Term
| Reasonable HTN Drug for all? |
|
Definition
|
|
Term
| Thiazide is _____ with african americans. |
|
Definition
|
|
Term
| Calcium Channel Blocker (DHP) _______ in African American and ______ in Elderly. |
|
Definition
|
|
Term
| ACE Inhibitors for HTN are good for what pts? |
|
Definition
| good with comorbidities: HF, LV dysfunction, diabetic nephropathy |
|
|
Term
| ACE Inhibitors _______ in African American. |
|
Definition
| Not initial therapy for African-American |
|
|
Term
|
Definition
Diuretics
RAAS-Inhibitors
Sympatholytics
Vasodilators |
|
|
Term
| Diuretic Types: ___________. |
|
Definition
Thiazide*
Thiazide Like
Loop
K-Sparring |
|
|
Term
|
Definition
Hydrochlorothiazide
Hydrochloro(thiazide) |
|
|
Term
|
Definition
|
|
Term
|
Definition
Furosemide
Ethacrynic acid |
|
|
Term
| Except with HTN with __________, the loop diruetics: ___________, are reduced to use with HF. |
|
Definition
Renal Failure
Furosemide
Ethacrynic acid |
|
|
Term
| K-Sparing Diuretic: ____________. |
|
Definition
Amiloride and Triamterene
Spironolactone
Eplerenone |
|
|
Term
| Thiazide MOA: __________. |
|
Definition
Io = (decrease) intravascular volume
-Decrease VR and LVEDV
IIo = (decrease) Arteriole reactivity
by decreasing Na+i and Ca2+i -> decrease in TPR |
|
|
Term
| Most common side effects of Thiazide? |
|
Definition
SEXUAL DYSFUNCTION
ALLERGIC Rx – Rash, Photosensitivity
-Ethacrynic acid for allergy to sulfonamides |
|
|
Term
| Thiazides cause hypo/hyper? |
|
Definition
HYPOVOLEMIA: Caution in Elderly
HYPOKALEMIA
HYPERGLYCEMIA (diabetics) |
|
|
Term
| Hypokalemia of Thiazides predisposes you to? |
|
Definition
|
|
Term
| Bc of Hypokalemia, Thiazides may require? |
|
Definition
May need K supplementation*
K Sparing diuretic |
|
|
Term
| Loop Diuretics side effect? |
|
Definition
|
|
Term
| Spironolactone diuretic side effect? |
|
Definition
| Estrogenic Side Effects = Gynecomastia, Mastodynia |
|
|
Term
| Diuretic drug drug interaction of most concern? |
|
Definition
| Digoxin: (increase) Dig. Toxicity bc of K+ loss |
|
|
Term
| Diuretic drug drug interactions? |
|
Definition
Digoxin: (increase) Dig. Toxicity
Corticosteroids: (increase) Na Retention
•Warfarin : (decrease) Effectiveness
•NSAIDS : Flip back to Hypertension |
|
|
Term
| Hyperkalemia of K-Sparing Diuretics Enhanced by drugs: ___________. |
|
Definition
•NSAIDS,
•Beta-blockers
•ACE inhibitors |
|
|
Term
| Drugs that Inhibit the RAAS: ___________. |
|
Definition
Direct Renin Inhibitor
ACE Inhibitors
Angiotensin II Receptor Blockers
Aldosterone Receptor Blocker |
|
|
Term
| ACE Inhibitors drugs: ______. |
|
Definition
•Captopril PRIL, just know PRIL
•Enalapril
•Lisinopril |
|
|
Term
| Angiotensin II Receptor Blockers: __________. |
|
Definition
•Losartan SARTAN, just know SARTAN
•Irbesartan
•Telmisartan |
|
|
Term
| Aldosterone Receptor Blocker: ________. |
|
Definition
|
|
Term
| Spironolactone and Eplerenone difference? |
|
Definition
| Eplerenone has less estrogen effects |
|
|
Term
| ACE inhibitors lead to a decrease in? |
|
Definition
decrease in TPR
decrease in VR |
|
|
Term
| How do ACE inhibitors cause a decrease in VR? |
|
Definition
| Decrease in aldosterone, so decrease in Na+ retention |
|
|
Term
| ACE inhibitors cause rises in _______ levels. |
|
Definition
Bradykinin: by inhibition of
destruction** |
|
|
Term
| ACE inhibitors preserve _________ in diabetics. |
|
Definition
|
|
Term
| Advantage of ACE over Thiazide? |
