Pharm Exam 2 Flashcards
Digoxin (lanoxin)
-
Positive Inotropic Effect
- inc forced of contraction
- Negative Chonotropic
- Antiarrhythmics
- Decreases conduction through SA and AV nodes
- Increases Cardic Output and Slow the Rate.
- Hypokalemia/Hypercalcemia
- toxicity first sign ab pain, anorexia, nausea, visual disturbances, bradycardia
- half life- 36-48 hrs
Spironolactine (aldactone)
- Potassium Sparing
- Inhibits Sodium Reabsorption
- manages hyperaldosterone
- manage edema
- antihypertensive
- treats hypokalemia
- for patients with Heart Failure
Nitrates
Potassium Sparing Drugs
- Triamterene (Dyrenium)
- Spironolactone (Aldactone)
AntiCoagulants Drugs
- Warfarin (coumadin)
- Dabigatran (Pradaxa)
- Heparin
Beta Blocker Drugs
- Atenolol (Tenormin)
Antiplatelet Agent Drugs
- Clopidogrel (Plavix)
ACE inhibitor Drugs
- Benazepril (Lotensin)
Thiazide Diuretic Drugs
- Hydrochlorothiazide
Calcium Channel Blocker Drugs
- Nifedipine (Procardia)
Thrombolytic Drugs
- Alteplase (tPA)
*
Loop Diuretic Drugs
- Digoxin
- Bumetanide
Lipid Lower Agent Drug(s)
- Simvastatin (Zocor)
Heparin
- Venous thromboembolism prophylaxis
- Anticoagulant
Thiazide i.e. Chlorthiazide (Diuril)
- Mild to Moderate hypertension
- Heart failure
- Renal Dysfunction
- Increases excretion of sodium and water by inhibiting sodium reabsorption in distal tubule
atenolol
- Antiangina/antihypertensive
- Block stimulation of beta1 (myocardia). DOES NOT affect beta 2 (pulmonary, vascular, uterin)
- decrease BP
- decrease frequency of attacks of angina
- prevention of MI
Warfarin Coumadin
Mannitol
- Natiuresis- sodium loss in the urine
- Osmotics
- used to decrease intracranial pressure (cerbral edema)
- Decreases intra ocular pressure (Glaucoma)
- Chemotherapy-induces frank diuresis
Dapigatran (Pradaxa)
Triamterene (Dyrenium)
Furosamide Lasix
- Loop Diuretic
- Antihypertensive
- Lead to ototoxicity
- increases excretion of water, Na, CL, Mg, K, Ca
- Effective even in patients with impaired renal function
-arin suffix means
anti-coagulant
Thrombolytics end in -ase
- Streptokinase, Altepase
- Enzymes
Which drugs have a major effect in decreasing the strength of cardiac contraction?
Calcium channel blockers
pril is what type of drug?
ACE inhibitor
An angiotensin-converting-enzyme inhibitor is a pharmaceutical drug used primarily for the treatment of hypertension and congestive heart failure
ACE inhibitor
Step 1: Blood has cicrulationg through the body, lost its oxygen and collected CO2, where does it enter?
- Right Atrium of the heart through the Vena Cava
Step 2: Right Atrium Contracts and pumps blood through which valves?
Tricuspid valve and right ventricle
Step 3 of 9: The Right Ventricle pumps blood where?
- Through the pulmonary artery into the lungs
Step 4: What do the tiny blood vessels (capillaries) in the lungs do?
absorb CO2 from blood and replace it with oxygen
Step 5: oxygenated blood flows through the pulmonary vein and into where?
- Left Atrium
Step 6: Oxygenated blood pumps throu the mitral valve and into where?
Left Ventricle
Once the blood has gone through the aortic arch, what are the option for where blood can be pumped?
- thru carotid artery into the brain
- auxiliary arteries into the arms
- aorta and into the torso/legs
Step 8: Blood moves through the arteries, then through capillaries, where does it return?
Veins
Step 9: What is the last step of the cardiac cycle?
Deoxygenated blood will return to the heart
Treatment of Angina
- Beta Blockers
- Calcium Channel Blockers
- Oranic Nitrates
Antidote for Heparine is?
protamine Sulfate
a substance which can counteract a form of poisoning. The term ultimately derives from the Greek αντιδιδοναι antididonai, “given against”
Antidote
INR Ratio
- Better test
- International Normalized Ratio
If INR is less than 2.0 what should happen for warfarin?
dose should be increased
If INR is greater than 3 how should warfarin be adjusted?
decreased
Inotropic Action
Influenced the force of muscular contractility
Chonotropic Action
Infuencing heart rate
Domotropic Action
- influencing the nerve conductivity of the muscles
- DERMATONES!
-plase drugs
Thrombolytics
-or drugs
HMG-COA Reductase Inhibitors (Statins)
Major adverse effect of Statins
Liver dysfunction, Category X
How do beta blockers work?
- slowing down the heart rate and the force at which it contracts
- They are ingested
How do calcium channel blockers work?
- Ingested
- slow down heart rate & force at which it contracts
- Decrease pressure on the circulation, by relaxing the blood vessels
- Allows blood to flow more smoothly
- Vasodilation
- Decrease afterload
How does nitroglycerin have a therapeutic effect on the patient with angina?
absense of chest pain.
Patient Education for Nitroglycerin
- Patients should change positions slowly to avoid orthostatic hypotension
- Keep in a cool dry place
- May cause a headache, tylenol for pain relief
- take 3 tablets every 5 minutes, if no relief seek med assistance.
Fluid and Electrolytes for Diuril/Chlorthiazide
- hypokalemia
- dehydration
- hypercalcemia
- hypochloremic alkalosis
- hypomagnesemia
- hyponatremia
- hyperglycemia
- hyperuricemia
Proranolol (Inderal) Precautions
- patients with pulmonary disease including asthma
- beta blocker- blocks 1 & 2
ACE inhibitor Captopril (Capoten)
- Peaks 60-90 min and lasts 6-12 hours
- may lead to neutropenia. Monitor the CBC with differential prior to therapy, every 2wks for first 3 mnths and up to 1 yr.
- for high BP and heart failure
- may cause cough, hyperkalemia and angioedema
Nitropursside (Nitropress)
- administered IV
- antihypertensive
- half life is 2 min
- monitor BP, HR, ECG frequently.
- Monitor for rebound hypertension
Diltiazem (Cardizem)
- Avoid Grapefruit Juice increases level and effect
- antiangina, antihypertensive, antiarrhythmics
- monitor I/O, daily weight
- cause edema, weight gain.
- may cause steven johnson syndrome
Nitroglycerin
- antiangina
- increases blood flow by dilating coronary arteries
- vasodilation, venous greater than arterial
- decreases preload
- reduced myocardial oxygen consumption
- half life 1-4 minutes
- Used w/ Sildenafil, Tadalafil and Vardenafil will lead to potentially fatal hypotension
Antihypertensive 6 Categories
- Diuretics
- Symatholytics
- Direct-acting arteriolar Vasodilators
- ACE inhibitor
- Angiotensin II Receptor Blockers (ARBS)
- Calcium Channel Blockers
Sympatholytic Categories x5
- Beta Adrenergic Blocker
- Centrally acting Alpha 2 Agonist
- Alpha Adrenergic Blocker
- Adrenergic Neuron Blocker
- Alpha 1 and Beta 1 Adrnergic Blocker.
