commonly used for what conditions?
- arrhythmias - tachycardia
46
drugs that prolong the AP from the SA to the AV node are commonly used for
- atrial arrhythmias - ventricular tachycardia
46
calcium channel blocker's MOA is to
decrease intracellular calcium that is required for cardiac muscle contraction
47
define heart failure
a reduction in cardiac output resulting in a loss of blood pressure
48
with heart failure there is an initial
compensatory response
49
the compensatory response in heart failure is accompanied by
elevated sympathetic NS activity
50
an elevation in SNS activity increases the
rate and force of contraction in the heart by stimulating beta1, 2, and alpha 1 receptors
51
long term SNS produces...
hyperadrenergic state
51
a hyperadrenergic state may lead to
- irreversible myocyte damage - fibrotic buildup - death of cardio-myocytes (myocardial infarction)
52
what are the 6 different pharmacological treatment options for heart failure
1. ACE inhibitors 2. angiotensin receptor blockers 3. beta-adrenergic blockers 4. aldosterone antagonists 5. diuretics 6. phosphodiesterase inhibitors
52
what is the MOA of beta-adrenergic blockers
to reverse the effect of SNS activity and reduce cardiac workload
53
what is the MOA of aldosterone antagonists
to inhibit sodium retention in the kidneys and sympathetic activity promoted by aldosterone binding to its receptors
53
what is the MOA for phosphodiesterase inhibitors?
increase cAMP in cell and produce a positive inotropic force of contraction

Pharmacology (9 decks)

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