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Pharm N317 - UW Madison Fall 2023 > EDIT Drugs for Hypertension & Heart Failure > Flashcards

EDIT Drugs for Hypertension & Heart Failure Flashcards

1
Q

Heart failure occurs when

A

the ventricle is pumping out <65% of it’s volume w/ each contraction

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2
Q

What’s the difference between chronotropic and inotropic drugs?

A

Chrono: affect HR
Ino: affect contraction force

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3
Q

What type of drugs accelerate/deccelerate conduction in the AV/SA nodes, bundle of His/purjinke fibers?

A

dromotropic drugs

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4
Q

Lisinopril class/MOA, use, warnings

A

-ACE inhibitor (vasodilator)
-hypertension, HF, MI
-Pregnancy class C and later
-Side effects: cough, hyperkalemia, renal disfunction (all ACE inhibitors)

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5
Q

Valsartan class/MOA, use, warnings

A

-ARB (angiotensin receptor blocker), vasodilator
-uses: hypertension, HF
-Pregnancy category D
-SFX: hyperkalemia, renal disfunction (all ARBs)

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6
Q

Valsartin-sacubitril (“Entresto”) class/MOA, use, warnings

A

-ARNis (apprvd 2015), inhibits neprilysin enzyme and reduces vaso-peptides, plus valsartin’s vasodilation
-BLACK BOX for pregnancy

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7
Q

A BP cuff too loose will cause falsely ____ BP, too tight will cause falsely ____ BP

A

high, low

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8
Q

Alpha2 receptor agonists (examples, class, MOA, side effects)

A

-clonidine, methyldopa (pregnancy)
-adrenergic
-MOA: stimulate A-II receptors, blocking norepinephrine and reducing BP
-SFX: orthostatic hypertension, fatigue, dizziness
!Don’t stop suddenly, get up slowly

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9
Q

Alpha1 receptor blockers (examples, class, MOA, side effects)

A

-adrenergic
-“sins”: doxasin, prazosin, tarazosin
-MOA: block norepinephrine receptors, decreasing BP and causing vasodilation
-SFX: orthostatic hypertension, fatigue, dizziness
!Don’t stop suddenly, get up slowly

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10
Q

Beta blockers (examples, class, MOA, side effects)

A

-adrenergic
-“lols”: propranolol, atenonol, metaprolol
-MOA: reduce HR/renin
-SFX: bradycardia, dizziness
!Don’t stop suddenly

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11
Q

Dual action A1 and Beta blockers (example, class, MOA, side effects)

A

-adrenergic
-labetalol, carvedilol
-MOA: block A1 norepinephrine receptors (A1) AND reduce HR/renin (BB)
-side effects: bradycardia, dizziness, orthostatic hypertension
-Don’t stop suddenly/get up quickly

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12
Q

ACE inhibitors for hypertension (examples, MOA, side effects/interactions/antidote)

A

-“prils” CELF: captopril, enalapril, lisonopril, fosinopril
-MOA: inhibit A-II and aldosterone, reduces BP and vasodilates
-SFX: dry cough, hyperkalemia, fatigue, dizziness
-interacts w/ NSAIDs, pregnancy category C/D (BLACK BOX)
-antidote: Hemodialysis

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13
Q

Most ACE inhibitors are prodrugs. What does this mean? Which 2 are NOT prodrugs?

A

-prodrugs: must be metabolized by liver to work
-Lisonopril and captopril are Not prodrugs

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14
Q

ACE inhibitors decrease _______ and _______, and are the first line of treatment for what?

A

-preload, afterload
-heart failure

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15
Q

ARBs for hypertension (examples, MOA, side effects–signs of overdose)

A

-“sartans”: losartan, valsartan, irbesartan, candesartan
-MOA: blocks conversion of A-I to A-II, reduces BP and vasodilates
-SFX: chest pain, fatigue, diarrhea, pregnancy category C (BLACK BOX)
-Overdose: tachycardia, hypotension (treat w/ fluids)

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16
Q

Hydralazine, nitroprusside, minoxidil, and diazoxide are ______. Name their MOA/side effects

A

Vasodilators for hypertension
-cause peripheral dilation directly
-SFX: bradycardia, low platelet aggregation

17
Q

Nitroprusside and diazoxide are mainly used in what setting?

