Drugs For Treating Cardiovascular Conditions

Question 1

Beta Blockers

Answer 1

• Block beta receptors that are a component of the sympathetic nervous system.
• Beta-1 receptors on the heart and kidneys.

Question 2

Beta Blockers inhibit these effects of Heart Beta-1 Receptor Activation

Answer 2

• Increased Heart Rate
• Increased Myocardial Contractility
• Increased Myocardial Conduction
• Activates RAAS
• Can be good for Anxiety

Question 3

Beta Blockers Uses: Hypertension

Answer 3

• Decreases cardiac output
  ~ HR and SV are decreased
• Inhibits RAAS
  ~ More water excreted
  ~ Less vasoconstriction

Question 4

Beta Blockers Uses: Stable Angina and Heart Failure

Answer 4

Decreases HR, contractility, and conduction, which decreases stress on the heart and the hearts demand for O2

Question 5

Diuretics

Answer 5

• Decrease blood volume by triggering the kidney to excrete sodium via urine excretion.
  ~ Aldosterone Antagonist
  > Act within the kidney to inhibit
  sodium retention
  > Makes kidneys get rid of sodium/
  pee more

Question 6

Diuretics Uses

Answer 6

• Hypertension
• Edema Associated with Heart Failure

Question 7

Angiotensin Converting Enzyme (ACE) Inhibitors

Answer 7

• Inhibit ACE
  ~ Decreases Angiotensin 2
  > Decreased aldosterone release.
  > Decreased vasoconstriction.
• Prevents Breakdown of BK
  ~ BK causes vasoconstricton
  ~ Bradykinin causes release of
  histamine and activates
  phospholipase A2.
  > Leads to normal/increased levels
  of HT, PG, & LT. (vasodilators)

Question 8

ACE Inhibitors Uses: Hypertension

Answer 8

• Decreased levels of Angiotensin 2 causes kidneys to excrete more sodium/water reducing blood volume/pressure
  ~ Because adrenal gland is not
  releasing Aldosterone
• Vasodilation due to less angiotensin 2 preservation of BK and production of HT/PG/LT decrease pressure

Question 9

ACE Inhibitors Uses: Heart Failure

Answer 9

• Decreases blood pressure and generalized edema
  ~ Vasodilation
  > Decreased angiotensin 2
  > Increased HT, PG, LT, and BK levels
  ~ Kindeys excrete sodium/water
  reducing volume/pressure
  > Decreased aldosterone

Question 10

Angiotensin Receptor Blockers

Answer 10

• Blocks binding of angiotensin 2 so it can’t exert its effects (vasoconstriction)
• Same end effects and uses as ACE inhibitors - Vasodilation and kidney excretion of sodium/water for
  HTN and HF.
  ~ Angiotensin 2 not allowed to cause
  release of aldosterone from adrenal
  cortex.
  > Kidney excretes sodium/water.
  ~ Vasoconstriction due to angiotensin li
  does not occur.
  > Vessels are dilated or relatively
  so.

Question 11

Calcium Channel Blockers

Answer 11

• Calcium channels control the flow of calcium into some cells.
  ~ Movement of calcium into muscle cells
  causes them to contract.
  > Calcium channel blockers block
  this effect interfering with muscle
  contraction (muscles will relax or
  contract less)

Question 12

Calcium Channel Blocker Uses: Hypertension

Answer 12

• Reduces HR and contractility, reducing cardiac output
• Causes vasodilation, decreasing blood pressure

Question 13

Calcium Channel Blocker Uses: Stable Angina

Answer 13

• Dilates coronary arteries, increasing blood/O2 delivery
• Reduces HR and contractility, reducing O2 demand of myocardium

Question 14

Nitroglycerin

Answer 14

Breaks down into nitric oxide
~ Relaxes vascular smooth muscle,
resulting in vasodilation
> Very powerful and fast absorbing,
but short acting
* Small amounts used
sublingually
> Use for Stable Angina
* Dialates coronary arteries

Question 15

Sudden Death Syndrome

Answer 15

• Prevalence
  ~ One in 50,000 to one in 100,000
  young athletes.
• Causes
  ~ Most Cardiac (85%)
  ~ Others
  > Respiratory Complication (asthma)
  > Drug Related
  > Heat Stroke

Question 16

Sudden Death Syndrome: Cardiac Causes

Answer 16

• Hypertrophic Cardiomyopathy
  ~ 1 in 500 gen. pop.
  ~ Number one cause of sudden death
  in athletes.
• Infarction
• Myocarditis
• Coronary Artery Abnormalities
  ~ Abnormal coronary artery origin.
  > Abnormal course can cause “kink”
  and obstruct the flow of blood
  ~ Myocardial Bridging - Artery tunnels
  into myocardium
• Martan’s Syndrome
  ~ Abnormal, hereditary condition of
  connective tissues of the body
  ~ Characterzed by a tall lean body long
  extremities and hypermobile joints
  ~ The aorta and heart valves tend to be
  weak which can result in rupture