|
Definition
|
|
Term
| Most common adverse effect of ACE inhibitors? |
|
Definition
Hypotension/Na+ depletion
Dry Irritating Cough**
•** Angioedema |
|
|
Term
| Angioedema with ACE inhibitors is characterized by? and higher incidence in? |
|
Definition
swelling of mucous membranes, choke, life threatening
African-Americans |
|
|
Term
| ACE Inhibitor Drug Interactions are with drugs that? |
|
Definition
Also elevate K+
•Potassium sparing diuretics
•Potassium replacements
•NSAIDs |
|
|
Term
| Angiotensin II Receptor Blockers (______) |
|
Definition
|
|
Term
| What drug ending equals Angiotensin II Receptor Blockers (ARB’s)? |
|
Definition
|
|
Term
| Angiotensin II Receptor Blockers (ARB’s) sexual dysfunction? |
|
Definition
|
|
Term
| Angiotensin II Receptor Blockers (ARB’s) ______ in African Americans? |
|
Definition
| African-Americans (low-renin activity) respond less favorably. (SAME AS ACE) |
|
|
Term
| Angiotensin II Receptor Blockers (ARB’s) have the same pharmacology as? |
|
Definition
|
|
Term
| ACE Inhibitors and ARB induced Angioedema occurs by? |
|
Definition
ACE inhibitors Inhibiting destruction of Bradykinin
Angiotensin II Receptor Blockers block the receptor subtype I only, while the subtype II goes on to form Bradykinin |
|
|
Term
| Direct Renin Inhibitor (DRI) drug? |
|
Definition
|
|
Term
| Alpha 2 agonist drug for HTN? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Decrease sympathoadrenal (SAS) outflow (tone) to periphery |
|
|
Term
|
Definition
| Rebound hypertension (withdrawal supersensitivity) |
|
|
Term
|
Definition
Prazosin, Terazosin, and Doxazosin
SIN -sin |
|
|
Term
|
Definition
|
|
Term
| Alpha and Beta Blockers: __________. |
|
Definition
Labetalol -alol
Carvedilol |
|
|
Term
| Cardio selective beta blocker means beta ____. |
|
Definition
|
|
Term
| Beta blockers used to treat HTN effects? |
|
Definition
lowering CO (lowered HR and contractile)
lowered RAAS
Reflex increase TPR through alpha |
|
|
Term
| ADVERSE EFFECTS OF beta- BLOCKERS? |
|
Definition
•Bronchospasm
•Heart Failure
•Bradycardia; AV Block
•Peripheral Vascular Disease, Raynaud’s (unchecked vasoconstriction) |
|
|
Term
|
Definition
| Alpha 1 and beta1/2 blocker |
|
|
Term
| Labetalol advantage over other sympatho drugs? |
|
Definition
|
|
Term
| Labetalol adverse effects? |
|
Definition
ORTHOSTATIC HYPOTENSION (alpha block)
BRADYCARDIA/HEART BLOCK (beta block) |
|
|
Term
| Labetalol bad with: __________ pt.s? |
|
Definition
|
|
Term
| Vasodilators work in HTN by _______. |
|
Definition
|
|
Term
| Which Vasodilator reduces TPR and VR? |
|
Definition
|
|
Term
| Vasodilators used in HTN? |
|
Definition
(Just TPR)
Hydralazine
Minoxidil
Diazoxide
(TPR and VR)
Nitroprusside |
|
|
Term
|
Definition
| SLE (systemic lupus erythematosus) |
|
|
Term
|
Definition
| Hypertrichosis is an abnormal amount of hair growth over the body |
|
|
Term
| Nitroprusside side effect? |
|
Definition
|
|
Term
| Calcium Channel Blockers: __________. |
|
Definition
Verapamil
Diltiazem
Nifedipine(and all -dipine drugs) |
|
|
Term
| Arteries or veins more sensitive to Calcium Channel Blockers? |
|
Definition
|
|
Term
| Calcium Channel Blockers treat HTN by? |
|
Definition
|
|
Term
| Nifedipine is a ______ type of drug that is administered _____ and causes a rapid __________, but has an adverse effect of? |
|
Definition
Calcium Channel Blocker
•SUBLINGUAL / SHORT DURATION
•RAPID (decrease) OF BP
