DRUGs ACTING ON THE CARDIOVASCULAR SYSTEM Flashcards by Michelle Laurista

7 Drugs acting on the cardiovascular system

Anti-hypertensive drugs
Cardiotonic agents
Antiarrhythmic agents
Antianginal agents
Lipid lowering agents
Drugs affecting blood coagulation
Drugs used to treat anemia

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Since the underlying cause of hypertension is
usually unknown (essential hypertension),
altering the body’s regulatory mechanisms is
the best treatment available. These
drugs work by altering the normal reflexes that
control blood pressure.

Anti-hypertensive drugs

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4 subclasses of Antihypertensive drugs

AngIOtenSIn-COnVertIng-EnZYMe (ACE)InHIBItOrS
AngIOtenSIn II ReCePtOr BLOCKerS (ARBS)
CaLCIuM-CHanneL BLOCKerS
VaSODILatOrS

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act in the lungs to prevent ACE from converting
angiotensin I to angiotensin II, a powerful vasoconstrictor and stimulator
of aldosterone release.

ACE INHIBITORS

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Drugs under ACE INHIBITORS

Ends with Pril
Benazepril

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selectively bind with the angiotensin II receptors in vascular smooth
muscle and in the adrenal cortex to block vasoconstriction and the release of
aldosterone.

ARBS

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Drugs under ARBS

ending with Tan
losartan

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inhibit the movement of calcium ions
across the membranes of myocardial and arterial muscle cells,
altering the action potential and blocking muscle cell contraction.

Calcium channel blockers

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drugs under calcium channel blockers

ending with pine
amlodipine

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act directly on vascular smooth muscle to cause muscle
relaxation, leading to vasodilation and drop in BP.

vasodilators

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drugs under vasodilators

Diazoxide (Hyperstat)
• Hydralazine (Apresoline)
• Minoxidil (Loniten)
• Nitroprusside (Nitropress)

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a common, often asymptomatic disorder in which systolic blood
pressure persistently exceeds 140 mm Hg and/or diastolic pressure exceeds 90mmhg

hypertension

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sustained blood pressure above normal limits with no
discernible underlying cause.

Essential hypertension

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sustained blood pressure that is lower than that required to
adequately perfuse all of the body’s tissues.

hypotension

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force that resists the flow of blood through the vessels,
mostly determined by the arterioles, which contract to increase resistance;
important in determining overall blood pressure

peripheral resistance

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drugs used to increase
the contractility of the heart muscle for patients
experiencing heart failure.

cardiotonics

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2 subclasses of cardiotonics

CarDIaC
GLYCOSIDe
PHOSPHODIeSteraSe
InHIBItOrS

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originally derived from
the foxglove or digitalis plant. These plants were once
ground up to make digitalis leaf. indicated for treating heart
failure and irregular heartbeats.

cardiac glycoside

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drugs under cardiac glycoside

digoxin- brand name called Lanoxin. Most
frequently it is used for atrial fibrillation, atrial flutter,
and heart failure it is one of the oldest
medications used in the field of cardiology
digitoxin- cardiac glycoside used for the
treatment of heart failure and certain kinds of heart
arrhythmia. It is a phytosteroid and is similar in
structure and effects to digoxin.

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belong to a second class
of drugs that act as cardiotonic (inotropic) agents. These
include inamrinone (Inocor) and milrinone (Primacor).
Approved only for use in patients with HF who does not
have been responsive to digoxin, diuretics, or
vasodilators.
● Short-term management of HF in adults receiving digoxin
and diuretics

Phosphodiesterase inhibitor

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enlargement of the heart, commonly seen with chronic
hypertension, valvular disease, and heart failure

cardiomegaly

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disease of the heart muscle that leads to an enlarged heart
and eventually to complete heart muscle failure and death

cardiomyopathy

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discomfort with respirations, often with a feeling of anxiety and
inability to breathe, seen with left-sided heart failure.

dyspnea

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condition in which the heart muscle fails to adequately pump
blood around the cardiovascular system, leading to a backup or congestion of
blood in the system

heart failure

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blood-tinged sputum, seen in left-sided heart failure when blood backs up into the lungs and fluid leaks out into the lung tissue

hemoptysis

getting up to void at night, reflecting increased renal perfusion with fluid shifts in the supine position when person has gravity-dependent edema related to heart failure; other medical conditions, including urinary tract infection, increase the need to get up and void

nocturia

difficulty breathing when lying down, often referred to by the number of pillows required to allow a person to breath comfortably

orthopnea

effect resulting in an increased force of contraction

positive inotropic

severe left-sided heart failure with backup of blood into the lungs, leading to loss of fluid into the lung tissue

pulmonary edema

rapid and shallow respirations, seen with left sided heart failure

tachypnea

also known as cardiac dysrhythmia medications, are a group of pharmaceuticals that are used to suppress abnormal rhythms of the heart (cardiac arrhythmias), such as atrial fibrillation, atrial flutter, ventricular tachycardia, and ventricular fibrillation.

