Renal, Urinary & Cardiovascular Drugs

Question 1

Cardiovascular Drugs

Answer 1

• Cardiovascular system’s main function is to deliver oxygenated blood to the various body organs
• additionally this system also transports various nutrients around the body, maintains blood volume and pressure, works with the urinary and renal systems to eliminate waste
• Cardiovascular disease is the leading cause of morbidity (illness) and mortality (death) in the U.S.
  
  • leading cause of death globally
• drug classes include:
  
  • antihypertensives
  • antiarrhythmics
  • lipid-lowering drugs
  • ischemic heart disease
  • CHF

Question 2

homeostasis

Answer 2

• as pertains to the human body
• the body works to maintain a state of homeostasis;
  
  • steady blood pressure
  • blood volume
  • temperature
  • electrylyte balance
  • hormone balance
  • pH

Question 3

atherosclerosis

Answer 3

thickening of the atrial wall

Question 4

Antihypertensive Drugs

Answer 4

• include:
  
  • calcium channel blockers
  • nitrates
  • alpha-blockers
  • beta-blockers
  • renin-angiotensin interference drugs
  • diuretics

Question 5

Renin-Angiotensis Interference Drugs

Answer 5

• Include:
  
  • Angiotensin-converting enzyme (ACE) Inhibitors
  • Angiotensin II Receptor Inhibitors
  • Selective Aldosterone Receptor Antagonists

Question 6

ACE Inhibitors

Answer 6

• Angiotensin-Converting Enzyme Inhibitors
• reduce blood pressure by blocking the antiotensin-converting enzyme
• drugs include (-pril):
  
  • captopril
  • enalapril
  • benazepril
• treat both:
  
  • hypertension
  • heartfailure

Question 7

Angiotensin II Receptor Inhibitors

Answer 7

• by different mechanicsm than ACE inhibitors
• (-sartan)
  
  • candesartan
  • eprosartan
  • losartan

Question 8

Selective Aldosterone Receptor Antagonists

Answer 8

• examples include:
  
  • spironolactone
  • eplerenone

Question 9

Calcium Channel Blockers

Answer 9

• inhibit the entry of calcium into cells, affecting the tone and contraction of the heart and vasculature by slowing the conduction of the cells preventing arrhythmia
• used for:
  
  • hypertension
  • arrhythmia
• nondihydropyridine:
  
  • diltiazem
  • nifedipine
  • verapamil
• dihydropyridine chemical class (-dipine)
  
  • amlodipine
  • barnidipine
  • nefedipine

Question 10

Nitrates

Answer 10

• (-nitro, -nitrate) or similar stem
• these drugs do reduce blood pressure, however they are not typically used in hypertension treatment
• primary drug:
  
  • nitroglycerine
    
    • administered SL for angina
• other drugs:
  
  • amylnitrate
  • isosorbide dinitrate

Question 11

alpha-blockers

Answer 11

• cause vasodilation
• used for:
  
  • hypertension
  • incontinence caused from prostate enlargement and bladder outlet obstruction
• examples include:
  
  • prazosin
  • terazosin (Hytrin)
  • doxazosin (Cardura)
  • tamsulosin (Flomax)

Question 12

beta-blockers

Answer 12

• cause decreased heart-rate and cardiac output
• works to stabelize the cardiac membrane
• used for:
  
  • hypertension
  • arrhymias
• examples include:
  
  • atenolol
  • betaxolol
  • metoprolol

Question 13

Antiarrhythmic Drugs

Answer 13

• Several Classes:
  
  • sodium channel blockers
  • beta blockers
  • potassium channel blockers
  • calcium channel blockers

Question 14

Arrhythmia

Answer 14

fluctuations of the normal heart rhythm

Question 15

Sodium Channel Blockers

Answer 15

• block sodium from entering cells
• examples include:
  
  • procainamide
  • lidocain
    
    • both of which are also used as local enesthetics
  • quinidine

Question 16

Potassium Channel Blockers

Answer 16

• block potassium from entering cells
• includes:
  