•REFLEX TACHYCARDIA** |
|
|
Term
| Adverse effect of Calcium Channel Blockers? |
|
Definition
| Peripheral Edema (kidney is going to ramp up RAAS) |
|
|
Term
|
Definition
|
|
Term
| _______ a ______ type drug may be more effective than Thiazides. |
|
Definition
Chlorthalidone
(Thiazide like) |
|
|
Term
| For HTN with Hypokalemia use? |
|
Definition
| Spironolactone (K+ sparing) |
|
|
Term
| For HTN with Sinus Tachycardia use? |
|
Definition
|
|
Term
| For HTN with renal failure use? |
|
Definition
| Furosemide (loop diuretic) |
|
|
Term
| HTN with Hypokalemia, ________ is contradicted? |
|
Definition
|
|
Term
| HTN drug with suicide problem? |
|
Definition
|
|
Term
| HTN with COPD/Asthma should avoid _____ drug. |
|
Definition
|
|
Term
| Dyslipidemia types of drugs: ________. |
|
Definition
• Nicotinic Acid -Niacin
• Fibrates
Omega - 3 - Fatty Acids
• Bile Acid Sequestrants
• Cholesterol Absorption Inhibitor
• HMG CoA reductase inhibitors - “Statins” |
|
|
Term
| Fibrates (Fibric Acid Derivatives) drugs: ________. |
|
Definition
|
|
Term
| Bile Acid Sequestrants drugs: ________. |
|
Definition
Cholestyramine ("CHOLESTEROL TRY ME, choke hold and carry it out)
Colestipol & Colesevelam (fewer GI SE) |
|
|
Term
| Cholesterol Absorption Inhibitor: ________. |
|
Definition
| Ezetimibe (Ez time to poop) |
|
|
Term
| Nicotinic Acid side effects: _______. |
|
Definition
flushing and pruritis (BAD)
Hepatotoxicity (>2gm) |
|
|
Term
| Fibric Acid Derivatives side effect? |
|
Definition
| Cholelithiasis (gallstones) esp. Gemfibrozil |
|
|
Term
| Does fish oil reduce LDL levels? |
|
Definition
|
|
Term
|
Definition
Binds bile acids which are precursors to cholesterol
•Prevents reabsorption of bile acids, hence liver metabolism is shifted toward bile acid production rather than cholesterol. |
|
|
Term
|
Definition
(TASTE LIKE THE BEACH) Nausea, abdominal cramps, major constipation, impaction, aggravation of hemorrhoids
Absorbs many drugs, folate, statins, warfarin, digoxin, vitamins. |
|
|
Term
|
Definition
| Decrease intestinal absorption of cholesterol |
|
|
Term
| HMG-CoA Reductase Inhibitors aka ________. |
|
Definition
|
|
Term
| HMG-CoA Reductase function? |
|
Definition
| RDS in synthesis of cholesterol |
|
|
Term
| HMG-CoA Reductase Inhibitors effects? |
|
Definition
Total cholesterol reduces 20 - 60%
increase HDL levels (slight at best)
decrease VLDL, TG and cholesterol |
|
|
Term
| HMG-CoA Reductase Inhibitors additional benefits? |
|
Definition
Improve endothelial function
Decrease platelet aggregation
Decrease inflammation (by decreasing C-reactive protein CRP) |
|
|
Term
| HMG-CoA Reductase Inhibitors Decrease the incidence of major coronary events and death in ______ prevention. |
|
Definition
| both primary and secondary |
|
|
Term
| Dose dependent side effect of HMG-CoA Reductase Inhibitors? |
|
Definition
|
|
Term
| Rarer side effects of HMG-CoA Reductase Inhibitors? |
|
Definition
Rhabdomyolysis (rare)
Hepatotoxicity |
|
|
Term
| HMG-CoA Reductase Inhibitors contradicted in? |
|
Definition
| pregnant women (babys need cholesterol) |
|
|
Term
| Antiplatelet aka __________ Agents. |
|
Definition
|
|
Term
| Antithrombotic Agents: __________. |
|
Definition
COX Inhibitors
ADP Inhibitors
GP Ilb/Illa Inhibitors |
|
|
Term
| COX Inhibitors: __________. |
|
Definition
|
|
Term
|
Definition
Clopidogrel
Parsugrel
Ticagrelor |
|
|
Term
| GP Ilb/Illa Inhibitors: _______. |
|
