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What do inotropes do?
increase force of contraction of the heart
What do cardiac glycosides do
- increase force of contraction
- - slow HR
- - slow impulse conduction
Common Cardiac glycoside?
What conditions do cardiac glycosides treat?
- - atrial fib and flutter
- - heart failure
PDE inhibitors - how do they work?
- increase CO
- increase strength of contraction
- decrease afterload by vasodilation
Two pde inhibitors
inamrinone and milrinone - used for heart failure
Class IA antiarrhythmics are used for?
- atrial and ventricular arrhythmias
- eg PVC; v tach; atrial fib and flutter
Class I Aantiarrhythmics: examples
How do class Ia antiarrhythmics work?
- block sodium channels in the cell membrane to interfere with AP conduction
- - block PNS at SA and AV nodes thus increasing rate
Class iB antiarrhythmics - how do they work
- block sodium ions during depolarization of heart - decreases excitability
Class IB antiarrhytmias - used to treat what?
Common Class IB antiarrhythmic?
Class IC antiarrhythmic- how do they work?
slow conduction in the heart
Class IC antiarrhythmic - what are they used for?
- life threatening ventricular arrytymias
- - SV arrhythmias
Class IC antiarrhythmic - common ones
Class II antiarrhythmics - also known as
Class II antiarrhythmics - common ones
Class II antiarrhythmics - how they work
- block beta receptors - slows SA node firing
- - decrease strength of contraction to decrease O2 consumption
Class III Antiarrhythmics - how they work
suppress arrhythmias by delaying repolarization, prolongs refractory
Class III Antiarrhythmics - what are they used for?
- ventricular arrhythmias
- - v-tach and v-fib
- - atrial fib
Class III Antiarrhythmics - common ones
amiodarone; dofetilide; ibutilide; sotalol
Class IV antiarrhythmics - how do they work
calcium channel blockers - decreases contractility
Class IV antiarrhythmics - used for what?
- SVT with rapid ventricular response
- - relieve angina
- - decrease BP
- - restore sinus rhythm
Class IV antiarrhythmics - common ones
Adenosine - used for what?
adenosine - how does it work?
depresses SA node - decrease hr and impulses from SA to AV node
important thing to remember in giving adenosine?
give rapidly in closest port - follow by saline bolus
3 classes of anti-angina drugs?
- - nitrates (acute)
- - beta blockers (long term prevention)
- - calcium channel blockers (when other drugs fail)
How do nitrates work?
- vasodilation - decreases blood return to heart (preload) which decreases O2 demand on heart because it doesn't have to pump as hard
- - decreases afterload by dilating the arteries
Classes of anti-hypertensives
- ACE inhibitors
- beta blockers
- calcium channel blockers
ACE inhibitors (angiotensin converting enzyme inhibitors) - how do they work?
- interrupt renin-angiotensin system.
- Prevents angiotensin I from being converted to angiotensin II which is a vasoconstrictor and which promotes aldosterone(sodium/water retention) thus vaso dilation and fluid excretion - decreases preload
ACE inhibitors - used for what?
- - hypertension
- - left heart failure
- - post MI
ACE inhibitors - common ones
- - benazepril
- - captopril
- - enalapril
- - enalaprilat
- - fosinopril
- - lisinopril
- - moexipril
ARBs (angiotensin II receptor blocking agents) how do they work?
block the vasoconstriction effect of angiotensin II
ARB's - common ones
ARBs - used for
Clonidine - used for what - how does it work
- used for hypertension
- - inhibits SNS - causing vasodilation and decresed CO
Direct vasodilators for hypertension- examples
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