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Pharmacology I > Cardiovascular Pharmacology (Jensen's video lecture) > Flashcards

Cardiovascular Pharmacology (Jensen's video lecture) Flashcards

(72 cards)

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1
Q

Hypertension - disorders

A
  • Excessive cardiac output
  • Excessive peripheral resistance
  • Excessive fluid volume
  • Combination of above
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2
Q

Hypertension - mitigation possibilities

A
  • Decrease cardiac output via negative inotropism or negative chronotropism
  • Decrease peripheral resistance via vasodilation
  • Decrease fluid volume via fluid and electrolyte reduction
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3
Q

Normal BP

A

< 120/80

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4
Q

Prehypertension

A

120-135/80-89

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5
Q

Hypertension

A

Greater than or equal to 140/90

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6
Q

Stage 1 hypertension

A

140-159/90-99

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7
Q

Stage 2 hypertension

A

Greater than or equal to 160/100

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8
Q

BP =

A

BP = CO x PR

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9
Q

CO =

A

CO = HR x SV

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10
Q

Angina pectoris - disorder

A
  • Cardiac oxygen demand exceeds oxygen supply
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11
Q

Angina pectoris - mitigation possibilities

A
  • Increase the myocardial oxygen supply via coronary dilation
  • Decrease the myocardial oxygen demand via negative inotropism or chronotropism or peripheral vascular dilation
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12
Q

Cardiac arrhythmias - disorder

A
  • Abnormal pacemaker

- Abnormal impulse propagation

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13
Q

Cardiac arrhythmias - mitigation possibilities

A
  • Decrease ectopic foci via negative chronotropism
  • Decrease cardiac conduction rate via negative chronotropism
  • Increase the refractory period
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14
Q

Antiarrhythmic class 1

A
  • Sodicum channel blockers (local anesthetics)
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15
Q

Antiarrhythmics class 2

A
  • Beta blockers
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16
Q

Antiarrhthmics class 3

A
  • Prolong action potential duration (ADP) and effective refractory period
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17
Q

Antiarrhythmics class 4

A
  • Calcium channel blockers
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18
Q

Congestive Heart Failure (edema) - disorder

A
  • Excessive fluid volume
  • Excessive cardiac afterload
  • Inefficient cardiac work
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19
Q

CHF - mitigation possibilities

A
  • Decrease fluid volume and afterload via fluid and electrolyte reduction
  • Decrease cardiac energy consumption
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20
Q

Propranolol - trade name

A
  • Inderal??
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21
Q

Propranolol - categories

A
  • Sympatholytic
  • Antihypertensive
  • Anti-angina
  • Anti-arrhythmic
  • Anti-CHF
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22
Q

Propranolol - MOA

A
  • Beta 1 and Beta 2 antagonist
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23
Q

Propranolol - distinguishing characterisitics

A
  • Highly lipid soluble and protein bound (crosses BBB)
  • Paradoxical use in migraines
  • Diminishes renin release via beta 2 antagonism
  • Category C in pregnancy
  • First pass metabolism in liver by CYP2D6
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24
Q

