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72 Cards in this Set
- Front
- Back
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Antidysrhythmics are used for what?
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to treat and prevent abnormal cardiac rhythms
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Antihypertensives are drugs used for?
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drugs used to treat hypertension
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Hemostatic agents are for?
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used to stop bleeding
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Antihyperlipidemic agents are used for?
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to treat high cholesterol
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Cardiac Glycosides have what 2 mechanisms of action?
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1-blocks certain ionic pumps(membrane ATPase) in the cellular membrane
2-increases calcium concentration to the contractile proteins |
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Cardiac glycosides affect the heart in what two ways?
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1-Increase force of contraction
2-dual electrophysiolgical effect, modest-chronological effect=slowing. Profound -dromo effect=decreased conduction velocity |
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Cardiac glycosides are used for what?
Commonly prescribed meds include (3)? |
CHF-increase myocardial contractility
Tachydysrhythmias-slows AV conduction, slows ventricular rate Digitalis, Digoxin, Lanoxin |
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Side effects of Cardiac Glycosides are?
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have a small therapeutic index, side effects are
common and include neurological, visual, GI, cardiac or psychiatric such as anorexia, N/V, altered color vision, cardiac rhthym disturbances-blocks and Ventricular dysrhythmias |
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Antihypertensives include which medication classes? (6)
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-diuretics
-adrenergic inhibiting agents, beta blockers -ACE inhibitors -angiotensin II receptor antagonsits -calcium channel blockers -direct vasodilators |
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Renin-angio------mechanism is what?
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The glomerular apparatus in the kidneys releases renin in response to decreased blood volume, sodium, and BP. renin acts on an enzyme to convert the inactive protein angiotensinogen into angiotensin I. ACE(lungs) converts angiotensin I to angiotensin II which causes both systemic and local vasoconstriction. It also increases the release of aldosterone which contributes to retention of Na and H20
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Definition, analgesics and antagonists
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medications that relieve the sensation of pain
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two subclasses of analgesics
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Opioid agonists and its derivitives, and Nonopioid
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Two types of HTN?
Htn is a major contributor to:(4)? |
-essential(unknown) and secondary(known)
-CAD, stroke, renal failure, blindness |
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Definition of diuretics
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used to increase urine flow, removal of excess extracellular(edema)fluid in disease and drug of choice in treating pts. w/ HTN and CHF
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Actions of Diuretics
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increase Na in urine
loss of excess salt and water from body decreased preload and SV direct effect on arterioles=decreased BP initial decline in CO-then decrease in PVR and decreased BP |
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3 major catorgories of diuretics
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Loop diuretics
Thiazides potassium sparing |
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Loop diuretics do what?
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profoundly affect circulating blood volume
excessive for treating moderate HTN primary med for LV failure and cardiogenic pulmonary edema ascending loop of Henle |
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prototype Loop diuretic, and its sideffects
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furosemide(lasix)
hyponatremia, hypovolema, hypokalemia, dehydration |
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Thiazides, prototype and description
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hydrochlorothiazide
similar to loop, early part of DCT, drug of choice for HTN, |
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Potassium sparing agents
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inhibit effects of aldosterone on distal tubules or the specific Na-K exchange mechanism, not very potent, late in nephritic loop, typically admin. with other diuretics
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adrenergic inhibiting agents, what used for and the classes?(5)
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inhibiting adrenergic stimulation can also control HTN, include-beta adrenergic antagonism, centrally acting alpha adrenergic antagonism, adrenergic neuron blockade, alpha 1 blockade, alpha beta blockade
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beta blocking agents do what?
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used to treat CV disorders including HTN, decreasing CO and inhibiting renin secretion from the kidneys, compete with epi for beta sites--inhibit beta response
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beta adrenergic antagonists do what?
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selective Beta 1 useful in treating HTN, decreases contractility decreasing CO, reduces tachycardia, represses renin release from kidneys, prototype=lopressor
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centrally acting adrenergic inhibitors
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reduce HTN by inhibiting CNS stimulation of adrenergic receptors(CNS alpha 2 agonists=inhibit norepi) net result= decrease HR and contractility, catapres
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peripheral adrenergic neuron blocking agents
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fx indirectly to decrease stimulation of adrenergic receptors, decrease amount of norepi released from presynapses, no longer commonly prescribed
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Alpha 1 antagonists work how?
