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Flashcards in Cardiac Pt 1 Deck (30)
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1
Q

adrenergic agents

A
  • antihypertensive
  • lower BP
  • ANS: alpha 1 (vasoconstrict) : want to block
  • alpha 2 agonists: mimic alpha 2 effect - vasodilate (good)
  • beta blockers: affect HR, help reduce BP
2
Q

ACE inhibitors

A

*“prils” and first line drug
angiotensin-converting enzyme inhibitors
-block the enzyme that helps convert angiotensin I to angiotensin II

Indication: HTN, HF
Conta: K+ of >5meq/L, lactation

AE: fatigue, dizzy, mood change, HA, **dry, non-productive cough, hyperkalemia (promote K resorption), hypotension

-interactions: NSAIDS, antiHTN, lithium (lithium toxicity)

3
Q

calcium channel blockers

A

make it so the muscle can’t contract

4
Q

alpha 2 agonists

A

*adrenergic agonists
**antihypertensive
MOA: synthetic stimulation of alpha 2 receptors in CNS
- Peripherally causes kidneys to reduce the amount of renin produced
- Indications: HTN (not first line), opioid withdrawal
- Contra: allergy, hypotension, MAOIs, acute HF
- AE: orthostatic hypotension, hypotension, HTN, fatigue, dizzy
- Additive- Diuretics, nitrates, other antihypertensives; Competitive- MAOIs, Amphetamines

5
Q

alpha blockers

A
  • adrenergic-blocking
  • *antihypertensive
  • MOA : Block Alpha 1 receptors; Vasodilation
  • Indications: HTN & BPH
  • Contra: Allergy, hepatic & renal disease, hypotension, acute HF
  • AE: Hypotension, Orthostatic Hypotension, Palpitations, Tachycardia, Chest Pain, Dizziness, Head ache
  • Interactions: Additive Effect-CNS Depressants, alcohol, beta blockers, antihypertensives
6
Q

angiotensin II receptor blockers

A

“sartans”
*antiHNT

MOA: blocks angiotensin II from binding to type I receptors

indication: HTN / HF
Contra: pregnancy, elderly, renal dysfunction

AE: URI, HA, dizzy, hypotension, hyperkalemia

Interactions: NSAID, lithium, rifampin, K supplements

7
Q

vasodilators

A

*antiHTN

MOA: relaxes vascular smooth muscle

indications: HTN and HTN crisis

Contra: hypotension, head injury**, AMI, CAD, HF

AE: dizzy, HA, orthostatic hypotension, NA and water retention, dysrhythmias, hyperglycemia in diabetics

interactions: other antiHTN

8
Q

clondine

A

antiHTN

  • alpha 2 adrenergic receptor stimulator
  • topical and oral patch for remove old one first
9
Q

doxazosin

A

antiHTN

  • alpha 1 blocker
  • vasodilation of both arterial and venous dilation
10
Q

labetalol

A

antiHTN

  • alpha and beta blockers
  • po & iv alpha and beta used for hypertensive emergencies Carvedilol is also an effective antihypertensive
11
Q

captopril

A

antiHTN
- ACE inhibitor

reduce left vent. Dysfunct after mi-shortest half life must be taken multiple times a day

12
Q

enalapril

A

antiHTN
- ACE inhibitor

iv and oral-oral form is pro drug so a functioning liver is a must

13
Q

lisinopril

A

antiHTN

- ACE inhibitor

14
Q

losartan

A

antiHTN

- ARBs

15
Q

hydralazine

A

antiHTN

  • vasodilator
  • is not used much any more but with patients who can not take po this does have an iv form
16
Q

sodium nitroprusside

A

antiHTN

  • vasodilator
  • metabolites cyanide thiocynate levels-sodium nitroprusside has reduced this slightly
    • watch for increasing cyanide levels
17
Q

beta blocker drugs

A

antianginal drugs

MOA: Selective v. Non-selective-Slow Heart rate

indications: angina, MI, Hypertension, dysrhythmias
contra: acute, Conduction disturbances, bronchial asthma

AE: Bradycardia, hypotension, dizziness, blood glucose changes, wheezing, mask hypoglycemia

interactions: additive - diuretics, Ca channel blockers

**metroprolol : beta 1 adrenergic blocker

18
Q

calcium channel blockers

A

antianginal drugs

MOA: Blocks calcium channels in muscle- Vasodilation- especially coronary arteries, decreased muscle contraction

indications: first line drugs
- angina, hypertension, tachycardia

contra: AMI, heart block

AE: hypotension, rhythm disturbances, palpitations

Interactions: beta blockers, dig, amiodarone, addivite, statins mycins, cyclosporine, grapefruit juice

