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77 Cards in this Set
- Front
- Back
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What receptors does carvedilol work on?
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Alpha 1
Beta 1 and 2 |
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What receptors do labetalol work on?
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Alpha 1
Beta 1 and 2 |
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Which class of anti-hypertensive drugs can potentiate the action of other anti-HTN drugs?
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Diuretics
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How do diuretics decrease blood pressure?
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Decrease peripheral resistance
Decrease sodium retention |
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At which four levels is BP maintained?
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Arterioles
Venules Heart Kidneys |
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Which drug has a risk of hypertensive crisis when taken off quickly?
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Clonidine
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Which class of diuretics has a side of effect of loss of hearing and watery diarrhea?
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Loop diuretics
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Which drug has a serious side effect of depression and suicide?
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Reserpine
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Which class of drugs can also act as local anesthetics?
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Beta blockers
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Why does angiotensin II cause increase in peripheral resistance?
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It is a powerful vasoconstrictor
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Which drugs can be used during a hypertensive crisis?
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Ganglionic blockers
Sodium nitroprusside |
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What the two anti-hypertensive drugs that are prodrugs?
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Methyldopa
Minoxidil |
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Which drugs are good to use for angina?
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Beta blockers
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Which vasodilator can cause cyanide intoxication?
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Sodium nitroprusside
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What is the mechanism of action of minoxidil and diazoxide?
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Activates potassium channels
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What is the mechanism of action of hydralazine?
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Activates potassium channels
Releases NO |
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Which vasodilator should not be given to patients with glaucoma?
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Fenoldopam
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Nifedipine is selective for what kind action?
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Smooth muscle
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Verapamil is selective for what kind of action?
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Cardiac
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Diltiazem is selective for what kind of action?
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Intermediate
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What is kininase II?
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Angiotensin converting enzyme (ACE)
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What is the preferred class of drugs for anti-hypertensive therapy?
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Thiazide diuretics
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What other additional effects do third generation beta blockers have?
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Block calcium entry
Block ROS action Release NO |
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Do antiarrhythmic drugs have a low or high therapeutic index?
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Low therapeutic index
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Do antiarrhythmic drugs have a low or high therapeutic index?
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Low therapeutic index
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In what two ways can altered impulse propagation occur?
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Reentry (due to myocardial damage or ischemia)
Accessory pathway |
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What is Wolf Parkinson White syndrome?
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Abnormal conduction of the heart where an accessory pathway depolarizes AV node before SA node
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How do you treat reentry propagation?
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Extend refractory period
Slow down conduction |
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Where does early afterdepolarization arise?
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Plateau phase
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Where does delayed afterdepolarization arise?
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Resting potential
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What causes early afterdepolarization?
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Torsades de pointes--long QT--usually by anti-arrhythmics
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What causes delayed afterdepolarization?
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Calcium overload
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How do you treat Wolf Parkinson White syndrome?
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Ablative therapy
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What is DC conversion or defibrillation used for?
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Treat ventricular fibrillation
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Class I antiarrhythmic agents act on what receptor type?
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Sodium
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Class II antiarrhythmic agents are what types of drugs?
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Beta blockers
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Class III antiarrhythmic agents act on what receptor type?
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Potassium
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Class IV antiarrhythmic agents act on what receptor type?
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L-type calcium
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How would you decrease automaticity?
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1. Decrease slope of phase 4 depolarization
2. Make diastolic potential more negative 3. Make threshold more positive |
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What is the difference between propanolol and esmolol in their duration of action?
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Esmolol has a shorter duration of action
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Which two drugs increase QT interval but does not cause Torsaddes?
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Flecainide
Amiodarone |
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Does an increased diastolic potential mean it is more negative or more positive?
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More negative
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What drugs increase the diastolic potential?
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Adenosine
Digoxin |
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Why doesn't NE have the capacity to increase airflow?
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Does not work on beta2 receptors to cause bronchodilation
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What is the effect of norepinephrine and epinephrine on coronary blood vessels?
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Vasodilation
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Would you use norepinephrine or epinephrine for treatment of shock?
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Norepinephrine
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Why is dopamine useful in hypovolemic shock?
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Vasodilator--diverts blood to renal and mesenteric circulation
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In what kind of cells in the intestine do you find seratonin?
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Chromaffin cells
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What effect does serotonin have on large arteries and veins?
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Vasoconstriction
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What effect does serotonin have on arterioles?
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Vasoconstriction
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What kind of chronotropic and ionotropic effects does serotonin have on the heart?
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Positive chronotropic and ionotropic effect
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What effect does serotonin have on venules?
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Vasodilation
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What does serotonin do to capillary pressure?
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Increases
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What nerve terminals is serotonin associated with?
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Trigeminal nerve terminals
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Histamine is released when which antibodies attach to the mast cells?
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IgE or IgM
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Activation of muscarinic (cholinergic) receptors on mast cells causes an increase or decrease of histamine?
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Increase
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Activation of beta-adrenergic and/or H2 receptors on mast cells cause an increase or decrease of histamine?
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Decrease
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What effect does histamine have on large and small diameter blood vessels?
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Small vessels-dilation
Large vessels-contraction |
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Phospholipase A2 is activated by increased concentrations of what?
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Calcium
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What is the action of PGF?
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Vasoconstriction of pulmonary arteries and veins
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What is the action of PGE?
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Vasodilation
Involved in inflammation |
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What is the action of PGD?
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Vasoconstriction
Vasodilation (lower concentrations) |
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What is COX-2 most associated with?
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Inflammation
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Do leukotrienes act as a vasoconstrictor at low or high concentrations?
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Higher concentrations
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What is the action of leukotrienes?
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Constriction at higher concentrations
Increasing vascular permeability Inflammation |
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What enzyme is involved in the formation of epoxides?
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Cytochrome p450 monooxygenase
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Vasopressin V1 receptors cause ___ while V2 receptors cause ___
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V1=vasoconstriction
V2=reabsorption of water |
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Atrial natriuretic peptide is released in response to what?
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Increased blood volume
Increased atrial pressure |
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ANP inhibits the release of what three things?
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Renin
Aldosterone Vasopressin |
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What does aldosterone do?
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Increases sodium reabsorption
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Angiotensin receptor blocking drugs target which receptor type (1 or 2)?
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Type 1 angiotensin receptor
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What is the mechanism of diuretics?
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Depletes body of sodium
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The main therapeutic objective of anti-anginal drugs is what?
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Decrease myocardial oxygen demand
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How is nitroglycerin administered?
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Sublingual--undergoes significant first pass
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Decreasing preload is usually done by giving ___ while decreasing afterload is usually done by giving ___
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Preload=nitrates
Afterload=CCBs |
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How do beta blockers and nitrates differ in their mechanism to stop or reduce angina?
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Nitrates--stops acute angina attacks
Beta blockers--doesn't stop acute attacks, but reduces frequency |
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Which anti-anginal drug has risk of increasing QT interval?
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Ranolazine
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