Pharm 5 Cardio pt3

Question 1

Ex of nonselective beta-blockers

Answer 1

Propranolol

Question 2

Ex of b-1 selective beta blockers

Answer 2

Atenolol

Metoprolol

Question 3

2 examples of alpha-beta blocker

Answer 3

Labetalol

Carvedilol

Question 4

Beta-1 blocker drugs
Where's the receptor site?
Drug interaction?
Action
Effect

Answer 4

Cardiac cells
Dopamine
Stimulation
Decrease rate and force of contraction

Question 5

Beta-2 blocker drugs
Where's the receptor site?
Drug interaction?
Action
Effect

Answer 5

Bronchial, vascular, and uterine smooth muscle
Albuterol
Stimulation
Muscle relaxation

Question 6

Prototypical beta-Blocker
Example
Indication (2)

Answer 6

Metoprolol

Indication: hypertension; in patients during and after AMI to reduce mortality

Question 7

Beta-Blockers Contraindications, Precautions, A/SEs

Answer 7

Contraindications: significant 1º Heart Block; any 2º or 3º AV block, overt heart failure, SBP < 100 mgHg, heart rate < 45 BPM
Pregnancy Cat. C
Avoid abrupt cessation
Precautions in brochospastic disease, COPD, SLE, hepatic dysfunction, DM, hyperthyroidism
May increase cardiac effects of digitalis, CCBs.
Bradycardia w/ catecholamine- decrease drugs
May block epinephrine
Fatigue, dizziness, depression, hypotension, diarrhea, rash, dyspnea, bradycardia, cold extremities, palpitations, CHF, peripheral edema, hypotension, bronchospasm, heart block, erectile dysfunction

Question 8

Prototypical Calcium Channel
Example, Route of Admin
Indications (3)

Answer 8

Diltiazem - PO (multiple formulations) or IV

Indications: hypertension; vasospastic & chronic angina; certain rapid narrow-complex dysrhythmias

Question 9

*3 CCB’s to know

Answer 9

Diltiazem, Verapimil, Amlodipine

Question 10

CCB CI and PC

Answer 10

Contraindicated in sick sinus syndrome, 2o or 3o heart block –unless patient is paced, hypotension, acute myocardial infarction and pulmonary edema documented by radiograph on admission
Precautions in heart failure, impaired renal or hepatic function; discontinue w/ persistent rash
Pregnancy Cat. C

Question 11

What drug should you NOT use for an MI to slow their heart down. (will make it worse)

Answer 11

CCB aka Dilitiazem

Question 12

Many CCBs are involved in __ metabolism.

Therefore its interactions include:

Answer 12

CP-450 enzyme metabol
Interactions: digoxin and -blockers may lead to AV block; serum propranolol and carbamazepine levels may be increased; potentiation with cimetidine; inhalation anesthetics may potientiate cardiac depression

Question 13

Indicications for Dilitiazam, Amlodipine, Verapamil (all the same) (3)

Answer 13

Stable Angina, Vasospastic Angina, Hypertension

Question 14

1 antihypertensive CCB. Seen often in the outpatient setting.

Answer 14

Amlodipine

Question 15

Which CCB would you give to a person that wants to exercise?

Answer 15

Amlodipine
Advantage of Amlodipine compared these other drugs: you don’t get some of the same blunting of the heart rate. Ppl can exercise better w/o getting short of breath.

Question 16

Advantage and Disadvantage of Amlodipine

Answer 16

Advantage of Amlodipine compared these other drugs: you don’t get some of the same blunting of the heart rate. Ppl can exercise better w/o getting short of breath.
Disadvantage: in high doses, there’s much more peripheral edema (pretibial/ankle), so they get a lower dosing

Question 17

CCB Mechanism of Action (they all share a basic electrophysiologic property)

Answer 17

they block the cellular influx of calcium thru slow-channels of the cell membrane of cardiac cells

Question 18

What was the first CCB?

Answer 18

Niefedipine

Question 19

*Do not use oral short-acting __ for hypertensive emergencies/urgencies

Answer 19

CCB’s

Question 20

3 details about Amlodipine

Answer 20

Good for peripheral vascular vasodilation
No reflex tachycardia
Less peripheral edema than nifedipine

Question 21

What CCB is useful in diastolic dysfunction?

Answer 21

Verapamil

Question 22

Name 2 drugs that are commonly used with BPH

Answer 22

Terazosin, doxazosin

aka alpha blockers

Question 23

alpha1 receptors do what?

Answer 23

constrict vascular smooth muscle

Question 24

alpha2 receptors do what?

Answer 24

contract selected vascular beds

Question 25

What is the therapeutic use for nonselective (either alpha-1 or 2) in hypertension?

Answer 25

treatment of hypertensive crises in pheochromocytoma

Question 26

a1 blockers reduce serum __ and__, increase __.

Answer 26

a1 blockers reduce serum triglycerides and LDL cholesterol, increase HDL cholesterol.