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Pharm Exam 3 > Cardio > Flashcards

Cardio Flashcards

(55 cards)

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1
Q

Mechanisms of Arrhythmias

A
  1. Abnormal automaticity
  2. Triggered acitivity (EADs, DADs)
  3. Re-entry
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2
Q

Abnormal automaticity

A

non-pacemaker cells take on pacemaker AP and fire faster than SA node

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3
Q

Early Afterdepolarizations (EADs)

A

Prolonged AP

Slow HR

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4
Q

Delayed afterdepolarizations (DADs)

A

Ca overload

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5
Q

Re-entry

A

Impulse persists to reactivate the myocardium instead of dying out

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6
Q

Classes of anti-arrhythmics

A

Class 1: Na channel blockers
Class 2: B-blockers
Class 3: K channel blockers
Class 4: Ca channel blockers

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7
Q

Class 1 Anti-arrhythmics

A

Block fast Na channels

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8
Q

Class 1a anti-arrhythmics

A

quinidine

procainamide

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9
Q

Class 1b anti-arrhythmics

A

lidocaine

mexiletine

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10
Q

Class 2 anti-arrhythmics

A

Propanolol
Atenolol
esmolol

(block b-receptors)

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11
Q

How to class 2 anti-arrhythmics work?

A

Decrease HR and contractility

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12
Q

Why must class 2 anti-arrhythmics be titrated?

A

Up regulate B receptors

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13
Q

Propanolol

A

Non-selective B blocker

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14
Q

Atenolol

A

B1 cardioselective

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15
Q

Esmolol

A

B1 cardioselective

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16
Q

Class 3 anti-arrhythmics

A

K channel blockers

Sotalol, amiodarone

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17
Q

Sotalol

A

non selective

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18
Q

Amiodarone

A

Class 1, 2, 3, 4, and a1 blocker
Long half life
Limited use
Side effects (turns people BLUE)

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19
Q

Class 4 anti-arrhythmics

A

Ca channel blockers

Diltiazem, Amlodipine

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20
Q

Furosemide

A

Loop diuretic
CHF and pulmonary edema
Always use with ACE inhibitor

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21
Q

Loop diuretics

A

Furosemide

Torsemide

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22
Q

Hydrochlorothiazide

A

Thiazide diuretic

Distal convoluted tubule

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23
Q

Sprionolactone

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A

K-sparing

Distal tubule and collecting duct

24
Q

Arteriodilators

Study These Flashcards
A

Relax smooth muscle of arterioles

Reduce AFTERLOAD

25
Venodilators
Relax vein smooth muscle | Reduce PRELOAD
26
Balanced or mixed vasodilators
act at both arteries and veins
27
Nitrates
Venodilators NO formation and reduction of Ca Nitrogylcerin Nitroprusside
28
Sodium nitroprusside
Balanced vasodilator (both arteries and veins)
29
Side effects of nitrates
Hypotension Rebound hypertension Cyanide poisoning
30
Arteriodilator drugs
Nitroprusside Amlodipine Hydralazine
31
Hydralazine
decreases cGMP
32
Sildenafil
treats pulmonary hypertension
33
ACE inhibitors
Enalapril Benazepril Given to patients with CHF to blunt effects of RAAS
34
Mechanism of positive inotropic drugs
Increase amount of Ca available to increase contractility
35
"Cost" of positive inotropes
Myocardial ischemia and monocyte death (due to increase oxygen consumption)
36
Classes of inotropes
1. Cardiac glycosides 2. B adrenergic agonists (synthetic catecholamines) 3. phosphodiesterase inhibitors 4. calcium sensitizing agents
37
Cardiac glycosides
``` Plant extracts (purple foxglove) Digoxin ```
38
How do cardiac glycosides work?
Inhibit Na/K ATPase pump -> increase intracellular Na | Na exchanges for Ca
39
When are cardiac glycosides used?
Systolic myocardial failure | Atrial fibrillation
40
Synthetic catecholamines are used for ____ inotropic support
Acute (half life is minutes)
41
Examples of synthetic catecholamines (b1 agonists)
Dopamine | Dobutamine
42
Dopamine
Act on alpha, b1, and dopaminergic receptors (Low doses: vasodilation, DA receptors Higher doses: positive inotropy, B1 Very high doses: vasoconstriction, a)
43
Dobutamine
B1 effects
44
Mechanism of Phosphodiesterase inhibitors
inhibit breakdown of cAMP
45
Examples of phosphodiesterase inhibitors
Amrinone | Milronone
46
Mechanism of Calcium sensitizing agents
Increases AFFINITY of troponin C for calcium during systole and diastole Enhances contractility without increasing O2 consumption
47
Examples of calcium sensitizing agents
Pimobendan | Levosimendan
48
Pimobendan
"Inodilator": positive inotrope AND systemic pulmonary vasodilator
49
Beta receptors found in cardiac muscle
B1
50
Beta receptors found in bronchial and vascular smooth muscle
B2
51
Effects of beta blockade
Decrease HR (decrease SA node firing) Improved myocardial perfusion Slows AV nodal conduction Decrease myocardial contractility (less O2 consumption)
52
Use of beta blockers
anti-arrhythmics HCM CHF
53
First generation beta blockers
Propanolol Sotalol (nonselectively inhibit both B receptors)
54
Second generation beta blockers
Atenolol esmolol (b1 receptors only)
55
Third generation beta blockers
additional vasodilatory properties B2 stimulatory properties added alpha blockade

Pharm Exam 3 (6 decks)

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