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Pharmacology > New Cardiac > Flashcards

New Cardiac Flashcards

1
Q

Beta Blocker (-lol)

1st Generation

  • non-selective
  • Block B1and B2
A

Propranolol

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2
Q

Beta Blocker (-lol)

2nd Generation

  • Cardioselective
  • Block B1
A

Metoprolol

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3
Q

Beta Blocker (-lol)

3rd Generation

  • Mixed Receptor Blockers
  • Used in Hypertension, but not first-line drugs
  • Block B1, B2, and a1
A

Carvedilol

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4
Q

Are the secondary drug used for hypertension

Adverse effects:
• Fluid retention
• Hypotension, bradycardia, heart attack

A

Beta Blocker

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5
Q

Block ____ receptors and *reduce sympathetic effect

  • decrease HR and contractility
  • decrease renin

Prevents Remodeling

Prevents arrhythmia’s

TX:
ANGINA
DYSRHYTHMIAS:
- Protect against tachydysrhythmias – slows ventricular rate

Adverse effects:

  • *Resp wheezing
  • *Insomnia/bizarre dreams/hallucinations

*abrupt withdrawal can worsen angina

A

Beta Blocker

-lol!

Propranolol, Metoprolol,

(Carvedilol (mixed))

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6
Q

Primary Drug for Beta Blockers

MOA:

  • Prevents excessive sympathetic stimulation to prevent heart muscle failure
  • Keeps heart responsive
  • Turn off structural remodeling
  • Increased survival in HF patients
A

Carvedilol (B1, B2, and a1)

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7
Q

*Calcium Channel Blockers - Block L -type calcium channels on *vascular smooth muscle only

• PREVENT angina
HYPERTENSION:
• Most commonly used in HTN

Effective in African American Populations

*More common with fewer adverse effects

A

-dipine

Nifedipine,
Amlodipine

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8
Q

Calcium Channel Blockers

  • Vascular + cardiac effects
  • Class IV antiarrhythmic - PREVENT angina
  • *Lessen how quick/hard the heart beats
  • *Cardiac SE - cardiac depression, conduction
A

Diltiazem
Verapamil

Diltia Vera

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9
Q

Anti_______ drugs decrease cardiac and O2 demand

A

Antianginal

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10
Q

ACEs

MOA:

  • Inhibit ACE
  • DECREASE angiotensin II
  • Block degradation of kinin

Decreases Pulmonary Hypertension

Adverse Effect

  • First dose hypertension
  • YES Bradykinin (promotes inflammation)
  • Intractable cough and angioedema (main-face swelling)

Pregnancy D Category

A

Enalapril
Catopril

-pril

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11
Q

ARBs

MOA:
- BLOCK angiotensin II receptors

Less Angiotensin II:
- *replacement for ACEI if they can’t be tolerated

  • *NO bradykinin/irretractable cough
  • *Increases survival in HF patients

Adverse Effect

  • Extensive hypotension initially
  • Hyperkalemia
A

(-sartan)

Losartan
Valsartan

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12
Q

Loop Diuretics

MOA:

  • Block Na+/K+/Cl- in *Loop of Henle (decreases Na+ reabsorption)
  • Causes Large reduction in plasma volume

Use: Mainly Edema and *HF (Tx symptoms caused by edema)

Adverse Effects:

  • hypokalemia
  • *Ototoxicity
A

Furosemide (lasix)

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13
Q

MOA:

  • Blocks Na+/Cl- in *Distal Convoluted tubule
  • Less sodium reabsorption (reduces total body sodium)

Use: Edema in HF
- primarily HTN

  • May cause arrhythmias

Effective in AA population

A

Hydrochlorothiazide

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14
Q

Potassium Sparing Diuretic:
HF first choice diuretic

MOA:
- Blocks aldosterone receptors (↑K+, ↓ Na+) (cortical collecting duct)

Use: small diuresis with other drugs, HF to reduce remodeling

Adverse Effects:

  • Hyperkalemia
  • Hormone Effects (gynecomastia, menstrual irregularities, and hirsutism)
  • Not for pregnancy
A

Spironolactone

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15
Q

Osmotic Diuretic – NOT used for HF

Route: IV

MOA:
- Draws water into nephron with osmotic force (holds water in nephron)

Use:

  • For patients with renal failure
  • Reduces Intracranial Pressure/Edema (ICP)

Adverse Effects:

  • HA
  • nausea
  • vomiting
  • Fluid loss and electrolyte imbalances

Laxative - stool in 3-12 hours

A

Mannitol

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16
Q

Cardiac Glycosides

MOA:

  • *Inhibits Na+/K+ ATPase in heart
  • *cardiotonic drug (heart contraction)