A

ICU

18
Q

What diuretics are typically used for hypertension? Are they considered “first line” treatment? Do they decrease pre/afterload?

A

-thiazides
-Yes
-decrease preload

19
Q

Calcium channel blockers (examples, MOA/use, side effects)

A

-amlodipine, nifedipine, nimodipine
-MOA: block calcium binding and prevent contraction (negative inotropic)
-use: hypertension, angina, migraines
-SFX: hypotension, peripheral edema
-NO: grapefruit juice, ED meds (hypotension)

20
Q

Classes of HF

A

1: no symptoms
2: mild symptoms
3: symptoms w/ exercise
4: symptoms always

21
Q

ACE Inhibitors for HF (examples, MOA, side effects)

A

-“prils”: lisonopril, enalapril, captopril
MOA: inhibit A-II and aldosterone –> diuresis –> decreased preload
SFX: dry cough, BLACK BOX for pregnancy (C/D), hyperkalemia, renal issues

22
Q

Heart failure is:

A

low ejection fraction (<65% of volume)

23
Q

ARB for HF (examples, MOA, side effects)

A

-“sartans”: valsartan, losartan, olmesartan
-MOA: block A-I to A-II conversion, reduces BP, vasodilates–decreases
-SFX: pregnancy category D, renal issues

24
Q

ARNiS (example, MOA, SFX)

A

-“Entresto” (valsartan/sacubitril)
-MOA: blocks neprilysin (enzyme that degrades vasoactive peptide) + an ARB (valsartan)
-SFX: preg cat D, hyptoension, hyperkalemia, renal issues

25
Q

Beta Blockers for HF (examples, MOA, SFX)–what classes of HF would you give these for?

A

-“lols”: metapropolol, carvedilol
-MOA: reduce HR/renin/contractility
-SFX: bradycardia, dizziness, don’t stop suddenly (chronotropic, inotropic, and dromotropic)
-HF class 1-2

26
Q

Aldosterone antagonists for HF (examples, MOA, side effects, use)

A

-spironolactone, eplerenone
-MOA: aldosterone antagonists
-SFX:
use: end stages of HF

27
Q

Loop diuretics for HF (examples, MOA, SFX)

A

-furosemide, torsemide, bumetanide
-MOA: work in LoH to inhibit solute reabsorption –> diuresis –> lower volume
-SFX: hypokalemia, hypotension

28
Q

Which beta blockers are nonselective? which are selective? What’s the main difference?

A

-nonselective: Propranolol
-selective: metoprolol, atenolol
Nonselective also interfere w/ respiratory system

29
Q

PDI (milrinon) MOA, use, side effects

A

-MOA: inhibit phospho enzyme
-increase contractility, decrease peripheral vascular resistance and afterload
-use: short term, ICU
-SFX: ventricular arrythmias, headache, hypokalemia, tremors

30
Q

Digoxin class, MOA, signs of toxicity/considerations

A

-class: cardiac glycoside
-MOA: Na/K pump inhibition –> increase contractility + stroke volume, reduces heart size
-Consider: narrow therapeutic window (0.5-2), monitor electrolytes
-Toxicity: bradycardia, visual disturbances (flickering), confusion/headache/dizziness
low potassium makes this worse!
antidote: digoxin immune fab

31
Q

Digoxin contraindications

A

NO:
-high fiber diet
-amiodarone, verapamil, St. John’s wort

32
Q

What should you NOT give w/ PDIs?

A

diuretics!

33
Q

BiDil is a medication made specifically for what population? What’s the MOA?

A

-Black patients w/ heart failure
-vasodilator

Pharm N317 - UW Madison Fall 2023 (23 decks)

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