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86 Cards in this Set
- Front
- Back
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5 major side effects for hydrochlorothiazide
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hypokaleia, slight hyperlipidemia, hyperuricemia, hypercalcemia, hyperglycemia
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4 major side effects for loop diruetics
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potassium wasting, metabolic alkalosis, ototoxicity, hypotension
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clonidine side effects (2)
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dry mouth, severe rebound hypertension
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methyldopa side effects (2)
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sedation, positive Coombs test
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hexamethonium side effects (4)
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severe orthostatic hypotension, blurred vision, constipation, sexual dysfunction
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reserpine side effects (4)
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sedation, depression, nasal stuffiness, diarrhea
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guanethidine side effects (4)
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orstastic/exericse hypotension, sexual dysfunction, diarrhea
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prazosin side effects (3)
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1st-dose orthostatic hypotensoin, dizziness, headache
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beta-blocker major side effects (6)
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asthma, impotence, sleep problems, bradycardia, chf, av block
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hydralazine side effects (4)
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lupus like snydrome, reflex tachycardia, angina, salt retention
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minoxidil side effets (5)
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hair, pericardial effusion, reflex tachycardia, angina, salt retention
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vasodilator: calcium blocker side effects (3)
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flushing, constipatipn, nausea
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nitroprusside major side efect
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cyanodie toxicity
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captopril side effects (8)
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hyperkalemia, cough, angioedema, proteinuria, taste changes, hypotension, pregnancy (fetal renal damage), rash
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ARB side effect (losartan)
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fetal renal toxicity, hyperkalemia
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two drugs that cause hyperkalemia
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losartan and captopril
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what do you have to do wit hhydralazine and minoxidil?
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use beta blockers to treat reflex tachy, diuretic to block salt retention
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mechanism of hydralazine
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increase cGMP, smooth muscle relaxation, vasodilatoin, afterload reduction
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what is dilation is hydralazine selective for
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arerioles
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clinical use for hydralazine (2)
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severe hypertension, CHF
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mechanism for clonidine
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alpha2 agonist
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mechanism for methyldopa
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alpha2 agonist
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mechanism for prazosin
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alpha1 blocker
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mechanism for reserpine
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decrease norepi
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mechanism for guanethidine
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decrease norepi
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block ach receptor
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hexamethonium
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name 3 calcium channel blockers
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nifedipine, verapamil, diltiazem
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mechanism of calcium blockers
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block voltage-dependent calcium channels on cardiac/smooth muscle and reducing muscle contractility
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rank vascular smooth muscle block by calcium blocker
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nifedipine>diltiazem>verapamil
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rank heart smooth muscle block by calcium blocker
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verapamil>diltiazem>nifedipine
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use for calcium blockers
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hypertension, angina, arryhtmia (not nifedipine)
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calcium blocker toxicity (3)
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cardiac depression, peripheral edema, flushing,
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mechanism for nitro drugs
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vasodilate by releasing nitric oxide, increase cGMP, smooth muscle relaxation, decrease preload
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rank the preference for dilation in nitro drugs
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veins > arterioles
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clinical use for nitro drugs (4)
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angina, pulmonary edema, aphrodisiac, erection enhancer
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name side effects for nitro (4)
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tachycardia, hypotension, headache, monday disease
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define monday disease
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build tolerance to nitro during work, resensitize on weekend and get tachy and dizziness
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goal of antianginal therapy
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reduce myocardial oxygen consumption
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name 5 determinants of antianginal therapy
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end diastolic volume, blood presure, heart rate, contractility, and ejection time
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how does nitro effect end diastolic volume, blood pressure, contractility, heart rate, and ejection time
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decrease, decrease, increase (reflex), increase (reflex), decrease
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how does beta-blocker affect diastolic volume, blood pressure, contractility, heart rate, ejection time
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increase, decrease, decrease, decrease, increase
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name 3 factors that combo beta-blockers + nitrates will decrease
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blood pressure, heart rate, and overall myocardial oxygen consumption
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for calcium channel blockers, what drug is similar to nitro