antiarrhythmic agents

subclasses of antiarrhythmic agents

calsses 1 classes 2 classes 3 classes 4

are fast sodium channel blockers. These drugs preferable in conditions such as tachycardia, in which the sodium gates are open frequently

class 1 anti arrythmics

are conventional beta blockers competitively block beta-receptor sites in the heart and kidneys. ● These drugs are indicated for the treatment of supraventricular tachycardias and PVCs.

class 2 antiarrhythmic

act by blocking depolarizing currents and thereby prolonging the effective refractory period of the myocardium. block potassium channels and slow the outward movement of potassium during phase 3 of the action potential, prolonging it.

class 3 antiarrhythmic

slow non-dihydropyridine calcium channel blockers. block the movement of calcium ions across the cell membrane, depressing the generation of action potentials and delaying phases 1and 2 of repolarization, which slows automaticity and conduction.

class 4 antiarrhythmic

slower-than-normal heart rate (usually less than60 beats/min).

bradycardia

the amount of blood the heart can pump per beat; influenced by the coordination of cardiac muscle contraction, heart rate, and blood return to the heart

cardiac output

large research study run by the National Heart and Lung Institute that found that long-term treatment of arrhythmias may have a questionable effect on mortality, and in some cases actually lead to increased cardiac death; basis for the current indication for antiarrhythmics (short-term use to treat

CAST cardiac arrhythmia suppression test

blocks to conduction of an impulse through the cardiac conduction system; can occur at the atrioventricular node, interrupting conduction from the atria into the ventricles, or in the bundle branches within the ventricles,preventing the normal conduction of the impulse.

heartblocks

study of the forces moving blood throughout the cardiovascular

hemodynamics

used to reduce ischemia by increasing the delivery of oxygen-rich blood to cardiac tissues or by reducing oxygen consumption by the coronary vessels. Either of these mechanisms can reduce ischemia and lead to a decrease in anginal pain.

antianginal agents

subclasses of antianginal agents

nitrates and nitrites beta blockers calcium channel blockers

work mainly by decreasing venous return to the heart (preload) and decreasing systemic vascular resistance (afterload).

nitrates and nitrites

help by slowing the heart rate and decreasing contractility, thereby decreasing oxygen demands.

beta blockers

decrease calcium influx into the smooth muscle, causing vascular relaxation. considered first-line drugs for the treatment of such conditions as angina, hypertension, and supraventricular tachycardia.

calcium channel blockers

Chest pain that occurs when the heart’s supply of blood carrying oxygen is insufficient to meet the demands of the he

angina pectoris

common form of arteriosclerosis involving deposits of fatty, cholesterol-containing material (plaques) within arterial walls

atherosclerosis

Chest pain that is primarily caused by atherosclerosis, which results in a long-term but relatively stable level of obstruction in one or more coronary arteries. (p. 369)

chronic stable angina

Arteries that deliver oxygen to the heart muscle.

coronary arteries

Any one of the abnormal conditions that can affect the arteries of the heart and produce various pathological effects, especially a reduced supply of oxygen and nutrients to the myocardiu

coronary artery disease CAD

Poor blood supply to an organ. (p.

ischemia

Poor blood supply to the heart via the coronary arteries

ischemic heart disease

Necrosis of the myocardium following interruption of blood supply; it is almost always caused by atherosclerosis of the coronary arteries and is commonly called a heart attack

myocardial infarction

A rapid heartbeat caused by a variety of autonomic nervous system effects, such as blood pressure changes, fever, or emotional stress

reflex tachycardia

Early stage of progressive coronary artery disease.

unstable angina

Ischemia-induced myocardial chest pain caused by spasms of the coronary arteries; also referred to as Prinzmetal or variant angina. (p. 369)

vasospastic angina

lower serum levels of cholesterol and various lipids. l

lipid lowering agents

subclasses of lipid lowering agents

bile acid sequestrants HMG-COA reductase inhibitors/statins cholesterol absorption inhibitor

prevent the reabsorption of bile salts, which are very high in cholesterol. Consequently, the liver will pull cholesterol from the blood to make new bile acids, lowering the serum cholesterol level.

BILe ACIDSequeStrantS

block the enzyme HMG-CoA reductase, resulting in lower serum cholesterol levels, a resultant breakdown of LDLs, and a slight increase in HDLs

HMG-COAREDuCtaSe InHIBItOrS/ StatInS

works in the brush border of the small intestine to prevent the absorption of dietary cholesterol, which leads to increased clearance of cholesterol by the liver and a resultant fall in serum cholesterol. · Change in diet and increased exercise are very important parts of the overall treatment of a patient receiving a cholesterol absorption inhibitor.

CHOLeSterOLABSOrPtIOn InHIBItOr

general term used for drugs used to lower lipid levels in the blood.

