Exam 3; Cardiovascular Drugs Flashcards by Courtney Kast

What is an arrhythmia

alternation in the normal impulse pathway

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What can be two causes of an arrhythmia

alteration in the pacemaker

alteration in the transmission pathway

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This is the source of the start of a rhythm

ectopic focus

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Which is worse, ventricular or atrial fibrillation

ventricular; life threatening

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What can result from ventricular fibrillation

decreased CO

clots may form

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What is a major cause of sudden cardiac death

ventricular arrhythmias

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Why is a non-drug treatment preferred for an arrhythmia

drug treatments may further cause arrhythmias

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What are four types of non-drug treatments of arrhythmia

pacemaker implantation
cardioversion
automatic defibrillator implantation
surgical removal of an ectopic signal

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This family of drugs are Na channel blockers that decrease the rate of depolarization

local anesthetics

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This Na channel blocker can be used for all arrhythmias; depresses muscle function and anticholinergic effects

La-quinidine

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What are three symptoms of La-quinidine

GI upset
vomiting
anorexia

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What are two CNS effects of la-quinidine

tinnitus

altered color vision

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This Na blocker does not enter the CNS, so no CNS effects and has a lupus like effect in low acetylators

procainamide

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This Na channel blocker has strong anti-vagal effects; anti-muscarinic effects or oppostie of DUMBELLS

disopyramide

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This Na channel blocker is give IV due to the first pass effect has low toxicity and is useful for treating ventricular tachycardia

Lb-lidocaine

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What are two symptoms of lb-lidocaine

tremors and seizures

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This Na channel blocker is given orally, has low toxicity and is useful for treating ventricular tachycardia; can result in tremors and seizures

mexiletine

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What are the 5 Na channel blockers (anti-arrhythmia)

la-quinidine
procainamide
disophyamide
lb-lidocaine
mexiletine

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These three drugs are anti-arrhythmia beta blockers

propranolol
metaprolol
esmolol

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What is the mechanism behind the beta blockers

block the beta1 receptors in the heart

effectively slows the heart rate

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This beta blocker decreases the pacemaker firing rate

propranolol

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This beta blocker is more selective and has less beta 2 effects

metaprolol

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This beta blocker has a more rapid onset

esmolol

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What are three symptoms of beta blockers

bradycardia
hypotension
if there is a beta2 effect, asthma

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What are the three potassium channel blockers

sotalol amiodarone dronedarone

This is a beta blocker that also blocks K channels

sotalol

This is a Na, K, and beta blockader

amiodarone

This is the most effective anti-arrhythmic; DOC in cases of cardiac arrest

amiodarone

This is an analog of amiodarone, with fewer side effects and less efficacy

dronedarone

This drug has symptoms such as potentially fatal pulmonary fibrosis, liver damage, blue-grey skin coloration, and GI upset

amiodarone

Where are two places on the body that amiodarone can be deposited and what are its effects

can be deposited in the cornea; optic neuritis | can be deposited in the skin; iodine containing

What are three Ca channel blockers

verapamil diltizaem nifedpine

What is the mechanism behind the Ca channel blockers

blocks Ca transport into cardiac cells; increasing the refractory period

This anti-arrhythmic is given IV and binds to the adenosine receptor which decreases the firing rate of the AV node

adenosine

What is the half life of adenosine

very short; 10 seconds

What is adenosine most useful for

atrial tachycardia | coronary vasodilator

This is when there is not enough blood flow to the heart muscles

angina

When is angina the most severe

if there is chest pain at rest and not solely after exercise

What are the two ways in which we can treat angina

increasing blood flow to the heart or decreasing oxygen demand behavior modifications

This drug rapidly dilates all blood vessels; arteries and veins, including the coronary arteries

glyceryl trinitrate (nitroglycerin)

What is the mechanism of nitroglycerin

activates cGMP which leads to vascular dilation

How long do the effects of nitroglycerin last

30 mins to an hour

What are three side effects of nitroglycerin

hypotension skin flushing headache

This becomes of nitroglycerin if you take it continuously within a day

rapid tolerance; after even a day there will be no effect

nitroglycerin is given which method

patch or paste | in order to divert the 1st pass metabolism

This drug is a slow release nitrate formulation and can be given orally

isosorbide dinitrate

This family of drugs is used to decrease heart rate via being a beta blocker

-olol's

This family of drugs is used to decrease heart rate via being a Ca channel blocker

-ipine

What is the concept behind congestive heart failure

cardiac muscles are not contracting as much blood comes to the heart but doesn't leave fast enough heart enlarges tissues become anoxic

The blood back up from congestive heart failure can go to wear and lead to what

can back up into the lungs and lead to pulmonary congestion, decreasing the ability to breathe

What happens to the kidney during congestive heart failure

the kidney is not well perfused; causing retention of Na and fluids leading to peripheral edema

The heart responds to congestive heart failure in what way

release of EPI, NE, and angiotension II

What effects do EPI, NE, and angiotension II have on the heart during congestive heart failure

increases blood pressure increases heart rate vasoconstriction

Angiotension II causes an increase in what

blood volume; increased Na retention and increased aldosterone secretion leads to increased Na/K exchanger

This occurs in response to the force of contraction due to stretching of cardiac muscles

enlargement of the heart

The heart will work harder to compensate for its failing mechanisms which is bad, why?

its already damaged so working harder makes it even more damaged

What is the mechanism behind digoxin

inhibits the Na/K ATPase which results in Na remaining high in the cardiomyocyte thus preventing Ca from leaving the cell increasing the contractility

What are two toxic effects of digtoxin

cardiac arrhthymia | CNS effects

What are the three CNS effects of digtoxin

vision; yellow/green tinting (VanGogh) hallucinations activation of chemoreceptor trigger zone; nausea

The effects of digoxin are associated with what condition

hypokalemia

How would you treat digoxin poisoning

with anti-digoxin antibodies

What is the mechanism behind dobutamine

it is a beta1 agonist and also increases the amount of Ca in the heart muscle

Dobutamine may increase the force of contraction but may not necessarily increase what

the rate

These four drugs are the best treatment of CHF; the use of agents that inhibit the body's compensatory changes in heart failure

ACE inhibitors beta blocketers vasodilators diuretics

This drug decreases blood pressure and fluid retention

ACE inhibitors

This drug decreases heart rate

beta blockers

This drug decreases blood pressure

vasodilators

What are four agents that increase blood flow to selected organs (penis)

``` sildenafil vardenafil tadalafil avanafil "-fil's" ```

What is the mechanism behind the drugs that increase blood flow to the penis

inhibitors of type 5 cGMP phosphodiesterases; strong vasodilator

What should you not take with the drugs that increase blood flow to the penis

nitrates they also increase cGMP leading to vasodilation alpha-1 blockers can lead to a severe decrease in blood pressure

What are two side effects of the drugs that increase blood flow to the penis

stroke or myocardial infarction

How can drugs that increase blood flow to the penis cause visual disturbances

impaired blue/green color discrimination | NAION; damage to the retina; induced by cGMP phosphodiesterase inhibitors

What are the drugs that increase blood flow to the penis metabolized by

P450

What other condition can drugs that increase blood flow to the penis treat

pulmonary hypertension

This is injectable prostaglandin E1 which leads to vasodilation when injected directly into the penis

alprostadil

Exam 3; Cardiovascular Drugs Flashcards

(75 cards)