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Medical Screening II > Lecture 4 > Flashcards

Lecture 4 Flashcards

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USMLE® Step 1 flashcards
1
Q

Diuretics

A
  • increase the formation and excretion of urine
  • decreases the volume of fluid in the vascular system
  • act directly on the kidney to decrease plasma fluid volume
  • direct effect on blood pressure
  • inexpensive and work in a large portion of patients
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2
Q

Side effects of Diurectics

A
  • Fluid depletion and electrolyte imbalance
  • excessive fatigue and weakness
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3
Q

3 classifications of diuretics

A
  • Thiazide
  • Loop
  • Potassium- sparing
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4
Q

Sympatholytic drugs - Beta blockers

A
  • Decrease heart rate and myocardial contraction force
  • Slow down the heart and reduces cardiac output
  • Maintain appropriate supply and demand of oxygen * Agina
  • *olol endings
  • Often complement other antihypertensives
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5
Q

Side effects of Beta Blockers

A
  • non-selective beta-blockers may produce bronchoconstriction in asthma or similar conditions, excessive heart rate/contractility reduction, may impair glucose/lipid metabolism
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6
Q

Sympatholytic drugs - Alpha blockers

A
  • Decrease in vascular resistance
  • improve blood lipid profiles
  • *osin endings
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7
Q

Side effects of Alpha Blockers

A
  • Hypotension
  • Dizziness
  • Reflex tachycardia
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8
Q

Sympatholytic drugs: Presynaptic adrenergic inhibitors

A
  • inhibit the release of norepinephrine from presynaptic terminals of peripheral adrenergic neurons
  • decreases sympathetic - mediated excitation of the heart and peripheral vasculature
  • not as well tolerated as other medications
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9
Q

Side effects of Presynaptic adrenergic inhibitors

A
  • bradycardia
  • arrhythmias
  • drowsiness
  • depression
  • GI disturbances
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10
Q

Sympatholytic drugs: Centrally acting agents

A
  • inhibit sympathetic discharge from the brainstem
  • decrease in cardiovascular stimulation and blood pressure
    • limit sympathetic activity at the source rather than the periphery
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11
Q

Side effects of Centrally acting agents

A
  • dry mouth
  • dizziness
  • sedation
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12
Q

Sympatholytic drugs: Ganglionic blockers

A
  • Block synaptic transmission at autonomic ganglia
  • Decreases systemic sympathetic activity
    • used in emergency situations, not as well tolerated
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13
Q

Side effects of Ganglionic blockers

A
  • GI disturbances
  • Urinary retention
  • visual disturbances
  • orthostatic hypotension
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14
Q

Vasodilators

A
  • vasodilate the peripheral vasculature, decreasing peripheral vascular resistance
  • inhibitory effect on vascular smooth muscle cells
    • Emergency situations
  • Nitric oxide, hydralazine
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15
Q

Side effects of Vasodilators

A
  • hypotension / orthostatic hypotension
  • dizziness
  • reflex tachycardia
  • weakness
  • nausea
  • fluid retention
  • headache
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16
Q

Drugs that inhibit renin-angiotensin system

A
  • regulate vascular tone as well as sodium, and water balance in the body
  • inhibition of ACE inhibitors
  • Lower incidence of cardiovascular side effects, lower vascular hypertrophy, lower morbidity and mortality associated with congestive heart failure
    • Pril endings
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17
Q

Side effects of drugs that inhibit renin-angiotensin system

A
  • skin rash
  • dry cough
  • GI discomfort
  • dizziness
  • reflex tachycardia
  • hypotension
18
Q

Calcium channel blockers

A
  • Selectively block calcium entry into vascular smooth muscle
  • Calcium partly activates contractile element in smooth muscle
  • Increasing coronary blood flow/oxygen supply to the heart
  • Maintain appropriate supply and demand of oxygen
  • Increased risk of heart attack, especially with shorter-acting formulas
  • *ipine endings
19
Q

Side effects of Calcium channel blockers

A
  • excessive vasodilation
  • swelling in feet or ankles
  • hypotension
  • heart rate abnormalities
  • dizziness
  • headache
  • nausea
20
Q

Nonpharmacological treatment of hypertension

A
  • Dietary modifications: Sodium restriction, increased fruits, vegetables, and low fat
  • Decreased alcohol and tobacco use
  • Decreased body weight
  • Regular exercise
  • Stress managment
21
Q

Angina pectoris

A
  • chest pain during ischemic heart disease
  • intense compression and tightness that can radiate to jaw or left arm
  • often preceded by increased physical exertion but can be spontaneous / at rest
  • supply of oxygen is insufficient to meet demands of the heart
22
Q

