Pharmacology Management of Heart and Vascular Diseases Flashcards
Alpha Adrenergic Antagonist Agents
Action: Reduce peripheral vascular tone, dilating arterioles and veins, decreasing blood pressure.
Indications: Hypertension, benign prostatic hyperplasia
Side effects: Dizziness, palpitations, orthostatic hypotension, drowsiness
Examples: Cardura (doxazosin), Minipress (prazosin), Hytrin (terazosin).
Angiotensin Converting Enzyme (ACE) Inhibitors
Action: Decrease BP and afterload by suppressing the enzyme that converts angiotensin I to angiotensin II.
Indications: Hypertension, CHF
Side effects: Hypotension, dizziness, dry cough, hyperkalemia, hyponatremia.
Examples: Capoten (captopril), Vasotec (enalapril), Prinivil (lisinopril), Altace (ramipril)
Angiotensin II Receptor Antagonist Agents
Action: Blocks angiotensin II receptors, which limit vasoconstriction and stimulation of vascular tissue.
Indications: Hypertension, CHF
Side effects: Dizziness, back and leg pain, angina pectoris
Examples: Cozaar (losartan) Atacand (candesartan), Diovan (Valsartan)
Antiarrhythmic Agents
Action: Divided into 4 classes. 1) Sodium channel blockers control cardiac excitation and conduction. 2) Beta blockers inhibit sympathetic activity. 3) Potassium channel blockers prolong repolarization by inhibiting both potassium and sodium channels. 4) Calcium channel blockers depress depolarization and slow conduction through AV node.
Indications: Cardiac arrhythmias
Side effects: Exacerbation of arrhythmias, dizziness, hypotension
Examples: Sodium channel blockers: Quinidine (generic), Xylocain (lidocaine). Beta blockers: Tenormin (atenolol). Prolonged repolarization: Cordarone (amiodarone). Calcium channel blockers: Cardizem (diltiazem)
Anticoagulant Agents
Action: Inhibit platelet aggregation and thrombus formation
Indications: Post coronary angioplasty and coronary artery bypass graft surgery. Prevention of embolism in those with atrial fibrillation and prosthetic heart valves.
Side effects: Hemorrhage, increased risk of bleeding, GI distress with oral meds.
Examples: Heparin, Coumadin (warafin), Lovenox (enoxaparin)
Antihyperlipidemia Agents
Action: 5 categories of lipid-modifying agent. Most common is statins, which inhibit enzyme action in cholesterol synthesis, break down LDL, decrease triglyceride levels, and increase HDL levels.
Indications: Hyperlipidemia, atherosclerosis, prevent coronary evens in those with coronary disease, diabetes, or peripheral vascular disease.
Side effects: Headache, GI distress, myalgia, rash
Examples: Lipitor (atorvastatin), Zocor (simvastatin), Tricor (fenofibrate)
Antithrombotic (Antiplatelet) Agents
Action: Inhibit platelet aggregation and clot formation
Indications: Post MI, atrial fibrillation, prevent arterial thrombus formation
Side effects: Hemorrhage, thrombocytopenia, potential liver toxicity with use of aspirin, GI distress
Examples: Bayer (aspirin), Plavix (clopidogrel), Persantine (dipurimadole)
Beta Blocker Agents (Beta-Adrenergic Blocking Agents)
Action: Decrease myocardial oxygen demand by decreasing HR and contractility by blocking beta adrenergic receptors.
Indications: Hypertension, angina, arrhythmias, heart failure, migraines, essential tremor
Side effects: Bradycardia, cardiac arrhythmias, fatigue, depression, dizziness, weakness, blurred vision
Examples: Tenormin (atenolol), Lopressor (meoprolol), Inderal (propanolol)
Calcium Channel Blocker Agents
Action: Decrease entry of calcium into vascular smooth muscle cells, resulting in decreased myocardial contraction, vasodilation, and decreased O2 demand of heart.
Indications: Hypertension, angina pectoris, arrhythmias, congestive heart failure
Side effects: Dizziness, headache, hypotension, peripheral edema
Examples: Norvasc (amlodipine), Procardia (nifedipine), Calan (verapamil), Cardizem (diltiazem)
Diuretic Agents
Action: Increase excretion of sodium and urine. Reduced plasma volume, which decreases BP. Classifications include thiazide, loop, and potassium sparing agents.
Indications: Hypertension, edema associated with heart failure, pulmonary edema, glaucoma
Side effects: Dehydration, hypotension, electrolyte imbalance, polyuria, increased LDL, arrhythmias
Examples: Thiazide: Diuril (chlorothiazide). Loop: Lasix (furosemid). Potassium sparing: Dyrenium (triamterene)
Nitrate Agents
Action: Decrease ischemia through smooth muscle relaxation and dilation of peripheral vessels
Indications: Angina pectoris
Side effects: Headaches, dizziness, orthostatic hypotension, reflex tachycardia, nausea, vomiting
Examples: Nitrostat (nitroglycerin), Isordil (isosorbide dinitrate), Amyl nitrite solution for inhalation.
Positive Inotropic Agents
Action: Increase force and velocity of myocardial contraction, slow HR, decrease conduction velocity through the AV node and decrease degree of activation of the sympathetic nervous system.
Indications: Heart failure, atrial fibrillation
Side effects: cardiac arrhythmias, GI distress, dizziness, blurred vision
Examples: Lanoxin (digoxin)
Thrombolytic Agents
Action: Facilitate clot dissolution through conversion of plasminogen to plasmin. Plasmin breaks down clots.
Indication: Acute MI, pulmonary embolism, ischemic stroke, arterial or venous thrombosis
Side effects: Hemorrhage, allergic reaction, cardiac arrhythmias
Examples: Kinlytic (urokinase), Activase (alteplase)