Propranolol - predictable actions

A
  • Negative inotropic and chronotropic effect
  • Decrease cardiac output
  • Decrease blood pressure
  • Enters CNS, where it may cause side effects
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25
Propranolol - interactions/contraindications
- Contraindicated in asthma - Caution with diabetes - Avoid use in pregnancy - Duration prolonged in patients with liver disease - Many pharmacodynamic and pharmacokinetic interactions
26
Atenolol - trade name
- Tenormin
27
Atenolol - categories
- Sympatholytic - Antihypertensive - Anti-angina - Anti-arrhythmic
28
Atenolol - MOA
- Selective beta 1 antagonist
29
Atenolol - distinguishing characteristics
- Modest beta 2 activity - Hydrophilic - Excreted unchanged in urine
30
Atenolol - predictable actions
- Negative inotropic and chronotropic effects - Decreases cardiac output - Decreases blood pressure - No CNS effects (doesn't cross BBB)
31
Atenolol - contraindications
- Caution with asthma | - Discouraged in diabetic patients
32
Atenolol - general notes
- Single daily oral use - Easy outpatient medication - Largely replaced propranolol for CV therapies
33
Prazosin - trade name
- Minipress
34
Prazosin - categories
- Sympatholytic - Antihypertensive - Anti-CHF
35
Prazosin - MOA
- Alpha 1 receptor antagonist
36
Prazosin - distinguishing characterisitics
- Effective orally - Highly lipid soluble and protein bound (only 5% free) - Phase 2 metabolites excreted in bile, little renal excretion
37
Prazosin - predictable actions
- Decreases peripheral resistance to reduce BP - Hypotension, especially orthostatic - Syncope - Reflex tachycardia - Treats urinary hesitancy in BPH (other alpha blockers are better)
38
Clonidine - trade name
- Catapress
39
Clonidine - category
- Sympathomimetic (sorta)
40
Clonidine - MOA
- Alpha 2 receptor agonist
41
Clonidine - distinguishing characteristics
- Effective orally - Crosses BBB - Prefers alpha receptors in the brainstem - Long half-life and duration of action - Diminish discharge from medullary vasomotor center
42
Clonidine - predictable actions
- Antihypertensive - Xerostomia is common side effect - Sedation - Used to treat ADHD - Can cause erectile dysfunction
43
Metoprolol - trade name
- Lopressor
44
Metoprolol - category
- Sympatholytic - Antihypertensive - Anti-arrhythmic - Anti-angina - Anti-CHF
45
Metoprolol - MOA
- Selective beta 1 receptor antagonist
46
Metoprolol - distinguishing characterisitics
- Highly lipid soluble - Phase 1 metabolism by CYP2D6 - Often used after myocardial infarction for protection
47
Metoprolol - predictable actions
- CNS benefits and adverse reactions - Bradycardia - Reduced blood pressure
48
Verapamil - category
- Calcium channel blocker
49
Verapamil - MOA
- Prevents calcium ion from penetrating membranes - Slows biochemical conduction - Inhibits muscle contraction (esp smooth and cardiac)
50
Verapamil - distinguishing characteristics
- Oral administration | - Blocks both cardiac and peripheral receptors
51
Verapamil - predictable actions
- Reduces cardiac arrhythmias by slowing conduction - Decreases blood pressure by relaxing arterioles - Reduces angina by reducing myocardial O2 demands - Causes headaches by causing vasodilation - Causes dizziness by causing hypotension - Causes constipation by relaxing smooth muscle of gut - Causes muscle weakness by reducing skeletal muscle contraction
52
Lisinopril - category
- Antihypertensive | - Possibly anti-CHF
53
Lisinopril - MOA
- Angiotensin Converting Enzyme (ACE) Inhibitor
54
Lisinopril - distinguishing characteristics
- Causes coughing | - Causes skin rash
55
Lisinopril - predictable actions
- Vasodilation - Decreased blood pressure - Orthostatic hypotension - Reflex tachycardia
56
Nitroglycerine - category
- Anti-angina
57
Nitroglycerine - MOA
- Vasodilation in coronary and peripheral circulation
58
Nitroglycerine - distinguishing characteristics
- 1st pass hepatic metabolism
59
Nitroglycerine - predictable actions
- Increase coronary blood flow --> increased myocardial oxygen supply - Decrease systemic blood pressure --> decreased myocardial oxygen demand - Ineffective orally > Prescribe sublingual or percutaneous - Causes bad headaches - Causes hypotension (esp orthostatic) - Causes reflex tachycardia - Short duration of action
60
Procainamide - category
- Local anesthetic | - Antiarrhythmic
61
Procainamide - MOA
- Sodium channel blocker
62
Procainamide - distinguishing characteristics
``` - Parent compound is Procaine > Has an increased half-life - Short half-life requires dosing every 3-4 hours - Used to treat supraventricular and ventricular arrhythmias - Numerous side effects > Ventricular dysrhythmias > Bradycardia > Hypotension > Hypersensitivity - Effective orally - Low margin of safety ```
63
Procainamide - predictable actions
- Slows action potential transmission | - Prolongs refractory period
64
Digoxin - category
- Cardiac glycoside - Anti-CHF - Antiarrhythmic (selective)
65
Digoxin - MOA
- Inhibits sodium pump - Reduces energy consumption - Increases force of contraction
66
Digoxin - distinguishing characteristics
- Stimulates chemoreceptor trigger zone - Visual disturbances - Low margin of safety - Slows conduction in AV node
67
Digoxin - predictable actions
- Increases cardiac efficiency - Increases renal perfusion and diuresis in edematous patients - Prevents ventricular fibrillation during atrial fibrillation - Often monitored via clinical lab
68
Reserpine - category
- Sympatholytic
69
Reserpine - MOA
- Promotes release of NE and reduces reuptake, resulting in depletion of NE stores
70
Reserpine - distinguishing characteristics
- Derived from a plant - Transitory sympathomimetic, followed by prolonged sympatholytic effect - Antiquated for therapeutic use, but extensive research use
71
Reserpine - predictable uses
- Antihypertensive
72
Reserpine - predictable side effects
- Prolonged paralysis of sympathetic nervous system

Pharmacology I (4 decks)

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