3 primary drug groups for Angina pectoris

A
  • organic nitrates: increase exercise tolerance
  • beta blockers: decreased cardiac response to exercise
  • calcium channel blockers
23
Q

Organic nitrates

A
  • decreasing myocardial demand
  • general vasodilation throughout the body
  • Administered sublingually, spray under the tongue or transdermal patch
24
Q

Side effects of Organic nitrates

A
  • orthostatic hypotension
  • dizziness
  • headache
  • nausea
25
Q

Other info on drugs for Angina

A
  • Supply and demand issue
  • Anticoagulants to prevent artery occlusion / clot formation
  • *Medications do not treat the underlying heart disease
  • Surgical techniques to improve coronary blood flow
26
Q

Congestive heart failure

A
  • chronic condition of the heart unable to pump enough blood to the peripheral tissues and become progressively worse
  • Symptoms: peripheral edema, decreased tolerance for PA, shortness of breath, dyspnea
  • High prevalence of people with the disease
  • Poor prognosis
27
Q

Agents that increase myocardial contraction force

A
  • positive inotropic agents: digoxin/digitalis
  • Improves cardiac pumping ability
  • Improves cardiac output at rest and during exercise
  • Blood can pump more effectively
  • Secondary to beta blockers, ace inhibitors
  • Side effects: Toxicity (GI distress, drowsiness, fatigue, confusion, visual disturbances and abnormal cardiac function)
28
Q

Agents that decrease cardiac workload

A
  • ACE inhibitors
  • Beta Blockers
  • Diuretics
  • Vasodilators
29
Q

Signs of congestive heart failure

A
  • increased cough, difficulty breathing/dyspnea, abnormal breathing sounds, frothy sputum
30
Q

Signs of digitalis toxicity

A
  • dizziness, confusion, nausea, arrhythmias
31
Q

Coagulation disorders

A
  • Blood coagulation (hemostasis) is necessary to prevent excessive hemorrhage from damaged blood vessels
  • Thrombogenesis: abnormal formation of blood clots
  • Thrombus formation can lead to vessel occlusion and tissue infarction
  • can create an embolism and infarction
32
Q

Hyperlipidemia

A
  • chronic and excessive increase in plasma lipids
  • cholesterol and other lipids progressively deposited into the arterial wall creating plague lesions (atherosclerosis)
  • progressively occlude the artery
  • can rupture
  • related heart disease
  • affected by diet, exercise, lifestyle choices, genetic, and other metabolic conditions
33
Q

Drugs used for overactive clotting

A
  • Anticoagulant
  • Antiplatelet
  • Fibrinolytic
34
Q

Anticoagulant

A
  • control function and synthesis of certain clotting factors
  • used primarily to prevent clot formation in the venous system
  • Heparin: IV administration
  • Warfarin (Coumadin): Oral administration
  • Long term Warfarin need periodic monitoring
35
Q

Side effects of Anticoagulant

A
  • increased risk of hemorrhage
  • decrease platelets
  • GI distress
  • sudden increases in joint pain could indicate hemorrhage
36
Q

Antiplatelet

A
  • prevent excessive clotting through increased platelet activity
  • primarily to prevent clot formation
  • Aspirin, Plavix
37
Q

Side effects of Antiplatele

A
  • increased risk of hemorrhage
  • decrease platelets
  • GI distress
  • sudden increases in joint pain could indicate hemorrhage
38
Q

Fibrinolytics

A
  • Facilitate breakdown and dissolution of clots that have already formed
  • Important in treating acute heart attack (IV administration)
  • T- PA
  • Careful with elderly patients, severe/untreated hypertension, history of hemorrhagic stroke
39
Q

Side effects of Fibrinolytics

A
  • increased risk of hemorrhage
  • decrease platelets
  • GI distress
  • Excessive bleeding
40
Q

Drugs used for clotting deficiencies

A
  • Hemophilia: hereditary disease in which an individual is unable to synthesize adequate amounts of a specific clotting factor
  • Small injuries can produce severe or fatal hemorrhage
  • Joint problems
  • Vitamin K, Manufactured clotting factors, antifibrinolytics ( after surgery, trauma, cancer treatments, etc)
41
Q

Statins- Hyperlipidemia

A
  • Increases the breakdown of “bad” cholesterol
  • support a modest increase of “good” cholesterol
  • can lead to vasodilating, anti-inflammatory, and antioxidant effects
  • improves morbidity and mortality in people with high cholesterol
  • Decrease risk of major cardiac event
  • side effects: GI distress, myopathy (muscular pain, inflammation, weakness)
42
Q

Fibric acids: Hyperlipidemia

A
  • Primarily decrease triglyceride levels
  • increase good cholesterol and lower bad ones
  • good for treating a combination of lipid abnormalities

side effects: GI distress

Medical Screening II (9 decks)

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