Lecture 6 - Cardiac Medications Flashcards
What medications would a person with hypertension take?
- B-blockers
- ACE inhibitors
- Diuretics
- CCB’s
- Alpha blockers
What medications would a person with CHF take?
- B-blockers
- ACE inhibitors
- Diuretics
- Digitalis
- Vasodilators
What medications would a person with MI take?
- B-blockers
- Aspirin
- Antihyperlipidemics
- Lasix
What does nitric oxide (NO) do?
- Causes vasodilation
- Reduces Preload and afterload (by increasing venous capacitance)
- Lowers heart wall stress
What are some common side effects of NO?
- HA
- Facial flushing
What are some serious side effects of NO?
- Syncope
- Hypotension
What do B-blockers do?
Reduces cardiac work (o2 demand) by:
- Reducing HR
- Reducing Contractility
What do B1 receptors do when active?
Heart: Increase 1. HR 2. Conduction 3. Contraction 4. Ejection Fraction Others: Increase 1. Renin release 2. Hunger
What do B2 receptors do when active?
- Relaxes smooth muscle in:
- Bronchus and Bronchioles
- Uterine muscle - Contracts urethral sphincter
- Increases renin release
- Stops insulin release
What do B2 receptors do when active?
- Relaxes smooth muscle in:
- Bronchus and Bronchioles
- Uterine muscle - Contracts urethral sphincter
- Increases renin release
- Stops insulin release
- Stimulates Gluconeogenisis and glycolysis
- Lipolysis
- Thick Saliva
What is the difference between Selective and Non-Selective B-blockers?
Selective (B1) cause fewer peripheral effects compared to Non Selective (B1 and B2) drugs
What type of B-blocker may a patient be taking if you notice they are coughing a lot?
Non Selective B-Blockers because inhibition of B2 receptors causes bronchospasms due to smooth muscle contraction.
What type of B-blocker may a patient be taking if you notice they are coughing a lot?
Non Selective B-Blockers because inhibition of B2 receptors causes bronchospasms due to smooth muscle contraction.
What do B-Blocker drugs end with in their names?
“olol”
For example: Propranolol
How do B-Blockers decrease sympathetic activity?
- Decreases calcium uptake
- Impairs CICR
What are the general cardiac effects of B-Blockers?
Negative: - Chronotropy - Inotropy - Dromotropy Anti: - Ischemic - Arrythmic
What are the general cardiac effects of B-Blockers?
Negative: - Chronotropy - Inotropy - Dromotropy Anti: - Ischemic - Arrythmic
What effect do Beta-Blockers have on an ischemic heart?
(Draw diagram
Decrease: HR Afterload Contractility O2 Wastage Demand Vasoconstriction Increase Diastolic perfusion
Compare and Contrast Glucose oxidation vs Fatty Acid Oxidation
GO:
- 10 - 40 % of energy
- Requires less oxygen
- ATP/oxygen = 3
FAO:
- 60 - 90 of energy
- Requires more oxygen
- ATP/oxygen = 2.6
Compare and Contrast Glucose oxidation vs Fatty Acid Oxidation
GO:
- 10 - 40 % of energy
- Requires less oxygen
- ATP/oxygen = 3
FAO:
- 60 - 90 of energy
- Requires more oxygen
- ATP/oxygen = 2.6
What effect do CCB’s have?
Cause
- Vasodilation
- Reduced peripheral resistance
How do CCB’s decrease the work of the heart?
They decrease contractility (inotropy) by reducing calcium uptake into the cell by blocking the L-type channels. Afterload is also reduced due to decrease in peripheral resistance
How do CCB’s decrease the work of the heart?
They decrease contractility (inotropy) by reducing calcium uptake into the cell by blocking the L-type channels. Afterload is also reduced due to decrease in peripheral resistance
Which type of CCB’s have a greater effect on vascular function?
DHP’s - Dihydropyridines
What do DHP’s normally end with in their name?
“dipine”
Eg: Amlodipine
How do DHP’s affect the periphery?
They reduce afterload by causing vasodilation in the periphery
What are some examples or Non-DHP drugs and how do they differ from DHP’s?
Verapamil and Diltiazem
Have more of an effect on the heart
Give examples of anti-cogaulants
Wafarin
Aspirin
Give examples of anti-cogaulants and what do they do?
Wafarin
Aspirin
- Blood thinners
How do diuretics reduce BP?
By decreasing BV
Give an example of a diuretic
Furosemide - affects the loop of Henle
