Medications

Question 1

Ischemic heart Disease (Medications)

Answer 1

-restablish balance of o2 supply and demand
-decreasing HR or BP to reduce O2 demand
-increase artery size, remove thrombus,

Question 2

Heart Failure (Medications)

Answer 2

-maintain CO, adress underlying issue, regulate fluids, decrease preload and afterload, increase conttractility, reduce workload, decrease SNS

Question 3

Arrhythmias (Medications)

Answer 3

-inhibit abnormal impulses by affectting membrane permeabiliy to specific ions (Cl, K, Ca, Na)
-SA & AV node
-prelong refractory period

Question 4

Hypertension (Medications)

Answer 4

-reduce fluid, limit SNS, decrease RAAS

Question 5

Beta Blockers

Answer 5

-olol
-reduced beta receptor binding
-selective of nonselective

B1: decrease HR and contractility
B2: bronchoconstriction and vasoconstriction

CI
-HTN, ischemic HD, heart failure, arrhythmias

SE
-sedation, may mask hypoglycemia, reduced thermoregulatry response, spasms, orthostatic hypotension

Max HR: 164 - (.7 x age)

Question 6

Orthostatic Hypotension

Answer 6

decreased of BP 20 and HR increase of 30 when standing from sitting

Question 7

Calcium Channel Blockers

Answer 7

-pine
-decrease HR & BP, conrtactility, O2 demand
-cause vasodilaiton of coronary artieries

CI
-reduce re-infarctions (dead tissue releases Ca), ischemic HD, heart failure, arrhythmias

SE
-negative inotropic effects, blunted HR responses to exercise

Question 8

Nitrates

Answer 8

-nitr
-slows HR, reduce preload and afterload, decrease contrtactility, lower BP, vasodilation

CI
-HTN, ischemic HD, heart failure, angina

SE
-hypotension, dizziness, reflex tachycardia, skin flushing

Question 9

Angina (Medications)

Answer 9

-chest pain due to ischemia
-lack of O2 stimulates pain receptors

-treated by nitrates, BB, CC blockers
S/s
-tightness and chest pain
-simular to MI
-ECG ST downward shift

Question 10

Stable Angina

Answer 10

-pain free at rest
-relieved by nitrates
-predictable

Question 11

Unstable Angina

Answer 11

-unpredictable
-at rest
->15mins
-progression of disease

Question 12

Prinzmetal’s Variant Angia

Answer 12

-only at rest; morning
-ST elevation
-cardiac vasospasm (CC blockers)

Question 13

Thrombolyic Agents

Answer 13

-break clots up quickly
-goal to keep ischemic time <120min

SE
-arrhythmias due to rapid reperfusion (high K, reflex tachycardia), bleeding, hemorrhage CVA

Question 14

Anti-Platelet Agents

Answer 14

-prevent platelet aggregation and thrombus formation
-decrease platele adverance to site of injury

Question 15

Anticoagulants

Answer 15

-prevention of blood clots, inhibit thrombin

Common: heparin, pradaxa, xarelto, eliquis

Question 16

Diuretics

Answer 16

-ide
-decrease blood volume by peeing
-improve cardiac contractility
-reduce cardiac demand
-act of kidneys (loop of henle most potent)

CI
-HTN, heart failure

SE
-hypotension, arrhyhmias (K+)

Question 17

Carbonic Anyhyrase Inhibitor Diuretics

Answer 17

-mild diuretics
-proximal tubules of kidney

Question 18

K+ Sparring Diuretics

Answer 18

-mild
-collecting tubules and ducts

Question 19

Thiazides Diuretics

Answer 19

-moderate
-can cause low K+ and glucose intolerance

Question 20

Sodium-Glucose Transporter Inhibitors

Answer 20

-ozin
-lower blood sugar, reduce CV deaths and kidney disease, reduce BP, weight loss

SE
-hypoglycemia, Hypotension, UTIs, diabetic ketoacidosis

Question 21

ACE Inhibitor

Answer 21

-pril
-prevents conversion of ang 1 to 2

SE
-hypotension, dizziness, angioedema (life thrreatening tongue swelling), hyperkalemia

Question 22

Angiotension II

Answer 22

-vasoconstriction
-watter and Na retention
-aldosterone stimulation

Question 23

Angiotensin Receptor Blockers (ARBs)

Answer 23

-sartan
-limits effects of ang 2

SE
-hypotension, dizziness, angioedema (life thrreatening tongue swelling), hyperkalemia

Question 24

Neprolysin Inhibitor

Answer 24

-reduces abnorrmal remodeling
-diuresis
-vasodilation

Question 25

Aldosterone Antagonists

Answer 25

-suppresses aldosterone
-decreased fluid retention (diuretic)

ex: spironolactone

SE
-hyperkalemia, Orthostatic hypotension

Question 26

Positive Inotropes

Answer 26

-increase contractions and HR
-opposite of BB

CI
-heart failure

Question 27

Cardiac Glycosides

Answer 27

-positive inotropes
-increase Ca+
-decrease HR
-increase delay from SA to AV
-increase PR interval
-anti arrhythmics

ex: digoxin

CI
-dilated cardiomyopathy
-a fib
NOT FOR 2nd or 3rd Heart Blocks

SE
-lots of symptoms of digitalis toxicity

Question 28

Sympathomimetics

Answer 28

-positive inotropes
-mimic SNS, treat shock, heart failure
-short term use only to prevent downrreg

CI
-parenteral use for hheart failure

Question 29

Phosphodiesterase Inhibitors

Answer 29

-positive inotropes

CI
-severe CHF, strengthen contractions

Question 30

Vasodilators

Answer 30

-decrease bv, vascular resistance
-Arterial: reduce afterload
-Venous: reduce preload

CI
-HTN, HF, ischemic heart disease

SE
-compensatory SNS actitvation

Question 31

Alpha Adrenergic Antagonists

Answer 31

-vasodilator
-manage HTN

SE
-reflex tachycardia
-increase in BV

Question 32

Morphine

Answer 32

-vasodilator
-decrease preload via venodilation
-reduce anxiety and effort during heart failure

Question 33

Anti-Hypertensive

Answer 33

-regulate BP, decrease HR and CO
-BB, Ca blockers, ACE inhib, vasodilators, diuretics

Question 34

Anti-Arrhythmics

Answer 34

Membrane stabilizers
-v tach and a fib
-reduces Na+ in cell

SE
-arrhythmias, bradycardia, photosensitivity, hepatotoxicity, hypothyroidism