Pharmacological Management Of Heart And Vascular Disease

Question 1

Alpha Adrenergic Antagonists

Answer 1

Action: causes dilation of arterioles/veins and ↓ BP
MOA: Reduce peripheral vascular tone by blocking alpha-1-adrenergic receptors
PT implication: slow positions changes 2 º dizziness/OH

Question 2

Angiotensin-Converting Enzyme (ACE) Inhibitors

Answer 2

Action: limits vasoconstriction (↓ BP and afterload)
MOA: suppress enzyme that converts angiotensin I to II
PT implications: slow position changes 2 º dizziness/ fainting, Pts with heart failure should avoid rapid ↑ in HR

Question 3

Angiotensin II Receptor Antagonists

Answer 3

Action: limit vasoconstriction
MOA: block angiotensin II receptors
PT implications: none

Question 4

Antiarrhythmic Agents (Class I-IV)

Answer 4

Action: control cardiac arrhythmias
MOA:
Class I: sodium channel blockers
Class II: inhibit sympathetic activity by blocking B-adrenergic receptors
*Class III: prolong repolarization by inhibiting K/Ca channels most effective
Class IV: depress depolarization and slows conduction through AV node
PT implications: adherence to dose schedule

Question 5

Anticoagulant Agents

Answer 5

Action: blood thinner and slows clot formation
MOA: inhibits platelet aggregation and thrombus formation
PT implications: avoid injuries 2 º ↑ bleeding/bruising risk

Question 6

Antihyperlipidemia Agents

Answer 6

Action: modifies lipids
MOA: statins inhibit enzyme action in cholesterol synthesis, ↓ LDL and triglycerides, and ↑ HDL, most commonly used
PT implications: aerobic exercise can also aid in ↑ HDL

Question 7

Antithrombotic/Antiplatelet Agents

Answer 7

Action: prevents clot formation
MOA: inhibits platelet aggregation and clot formation
PT implications: avoid injuries 2 º ↑ bleeding/bruising risk

Question 8

Beta Blocker Agents (Beta-Adrenergic Blocking Agents)

Answer 8

Action: decrease myocardial O2 demand by ↓ heart rate/contractility
MOA: blocks B-adrenergic receptors
PT implications: ↓ HR/BP response with activity, use RPE, OH

Question 9

Calcium Channel Blockers

Answer 9

Action: ↓myocardial contraction, vasodilation, ↓ O2 demand of heart
MOA: ↓ Ca++ entry into smooth muscle
PT Implications: ↓ HR/BP response with activity, OH, s/s of heart failure (ie peripheral edema, dyspnea, weight gain)

Question 10

Diuretic Agents

Answer 10

Action: ↓ BP
MOA: increase excretion of Na/urine
PT implication: OH, s/s electrolyte imbalance, muscle weakness, cramping

Question 11

Nitrate Agents

Answer 11

Action: decrease ischemia
MOA: smooth muscle relaxation and vasodilation
PT Implications: OH, sublingual administration for acute angina attack

Question 12

Positive Inotropic Agents

Answer 12

Action: increase force/velocity of myocardial contraction, ↓ HR
MOA:↓ conduction through AV node, ↓ SNS activation
PT Implications: monitor HR during activity, seek HCPs if rate < 60 or > 100 bpm

Question 13

Thrombolytic Agents

Answer 13

Action: clot dissolution, reopens vessels to maintain blood flow
MOA: conversion of plasminogen to plasmin.
PT Implications: Avoid trauma due to altered clotting