Pharm 5 Cardio pt3 Flashcards Preview

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Flashcards in Pharm 5 Cardio pt3 Deck (26)
1

Ex of nonselective beta-blockers

Propranolol

2

Ex of b-1 selective beta blockers

Atenolol
Metoprolol

3

2 examples of alpha-beta blocker

Labetalol
Carvedilol

4

Beta-1 blocker drugs
Where's the receptor site?
Drug interaction?
Action
Effect

Cardiac cells
Dopamine
Stimulation
Decrease rate and force of contraction

5

Beta-2 blocker drugs
Where's the receptor site?
Drug interaction?
Action
Effect

Bronchial, vascular, and uterine smooth muscle
Albuterol
Stimulation
Muscle relaxation

6

Prototypical beta-Blocker
Example
Indication (2)

Metoprolol
Indication: hypertension; in patients during and after AMI to reduce mortality

7

Beta-Blockers Contraindications, Precautions, A/SEs

Contraindications: significant 1º Heart Block; any 2º or 3º AV block, overt heart failure, SBP < 100 mgHg, heart rate < 45 BPM
Pregnancy Cat. C
Avoid abrupt cessation
Precautions in brochospastic disease, COPD, SLE, hepatic dysfunction, DM, hyperthyroidism
May increase cardiac effects of digitalis, CCBs.
Bradycardia w/ catecholamine- decrease drugs
May block epinephrine
Fatigue, dizziness, depression, hypotension, diarrhea, rash, dyspnea, bradycardia, cold extremities, palpitations, CHF, peripheral edema, hypotension, bronchospasm, heart block, erectile dysfunction

8

Prototypical Calcium Channel
Example, Route of Admin
Indications (3)

Diltiazem - PO (multiple formulations) or IV
Indications: hypertension; vasospastic & chronic angina; certain rapid narrow-complex dysrhythmias

9

*3 CCB's to know

Diltiazem, Verapimil, Amlodipine

10

CCB CI and PC

Contraindicated in sick sinus syndrome, 2o or 3o heart block --unless patient is paced, hypotension, acute myocardial infarction and pulmonary edema documented by radiograph on admission
Precautions in heart failure, impaired renal or hepatic function; discontinue w/ persistent rash
Pregnancy Cat. C

11

What drug should you NOT use for an MI to slow their heart down. (will make it worse)

CCB aka Dilitiazem

12

Many CCBs are involved in __ metabolism.
Therefore its interactions include:

CP-450 enzyme metabol
Interactions: digoxin and -blockers may lead to AV block; serum propranolol and carbamazepine levels may be increased; potentiation with cimetidine; inhalation anesthetics may potientiate cardiac depression

13

Indicications for Dilitiazam, Amlodipine, Verapamil (all the same) (3)

Stable Angina, Vasospastic Angina, Hypertension

14

#1 antihypertensive CCB. Seen often in the outpatient setting.

Amlodipine

15

Which CCB would you give to a person that wants to exercise?

Amlodipine
Advantage of Amlodipine compared these other drugs: you don’t get some of the same blunting of the heart rate. Ppl can exercise better w/o getting short of breath.

16

Advantage and Disadvantage of Amlodipine

Advantage of Amlodipine compared these other drugs: you don’t get some of the same blunting of the heart rate. Ppl can exercise better w/o getting short of breath.
Disadvantage: in high doses, there’s much more peripheral edema (pretibial/ankle), so they get a lower dosing

17

CCB Mechanism of Action (they all share a basic electrophysiologic property)

they block the cellular influx of calcium thru slow-channels of the cell membrane of cardiac cells

18

What was the first CCB?

Niefedipine

19

*Do not use oral short-acting __ for hypertensive emergencies/urgencies

CCB's

20

3 details about Amlodipine

Good for peripheral vascular vasodilation
No reflex tachycardia
Less peripheral edema than nifedipine

21

What CCB is useful in diastolic dysfunction?

Verapamil

22

Name 2 drugs that are commonly used with BPH

Terazosin, doxazosin
aka alpha blockers

23

alpha1 receptors do what?

constrict vascular smooth muscle

24

alpha2 receptors do what?

contract selected vascular beds

25

What is the therapeutic use for nonselective (either alpha-1 or 2) in hypertension?

treatment of hypertensive crises in pheochromocytoma

26

a1 blockers reduce serum __ and__, increase __.

a1 blockers reduce serum triglycerides and LDL cholesterol, increase HDL cholesterol.