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Human Disease and Therapeutics > Quiz 3 Study Guide: Cardiovascular Therapeutics > Flashcards

Quiz 3 Study Guide: Cardiovascular Therapeutics Flashcards

1
Q

By what 2 mechanisms is angina treated?

A
  1. Vasodilation (Increase flow)
    • Nitrates and Nitrites
  2. Decrease O2 consumption
    • B Blockers; Ca++ channel blockers
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2
Q

How do Nitrates/Nitrites work to treat angina?

A

Metabolize Nitric oxide to increase cGMP therefore relaxing smooth muscle and dilating cardiac vessels

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3
Q

What are some examples of Nitrates/Nitrites?

A

Nitroglycerine

Amyl nitrate

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4
Q

Characteristics of Nitroglycerine…

A

-Sublingual Administration
-Volatile (Sealed Glass bottle)
Long-lasting patches (8hrs)

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5
Q

Characteristics of Amyl-Nitrate

A
  • Crushed ampule and fumes inhaled

- Short acting

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6
Q

Side effects of Nitrates/Nitrites

A 
Orthostatic hypertension
Tachycardia (reflex to dilation)
Throbbing headache (Vasodilation)

Tolerance develops rapidly

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7
Q

How do Ca++ Channel Blockers work to treat angina?

A

Blocks contraction of smooth and cardiac muscle to reduce O2 demand.

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8
Q

What are Ca++ Channel Blockers used for?

A

Prophylaxis of angina (4-8 hour duration)

“take in the morning to prevent angina during the day”

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9
Q

What are examples of Ca++ Channel Blockers?

A

Verapamil
Nifedipine
Diltiazem

*also used as hypertensives

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10
Q

What Toxic side effects can be present with Ca++ Channel Blockers?

A
  • Cardiac depression and bradycardia (Heart Failure)

- Flushing and dizziness.

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11
Q

How do B Blockers (B1) work to treat angina?

A

Decreases Blood output by decreasing the HR, causing BP and contractility to decrease.

  • Not a vasodilator
  • Prophylactic use
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12
Q

What are some examples of B blockers used to treat angina?

A

Propanolol (Nonselective - Pulmonary problems)

atemolol (B1 selective - less lung problems)

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13
Q

What Toxic side effects can be present with B Blockers?

A
  • Asthma

- acute heart failure

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14
Q

What are non-drug lipid and cholesterol-lowering treatments?

A

Dietary

  • 15-20% daily intake of fat calories
  • avoid red meats

-Exercise

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15
Q

What do Statins do?

A

They are competitive inhibitors of HMG-COA Reductase.

*they reduce the synthesis of cholesterol (LDL) and reduce coronary events.

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16
Q

What are some examples of Statins?

A

Lovastatin (Mevacor)
Atorvastin (Lipitor)
Simvastatin (Zocor)

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17
Q

What are side effects of Statin Toxicity?

A

Liver Damage

Weakness in skeletal muscles.

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18
Q

What do Fibrates do?

A

Increases lipolysis in liver and muscles

*reduces VLDL, modest effect on LDL, and moderate increase in HDL. Reduces Triglycerides.

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19
Q

What is an example of a fibrate?

A

Fenobrate (Tricor)

*side effect is GI symptoms

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20
Q

What does Niacin (nicotinic acid) do?

A

Decreases triglyceride and LDL

*Tolerance develops

21
Q

What is a side effect of Niacin?

A

Fairly pronounced Mild Flushing.

22
Q

What do Bile acid-binding agents do?

A

Reduces reabsorption of bile acids and metabolite.

Toxicity: Constipation and Bloating

23
Q

What is and example of a Bile acid-binding agent?

A

Cholesteramine

24
Q

What do inhibitors of intestinal sterol absorption do?

A

Inhibits intestinal absorption of cholesterol and reduces LDL.

25
Q

What is an example of and inhibitor of intestinal sterol absorption drugs?

A

Ezetimibe

26
Q

What is the objective of treatment for patients with heart failure?

A

Reduce symptoms and slow progression

27
Q

What are the 6 types of drugs that treat heart failure?

A 
Positive Ionotropic Drugs
B1 adrenoceptor agonists
Diuretics
ACE Inhibitors
Vasodilators
B adrenoceptor blockers

*Na+ restriction as dietary non-drug treatment

28
Q

What do Positive Ionotropic drugs do?

A

Increases intracellular Ca++ and Cardiac contractility therefore increasing blood ejection.

29
Q

What are examples of Positive Ionotropic Drugs?

A

Digitalis (foxglove)

Milrinone -this is really a Bipyridine drug

30
Q

What are side effects of Positive Ionotropic Drugs?

A

Premature depolarization (arrhythmias)
Ectopic beats
Affects all excitable tissues

31
Q

What is an example of a B1-adenoceptor agonist?

A

Dobutamine

*can cause arrythmias

32
Q

What do diuretics do?

A
  • Reduce salt and H2O retention and edema

- Reduce venous pressure and ventricular preload

33
Q

What is an example of a diuretic?

A

Furosemide

34
Q

What do ACE inhibitors do?

A

Reduce peripheral resistance by reducing salt and water

35
Q

What is an example of an ACE inhibitor?

A

Captopril

36
Q

What does a Vasodilator do?

A

Relax smooth muscle

37
Q

What is an example of a Vasodilator?

A

Hydralazine

38
Q

What does a B adrenoceptor blocker do?

A

Reduce heart rate and block the Sympathetic Nervous System

39
Q

What is and example of a B adrenoceptor blocker?

A

metoprolol

40
Q

What are characteristics of Cardiac Arrhythmias?

A
  • 80% with history of Myocardial Infarct
  • Requires treatment if there is significant reduction in cardiac output
  • Treatments themselves can cause arrhythmias
41
Q

What types of drugs treat Cardiac Arrhythmias?

A

Na+ channel blockers
B adrenergic blockers
Prolong refractory
Ca++ channel blockers

42
Q

What do Na+ channel blockers do to treat cardiac arrhythmias?

A

Slows action potential conduction
Effective for most A or V arrhythmias.

*can precipitate new arrhythmias.

43
Q

What is an example of a Na+ channel blockers used to treat cardiac arrhythmias?

A

Procainamide
Quinidine
Lidocaine

(Class 1)

44
Q

Which drug is the 1st choice for ventricular arrhythmias.

A

Lidocaine

*low toxicity

45
Q

What are Prolong refractory drugs used for when treating cardiac arrhythmias?

A

A fib. or V. arrhythmias

46
Q

What is an example of a Prolong Refractory Drug?

A

Amiodarone

Class III

47
Q

What is and example of a B blocker used for arrhythmias?

A

propanolol

Class II

48
Q

What do Ca++ channel blockers do to treat cardiac arrhythmias?

A

Prolong refractory time

Peripheral Vasodilation

49
Q

What is an example of a Ca++ blocker used to treat arrhythmias?

A

Verapamil
Diltiazem

(Class IV)

Human Disease and Therapeutics (24 decks)

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