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33 Cards in this Set
- Front
- Back
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What are the 3 effects of an ACE inhibitor?
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1. Balanced vasodilation
2. Inhibit aldosterone release 3. Reduce cardiac remodeling |
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What are the 2 main side effects of ACE inhibitors?
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1. hypotension
2. deterioration of renal function |
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What kind of drugs are enalapril, lisinopril, benazepril, ramapril, fosinopril, quinapril?
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ACE inhibitors
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What are Furosemide (Lasix), bumetanide, torsemide?
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Loop or high-ceiling diuretics
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What is the MoA of Furosemide diuretics?
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Inhibit Cl/Na resorption in the thick ascending loop of henle by blocking Na/K/Cl cotransport
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What side effects are associated with furosemide diuretics?
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Excessive dosage can cause azotemia, weakness, dehydration, lethargy, electrolyte depletion (Na, Cl, K, Mg) and hypotension.
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What are spironolactone, hydrochlorothiazide, eplerenon?
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Potassium sparing diuretics
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What is the MoA of potassium sparing diuretics?
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Competitively blinds to the plasmic receptor in aldosterone responsive cells in the distal tubule and early collecting duct.
Blocks K/Na exchange so that K+ is conserved and Na+ is excreted. |
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What drugs are potassium sparing diuretics used in combination with and why?
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furosemide - to achieve greater diuretic effects
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What is the main side effect of potassium sparing diuretics? What are the contraindications?
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GI side effects
Contraindicated for hyperkalemia because it can cause hyperkalemia |
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What is hydrochlorothiazide?
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Thiazide diuretic
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What is the MoA of thiazide diuretics?
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Inhibits distal tubule NaCl reabsorption
Promotes K+ and Mg+ wasting in urine |
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What are some side effects of thiazide diuretics?
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azotemia, weakness, dehydration, lethargy, electrolyte depletion (K+, Mg+), GI side effects and hypotension
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What is the MoA of cardiac glycosides?
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Inhibition of Na/K ATPase pump
- positive inotropic effect - vagomimetic - slow HR, slow conduction across AV node - restores baroreceptor responses toward normal - reduces sympathetic activation in CHF patients |
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What are 2 clinical uses of cardiac glycosides?
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1. CHF
2. Supraventricular tachyarrhythmias - slow HR, prolong AV conduction time |
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What is the most common side effect with digoxin?
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Arrhythmia
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What is pimobendan?
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Calcium sensitizer
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Why does pimobendan have fewer deleterious effect than digoxin?
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Pimobendan - increases sensitivity to EXISTING Ca++
Digoxin - increase Ca++ influx into myocardium |
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What are three types of vasodilators what is the main function of each?
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1. Venodilators - reduced preload
2. Arterial dilators - reduced afterload 3. Balanced vasodilators - both arterial and venous vasodilation |
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What kind of drug is nitroglycerin?
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Vasodilators - metabolized to NO
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What is the main clinical use of nitroglycerin?
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Pulmonary edema - moves blood away from pulmonary circulation
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What is a consideration when handling nitroglycerin?
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Transcutaneous absorption - always wear gloves when administering
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What kind of drug is hydralizine?
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Arteriolar vasodilator
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What are 2 clinical uses of hydralazine?
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1. Mitral insufficiency
2. Hypertension |
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What kind of drug is nitroprusside? What is the main clinical use?
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Balanced vasodilator - acts via NO
Pulmonary edema - when patient is not responding to furosemide |
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What are the 4 classes of antiarrhythmic drugs?
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1. local anesthetics
2. b-blockers 3. prolong action potential duration 4. ca-channel blockers |
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Why would you see azotemia with ACE inhibitors? What can you do about it?
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It is usually a results of giving a diuretic at the same time. You can reduce the dose of the diuretic.
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How do most positive inotropes act?
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By increasing the amount of available Ca++, unless you are a calcium sensitizer like pimobendan then you just sensitive the myocardial cell to present Ca++
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What is the main function of pimobendan?
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Vasodilation - pulmonary and systemic arteries
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What does it mean that furosemide is a high ceiling diuretic?
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The greater the dose, the greater the diuresis
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Would you give furosemide for non-cardiogenic edema or pericardial disease?
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No, it is only effective for cardiogenic edema - pulmonary edema, pleural effusion, ascites
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How can an ACE inhibitor reduce the diuretic effect of furosemide?
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w/ hypotension the RAAS will cause efferent arteriole vasoconstriction and increase GFR and urine output
An ACE inhibitor will block the efferent arteriole vasoconstriction and GFR will be decreased |
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How does inhibiting the Na/K ATPase create a positive inotropic effect?
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Rely on Na+/Ca+ exchanger so more Ca+ is available inside the cell
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