**if apical is less than 60, do not admin Ca+ channel blocker — already slow, would/could stop heart

  • *diltiazem
  • *amoldipine
19
Q

antianginal nitrates

A

MOA: Relaxation of Smooth muscle-vasodilation

Indications: Vasospastic angina, angina

Contra: Anemia, closed angle glaucoma, hypotension, head injury

AE: Headache, tachycardia, postural hypotension

Interactions: Additive hypotensive effects (Alcohol, beta blockers, ca channel blockers)

20
Q

isosorbide dinitrite

A

nitrate

pill for chronic angina

21
Q

nitroglycerine

A

nitrate
topical - angina
sublingual: should see reaction in 5 min, if not, can give another, wait 5 min and give one final (3 max in 15 min)

22
Q

carvedilol

A

beta blocker, alpha 1 blockers, calcium channel blocker

23
Q

labetalol

A

alpha and beta blockers

24
Q

B-Type Natriuretic Peptide

A

HF drug

MOA/DE: Synthetic B-Type Natriuretic Peptide-Vasodilation (especially in the coronary arteries) and Diuresis

Indications: Acute Decompensated Heart Failure

Contraindications: Drug Allergy

Adverse Effects: Hypotension, cardiac dysrhythmias, insomnia, Headaches and abdominal pain

Interactions: Additive hypotensive effects with antihypertensives.

25
Q

cardiac glycosides

A

HF drugs

MOA: Inhibition of the sodium-potassium adenosine triphosphatase pump

Indications: Systolic Heart Failure & Atrial Fibrillation

Contraindications: Bradycardia & advanced heart blocks, Diastolic Heart Failure

Adverse Effects: Bradycardia, Tachycardia, Hypotension, Colored vision, Halo Vision, Headache, fatigue, confusion

Interactions: Antidysrhythmics, Beta-Blockers, Calcium Channel Blockers

**colored/halo vision = dig toxicity

26
Q

Carbonic anhydrase inhibitor

A

**diuretic

MOA: Dec. H+ formation

Indications: glaucoma & edema

Contraindications: Allergy, hyponatremia, hypokalemia, hepatic or renal dysfunction, sensitivity to sulfonamide antibiotics, diabetes.

Adverse Effects: Metabolic Abnormalities, Drowsiness, Anorexia, paresthesias, hematuria, melena, hyperglycemia

Interactions: Digoxin, Corticosteroids, Amphetamines, carbamazepine, cyclosporine, phenytoin & quinidine

***drives K down, drives glucose up

27
Q

loop diuretic

A

**diuretic

MOA: Blocks chloride and sodium resorption

Indication: Heart Failure, renal failure, liver failure and HTN

Contraindications: Allergy, allergy to sulfonamide antibiotics, hepatic coma, severe electrolyte imbalances

AE: Dizziness, headache, tinnitus, ototoxicity (especially when parenteral forms are administered too quickly), and electrolyte disturbances (especially K+!)

Interactions: ibuprofen, digoxin

28
Q

Osmotic diuretics

A

**diuretic

MOA: Proximal convoluted tubule and the descending loop of Henle—diuresis.

Indications: Early, oliguric phase of ARF (as long as renal perfusion is adequate).

Contraindications severe renal disease & pulmonary edema

AE: Convulsions, pulmonary congestion, and thrombophlebitis at the site of injections.

No significant interactions

**effective in liver and head injuries

29
Q

K+ sparing diuretics

A

**diuretic

MOA: binding to aldosterone receptors and blocking resportion of sodium and water.

Indications: Hyperaldosteronism, HTN, counteract electrolyte loss among those taking potassium-wasting diuretics, and CHF

Contraindications: hyperkalemia, severe renal failure,

AE: Gynecomastia (large mammory glands: AKA, breasts) in men and dysmenorrhea in women, hyperkalemia!

Interactions: Lithium, NSAIDS, K+ supplements!

30
Q

Thiazides

A

MOA: distal convoluted tubule—Diuresis

Indications: Edema, HTN, and HF

Contraidications: hepatic coma

AE: Electrolyte disturbances, dehydration, orthostatic hypotension, impotence, and decreased libido

Interactions: NSAIDS, Lithium, digoxin, Table 28-6

**low Na, high K+