Pharm cardio condensed

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Pharm cardio condensed
2010-09-09 19:37:41
Pharm cardio

Pharm cardio
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  1. Cardioselective (beta 1) blockers
    Atenolol, Metoprolol, Acebutolol
  2. problems w/ beta 2 block
    asthma, diabetes, vascular disease
  3. Decrease arteriolar tone (decr TPR) and incr venous compliance (decr CO—low SV)
    alpha blockers
  4. Mixed acting alpha blocker, short acting, iv, reversible
  5. Mixed alpha blocker, Irreversible, nonselective
  6. “First Dose Effect” hypotension. Sympathetic and Renin-Angiotensin-Aldosterone compensations --> (Na+ and water retention, potassium loss)
    problems w/ alpha blockers
  7. Decr CO & TPR simultaneously. Decr VMC activity
    Alpha 2 agonists
  8. Problems w/ alpha 2 agonists
    CNS depression, Rebound phenomenon, Low blood pressure. Dry mouth
  9. Mixed alpha & beta antagonist. Can be used in Hypertensive crisis, Pheochromocytoma, Clonidine withdrawal rebound
  10. alpha & beta mixed antagonist having special use in congestive heart failure
  11. no crossing BBB, no CNS depression. Reversible displacement of NE from vesicles. 1st effect is positive. Hypotension, diarrhea
  12. Proximal convoluted tubule carbonic anhydrase inhibitor
  13. Acetazolamide side effects
    Metabolic acidosis, Elevated urinary pH and renal stones
  14. ascending loop diuretics
    Furosemide, Ethacrynic Acid, Bumetamide
  15. Side effects of Ethacrynic acid
    Hypokalemia, Alkalosis, Hypovolemia, Ototoxicity
  16. Side effects for Furosemide & Bumetamide
    Hyperuricemia, Hyperglycemia, Sulfa sensitivity – skin rash, nephritis
  17. used w/ thiazides to counteract potassium loss
    amiloride and triamterene
  18. Potassium sparing diuretics & their side effects
    Amiloride, Triamterene, spironolactone. Hyperkalemia & metabolic acidosis.
  19. CHF cardiac hypertrophy may benefit from which hypertensive drug?
    ACE inhibitors
  20. act at arteriole only, block L-type calcium channels, and decrease vascular resistance.
    Nifedipine and other dipines
  21. calcium channel blockers for arteriole and heart, therefore resist reflex tach.
    and useful against arrhythmias and angina pectoris
    Verapamil and Diltiazem
  22. side effects of Verapamil and Diltiazem
    Hypotension, cardiac depression (SA & AV node), asystole
  23. interferes w/ action of IP3, limiting Ca release from SR of smooth muscle. never given to males over 45 --> chest pain & MI
    Hydralazine vasodilator