  • bretylium
  • amiodarone

Question 17

Lipid-Lowering Drugs

Answer 17

• do not work directly on the cardiovascular system
• work to lower LDL cholesterol which is directly coorelated with heart disease, hypertension and stroke
• (-statin) include:
  
  • lovastatin
  • atorvastatin (Lipitor)
  • fluvastatin
  • rosuvastatin (Crestor)
  • simvastatin
• non statin drugs include:
  
  • cholestyramine
  • ezetimibe

Question 18

Ischemic Heart Disease Drugs

Answer 18

• work to lower the heart’s demand for oxygen
• commonly treated with:
  
  • beta-blockers
  • nitrates

Question 19

Renal and Urinary Drugs

Answer 19

• urinary system is part of the renal system
  
  • works to produce, store and eliminate urine
• renal and urinary systems are important end points for the cardiovascular system by filtering and eliminating waste it works to maintain homeostasis through helping to balance chemicals and water volume
• common conditions:
  
  • infections
  • renal failure
  • kidney diesase
• Often renal conditions are caused by blood volume, blood pressure and cardiac output
  
  • many drugs classified as cardiovascular are important in renal/urinary treatment

Question 20

UTI

Answer 20

• urinary tract infection
• common bacterial infection that will effect urethra, bladder and kidneys depending on severity
• treatment typically involves beta-lactam antiobiotics and non beta-lactam antibiotics
• phenazopyridine (Pyridium) may also be given to alleviate burning pain associated with this infection

Question 21

Incontinence

Answer 21

• common urinary disease
• resulting from:
  
  • overactive bladder
  • pelvic prolapse
  • urine overflow resulting from urine retention (bladder not emptying completely)
• treatments include:
  
  • surgery
  • 4 drug classes:
    
    • alpha-blockers
    • antispasmodics
    • 5-alphas reductase inhibitors
    • imipramine

Question 22

Antispasmodics

Answer 22

• relaxes the bladder muscles and relieves spasms
• examples include:
  
  • propantheline (Pro-Banthine)
  • tolterodine (Detrol LA)
  • oxybutynin (Ditropan XL)

Question 23

5-Alpha Reductase Inhibitors

Answer 23

• inhibits the production of the male hormone DHT
  
  • DHT is thought to be responsible for prostate enlargement
• examples include:
  
  • finasteride (Proscar)
  • dutasteride (Avodart)

Question 24

Imipramine

Answer 24

• main drug is
  
  • Tofranil - which actually belongs to the tricyclic antidepressant class
    
    • it relaxes the muscles and blocks the nerve signals that might cause bladder spasms

Question 25

Kidney Stones

Answer 25

• occur when chemicals (calcium oxalates) concentrate enough to form solid masses in the urinary tract
• causes:
  
  • back pain
  • side pain
  • blood in urine
• pain relievers are used to reduce the perception of pain
• most effective treatment is:
  
  • shock wave lithotripsy
    
    • using shock waves to disentegrate the stones

Question 26

Kidney Disease

Answer 26

• nephropathy
• occurs when kidney is damaged, has a variety of causes:
  
  • drugs
    
    • ASA, tylenol, NSAIDS can cause chronic analgesic nephritis = an inflammation state in the kidneys
    • lithium can cause nephropathy and in some cases kidney failure (either temporary or chronic)
• Treatment:
  
  • dialysis
  • kidney transplant

Question 27

Diuretics

Answer 27

• used to:
  
  • increase urine flow
  • decrease blood volume
  • lower blood pressure
• 3 main classes:
  
  • thiazide diuretics
    
    • chlorothiazide
    • hydrochlorothiazide
    • (these are drugs of choice for primary hypertension)
  • loop diuretics
    
    • furosemide
    • bumetanemide
  • potassium-sparing diuretics
    
    • spironolactone
    • amiloride

Question 28

LDL

Answer 28

low-density lipoprotein