Cardio Pharm Flashcards
(13 cards)
What 4 meds do you give for essential HTN?
- Diuretics
- ACE inhibitors
- Angiotensin II receptor blockers (ARBs)
- Calcium channel blockers
What antihypertensive therapy might you give for CHF?
- Diuretics
- ACE inhibitors
- ARBS
- Beta-blockers (compensated CHF)
- K+ sparing diuretics (WHY LISTED SEPARATELY - how do you choose appropriate diuretic?)
What caveats are there for the use of beta blockers in CHF?
Beta blockers must be used cautiously in decompensated CHF, and are contraindicated in cardiogenic shock
What antihypertensive therapy would you give for diabetes mellitus?
- ACE inhibitors (protective against diabetic neuropathy!)
- ARBs
- calcium channel blockers
- diuretics
- beta blockers
- alpha blockers
Name four calcium channel blockers
- Nifedipine
- Verapamil
- Diltiazem
- Amlodipine
What is the mechanism of Ca++ channel blockers?
Block voltage-dependent L-type calcium channels of cardiac and smooth muscle and thereby reduce muscle contractility
Which Ca++ channel blockers have the biggest effect on vascular smooth muscle?
Amlodipine = nifedipine ( >diltiazem > verapamil)
Which calcium channels have the biggest effect on the heart?
Verapamil > diltiazem > amlodipine = nifedipine
Verapamil = ventricles
For what clinical manifestations would you prescribe a calcium channel blocker?
- HTN
- Angina
- Arrhythmias (NOT nifedipine)
- Prinzmetal’s angina
- Raynaud’s
What are side effects of calcium channel blockers?
- Peripheral edema
- Constipation
- Cardiac depression
- AV block
- Flushing
- Dizziness
What is the mechanism of hydralazine?
Increased cGMP –> smooth muscle relaxation
Vasodilates arterioles > veins
Afterload reduction
When you would prescribe hydralazine?
Severe HTN;
CHF
* First line therapy for HTN in pregnancy w/ methyldopa
*Frequently coadministered with a beta blocker to prevent reflex tachycardia
What are the side effects of hydralazine?
Compensatory tachycardia (contraindicated in angina/CAD), fluid retention, nausea, headache, angina. Lupus-like syndrome.
