Test three Flashcards
What do ACE inhibitors do?
relax veins and arteries to lower blood pressure
they do this by stopping angiotensin II production
Also prevent or reverse pathological changes in heart and blood vessels
common side effect vs adverse effects of ace inhibitors
cough bc increased bradykinin
first dose hypotension
teratogenic
angioedema –> fucks up airway
ARBs
less effective than ACEis, but work similarly
also block aldosterone
no cough
ARB side effects
Low bp
Other (fatigue, dizzy, headache)
Swelling
Allergic rxn
Raised K
Teratogenic
AKI (drops perfusion)
Nasal congestion
Who should you NOT give CCBs to?
HF patients
Where do CCBs work?
-which conditions are they good for?
heart and blood vessels (not so much veins)
reduce work
good for angina and afib
How do CCBs work?
decrease AV conduction
slow HR and force of contraction
reduce afterload
increase coronary perfusion
examples of CCBs
verapamil and diltiazem
Nifedipine is a hard core one
How to identify CCB OD
dizzy, headache, nausea, face flushing
EKG
How do vasodilators reduce cardiac workload?
act on arteries to reduce afterload
act on veins to reduce preload
Adverse side effect of vasodilators
reflex tachycardia –> increases O2 demand
examples of vasodilators
hydrazaline
Sodium nitroprusside
-fast acting drip for emergencies
-can cause cyanide poisoning
Treatment choices in order for htn
lifestyle mod, diuretic, vasodilator, ACEi, BB, CCB
Why shouldn’t you use salt substitutes if htn?
they usually contain K which activates the RAAS
Which drug classes are prohibited in pregnant ppl with htn?
ACEi, ARBs, DRIs
(use BBs instead)
Nitrates use for angina
dilate everything
don’t mix with ED meds
tablets dissolve (no first pass effect)
take off at night
stable vs unstable angina
stable= predictable (e.g. after exercise)
unstable = random –> happens at rest
Anti-ischemia therapy
MONA (morphine, O2, Nitroglycerine, aspirin)
also BBs and ACEis
if a patient is on aspirin and they come in with GI bleed and their platelet is normal, do they need more platelets?
yes –> js bc platelets are there doesn’t mean they’re working
aspirin deactivates them
side effects of BBs (why aren’t ppl complient?)
ED, weird dreams, depression, fatigue
anticoagulants vs antiplatelets vs thrombolytics
- disrupt coagulation cascade, suppressing fibrin (heparin)
- inhibit platelet aggregation (aspirin)
- promote lysis of fibrin
heparin vs LMWH
both are made from animals and act on platelets and thrombin
LMWH works slower –> once dailly –> longer half life
heparin works super fast –> small half life
both bad for renal patients bc kidney excretion
Warfarin
anticoagulant
Super variable –> gotta get labs done all the time
Vit K antagonist
Takes forever to kick in, so you gotta start with enoxaparin
Antidotes for heparin and warfarin
heparin: protamine sulfate (also platelet infusion)
warfarin: Vit K or fresh frozen plasma
