Cardiovascular Pharmacology Flashcards

Question

loop diuretic targets - how does it work - useful in what patients? - most common one

Answer 1

``` inhibits Na, K, Ca, Mg reabsorption in the loop of Henle powerful diuresis and volume reduction decreased afterload not sued much for BP reduction useful in patients with edema and HF most common is furosemide (Lasix) ```

Answer 2

``` inhibits aldosterone by inhibiting sodium-potassium exchange site in the distal tubule -excretes sodium -excretes water -retains potassium used for resistant hypertension used to treat HF aldosterone antagonists -spironolactone -eplerenone ```

Answer 3

inhibition of angiotensin converting enzyme -inhibition of the conversion of angiotensin I to angiotensin II peripheral vasodilation -ATII causes peripheral vasoconstriction reduced antidiuretic hormone (ADH) production -reduced fluid volume reduced aldosterone production -reduced fluid volume first line option

Answer 4

hypertension post MI (with LVSD) - remodeling HF diabetic patients

Answer 5

BP K+ renal function (BUN/SCr)

Answer 6

angioedema cough (dry) orthostasis/hypotension hyperkalemia

Answer 7

acute kidney injury bilateral renal artery stenosis hypotension history of angioedema

Answer 8

``` inhibition of angiotensin II receptor -action of angiotensin II is blocked despite its production peripheral vasodilation -ATII causes peripheral vasoconstriction reduced ADH production -reduced fluid volume reduced aldosterone production -reduced fluid volume first line option -should not be combined with ACE inhibitors ```

Answer 9

same as ACE inhibitors hypertension post MI - remodeling HF diabetic patients

Answer 10

same as ACE inhibitors BP K+ renal function

Answer 11

angioedema orthostasis/hypotension hyperkalemia NO COUGH

Answer 12

acute kidney injury bilateral renal artery stenosis hypotension history of angioedema

Answer 13

``` inhibition of sympathetic stimulation of vascular smooth muscle -reduce afterload -reduced cardiac muscle contractility mechanisms -reduced contractility, reduced HR -preserve renal function in those with HTN-related renal disease examples -diltiazem -amlodipine -nicardipine ```

Answer 14

vasodilation of vasculature -decreased BP -alleviates chest pain/spasm first line option for HTN

Answer 15

``` hypertension -causes less orthostatic HTN than any othe vasodilator angina atrial fibrillation subarachnoid hemorrhage Raynaud's Phenomenon ```

Answer 16

``` hypotension AV block reflex tachycardia headache, dizziness, flushing, drowsiness Pedal edema nausea constipation ```

Answer 17

``` -pine amlodipine -dihydropyridine diltiazem, verapamil -non-dihydropyridine ```

Answer 18

cerebral vasospasm - after sub-arachnoid hemorrhage - allows them to relax and effectively perfuse the brain

Answer 19

``` primarily a function of beta 1 blockade -inhibition of sympathetic carciad stimulation of the SA node -inhibition of renin secretion secondary effects of Beta 2 Blockade -vasodilation of GI vasculature ```

Answer 20

second line for hypertension when first line agents are optimized can decrease exercise tolerance initially important agent for HTN with other cardiovascular co-morbidities -ischemic heart disease -MI -CHF

Answer 21

"cardioselective" inhibits sympathetic contractility, inotropy, and conductivity of the heart inhibits sympathetic renin secretion in the kidneys

Answer 22

near beginning of alphabet

Answer 23

beta 2 receptors inhibit smooth muscle contractions in the lungs and GI tract beta 2 blockade is useful for restricting hepatic blood flow for patient with liver cirrhosis, but generally not a therapeutic effect for CVD beta 2 blockade may cause bronchospasm

Answer 24

``` alpha 1 blockade -causes peripheral vasodilation lowers blood pressure more compared to w/ no alpha blockade commonly used -carvedilol -labetalol ```

Answer 25

inhibition of sympathetic stimulation of vascular smooth muscle -reduced afterload alternative sympatholytic -has some synergistic effects for people with CVD -reduced BP -reduced afterload and increased CO -resulting tachycardia via baroreceptor response as side effect

Answer 26

primary concern is the presence of hypotension and postural-related hypotension reduced CV response to exercise, especially with beta-blockers and CCBs physical therapists can increase compliance through education -emphasize "silent killer" nature of HTN

Answer 27

``` diet modificatiion -low fat -low sodium -Omega-3 fatty acids exercise -limit alcohol -smoking cessation weight loss ```