  24. side effects of Hydralazine
    headache, flushing, dizziness, hypotension, tachycardia, angina pectoris. Lupus syndrome
  25. activates K channels. Drug available orally & IV. Always used w/ beta blocker or diuretic.
    Minoxidil vasodilator
  26. side effects of minoxidil
    Hypertrichosis. Hypotension, SANS and AII compensations. Hyperglycemia
  27. Longer use is associated with hyperglycemia (50%) and hypertrichosis (20%). Low BP, tachycardia, angina, myocardial ischemia, hyperglycemia,
    water retention
    Diazoxide vasodilator
  28. Metoprolol often combined w/ _____ for hypertension
  29. Clonidine often used in combo w/ __________ for hypertension
  30. Reserpine and amiloride each can be used in combo w/ __________ for hypertension
  31. Verapamil can be used in combo w/ _______ for hypertension
  32. Prazosin can be used w/ ______ for hypertension
  33. Cardiotonics for CHF
    Digitalis (Ca++) , Dobutamine (Beta-1) , Inamrinone (c-AMP)
  34. As anti-arrhythmia, Ca channel blockers treat ...
    • SA node - Sinus Tachycardia.
    • AV node - Paroxysmal Supraventricular Tachycardia
    • Protect the ventricle
  35. Beta blocker w/o CNS depression and non selective
  36. use in Variant angina alone; Typical angina use with a Beta blocker. Arterioles only. Can cause coronary steal
  37. drugs that Increases slope of phase 4 depolarization --> problems w/ automaticity of impulse
    NE/E, hyperthyroidism, atropine, hypokalemia, digoxin
  38. problems w/ automaticity of impulse: Decreased slope of phase 4 caused by
    Ca channel blockers and beta blockers
  39. problems generating automaticity: Hyperpolarized diastolic potential caused by
    vagal/PSNS activity, muscarinic agonists, anticholinesterase, digoxin
  40. problems generating automaticity: elevated threshold caused by
    sodium channel blockers and injury
  41. Early after depol (EAD): during phase 3, can trigger V tach and Torsades des pointes. Can be caused by
    Beta blockers, long action potential duration (long QT syndrome, class III antiarrythmias potassium channel blockers), hypokalemia (diuretics)
  42. Late after depol (LAD): arise from phase 4 caused by
    elevated intracellular calcium (digoxin), hypokalemia (diuretics), excessive catecholamines (SANS, hyperthyroidism, drugs), or ischemia
  43. Blocks Na+ channel, K+ channel, Blocks M2 receptor, Alpha-1 receptors
  44. anti-arrhythmia drug that blocks Na channels and M2 receptors but doesnt block alpha 1 receptors
  45. anti-arrhythmia drug. Na+ channel block, no M2 or Alpha-1 block Prefer iv route to avoid metabolism or slow metabolism. Can lead to lupus syndrome, long QT syndrome, and torsades des pointes
  46. anti-arrhythmia drug that can lead to lupus syndrome if not metabolized and lead to long QT syndrome and torsades des pointes if metabolized to NAPA
  47. orally available versions of lidocaine
    Mexiletine, tocainide
  48. Class IB anti-arrhythmia drug. Given iv, short-acting and safe. Used for ventricular extrasystoles Activates AV node to increase conduct. Can suppress digoxin V. arrhythmias w/o aggravating dig.-related AV node depression
  49. Class IC anti-arrhythmias. Potent sodium channel blockers CAST trial revealed danger, therefore used only as last resort or short-term
    Flecainide, Encainide, Moricizine
  50. Class III anti-arrhythmia drug. Long t1/2, difficult dosing. Many dangerous and unusual side effects: Cardiac depression, pulm. fibrosis, liver damage, optic nerve, cornea halos, and blue skin
  51. Arrhythmias of sodium-conducting pathways of atria or ventricles respond to...
    class I and III drugs
  52. Arrhythmias of calcium-conducting sites, SA node, AV node respond to...
    class II and IV drugs
  53. Atrial flutter, a fib treatments
    Digoxin- AV depression, Protect the ventricle, Also verapamil, beta blockers. Class IA to suppress the sodium driven ectopic focus or foci.
  54. SVT caused by Atrial, AV node reentry circuit can be treated with...
    Verapamil, beta blockers, digoxin, and adenosine (all AV depressants)
  55. SVT caused by atrial wall re-entry can be treated with
    • Inhibit initiation of action w/ Class IA - Quinidine, etc.
    • Increase refractoriness w/ Class III – Amiodarone
  56. Treatment for Premature V contraction, extra systoles, EADs, DADs
    Lidocaine, other class I drugs, and beta blocker in SNS
  57. Ventricular tachycardia Caused by repeated ectopic depolarizations in conducting tissue or by a conducting path reentry circuit. Sodium driven. can be treated w/
    Lidocaine, class IA, or Class III drugs
  58. V fib can be treated w/
    Class IA, IB, and class III
  59. treatment for Digitalis - induced arrhythmias. Extrasystoles or Vtach w/ added danger of AV nodal depression.
    Class IB, phenytoin, Procainamide. All has no AV depression effect
  60. block ADP – prevents platelet formation
    Ticlopidine, clopidogrel
  61. Bronchodilation, vasodilation, cardiac stimulation due to phosphodiesterase inhibition (cAMP)
  62. treatments for pulmonary congestion due to acute heart failure
    furosemide, morphine pain reliever, Aminophylline
  63. Block PDE, cAMP up to increase cardiac output
    Inamrinone and Milrinone
  64. CHF drugs that decrease afterload, decrease blood volume, decrease cardiac remodeling
    ACE inhibitors
  65. Blocks Na+, K+-ATPase. Improves calcium availability in cardiac cells in CHF. Protect ventricle. additional use in AV node depression.
    digoxin (digitalis)
  66. side effects: Ventricular Extrasystoles leading to V tach & V fib. Can have too much AV node depression
    digoxin (digitalis)
  67. side effects of diuretics in CHF
    hypokalemia and will aggravate ventricular arrhythmias. Lack of moderating ion, high calcium
  68. Brain Natriuretic Peptide (BNP) increases cGMP, relaxes smooth muscle. For CHF