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CARD 1101 > Mod12 Cardiac Drugs > Flashcards

Mod12 Cardiac Drugs Flashcards

1
Q

Antiarrhythmic drug classes

A

to treat arrhythmias to alleviate symptoms or prolong life

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2
Q

Vaughan Williams Classification

A

most commonly used drug classification system; classifies arrhythmias into four classes (Ia,b,c, II, III, IV) based on their electrophysiological properties/effects on myocardial APs

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3
Q

IA (Quindine, procainamide, disopyramide)

A

prolonged PR interval and QRS duration; Inhibit fast Na+ channel depression of Phase O of AP
Prolong AP

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4
Q

Complications of class IA

A

quindine has dangers associated with it; proarrhythmic complications (prolonged QT or depression of conduction, and promote re-entry tachyardias

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5
Q

IB (lidocaine, phenytoin, mexiletine, tocainide)

A

acts selectively on diseased or ischemic tissue by shortening their APs and inhibiting fast Na+ current; causes only minimal slowing of depolarization and conduction

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6
Q

IC (felcainide, propafenone)

A

prolonged PR and QRS interval; marked depression of Phase O of AP; variably prolong AP duration and marked inhibitory effects on conduction of the HIs purkinje; may have proarrhythmic effects

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7
Q

Class II drugs (beta-andrenergic antagonists)

A

atenolol, metroprolol, timolol, propranolol

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8
Q

function of Class II drugs

A

promote proarrhythmic depolarization in damaged heart tissues and the inward Ca2+ current; vary in their selection for Beta-I receptors and intrinsic sympathomimetic activity (ISA); each drug is therefore slightly different

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9
Q

Indications for B-blockers

A 
Inappropriate sinus tachycardia
hereditary prolong QT syndrome
HF
arrhythmias from mitral valve prolapse 
VF
VT
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10
Q

Contraindications of Class II drugs (reasons not to take them)

A

pulmonary problems
conductions defects
overt treated HF

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11
Q

Class III drugs (mixed examples)

A 
Amiodarone (Na channel blocker)
Sotalol (acts as beta-blocker) ; these have more beneficial effects than class I
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12
Q

Class III drugs (pure examples )

A

Ibutilide, dofetilide

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13
Q

Class III drugs mode of action

A

prolong AP and refractory period (prolongs QT)

**only supposed to effect the repolarization phase of AP

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14
Q

Class IV drugs

A

verapamil and diltiazem; Ca2+ channel blockers

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15
Q

effects and actions of verapamil and diltiazem (class Iv)

A

Ca2+ channel blockade slows conduction of AV node; increases refractory period in nodal tissue
ACTS: to prevent AV nodal reentry and slow ventricular response in atrial arrhythmias

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16
Q

Contraindications of Class IV drugs

A

ventricular tachyarrhythmias (because of heamodynamic effects)

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17
Q

Class IV-LIKE DRUG

A

Adenosine

18
Q

Adenosine (class IV like drug)

A

first line drug used to terminate narrow complex supraventricular tachyarrhythmias
for diagnosis of wide complex tachycardias of unknown origin

19
Q

side effects of adenosine

A

headache
chest pain
flushing
excess sinus or AV node inhibition

20
Q

Contraindications of adenosine (don’t use if have…)

A

asthma (or history of)
2nd or 3rd degree heart block
sick sinus snydrome
atrial flutter

21
Q

ACE inhibitors

A

group of pharmaceuticals used primarily in treatment of HF, hypertension and cardiovascular protection

22
Q

ACE inhibitor function

A

lessen the effects of Angiotensin II

23
Q

Major indications for ACE inhibitors

A 
cardiovascular protection 
HF
acute MI
hypertension 
post-infarct 
renal protection
diabetic nephropathy (diabetes is RF for atherosclerosis)
24
Q

Major side effects of ACE inhibitors

A

cough (from pulmonary congestion assoc with left HF and hypotension)

25
Q

Types of ACE inhibitors

A 
Captropril (class I)
Ramipril (class II) 
Lisinopril (class III)
26
Q

Angiotensin II receptor Blockers (ARBs)

A

direct antagonists of the angiotensin II receptor; act similarly to ACE BUT due to their specificity they have fewer side effects; treat ppl with HF and hypertension
-used when patients cannot tolerate ACE

27
Q

Example of ARBs

A

Losartan (Cozaar)
Candesartan (atacand)
telmisartan (micardis)

28
Q

Nitrates

A

manage stable and unstable angina; potent coronary vasodilators

29
Q

Coronary vasodilation

A

redistributes blood flow to collateral arteries and from epicardial surfaces; relieves coronary artery spasm and dynamic stenosis as result of preload and afterload reduction

30
Q

Adminstration of Nitrates

A

siblingually (under tongue), IV, transdermal patch; all depends on desired effect (long/short)

31
Q

Sublingual Nitrogylcerine

A

short acting nitrate used to treat angina that occurs with effort (exercise)

32
Q

Transdermal nitroglycerine

A

patches; slow release preparation that offers angina prophylaxis over a 24hr period

33
Q

Indications for Nitrates

A

angina attacks
acute MI
CHF
acute pulmonary edema

34
Q

Side effects of Nitrates

A

headache
syncope
tachycardia

35
Q

Contraindications (reasons not to take) of Nitrates

A

hypertrophic obstructive cardiomyopathy
acute inferior wall MI with right ventricular involvement
cor Pulmonale

36
Q

Drawbacks of Nitrates

A

body has ability to develop tolerance which limits efficacy after continuous and high dose therapy

37
Q

Statins (HMG CoA Reductase Inhibitors)

A

current lipid lowering agent of choice due to minimal side effects and long standing history of safe use

38
Q

Three main effects of Statins

A

reduce total cholestrol
reduce low density lipid-C (LDL-C)
increase high density lipid-C (HDL-C)
**recall: high LDL (from smoking, obesity, inactivity, dyslipidemia..) is a RF for atherosclerosis

39
Q

Benefits of Statins

A 
alter lipid profile
improve endothelial function
stabilize platelets 
reduce fibrinogen 
inhibit inflammatory response with atherogensis

***all of these cause regression of atherosclerotic plaque)

40
Q

Major concerns of Statins

A

liver damage

myopathy

41
Q

Examples of Statins

A 
Atrovastatin (Lipitor)
Lovastatin (Mevacor)
Mevastatin
Pravastatin (Lipostat)
Simvastatin (Zocor)

CARD 1101 (14 decks)

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