ch. 11 cardio drugs Flashcards
(93 cards)
1
Q
what are the cardiovascular disorders ?
A
hypertension, angina pectoris, congestive heart failure, arrythmias
2
Q
blood pressure is influenced by
A
blood volume; peripheral resistance/diameter of arterioles; cardiac output
3
Q
alpha 1 receptor does
A
vasoconstriction(skin/mucosa)
4
Q
beta 1 receptor does
A
increases cardiac activity
5
Q
beta 2 receptor does
A
vasodilation(skeletal muscle) and bronchodilation
6
Q
treatment of hypertension goal
A
decrease plasma volume
dilate blood vessels
decrease cardiac output
7
Q
decrease plasma volume medication
A
diuretics
8
Q
dilate blood vessels medication
A
ace inhibitors; arbs, ccb, alpha 1 blockers
9
Q
decrease cardiac output medication
A
beta blockers
10
Q
what are the three classes of diuretics
A
thiazides, loop diuretics, potassium-sparing diuretics, combination
11
Q
what is diuretics used for
A
high bp and congestiv heart failure
12
Q
diuretics
A
thiazide, looo[(ide) k-sparing or combo
13
Q
ace inhibitors end in
A
pril
14
Q
arbs end in
A
sartan
15
Q
alpha blockers end in
A
zosin
16
Q
beta blockers end in
A
olol
17
Q
calcium channel blockers end in
A
dipine
18
Q
contraindications for antihypertensive drugs
A
nsaids decrease effect
orthostatic hypotension
xerostomia
19
Q
frequent urination
A
diuretics
20
Q
only ___ carps of epi for ____
A
2 carps for non cardioselective beta blockers
21
Q
do ccb have an interaction with nsaids
A
no; but cause gingival enlargement
22
Q
what do loop diuretics end in
A
ide
23
Q
potassium sparing diuretics end in
A
one
24
Q
what is the ace inhibitors mechanism of action
A
relax bv, decrease bp
25
what is the big thing with ace inhibitors that is under dental hygiene management? what does it produce
a nonproductive dry cough along with other side effects of all cardio drugs
26
arb stands for
angiotensin receptor blockers
27
mechanism of action of arbs
modulate renin- angiotensin system(block receptors)= decrease in bp and vasodilation
28
what do arbs end in
sartan
29
alpha 2 antagonists/ inhibitors examples
clonidine and methylodopa; NO NSAID ISSUE; lower bp by vasodilation of bv
30
alpha 1 adrenergic receptor antagonists(alpha 1 receptor blockers) prototype
prazosin(minipress)
31
actions of a1 adrenergic receptor antagonists
vasodilator of blood vessels(lowers peripheral vascular resistance)
blocks a1 receptors(lowers blood pressure)
32
dental implications of alpha 1 blockers
same as other cardio meds
33
cardio selective beta blockers are what letters
A-M
34
non cardio selective beta blockers are what letters
N-Z
35
do you use minimal of 2 carps of epi with noncardioselective beta blockers?
yes
36
calcium channel blockers big dental consideration
gingival enlargement; ends in dipine
37
is epinephrine in local anesthetic contraindicated?
no, but use minimal amounts if patient is taking a nonselective beta blocker
38
what are classic symptoms of angina
squeezing chest pain that radiates to the left, both or right arms, and the jaw; risk of heart attack
39
what are some drugs to treat angina
```
nitrates
beta 1 blockers
ccb
aspirin
lifestyle modifications
```
40
patients with unstable angina are at high risk for ___ and require ______ drugs
heart attack; antiplatelet drugs
41
what do nitrates do
relax vascular smooth muscle and cause vasodilation
42
what is the prototype nitrate
nitroglycerin
43
what do beta blockers do
reduce mortality and decrease myocardial oxygen demand by decreasing heart rate, contractility, and tension; treat angina and hypertension
44
what kind of beta blocker should be used to treat angina
cardioselective a-m
45
what do calcium channel blockers do
reduce anginal symptoms but do not reduce mortality; useful in variant angina and hypertension
46
what drug can be used only for prophylaxis and not for an acute angina attack; may decrease platelet aggregation; nonnitrates
dipyridamole(persantine)
47
what does aspririn do for angina patients
antiplatelet drug, inhibits platelet aggregation(clotting) and reduces mortality in patient with unstable angina and prevention of strokes
48
what do meds for heart failure do
indirectly reduce cardiac workload (decrease preload) and reduce edematous fluid (preload) with diuretics; directly increase heart contractions with cardiac glycosides
49
what meds to use for heart failure
ace inhibitors, diuretic, cardiac glycoside, adrenergic agonist, vasodilators, ccb's
50
