Pharm Final: Cardiovascular Flashcards
What are considered 1st line medications? (4)
- Thiazide Diuretics
- ACE inhibitors
- Angiotensin Receptor Blockers (ARBs)
- Calcium Channel Blockers (CCBs)
What are considered 2nd line medications? (4)
- Beta-blockers
- Aldosterone Antagonists
- Loop Diuretics
- Direct Vasodialators, alpha-1 blockers, alpha-2 blockers
Category: Diuretics
Mechanism of Action:
Side Effects:
Purpose:
Category: Diuretics Antihypertensive Drug Thiazide Diuretics- First line Loop Diuretics- Second line Renal Agent
Mechanism of Action: inhibition of sodium/chloride reuptake (Thiazide), excretes electrolytes (Loop).
Side Effects: Hypotension, Renal Dysfunction, Volume Depletion, Electrolyte disturbances.
Purpose: Primarily act on kidneys to decrease plasma fluid volume and reduce afterload.
Category: Sympatholytics (Beta Blockers)
Mechanism of Action:
Side Effects:
Purpose:
Category: Sympatholytics (Beta Blockers
Antihypertensive Drug
Mechanism of Action: Beta 1 blockade; inhibits sympathetic cardiac stimulation of SA node; inhibits reinin secretion –> vasodilation
Side Effects: Fatigue, cold hands, headache, dizziness, shortness of breath.
Purpose: Primarily act on various sites within sympathetic nervous system to decrease sympathetic influence on heart.
Category: Vasodilators
Mechanism of Action:
Side Effects:
Purpose:
Category: Vasodilators
Antihypertensive Drug
Direct Vasodialators- 2nd Line
Peripheral Vascular Agent
Mechanism of Action:
Side Effects:
Purpose: Primarily act on peripheral vasculature to lower vascular resistance.
Category: ACE Inhibitors
Mechanism of Action:
Side Effects:
Purpose:
Category: ACE Inhibitors
Antihypertensive Drug
First Line
Renal Agent
Mechanism of Action:
- Inhibits ACE/conversion of Angiotensin I to Angiotensin II
- Reduces production of ADH
- Reduces aldosterone production
Side Effects: angioedema, cough, orthostasis, hypotension, hyperkalemia
Purpose: Primarily act on peripheral vasculature and certain involved organs to prevent vasoconstriction and reduce fluid volume.
Category: CCBs
Mechanism of Action:
Side Effects:
Purpose:
Category: CCBs
Antihypertensive Drug
First Line
Direct Cardiac Agent
Mechanism of Action: blocks calcium re-entry
Side Effects: hypotension, AV blocks, reflex tachycardia, headache, dizziness, drowsiness, edema, nausea, constipation
Purpose: Primarly acts on vascular smooth muscle and cardiac muscle to decrease contractility, cardiac force and rate; reduces afterload and causes vasodilation.
Ace inhibitors often end with the suffix ___
“pril”
CCB’s often end with the suffix ___
“pine”
Beta Blockers often end with the suffix ___
“olol”
Category: ARB’s
Mechanism of Action:
Side Effects:
Purpose:
Category: Angiotensin Receptor Blocker
1st Line
Antihypertensive Drug
Mechanism of Action:
Inhibits angiotensin II receptor –> causes vasodilation
Reduces ADH production –> reduces fluid volume
Reduces Aldosterone production –> reduces fluid volume
Side Effects:
Angioedema, Orthostasis/hypotension, Hyperlakemia
Purpose:
Cause vasodilation and reduce fluid volume
ARB’s often end with the suffix ____
“sartan”
What is angina?
chest pain due to ischemia and imbalance of oxygen supply and demand
What are the 4 pirmary medications for Angina management
- Nitrates
- Beta Blockers
- CCB
- Ranolazine
What is the function of Nitrates?
reduces O2 demand by promoting nitric oxide release –> vasodilation, decreases preload
(short acting first line for angina attacks, long acting second line after beta blockers for symptom relief)
What is the function of Beta Blockers?
reduces O2 demand by limiting maximum stimulation (HR)
What is the function of CCB?
increases O2 supply and decreases O2 demand by blocking calcium re-entry –> reduces contractility and HR
What is the function of Ranolazine?
no effects on O2 supply or demand; mechanism unknown
2nd line
What is ischemic heart disease?
cardiac muscle has insufficient oxygen
What are the two solutions to ischemic heart disease and how can the be achieved physiologically?
- Reduce cardiac O2 demand (decrease preload, contractility, and/or afterload)
- Increase cardiac O2 supply (increase coronary flow and/or O2 extraction)
What are the 5 medications for MI?
- Aspirin
- P2Y12 Inhibitor
- Beta Blocker
- Statin
- ACE Inhibitor
MI - Aspirin
Mechanism of Action:
Side Effects:
Purpose:
MI - Aspirin
Mechanism of Action: antiplatelet agent
Side Effects: bruising, GI intolerance
Purpose:
MI - P2Y12
Mechanism of Action:
Side Effects:
Purpose:
MI - P2Y12
Mechanism of Action:
antiplatelet agent
Side Effects:
Purpose:
MI - Beta Blocker
Mechanism of Action:
Side Effects:
Purpose:
MI - Beta Blocker
Mechanism of Action: Beta 1 blockage; inhibits sympathetic cardiac stimulation of SA node; inhibits renin secretion –> vasodilation
Side Effects: fatigue, cold hands, headache, dizziness, shortness of breath
Purpose: acts on sympathetic nervous system to decrease sympathetic influence on heart (decrease HR)
