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Cardiovascular Pharm Flashcards

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1
Q

If a patients SpO2 is 85% on 2L/min nasal cannula and pursed lip breathing is not working what should you do?

A

Titrate the oxygen to 3-4 L/min, take appropriate safety precautions, and reassess response

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2
Q

When should BP medication be started?

A

If pt has stage 1 hypertension for greater than 6 months or if pt has stage 2 hypertension at all

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3
Q

What are drug classes for congestion?

A

Antitussives, decongestants, expectorants, mucolytics, and antihistamines

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4
Q

What are drug classes for obstruction?

A

Bronchodilators, glucocorticoids

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5
Q

What are bronchodilators?

A

Beta-adrenergic agonist

Anti-cholinergic

Xanthine derivatives

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6
Q

What do beta-adrenergic agonists (SABAs and LABAs) do?

A

Activate beta 2 adrenergic receptors in the airway smooth muscle to cause bronchodilation

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7
Q

What do anti-cholinergic (SAMAs, LAMAs) do?

A

Block action of AcH in the airways by blocking muscarinic receptors causing Bronchodilation

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8
Q

What are anti-inflammatory drug classes?

A

Glucocorticoids

Cromones

Leukotriene inhibitors

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9
Q

How does ACE inhibitor affect the RAAS?

A

Blocks angiotensin 1 from converting into angiotensin 2

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10
Q

How does ARB affect RAAS?

A

It does not allow angiotensin 2 to cause blood vessels to vasoconstrict

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11
Q

What is the most common manifestation of intolerance to an ACE inhibitor?

A

Sustained cough

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12
Q

What are the 1st line medications used for hypertension?

A

Diuretics, ACE inhibitors, Angiotensin receptor blockers, and CCBs

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13
Q

What are the 2nd line medications used for hypertension?

A

Loop diuretics, potassium sparing diuretics, beta blockers, and direct vasodilators

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14
Q

What are the basic targets for treating hypertension?

A

Direct cardiac agent

Peripheral vascular agent

Renal agents

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15
Q

Where do diuretics take action at?

A

Kidneys

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16
Q

What are diuretics anti hypertension effect?

A

Decrease plasma fluid volume

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17
Q

Where do sympatholytics take action at?

A

Sympathetic nervous system

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18
Q

What are the anti hypertensive effects of sympatholytics?

A

Decreased sympathetic influence on heart

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19
Q

Where is the primary action of vasodilators?

A

Peripheral vasculature

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20
Q

What is the anti hypertensive effects of vasodilators?

A

Lower vascular resistance

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21
Q

Where is the primary action of ACE inhibitors?

A

Peripheral vasculature and certain involved organs

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22
Q

Where is the primary action of calcium channel blockers?

A

Vascular smooth muscle and cardiac muscle

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23
Q

What are the anti hypertensive effects of calcium channel blockers?

A

Decreased contractility and cardiac force

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24
Q

What do thiazide medications do to help hypertension?

A

Inhibit sodium reuptake (first line option)