Definition
Abciximab
Eptifibatide
Tirofiban |
|
|
Term
| Anticoagulants: ________. |
|
Definition
Warfarin
Heparin
Enoxaparin, Dalteparin
Fondaparinux |
|
|
Term
| Thrombolytics: ___________. |
|
Definition
Streptokinase
Tissue Plasminogen Activator (TPA) |
|
|
Term
| Tissue Plasminogen Activator (TPA): ________. |
|
Definition
Alteplase
Reteplase
Tenecteplase |
|
|
Term
| Antithrombotic ______ clot prevention. |
|
Definition
|
|
Term
| Anticoagulants ________ clot prevention. |
|
Definition
|
|
Term
| Aspirin blocks ________ synthesis by irreversibly inhibiting _______ enzyme. |
|
Definition
thromboxane A2
cyclooxygenase |
|
|
Term
| cyclooxygenase key enzyme in the synthesis of _______ and ________. |
|
Definition
thromboxane A2
prostacyclin |
|
|
Term
|
Definition
| potent activator of platelets |
|
|
Term
| Thromboxane A2 produced where? |
|
Definition
|
|
Term
|
Definition
Clopidogrel
Parsugrel
Ticagrelor |
|
|
Term
| Clopidogrel & Parsugrel through ADP inhibition irreversibly inhibits _______ through the ______ receptor. |
|
Definition
Platelet Aggregation
purinergic |
|
|
Term
|
Definition
|
|
Term
| Ticagrelor drawback compared to Clopidogrel? |
|
Definition
| Greater risk of Intracranial Hemorrhage |
|
|
Term
| Ticagrelor not to be used with? |
|
Definition
|
|
Term
| GP IIb/IIIa Inhibitors: __________. |
|
Definition
Abciximab
Eptifibatide
Tirofiban |
|
|
Term
|
Definition
| Fibrinogen & Van Willebrand Factor |
|
|
Term
| GP IIb/IIIa Inhibitors MOA? |
|
Definition
| Bind GP IIb/IIIa and block it from binding Fibrinogen & Van Willebrand Factor |
|
|
Term
| GP IIb/IIIa Inhibitors are administered? |
|
Definition
|
|
Term
| GP IIb/IIIa Inhibitors half life? |
|
Definition
|
|
Term
| anticoagulants for _____ clots. |
|
Definition
|
|
Term
| Reasons to use anticoagulants: ___________. |
|
Definition
DVT
Artificial heart valves
Atrial fibrillation
Prophylactically after surgery |
|
|
Term
| Anticoagulants do not ___________. |
|
Definition
|
|
Term
| ANTICOAGULANTS: ___________. |
|
Definition
Coumarin : Warfarin
Heparin
LMWH
Lepirudin
Rivaroxaban |
|
|
Term
| Low Molecular Weight Heparin (LMWH): __________. |
|
Definition
Enoxaparin
-parin
Fondaparinux (super small LMWH) |
|
|
Term
| ______ is the main oral anticoagulant. |
|
Definition
|
|
Term
|
Definition
| Inhibits vitamin K epoxide reductase |
|
|
Term
| Warfarin inhibits vitamin K epoxide reductase and therefore ________. |
|
Definition
| decreases the amount of reduced vitamin K |
|
|
Term
| Reduced Vitamin K function? |
|
Definition
| Needed as a cofactor in the synthesis of coagulation factors: II, VII, IX, & X |
|
|
Term
| Warfarin effects observed at ______. |
|
Definition
|
|
Term
| Warfarin decreases ______ coagulation factors. |
|
Definition
|
|
Term
| Two pharmokinetic concerns for Warfarin? |
|
Definition
Highly Protein Bound (Drug Drug interactions)
Long T 1/2 = 36hrs. |
|
|
Term
| ANTICOAGULANTS: ___________. |
|
Definition
Coumarin : Warfarin
Heparin
LMWH
Lepirudin
Rivaroxaban |
|
|
Term
| Low Molecular Weight Heparin (LMWH): __________. |
|
Definition
Enoxaparin
-parin
Fondaparinux (super small LMWH) |
|
|
Term
| ______ is the main oral anticoagulant. |
|
Definition
|
|
Term
|
Definition
| Inhibits vitamin K epoxide reductase |
|
|
Term
| Warfarin inhibits vitamin K epoxide reductase and therefore ________. |
|
Definition
| decreases the amount of reduced vitamin K |
|
|
Term
| Reduced Vitamin K function? |