Answer 28

``` orthostasis hypotension dizziness fatigue use caution when doing activites that may cause vasodilation and further drops in BP ```

Answer 29

cardiac muscle has insufficient oxygen two solutions -reduce cardiac oxygen demand -increase cardiac oxygen supply

Answer 30

decrease preload reduce contractility reduce afterload

Answer 31

increase coronary flow | increase oxygen extraction

Answer 32

``` chest pain due to ischemia imbalance of O2 supply and demand to the myocardium -EKG changes -increase lactate -wall motion abnormalities ```

Answer 33

``` nitrates -decrease O2 demand beta-blockers -decrease O2 demand calcium channel blockers -increase O2 supply and decrease O2 demand ranolazine -no effects on O2 supply or demand; mechanisms unknown ```

Answer 34

stable angina Prinzmetal's angina (variant) unstable angina

Answer 35

O2 demand > O2 supply | usually seen with physical exertioin

Answer 36

can occur at rest | caused by vasospasm --> decreased O2 supply

Answer 37

decreased O2 supply (blocked artery) and increased O2 demand | caused by atherosclerotic plaque rupture

Answer 38

``` organic nitrates beta blockers CCBs ranolazine help to restore the balance between cardiac oxygen supply and cardiac oxygen demand ```

Answer 39

``` reduced cardiac O2 demand by limiting maximum stimulation (HR) place in therapy -first line for stable angina -decreases morbidity (reduced Sx) -decreases mortality ```

Answer 40

peripheral vasodilation by promoting nitric oxide release -veins, arteries, arterioles decrease preload short acting line for angina attacks (nitroglycerin) long acting second line after beta blockers for Sx relief

Answer 41

``` blocks calcium re-entry -reduced contractility, reduced HR -agent of choice for Pinzmetal angina examples -amlodipine -diltiazem -verapamil ```

Answer 42

blocks sodium channels but mechanisms for treating angina is not fully known does not impact blood pressure or HR second line based on cost and potential side effect of arrhythmias

Answer 43

``` underlying disease state needs to be addressed -HTN -CAD -HF -anemia weight loss smoking cesssation stress reduction PCI/CABG ```

Answer 44

ensure proximity and availability of drug during rehab sessions avoid over-challenging the heart during sessions artificial increase in tolerance to exercise guard against orthostatic hypotension

Answer 45

therapy may disturb the myocardial oxygen balance make sure patients with stable angina have SL nitro available may have to adjust exercise based on patient's medication regimen be aware of hypotension and dizziness use caution when doing activities that may cause vasodialtion and further drops in BP help with compliance

Answer 46

``` aspirin P2Y12 inhibitor for at least 12 months beta blockers statin +/- ACE inhibitor info regarding -weight management -smoking cessation -exercise ```

Answer 47

cardiac plaques rupture or fully occlude _________-

Answer 48

``` aspirin -antiplatelet agent may cause bruising P2Y12 inhibitors - also antiplatelet agents which may cause bruising -clopidogral -prasugrel -ticagrelor statins -most common side effect is myopathy ```

Answer 49

S/S to look for

Answer 50

S/S to look for -diaphoresis -chest pain (often radiates to jaw or arm -shortness of breath what to do -call 911 -administer nitro if patient uses -administer 325 mg of aspirin - chew and swallow -if O2 available, administer via NC if O2 sat is <90% -hospital acronym: MONA

Answer 51

chronic overwork of the heart muscle causes hypertrophic remodeling reduced CO fluid retention

Answer 52

``` treat to -decrease cardiac load -decrease resistance -increase contractility drugs -cardiac glycosides -ACE inhibitors -beta blockers -aldosterone antagonists -vasodilators -diuretics ```

Answer 53

``` positive inotrope - will increase contractility of heart no impact on mortality but can reduce hospitalizations narrow TI medications S/S -visual disturbances -bradycardia and heart block -anorexia -nausea and vomiting ```

Answer 54

know signs of HF exacerbations -dyspnea -cough be aware of medication side effects, especially digoxin be aware of hypotension and dizziness use caution when doing activites that may cause vasodilation and further drops in BP

Answer 55

``` heart rate -bradyarryhythmia -tachyarrhythmia origin of irregular electrical activity -supraventricular -ventricular ```

Answer 56

``` class I -drugs that block Na+ channels class II -beta blockers class III -drugs that prolong repolarization class IV -calcium channel blockers ```

Answer 57

``` underlying source of arrhythmia needs to be addressed procedures/devices -ablation -AICD -pacemakers ```

Cardiovascular Pharmacology Flashcards

(83 cards)