Antihyperlipidemic agents

cholesterol-containing acids found in the bile that act like detergents to break up fats in the small intestine.

bile acids

necessary component of human cells that is produced and processed in the liver, then stored in the bile until stimulus causes the gallbladder to contract and send the bile into the duodenum via the common bile duct;

cholesterol

carrier for lipids in the bloodstream, consisting of proteins, lipids, cholesterol, and so forth.

chylomicrons

endogenous substances that activate nervous system receptors that are important in the regulation of appetite, food intake, and metabolism.

endocannabinoid

loosely packed chylomicron containing fats, able to absorb fats and fat remnants in the periphery;

HDL

A (HMG-CoA) reductase: enzyme that regulates the last step in cellular cholesterol synthesis.

hydroxymethylglutaryl-coenzyme

increased levels of lipids in the serum, associated with increased risk of coronary artery disease development.

hyperlipidemia

tightly packed fats that are thought to contribute to the development of coronary artery disease when remnants left over from the LDL are processed in the arterial lining.

LDL

a collection of factors, including insulin resistance, abdominal obesity, low high-density lipoprotein and high triglyceride levels, hypertension, and proinflammatory and prothrombotic states, that increase the incidence of coronary artery disease.

metabolic syndrome

factors that have been identified as increasing the risk of the development of a disease; for coronary artery disease, risk factors include genetic predisposition, gender, age,

risk factors

some of the most dangerous drugs used today, and numerous factors can affect their action. These drugs are among the most commonly associated with adverse drug reactions.

drugs affecting blood coagulation

sublasses of drugs affecting blood coagulation

anticoagulants antiplatelet drugs thrombolytic drugs

drugs that interfere with the normal coagulation process by interfering with the clotting cascade and thrombin formation.

anticoagulants

decrease the formation of the platelet plug by decreasing the responsiveness of the platelets to stimuli that would cause them to stick and aggregate on a vessel wall.

antiplatelEt drugs

break down the thrombus that has been formed by stimulating the plasmin system. thrombus has already formed in a vessel (e.g., during an acute MI), it may be necessary to dissolve that clot to open the vessel and restore blood flow to the dependent tissue.

thrombolytic agents

drugs that block or inhibit any step of the coagulation process, preventing or slowing clot formation

anticoagulants

drugs that interfere with the aggregation or clumping of platelets to form the platelet plug

antiplatelet agent

the process of blood’s changing from a fluid state to a solid state to plug injuries to the vascular system

coagulation

drugs that lyse, or break down, a clot that has formed; these drugs activate the plasminogen mechanism to dissolve fibrin threads

thrombolytic agents

7th drug class

drugs used to treat anemia

subclasses of drugs used to treat anemia

ErYtHrOPOIeSIS StIMuLatIng AgentS AgentS uSeD FOr IrOn-DeFICIenCY AneMIa AgentS USeD FOrOtHer aneMIaS

substance that stimulates the bone marrow to make more red blood cells.

ErYtHrOPOIeSIS StIMuLatIng AgentS

Indicated for the treatment of iron-deficiency anemias and may also be used as adjunctive therapy in patients receiving an erythropoiesis-stimulating drug

AgentS uSeD FOrIrOn-DeFICIenCY aneMIa

treated with folic acid and vitamin B12 tissue. Folic acid and vitamin B12 are essential for cell growth and division and for the production of a strong stroma in RBCs.

MegaLOBLaStIC aneMIaS l

treated with antibiotics to help fight the infections that can occur when blood flow is decreased to any area; with pain-relieving activities to help alleviate the pain associated with the anoxia to tissues, which can range from heat applied to the area to over-the-counter pain medications to prescription opioids; and now, for adults, with hydroxyurea (Droxia).

sickle cell anemia

disorder involving too few red blood cells (RBCs) or ineffective RBCs that can alter the blood’s ability to carry oxygen

anemia

RBCs, responsible for carrying oxygen to the tissues and removing carbon dioxide; they have no nucleus and live approximately 120 days

erythrocytes

process of RBC production and life cycle; formed by megaloblastic cells in the bone marrow, using iron, folic acid, carbohydrates, vitamin B12, and amino acids; they circulate in the vascular system for about 120 days and then are lysed and recycled

erythropoiesis

glycoprotein produced by the kidneys, released in response to decreased blood flow or oxygen tension in the kidney; controls the rate of RBC production in the bone marro

erythropoietin

RBC count with low iron available because of high demand, poor diet, or poor absorption; treated with iron replacement

iron deficiency anemia

anemia caused by lack of vitamin B12 and/or folic acid, in which RBCs are fewer in number and have a weak stroma and a short lifespan; treated by replacement of folic acid and vitamin B12

megaloblastic anemia

DRUGs ACTING ON THE CARDIOVASCULAR SYSTEM Flashcards

(94 cards)