Increase:
- Cardiac output&raquo_space; Urine production&raquo_space; reduce edema

Decrease:
- Sympathetic tone & renin release
Competes with K+

Adverse:
Cardiac - Arrhythmias and bradycardia
- *Blurred vision, Visual Disturbances = yellowish/greenish tinge

A

Digoxin

17
Q

Direct Vasodilators (Drug combo)

MOA:

  • __________ Dinitrate decreases preload (dilating veins)
  • ___________ decreases afterload (dilating arteries)

Use with: Severe Heart Failure

More effective in: African Americans

Adverse Effects:

  • Orthostatic hypotension
  • reflex tachycardia
  • *___________: lupus erythematosus
A

Isosorbide Dinitrate
+
Hydralazine

= “BiDil”

Hydralazine

18
Q

Selective a1 blocker:

MOA:
- Blocks a1 *vascular receptors that usually cause vasoconstriction

Adverse Effects:

  • *First Dose Phenomenon:
    1. Orthostatic hypotension
    2. Dizziness
    3. Fainting
  • Reflex Tachycardia
  • Fatigue
A

Terazosin

19
Q

Direct Vasodilators

MOA:

  • Causes direct vasodilation
  • Large drop in blood pressure from Nitric oxide or decrease Ca+

NOT for monotherapy (tachycardia, Na+ & H20 retention, etc).

*Drug used in Hypertensive emergencies: _______________

A

Hydralazine

nitroprusside

20
Q

Anti-Hypertensive drugs treat ____ blood pressure

They ________ cardiac output and vascular constriction

A

High

decrease

21
Q

________ choices that increase high blood pressure

  • High sodium intake
  • obesity
  • lack of exercise
  • cigarettes

Consequences:

  • _______ pectoris
  • Kidney disease
  • heart failure
  • __________ infarction
  • stroke
  • ______pathy (vision loss)
A

Lifestyle

Angina

Myocardial

retinopathy

22
Q

Nitrates

  • Nitrate&raquo_space; nitric oxide
  • increase formation of cGMP
  • cGMP dephosphorylates&raquo_space; vasodilation

(treat chest pain or lack of blood flow)

Adverse effects:

  • *Facial Flushing
  • Severe Heart Attack
  • *Orthostatic hypotension
  • Reflex Tachycardia

Notes:
Sublingual&raquo_space; RAPID to treat acute angina attacks

PO (oral)&raquo_space; Slower acting&raquo_space; tx: angina (higher dose needed for 1st pass effect)

_ should not be taken with erectile dysfunction drugs _

A

Nitroglycerin

Vasoo Nitroo

23
Q

New Drug

Decreases entry of sodium into heart&raquo_space; decreases calcium overload&raquo_space; decreases contractions = *prevents cardiac overload

Adverse effects:
- Arrhythmias = Prolonged QT (fast chaotic heartbeat)

  • n/v/c
  • dizzy
  • HA
A

Ranoliazine

24
Q

_____-ANGIOTENSIN SYSTEM BLOCKERS
• Turns off the ____ system and **lowers BP
• Blocks renin&raquo_space; angiotensin&raquo_space; angiotensin I&raquo_space; angiotensin II

– Angiotensin II: Vasoconstrictor and _________ aldosterone causing sodium retention

Types
– ACE inhibiotrs
– ARB

A

RENIN

increases

25
Q

_______ DRUGS:
• Thiazide diuretics

• Renin-angiotensin system blockers
– Angiotensin converting enzyme(ACE) inhibitors
– Angiotensin receptor blockers (ARB)

• Calcium channel blockers (CCB)

A

PRIMARY

26
Q

_________ Drugs:
• Adrenergic receptor blockers
– β-blockers (BB);
– α1-blockers

• Sympathetic nerve blockers
– CNS α2 -adrenergic receptor agonists

  • Direct vasodilators
  • Others
A

Secondary

27
Q

Alpha 2 blockers - CNS

Stimulates A2 in brain&raquo_space; Reduces SNS input to the cardiovascular system
= vasodilation
= decrease HR & BP

_________ - crosses BBB

___________ - used in pregnancy

Adverse effects

  • Sedation
  • Dry Mouth
  • Withdrawal Sydrome

Need to taper the dose slowly

A

Clonidine

Methyldopa

28
Q

IV vasodilator

Adverse effect:
Profound hypoTN

A

Sodium nitroprusside

29
Q

IV vasodilator

Adverse effect:
Symptomatic hypoTN

A

Nesiritide

30
Q

Phosphdiesterase

Adverse effect:
Thrombocytopenia

A

Milrinone

Pharmacology (9 decks)

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