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nifedipine
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for calcium channel blockers, what durg is similar to beta-blockers
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verapamil
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define bioavailability, protein bound percentage, where ecreted, and 1/2 life for digoxin
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75%, 20-40%, kidney, 40 hours
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mechanism for digoxin
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block na/k atpase, increase na, slow na/ca antiport, increaes ca, positive inotrope
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how does digoxin affect arryhtmia
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vagal effects increase PR, decrease QT, T wave inversion on ECG
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name 2 uses for digoxin
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CHF (increase contractility) and a fib (decrease conduction at AV node)
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5 major general digoxin side efects
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nausea, vomiting, diarrhea, blurry yellow vision, arryhtmia
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name 3 contraindications with digoxin
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renal failure, quinidine (will displace dig on protein, potentiate effect), hypokalemia (potentiate effect)
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what is the antidote for digoxin
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slowly normalize K, lidocaine, cardiac pacer, anti-dig FAB fragments
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describe function that all class I antiarryhtmics have
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decrease slope of phase 4 depolarization
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define state dependency and state what drugs are state dependent
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class I antiarryhtmics. selectively depress tissue what is depolarized
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name 4 class Ia drugs
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quinidine, amiodarone, procainamide, disopyramide
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name 3 mechanisms of class Ia
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increase AP duratoin, increase ERP, increase QT interval
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what do you use class Ia for?
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atrial and ventricular arryhtmias
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quinidine toxicities
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cinchonism: headache, tinnitisum, thrombocytopenia plus torsades
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procainamide toxicity
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reversible lupus like side effect
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name 3 class IB drugs
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lidocaine, mexiletine, tocainide
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mechanism for class IB
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decrease AP duration.
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where does class IB affect?
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affect ischemic or depolarized purkinje ventricular tissue.
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what is class IB useful for?
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acute ventricular arryhtmias (post-MI) and digitalis induced arryhtmia
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name 4 side effects of class IB
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local anesthetic, cns stimulation, cns depression, cardiovascular depression
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name 3 class IC drugs
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flecainide, encainide, propafenone
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name mechanism of class IC
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no effect on AP
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what is class IC sueful for?
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v-tach that progress to V fib and also for SVT. usuaully only good for refractory tachyarryhtmias
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class IC toxicities
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proarryhtmitic, especially post-mI (contraindiciated)
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name 5 class II antiarrythmiycs
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propanolol, esmolol, metoprolol, atenolol, timolol
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mechanism of class II drugs
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decrease camp, decrease CA, decrease slope phase 4, increase PR interval at AV node
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what is a short acting class II
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esmolol
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name 5 side effects of class II drugs
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mask hypoglycema, impotence, asthma, CV effects (bradycardia, av block, chf). sleep
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name 4 class III drugs
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sotalol, ibutilide, bretylium, amiodarone
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mehcanism of class III
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increase AP duration, incrase ERP, increase QT, used when others fail
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sotalol toxicity
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torsades, excessive beta-block
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ibutilide toxicity
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torsades
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bretylium toxicity
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new arrhythmias, hypotension
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amiodorone toxicity
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hypothyrodism/hyperthyrodism, pulmonary fibrosis, hepatic toxicity, corneal deposits, skin deposits (photodermatitis), neurologic defects, constipation, bradycardia, heart block, chf
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what 3 tests to do before using amiodarone?
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PFT, LFT, TFT
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name 2 class IV antiarrhytmics
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verapamil, diltiazem
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mechanism for class IV
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affect AV nodal cells, decrease conduction velocity, incrase ERP, increase PR.
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what is class IV used for
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prevent nodal arryhtmias (SVT)
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what are 4 general side effects for class IV
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constipation, flushing, edema, cv (chf, av block, sinus node depression)
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bepridil toxicity
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torsades
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adenosine function
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drug of choice in diagnosisng/abolishing AV nodal arryhtmias
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potassium function
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depress ectopic pacemaker, esp in dig toxicity
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magnesium function
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torsades and dig toxicity use
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