Lecture 14 - Medications for Cardiovascular conditions Flashcards
What are the 3 layers of the heart?
- Endocardium (inner)
- Myocardium (middle, muscle)
- Epicardium (outer)
What are some risk factors for heart disease?
- diabetes mellitus
- hypertension
- obesity
- stress
- smoking
- poor diet
What is an ischemia?
when oxygen being delivered to the heart is insufficient to meet the needs
What is coronary artery disease?
atherosclerosis (build of plaque) and arteriosclerosis (hardening of arteries during aging)
What is Angina pectoris?
episodic, reversible oxygen insufficiency
What is a myocardial infarction?
severe, prolonged lack of oxygen –> kills an area of heart muscle
What is the goal of therapeutic agents for myocardial infarctions?
to limit DAMAGE and STOP progression
What are medications used to treat myocardial infarctions or angina x3? (Organonitrates and other anginal meds)
- Nitroglycerin
- metoprolol
- propanolol
What does Nitroglycerin do?
- dilates blood vessels to decrease cardiac oxygen demands, improving blood flow
- treats stable angina
- decreases BP
-prevents chest pain
What is the mechanistic steps for nitroglycerin?
- forms free radical NO
- activates guanylate cyclase in smooth muscle and other tissues
- dephosphorylation of myosin light chains
- vasodilation
How long after taking nitroglycerin do you get relief?
1-3 minutes after by max 5 minutes
What are the adverse effects of nitroglycerin?
CNS related (dizzy, hypotension)
What are beta-adrenergic blockers meds do?
- decrease heart rate
- 3 beta receptors (B1, B2, B3)
What does B1 receptor do when you stimulate it with epinephrine?
increases cardiac conduction velocity and automaticity
increases renin release on kidneys
What does stimulation on B2 receptor do?
induces smooth muscle relaxation
induces tremors in skeletal muscle
What does stimulation of B3 receptor do?
induces lipolysis
What beta receptors does propranolol block?
B1 –> decrease heart force of contraction, heart rate and renin secretion
B2 –> increase airway resistance and increase vascular resistance
What is the “P” in cardiac heart beat graph?
atrial depolarization
What is the “QRS” in cardiac heart beat graph?
ventricular depolarization
What is the “T” in cardiac heart beat graph?
Ventricular repolarization
look at cardiac graphs on slide 21
What are the 5 classes of antiarrhythmic drugs?
class 1. sodium channel blockers
class 2. beta blockers
class 3. potassium-channel blockers
class 4. calcium-channel blockers
class 5. miscellaneous = adenosine
What is one Class 1a) antidysrhythmic medication?
quinidine sulfate
What does quinidine do?
- DECREASES speed of electrical current
-PROLONGS period during which heart muscle cells can become electrically stimulated to contract - PROLONGS recovery period after contraction