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25
What are common thiazides used for hypertension?
Hydrochlorothiazide Chlorthalidone Metolazone Chlorothiazide Indapamide
26
What is the route of HCTZ?
Orally
27
What is the route of metolazone?
Orally
28
What is the route of chlorothiazide?
IV
29
What is the route of chlorothalidone?
Orally
30
What do loop diuretic targets do to help with hypertension?
Inhibit Na, K, Ca, Mg reabsorption in loop of Henle (decrease Afterload)
31
What are loop diuretic targets often used for?
Edema and heart failure patients
32
What is the most common loop diuretic used?
Furosemide (lasix)
33
What is the route of furosemide?
Orally or IV
34
What is the route of bumetanide?
Orally or IV
35
What is the route of torsemide?
Orally
36
What is the route of ethacrynic acid?
Orally or IV
37
What is the mechanism of action of aldosterone antagonists (potassium sparing diuretics)?
Inhibits aldosterone by inhibiting sodium-potassium exchange site in the distal tubule
38
What do aldosterone antagonist excrete and retain?
Excretes sodium and water Retains potassium
39
What are aldosterone antagonists used to treat?
Hypertension and heart failure
40
What are types of aldosterone antagonists?
Spironolactone Eplerenone
41
How are all aldosterone antagonists taken?
Orally
42
What do ACE inhibitors do?
Inhibit conversion of angiotensin 1 to angiotensin 2
43
What causes peripheral vasoconstriction?
AT2
44
What line option is an ACE inhibitor?
First
45
What are the therapeutic uses of ACE inhibitors?
Hypertension Post MI Heart failure Diabetes
46
What are side effects of ACE inhibitors and angiotensin receptor blockers?
Angiodema Cough Hypotension Hyperkalemia
47
What is the suffix for ACE inhibitors?
Pril
48
How are ACE inhibitors often administered?
Orally
49
What is the action of angiotensin receptor blocker?
Action of angiotensin 2 is blocked despite its production
50
What should angiotensin receptor blocker not be combined with?
ACE inhibitors
51
What is the suffix for ARBs?
Sartans
52
What do calcium channel blockers inhibit?
Sympathetic stimulation of vascular smooth muscle
53
What is the mechanism of action of calcium channel blockers?
Blocks calcium re entry which results in reduced contractility and HR
54
What is suffix for calcium channel blockers?
Pine
55
What do calcium channel blockers do to peripheral vasodilation?
Decrease it
56
What do calcium channel blockers do to coronary blood flow?
Increase it
57
What do calcium channel blockers do to myocardial O2 demand?
Decrease it
58
What are the primary functions of sympatholytics (beta blockers)?
Beta 1 blockade
59
What are the secondary effects of sympatholytics (beta blockers)?
Beta 2 blockade
60
What does the beta 1 blockade inhibit?
Sympathetic cardiac stimulation of the SA node and renin secretion
61
What does the beta 2 blockade do?
Vasodilation of GI vasculature
62
What line of therapy are sympatholytics (beta blockers)?
Second line for hypertension
63
What is the suffix for beta blockers?
-olol
64
Why would you combine alpha and non selective beta blockers?
It lowers BP more than just beta blockers without combination
65
What are the most common combined alpha and non-selective beta blockers?
Carvedilol Labetalol
66
What are the two ways to treat ischemic heart disease?
Reduce cardiac oxygen demand and increase cardiac oxygen supply
67
What are the treatment options for angina?
Nitrates Beta blockers Calcium channel blockers Ranolazine
68
How do nitrates treat angina?
Lower O2 demand
69
How do beta blockers treat angina?
Lower O2 demand
70
How do calcium channel blockers treat angina?
Increase O2 supply and lower O2 demand
71
How does ranolazine treat angina?
Mechanism unknown
72
What are the different types of angina?
Stable Prinzmetals (variant) Unstable
73
What is best at treating Prinzmetals (variant) angina?
Calcium channel blockers due to reducing vasospasm
74
What are drugs trying to do to help with angina?
O2 supply=O2 demand
75
What line of therapy are beta blockers for angina?
1st line (reduces cardiac oxygen demand by limiting HR)
76
What line of therapy are nitrates for angina?
Short acting 1st line for angina attacks 2nd acting after beta blockers
77
How do calcium channel blockers help with angina?
Block calcium re entry (reduce contractility and HR)
78
What medications should you be on post MI?
Aspirin P2Y inhibitor (at least 12 months) Beta blocker Statin ACE inhibitor
79
What are aspirin and P2Y inhibitors?
Anti platelet agents that may cause bruising
80
What is the most common side effect of statins?
Myopathy
81
What should you do if a patient experiences a MI?
Give nitro and have them chew and swallow 325 mg of aspirin
82
What are the letters of heart failure?
A- risk only (no symptoms and no damage) B- damage (no symptoms) C- symptoms and damage D- end stage
83
What do medications do to treat chronic heart failure?
Decrease cardiac load and resistance Increase contractility
84
What medications are taken for chronic heart failure?
Cardiac glycosides ACE inhibitors Beta blockers Aldosterone antagonists Vasodilators Diuretics
85
What will cardiac glycoside (digoxin) do?
Increase heart contractility
86
Why is it easy to overdose on cardiac glycoside (digoxin)?
Narrow therapeutic index
87
What are the side effects of cardiac glycoside (digoxin)?
Visual disturbances Bradycardia Anorexia Nausea and vomiting
88
What do class 1 antiarrhythmic drugs do?
Block Na+ channels
89
What do class 2 antiarrhythmic drugs do?
Beta blockers
90
What do class 3 antiarrhythmic drugs do?
Prolong repolarization
91
What do class 4 antiarrhythmic drugs do?
Calcium channel blockers

Pharmacology (20 decks)

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