|
Definition
| Needed as a cofactor in the synthesis of coagulation factors: II, VII, IX, & X |
|
|
Term
| Warfarin effects observed at ______. |
|
Definition
|
|
Term
| Warfarin decreases ______ coagulation factors. |
|
Definition
|
|
Term
| Two pharmokinetic concerns for Warfarin? |
|
Definition
Highly Protein Bound (Drug Drug interactions)
Long T 1/2 = 36hrs. |
|
|
Term
| Single Nucleotide Polymorphisms (SNPs)* for Warfarin: ___________. |
|
Definition
C1 subunit of Vit K (VKORC1) - – need less warfarin
CYP2C9– can reduce metabolism by 30-90%. |
|
|
Term
| Warfarin Therapeutics: ________. |
|
Definition
Atrial Fibrillation
Acute Myocardial Infarction (50% reduc)
Treatment Of Venous Thrombosis & Pulmonary Embolism
Prosthetic Heart Valves |
|
|
Term
| CHADS2 Score ≥ ____: Warfarin |
|
Definition
|
|
Term
| CHADS2 Score = 0: ______. |
|
Definition
|
|
Term
| Adverse effects of Warfarin? |
|
Definition
Cross BBB And Placenta**
Hemorrhage: Bowel & Brain
Skin Necrosis : Decrease Protein C** |
|
|
Term
| _______ drugs increase Warfarin activity. |
|
Definition
Acetaminophen
Amiodarone
Aspirin
Cimetidine |
|
|
Term
| _______ drugs decrease Warfarin activity. |
|
Definition
Cholestyramine
Griseofulvin
Phenobarbital
Phenytoin
Rifampin |
|
|
Term
|
Definition
|
|
Term
| PT – Prothrombin time measures the effect of clotting factors: ________. |
|
Definition
|
|
Term
| ______- the best test to adjust warfarin |
|
Definition
| INR (International Normalized Ratio) |
|
|
Term
| Mild Bleeding (INR > 3.0) do what? |
|
Definition
|
|
Term
| Severe Bleeding do what with Warfarin? |
|
Definition
Stop Warfarin
Administer Vit. K (Sc) |
|
|
Term
| Life Threatening Bleeding do what with Warfarin? |
|
Definition
Replace Vit K Clotting Factors With Concentrate Or Plasma
Prothrombin Complex* |
|
|
Term
|
Definition
| binding to antithrombin III (AT III) producing inhibition of proteolytic activity of thrombin (IIa) and Xa |
|
|
Term
| Heparin dose is titrated so that? |
|
Definition
| aPTT is 1.5 – 2.5X normal |
|
|
Term
| Low-molecular weight heparin (LMWH) MOA? |
|
Definition
| inhibition of Factor Xa by ATIII (Not IIa) |
|
|
Term
| Low-molecular weight heparin (LMWH) does not affect? |
|
Definition
|
|
Term
|
Definition
| Minutes (vs 12hrs to days with Warfarin) |
|
|
Term
| Heparin Binds To __________. |
|
Definition
|
|
Term
| Heparin binding site on Antithrombin III is? |
|
Definition
|
|
Term
| Antithrombin III Binds To ________ Irreversibly And Both Are Inactivated |
|
Definition
|
|
Term
| ________ Only the Pentasaccharide of LMWH |
|
Definition
|
|
Term
|
Definition
| IV (Not Effective Orally) |
|
|
Term
| Unlike Warfarin, Heparin does not ______ or _______. |
|
Definition
Do Not Cross BBB
Do Not Cross Placenta |
|
|
Term
| IM Heparin Is Contraindicated Because Of ______. |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Heparin Spontaneous Hemorrhage antidote? |
|
Definition
|
|
Term
| Heparin can have _______ SE after prolonged use. |
|
Definition
|
|
Term
| Direct Thrombin Inhibitors (DTI’s): __________. |
|
Definition
|
|
Term
| Lepirudin shortens/prolongs _______ measure like ________. |
|
Definition
| Prolongs PTT like heparin |
|
|
Term
|
Definition
| Given to replace heparin in Heparin-Induced thrombocytopenia (HIT) |
|
|
Term
| _______ is an oral Direct Thrombin Inhibitors (DTI’s) that is threatening Warfin. |
|
Definition
|
|
Term
| Direct Thrombin Inhibitors (DTI’s): ___________. |