what prototype diuretic used for heart failure
furosemide(loop diuretic)
51
what is prototype cardiac glycoside for heart failure
digoxin
52
what does digoxin do
treat chf and heart arrythmias(direct effects on heart) ^ constriction, cardiac output, and circulation
53
what are the vasodilators used for heart failure
ace inhibitors
| prototype: captopril
54
what does captopril do
prevent prog of HF
| decrease work and o2 demand of heart
55
when there is a change in the rhythm of the heart
arrhythmia
56
meds will suppress the arrhythmia by blocking either autonomic function or ___ , ___, ____ channels, which slow conduction of ______ impulse
calcium, potassium, sodium
| cardiac
57
antiarrhythmic drugs class 1
sodium channel blockers
| end in ide
58
antiarrhythmic drugs class 2
beta-adrenergic blockers
| end in olol
59
aniarrhythmic drugs class 3
potassium channel blockers
| end in one
60
antiarrhythmic drugs class 4
calcium channel blockers
| ends in dipine
61
in normal healthy patients the maximum amount of epi is ___ mg per appt and in patients with clinically significant cardiovascular impairment ___ mg per appt
0. 2
| 0. 04
62
triglycerides are synthesized where
liver
63
where is cholesterol obtained
from diet
64
lipids are insoluble in blood, so they are transported in blood in the form of _____
lipoproteins
65
triglycerides and cholesterol are transported in blood as this form
vldl
66
highest amount of cholesterol is carried by this; bad cholesterol
ldl
67
transports cholesterol to liver, where it is eventually removed from body
good cholesterol
hdl
68
lipid lowering drugs are indicated in patients with high risk or _____ disease because of multiple risk factors
coronary artery disease
69
targets of lipid lowering drugs
lowering triglycerides, total cholesterol, and ldl/hdl ratio
70
what are the drugs used in the treatment of hyperlipidemia
- hmg coa reductase inhibitors(statin)
- bile acid biding resin sequestrants
- fibric acid derivatives
71
hmg coa atorvastatin(lipitor) does what/causes
increase liver enzyme, myopathy
72
what does sequestrants(colestid) do/cause
gi distress
73
what does fibric acid gem fib do/cause
gallstones, indigestion
74
drugs bind bile acids, which contain high amounts of cholesterol; only 20% decrease in ldl; more adverse side effects than statins
bile acid sequestrants
75
have c.o.l. in the name
bile acid sequestrants
76
reduce triglyceride levels; can displace other highly protein-bound drugs(warfarin) from their receptors, causing elevated plasma levels
fibric acid drugs
77
prototype fibric acid drug
gemfibrozil(lopid)
| has fib in the name
78
natural product- vitamin that lowers triglycerides and ldl-c and increases hdl-c; contraindicated in diabetics and people with peptic ulcer disease; gastric irritation, glucose intolerance, flushing, skin problems, myalgia
nicotinic acid(niacin)
79
latest approach to drug management for ldl-c reduction
amlodipine/atorvastatin(caduet)
and ezetimibe/simvastatin(vytorin)
may be superior to the statin drugs
combination drugs
80
these drugs not only block absorption of cholesterol(cholesterol absorption inhibitors) from food but also reduce the cholesterol that the body makes in the liver
combination drugs
81
are there dental considerations for patients taking antihyperlipidemic drugs?
no
82
do not give _____/___ to patients taking statin drugs
erythromycin/clarithromycin
83
adherence of platelets to the blood vessel wall (platelet aggregation)
- causes coagulation and blood clotting
- leads to formation of a thrombu (blood clot)
atherosclerosis
84
retard coagulation and prevent the occurrence of a thrombus
anticoagulant drugs
85
prototype anticoag drugs
heparin and warfarin
86
oral and injectable; med consult; artificial heart valves also(have to come off of it for cleaning); have to call heart doctor to fax a form to say if ok to get off before appt
warfarin
87
indications for anticoag drugs
thromboembolic disorder; artificial heart valves
88
what two meds prevent blood clot
heparin and warfarin
89
inhibit platelet aggregation
antiplatelet
90
prevent arterial thrombosis in patients with heart disease and stroke, and heart attacks
aspirin
91
prevention of heart attack, stroke in patients with recent heart attack and stroke
clopidogrel(plavix)
92
prevents thrombosis associated with artificial heart valves
dipyridamole(persantine)
93
limit cholesterol synthesis and stimulate ldl catabolism
hmg-co A
