Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
53 Cards in this Set
- Front
- Back
|
primary use of CCB
|
angina, selected arrhythmias, HTN
|
|
|
intracellular Ca stimulates…
|
contraction of the vasculature
|
|
|
If a CCB is specific for the heart…
|
good antiarrythmic proprties, negative ionotropy, and moderate affect on BP
|
|
|
CCB is not a great drug for …
|
CHF (negative chronotropy-force of contraction of the heart)
|
|
|
IF CCB is specific for the vasculature…
|
safe for CHF, great antiHTN drug, bad for arrythmia
|
|
|
IR nifedipine
|
pts using IR dosage forms had an increased rate of MI in clinical studies-postulated to be an effect of high peak serum drug levels.
|
|
|
nifedipine-monitor
|
HR, BP , S/s CHF-including peripheral edema
|
|
|
Nifedipine-AEs
|
flushing/rash, peripheral edema, dizziness/lightheadeness. RARE CASES OF GINIGIVAL HYPERPLASIA-phenytoin can do this too
|
|
|
Nifedipine and peripheral edema
|
has been assoc with peripheral edema unrelated to CHF effects = weird SE
|
|
|
Other potential uses of nifedipine
|
migraine prophylaxis, ACHALASIA, RAYNAUD'S phenomenon
|
|
|
Diltiazem-class
|
benzothiazepine
|
|
|
Injectable diltiazem used for…
|
tx of atrial fibrillation
|
|
|
Cardizem SR dosed…
|
PO BID-IR better for titrating
|
|
|
Cardizem CD dosed
|
PO QD-bad for titrating
|
|
|
Cardizem conversion from IV to PO
|
use IR PO dosage form and overlap by approximately 3 hr
|
|
|
Use SR cardizem in..
|
AM and do no chew or crush
|
|
|
ADR of verapamil
|
CHF, peripheral edema, hypotension, constipation
|
|
|
verapamil class
|
phenylalkylamine
|
|
|
Covera HS
|
qHS dosing-circardian dosing-when NE and EPI peak during the day (in the AM) -verapamil
|
|
|
amlodipine
|
paricularly selective for the vasculature so compared to other CCBs, much lower incidence of negative ionotropic effects
|
|
|
good CCB for use in pts with CHF
|
amlodipine
|
|
|
negative ionotropy
|
force of contraction of the heart
|
|
|
beta 1 affect the..
|
heart
|
|
|
beta 2 affect
|
the lungs and in vasculature
|
|
|
BBs are…
|
negative ionotropes and negative chronotropes
|
|
|
negative chronotropy =
|
dec ht rate, and allows ventricles to fill more and pump out more blood--HF pts get BBs
|
|
|
HF pts get…
|
BBs
|
|
|
ISA
|
bbs that also possess beta agonizing properties-less reflex tachycardia and less effective bbs
|
|
|
BBs with ISA
|
acebutolol and pindolol
|
|
|
BB caution with withdrawal
|
avoid abrupt withdrawal-super sensitization of beta-receptors
|
|
|
Pts with anaphylactic type allergies and BBs
|
resistance to reversal agents such as EPI and NE will require higher than usual doses
|
|
|
BBs may potentiate and mask sxs of…
|
hypoglycemia (tremor, tachycardia, HA)
|
|
|
Most BBs inc…
|
TGs and lipids
|
|
|
CHF and BBs administration
|
start low and go slow-CHF secondary to negative inotropy
|
|
|
cocaine overdose-don't use…
|
propranolol-beta 2 opposes alpha-1. Propranolol shuts down beta 1 but beta 2 is not opposed-so bring BP back up
|
|
|
Common AEs of BBs
|
bradycardia, hypotension, AV block
|
|
|
Do not use BBs in
|
prinzmetals angina/vasospastic angina-angina from alpha receptors over sensitized because mediated by alpha 1
|
|
|
dirty BB
|
propranolol
|
|
|
propranolol indication
|
thyroid storm, esophageal varices (alcoholics), DOC for portal HTN
|
|
|
DOC for portal HTN
|
propranolol
|
|
|
Propranolol AEs
|
depression, impotence
|
|
|
Metoprolol and selectivity
|
selective-but will lose selectivity at higher doses
|
|
|
propranolol selectivity
|
non-selective-blocks BB1 and BB2
|
|
|
metoprolol indication
|
XL product used in mgmt of CHF
|
|
|
popular drug for HTN urgency/emergency as well as cocain o/d
|
labetolol-avoids unopposed alpha
|
|
|
HTN emergency
|
see organ damage. High BP with damage in 3 organs: kidney, brain, eyes
|
|
|
HTN urgency
|
high BP
|
|
|
Labetalol blocks
|
alpha (-alol = blocks alpha)
|
|
|
Carvedilol blocks
|
alpha too
|
|
|
Carvedilol vs labetalol
|
carvedilol is more of an alpha 1 blocker than labetalol
|
|
|
esmolol preparation
|
IV only
|
|
|
esmolol half life
|
9 min-metabolized by plasma esterases. Can use w/o regard to liver/kidney failure
|
|
|
DOC for HTN emergencies
|
labetolol and nitroprusside
|