|
Definition
Lepirudin
Bivalirudin
Dabigatran |
|
|
Term
|
Definition
|
|
Term
| Oral direct factor Xa inhibitors: ________. |
|
Definition
|
|
Term
| Rivaroxaban & Apixaban drawbacks? |
|
Definition
Irreversible
No antidote (Same as Dabigatran) |
|
|
Term
| Thrombolytic Agents: _________. |
|
Definition
Streptokinase
Tissue Plasminogen Activator (tPa) |
|
|
Term
| Tissue Plasminogen Activator (tPa): _________. |
|
Definition
Alteplase
Reteplase
Tenecteplase |
|
|
Term
| Thrombolytic Drugs dissolve clots by ________. |
|
Definition
| activating the conversion of plasminogen to plasmin that hydrolyzes fibrin |
|
|
Term
| Thrombolytic Drugs Therapeutic window – __________. |
|
Definition
|
|
Term
| Streptokinase forms 1:1 complex with _______ causing its activation into ______. |
|
Definition
|
|
Term
| Streptokinase therapeutic use? |
|
Definition
DVT
Serious PE
Acute MI
Unclothing catheters & shunts |
|
|
Term
| Streptokinase never used in? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Tissue Plasminogen Activator (tPa) MOA: __________. |
|
Definition
| Rapidly activates plasminogen bound to fibrin in a thrombus (fibrin selective) |
|
|
Term
| Tissue Plasminogen Activator (tPa) have low affinity for _______. |
|
Definition
|
|
Term
| Alteplase (tPA) MI : Window – __________. |
|
Definition
|
|
Term
| Alteplase (tPA) therapeutic use: __________. |
|
Definition
MI
Massive Pulmonary Embolism
Stroke
Superior in dissolving older clots |
|
|
Term
| Chronic Stable Angina, ekg? |
|
Definition
|
|
Term
| Double product for measuring cardiac work? |
|
Definition
| HR X S.B.P. (Systolic blood pressure) |
|
|
Term
| Chronic Stable Angina will occur at __________. |
|
Definition
|
|
Term
| Chronic Stable Angina, ________ relieves. |
|
Definition
|
|
Term
| Prinzmetal’s Angina, ekg? |
|
Definition
|
|
Term
| Drugs Used to Treat Angina: ____________. |
|
Definition
Nitrates
Beta Blockers
Calcium Channel Blockers |
|
|
Term
| Vasospastic Angina drugs? |
|
Definition
| Nitrates and Ca2+ Channel Blockers |
|
|
Term
| Chronic Effort Angina drugs? |
|
Definition
| Nitrates and Ca2+ Channel Blockers and beta blockers |
|
|
Term
| Why can't Beta Blockers be used to treat Vasospastic Angina? |
|
Definition
| Don't vasodilate like Nitrates and Ca2+ Channel Blockers |
|
|
Term
| Nitrates preferentially act on? |
|
Definition
| VEINS > CORONARY ARTERIES >> PERIPHERAL ARTERIES |
|
|
Term
|
Definition
| Increases cGMP which causes dephosphorylation of Myosin-Light Chain leading to relaxation |
|
|
Term
| Overall effect of nitrates? |
|
Definition
| Decrease in Cardiac work -> Decrease in MVO2 |
|
|
Term
| Nitrates decrease Cardiac work by ________. |
|
Definition
| Decreasing venous resistance and decreasing preload & LVEDV. |
|
|
Term
| Adverse effect of Nitrates? |
|
Definition
Blushing
Pulsating Headache
Postural Hypotension
Methemoglobinemia
Halitosis |
|
|
Term
|
Definition
Sublingual
Topical
Transdermal |
|
|
Term
| Tolerance to Nitrates will develop unless? |
|
Definition
|
|
Term
|
Definition
| Effort and vasospastic angina |
|
|
Term
| Nitrates treat effort angina by causing? |
|
Definition
| a decrease in preload and therefore cardiac work |
|
|
Term
| Nitrates treat vasospastic angina by causing? |
|
Definition
| increasing coronary flow through the previously spastic coronary artery |
|
|
Term
| Beta blockers can be used to treat _____ anigna? |
|
Definition
|
|
Term
