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PHTH 561 - Pharm > Hypertension and Arrhythmia > Flashcards

Hypertension and Arrhythmia Flashcards

1
Q

What is the American Heart Association BP categories?

Should be review

A
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2
Q

What are non-pharmacological treatments for blood pressure?

A
  • dietary salt restriction
  • potassium supplementation (but big emphasis on diet change)
  • weight loss
  • DASH diet
  • aerobic exercise
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3
Q

What is tachycardia?

A

Fast HR
> 100 bpm

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4
Q

What is bradycardia?

A

Slower HR
< 60 bpm

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5
Q

What is depolarization?

A

Process where the electrical current to the heart is changing each cell from:
resting -> depolarized state

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6
Q

What is repolarization?

A

Heart muscle goes back to rest after contraction

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7
Q

What are the anti-hypertensive drugs?

Chart for all the drugs

A
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8
Q

What is the use of thiazide diuretics?

A

for mild-moderate hypertension

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9
Q

What is the use for loop diuretics?

A

effective in reducing edema but NOT a good hypertensive med

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10
Q

What is the use of potassium sparing diuretic?

A

a very weak anti-hyperensive agent

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11
Q

What are the effects of renin angiotensin?

A
  • vasoconstriction
  • release of aldosterone
  • release of ADH
  • induces thrist = more fluid intake
  • chronic activation of renin-angiotensin system
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12
Q

Cardiac Action Potential

What is phase 0?

A

opening of fast Na channels and rapid depolarization
- Na+ into the cell
- changing membrane potential

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13
Q

Cardiac Action Potential

What is phase 1?

A

Initial rapid repolarization
- closing of fast Na+ channels

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14
Q

Cardiac Action Potential

What is phase 2?

A

The plateu phase
- balance between Ca+ coming in = K+ coming out

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15
Q

Cardiac Action Potential

What is phase 3?

A

Repolarization
- K+ channels stay open
- lets K+ to build up outside the cell
- cell repolarization

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16
Q

Cardiac Action Potential

What is phase 4?

A

Resting phase

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17
Q

What is the role of diuretics?

A

Acting on the kidney to increase excretion of sodium and water

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18
Q

What is the role of the renin angiotensin system?

A

BP regulation by:
- controlling fluid volume
- vascular tone by angiotensin II production

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19
Q

What is the roll of Ace inhibitors?

A

Lowering the BP
- prevents blood vessel and heart remodeling

20
Q

What is the role Angiotensin receptor blockers?

A

lowering BP
- preventing blood vessel and heart remodeling

21
Q

What is the role of calcium channel blockers?

A

lowers BP and preventing Ca+ from going into the cells of the heart and arteries:
- lowers BP
- treates angina
- controlling arrthymias
- treat migraines

22
Q

What is the role of beta blockers?

A

decreases HR and force of contraction = decreased CO

23
Q

What is the role of alpha blockers?

A

causes:
- reflex tachycardia
- but can also cause orthostatic hypotension

24
Q

What is the role of alpha-2 agonist?

A

decrease in:
- HR
- CO
- vascular resistance

25
Q

What is the role of vasodilators?

A

used to treat moderate-severe hypertension that is difficult to control

26
Q

What are some of the anti-arrhythmic drugs?

Picture 1 of 2 - with MOA and common side effects

A
27
Q

What are some of the anti-arrhythmic drugs?

Picture 2 of 2 - with MOA and common side effects

A
28
Q

Class 1

What is the purpose of class 1 antiarrhythmics drug?

A

Blocks fast Na+ channels

29
Q

Class 1

What is the purpose of subclass 1A?

A

causes mod phase 0 depression
longer repolarization
increased duration of action potential

30
Q

Class 1

What are some of the drugs and its effects of class 1a?

A
31
Q

Class 1

What is the purpose of subclass 1B?

A

weak phase 0 depresion
shorter repolarization
decreased action potential duration

32
Q

Class 1

What are some of the drugs and effects of class 1b?

A

Best to treat ventricular arrhythmias

33
Q

Class 1

What is the purpose of subclass 1c?

A

Strong phase 0 depression
little effect of repolarization

34
Q

Class 1

What are the drugs and its effects of subclass 1C?

A

Best to treat ventricular arrhythmias

35
Q

Class II

What is the two major actions of class II?

A
  1. blockage of myocardial B-adrenergic receptors
  2. Direct membrane-stabilizing effects related to Na+ channel blockage
36
Q

Class II

What are some of the drugs and effects of class II?

A

Effective in treating atrial tachycardias and ventricular arrhythmias

37
Q

Class III

What is the purpose of class III drugs?

A

K+ channel blockers
= causes delay in repolarization

38
Q

Class III

What are some drugs and effects of class III drugs?

A
39
Q

Class IV

What is the purpose of class IV drugs?

A

Ca2+ channel blockers
= slows rate of AV conduction in patients with atrial fibrillation

40
Q

Class IV

What are some drugs and its effects for class IV?

A
41
Q

What is the function of adenosine drug?

A

inhibits AV conduction (short effect) = IV injection for supraventricular tachycardia

42
Q

What is the function of digoxin?

A

reduces conduction throught the AV node
= helpful to control atrial flutter and fib

43
Q

What is the function of atropine?

A

blocks the vagal effects on the SA node
= treats sinus bradycardia

44
Q

What is the PT considerations for class I: sodium channel blockers?

A

Consideration: risk of proarrhythmias

Intervention:
- monitor HR and rhythm closely
- adapt exercise intensity and duration to tolerance

45
Q

What is the PT consideration for class II: beta-blockers?

A

Consideration: reduced HR and exercise tolerance

Intervention:
- use RPE sclaes to monitor intensity (because of HR is blunted)

46
Q

What is the PT consideration for class III: potassium channel blockers?

A

Consideration: risk of torsades de pointes and other arrhythmias

Intervention:
- always monitor ECG during exercise if possible
- be ready for any acute changes

47
Q

What is the PT considerations for class IV: calcium channel blockers?

A

Considerations: potential for hypotension and bradycardia

Intervention:
- monitor vitals
- avoid sudden positional changes to prevent orthostatic hypotension

PHTH 561 - Pharm (6 decks)

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