| Beta blockers used to treat angina? |
|
Definition
Propranolol
Atenolol
Metprolol |
|
|
Term
| Beta blockers are used to treat effort angina by? |
|
Definition
| Decreasing HR and therefore cardiac work |
|
|
Term
| Adverse effects of beta blockers: ________. |
|
Definition
Bronchospasm
Bradycardia
Peripheral Vascular disease- Raynaud's
Sexual dysfunction |
|
|
Term
| Which Calcium channel blockers can be used to treat angina and which cannot? |
|
Definition
Can: Verapmil and Diliazem
Not: Dihydropyridines- Amlodipine/Nifedipine -dipine |
|
|
Term
| Ca2+ channel blockers affect _____ most. |
|
Definition
|
|
Term
| Which types of Ca2+ blockers act on cardiac tissue? |
|
Definition
| Verapmil and Diliazem (the ones that can be used for effort angina) |
|
|
Term
| Verapmil and Diliazem Ca2+ Channel Blockers can be used to treat angina bc they? |
|
Definition
| Decrease HR and CF (effort angina) while increase coronary flow (vasospastic) |
|
|
Term
| Main use of Ca2+ Channel Blockers? |
|
Definition
|
|
Term
| When are Ca2+ Channel Blockers used to treat effort angina? |
|
Definition
(Verapmil and Diliazem only)
Pts. with adverse effects to Beta Blockers/ Nitrates |
|
|
Term
| Ca2+ Channel Blockers pharmokinetics? |
|
Definition
Oral
Short Half Life (3-6 hrs.) |
|
|
Term
| Which Ca2+ Channel Blocker has greatest effect on peripheral vasodilation? |
|
Definition
| Dihydropyridines- Amlodipine/Nifedipine -dipine |
|
|
Term
| The peripheral vasodilation with Nifedipine is followed by _______ and why it is bad for ________. |
|
Definition
reflex tachy
treating effort angina |
|
|
Term
| Nifedipine adverse effects? |
|
Definition
| Hypotension, edema (esp. women), |
|
|
Term
| Drug types used in the treatment of systolic failure: ________. |
|
Definition
Inotropes:
Afterload reducers:
Preload Reducers:
Afterload/Preload Reducers:
Beta Blockers |
|
|
Term
| For HF, Inotropes: __________ |
|
Definition
Cardiac Glycosides (Digoxin)
Dobutamine
Dopamine
PDE - Inhibitors |
|
|
Term
| For HF, Afterload reducers: __________ |
|
Definition
Hydralazine
Calcium Channel Blockers |
|
|
Term
| For HF, Preload Reducers: __________ |
|
Definition
Nitrates
Loop/ Thiazide Diuretics
Spironolactone/ Eplerenone |
|
|
Term
| For HF, Afterload/Preload Reducers: __________ |
|
Definition
Hydralazine + ISDN
ACE Inhibitors
ARB’s
Nitroprusside
alpha-antagonists |
|
|
Term
| For HF, beta-blockers: __________ |
|
Definition
Carvedilol
Metoprolol
Bisoprolol |
|
|
Term
|
Definition
Inhibitor of Na+,K+ ATPase
(increase) [Na+]i thus (increase) [Ca++]i |
|
|
Term
| Digoxin's efficacy is determined by? and why? |
|
Definition
K+
Digioxin Binds phosphorylated form and K+ causes dephosphorylation of Na+,K+ ATPase |
|
|
Term
| ______ K+ levels inhibit digioxin activity |
|
Definition
|
|
Term
| Overall effect of digioxin's inhibition of Na+,K+ ATPase? |
|
Definition
| Increase Ca2+ and increase in velocity of cardiac muscle |
|
|
Term
| Digioxin affect on Ventricular Function Curve? |
|
Definition
| Causes it to jump up a contractility line and eventually compensated back to same CO, just slightly higher LVEDP |
|
|
Term
| Digoxin _____ CO and _____ TPR |
|
Definition
Increase CO
Decrease TPR )*Vascular Effects result from (decrease) SAS/RAAS) |
|
|
Term
|
Definition
| (decrease) HR : (decrease) SAS & (increase) Vagal Stimulation |
|
|
Term
| Digoxin is _______mimetic/lytic. |
|
Definition
|
|
Term
| Digxoin can be used to treat supraventrricular tachy bc of its ______ effect. |
|
Definition
| Decrease in AV node conduction |
|
|
Term
| Adverse Effects of Digoxin : _________. |
|
Definition
Visual : Yellow halos
Cardiac Arrhythmias : Proarrhythmic: all (can produce pretty much every arrythmia) |
|
|
Term
| Treatment of Cardiac Glycoside Intoxication : __________ (sinus bradycardia, S.A. arrest, A.V. node block) |
|
Definition
|
|
Term
| Treatment of Cardiac Glycoside Intoxication : __________ (V.dysrhy.) |
|
Definition
|
|
Term
| Digoxin toxication can be treated overall with? |
|
Definition
| Digibind (Digoxin Immune Fab fragment) |
|
|
Term
|
Definition
|
|
Term
| Dobutamine (___) SV, (____) HR, (____) CO. |
|
Definition
| Increase SV, Increase HR = Increase CO |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Beta Agonist (Dopamine first though) |
|
|
Term
| Dopamine (___) SV, (____) HR, (____) CO. |
|
Definition
| Increase SV, Increase HR = Increase CO |
|
|
Term
|
Definition
| Increase (alpha-adrenergic effect - Higher doses) |
|
|
Term
|
Definition
|
|
Term
| Phosphodiesterase Inh. drug? |
|
Definition
|
|
Term
|
Definition
| Phosphodiesterase Inh. -> increase cAMP |
|
|
Term
| Milrinone (___) SV, (____) CO. |
|
Definition
| Increase cAMP -> increase SV and CO |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Bronchodilation (increasing cAMP, same effect as stimulating beta) |
|
|
Term
| Arteriodilators decrease/increase? |
|
Definition
|
|
Term
| Arteriodilators decrease in afterload leads to? |
|
Definition
| increase in stroke volume and CO |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Hydralazine not approved for HF without ______. |
|
Definition
|
|
Term
| Diuretics and the Ventricular Function Curve? |
|
Definition
| MOA: “Slide down Frank-Starlings” |
|
|
Term
| Diuretics only improve cardiac function for? |
|
Definition
| Those in congestive heart failure |
|
|
Term
| Loop Diuretics: _________. |
|
Definition
Furosemide
Bumetanide
Torsemide
Ethacrynic acid |
|
|
Term
| Potassium Sparing diuretics: _______. |
|
Definition
|
|
Term
| ________ diuretics Improves mortality in severe heart failure. |
|
Definition
|
|
Term
| Nitrates affect preload or afterload? |
|
Definition
|
|
Term
| Nitrates increase _______ leading to a decrease in preload. |
|
Definition
| Venous capacity/compliance |
|
|
Term
|
Definition
| Increase cGMP which causes smooth muscle relaxation |
|
|
Term
| Nitrates affect which vascular in descending order? |
|
Definition
Veins > Coronary arteries > peripheral arteries
(preload reducer) |
|
|
Term
| Isosorbide dinitrate _____ VR? |
|
Definition
|
|
Term
| Nitrates and the Ventricular Function Curve? |
|
Definition
| Same as diuretics, MOA: “Slide down Frank-Starlings” |
|
|
Term
| Afterload and Preload Reducing Agents: ___________. |
|
Definition
Nitroprusside
Hydralazine+ISDN (nitrate)
ACE-Inhibitors
Angiotensin II Antagonists |
|
|
Term
| Nitroprusside decreases ______ and _______. |
|
Definition
| VR and TPR (vasodilates veins and arteries equally, afterload&preload reducer) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Nitroprusside effectiveness is limited to? |
|
Definition
|
|
Term
| Nitroprusside and the Ventricular Function Curve? |
|
Definition
Triangle.
Jump up a curve for increase in contractility (afterload reducer) and then slide down that line (preload reducer) |
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|