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decreases blood pressure by competively blocking the alpha 1 receptors, causes arteriole dilation, decreasing afterload, venous dilation occurs reducing preload together decreasing BP
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Combined alpha/beta antagonists work how?
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competitively bind with alpha 1 and beta 1 receptors increasing anti-HTN action, preload, afterload and cardiac workload are reduced
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Vasodilatory drugs work how?
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act directly on smooth muscle walls of arterioles, veins or both=lower PVR and BP, stimulate sympathetic nervous system and activate baroreceptor reflexes leading to increased HR and CO and renin release, combined therapy is usual to inhibit sympathetic response, useful in treating angina
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ACE inhibitors do what?
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lowers BP by inhibiting angiotension II a powerful vasoconstrictor, PVR is decreased
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main advantage of ACE inhibitors to other antihypertensives?
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does not interfere with beta receptors and does not cause potassium depletion
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most dangerous side effect of ACE inhibitors?
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pronounced hypotension after the first dose
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Calcium channel blocking agents do what?
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block influx of calcium in cardiac and vascular smooth muscles
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what is the difference btwn procardia or adalat and verapamil and cardizem?
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procardia and adalat do not effect the calcium channels of the heart at therapeutic doses
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direct vasodilators do what?
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selective dilation of arterioles causes decrease in PVR
decreasing PVR=lowered BP, increased CO, and reduces cardiac workload dilating veins increases capacitance and decreases preload decreases blood pressure and CO *notes say"increased CO, don't know if it is a typo since it also says decreased CO which makes more sense. |
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side effect of direct vasodilators?(1)
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tachycardia
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ganglionic blocking agents do what?
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nicotine antagonists, competitively blocks ANS reducing preload, afterload and BP. dangerous and not commonly used medications for HTN
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What is the pathophysiology of angina?
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imbalance between myocardial oxygen supply and demand
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What are the 3 types of angina?
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stable-predictable
unstable-changes in frequency, severity and duration, need for more nitrates to terminate Prinzmetal-vasospastic, pts with relatively clean CA |
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What is the treatment for angina?
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nitrates/calcium and beta blockade
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How do nitrates work?
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relax smooth muscle promoting vasodilation, dilates coronary arteries improving myocardial perfusion, decreases venous return by venous dilation and pooling, reduce LVEDV and LVEDP, decreases Myocardial O2 demand and relief of chest discomfort associated with ischemia
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3 classes of Hemostatics and their descriptions?
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antiplatelet-decreases formation of platelet plugs
anticoagulants-disrupt the clotting cascade thrombolytics-act directly on thrombi to break them down |
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Antiplatelets-prototype and actions?
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ASA-inhibits cyclooxygenase, and enzyme needed for the synthesis of thromboxane A2, decreases formation of platelet plugs and potential thrombi, NO EFFECT on existing thrombi, indicated for an acute MI and often post MI or stroke, side effect-bleeding
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Anticoagulants-prototype and actions?
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Heparin(parenteral)-enhancing antithrombin III's ability to interrupt the clotting cascade, indicated for treating and preventing DVT, pulm emboli, strokes, and used with thrombolytics to treat AMI
Warfarin(coumadin, oral)-antagonizing the effects of Vitamin K |
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Thrombolytics-example and actions?
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streptokinase-dissolve blood clots after their formation by promoting digestion of fibrin, converting plasminogen to plasmin treatment of choice for AMI-establish blood flow and prevent Myocardial ischemia and tissue death also for acute pulm emboli, DVT, and peripheral arterial occlusion and stroke
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When can you use thrombolytics?
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must be used within 2 hours of onset of thrombus
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Antihyperlipidemic agents are used for what?
Most common class? |
reduce LDL(causative factor of CAD). Inhibiting
hydroxymethyglutaryl coenzyme A reductase(HMGCoA, which is necessary to synthesize cholesterol), lowers LDL-ex. Zocor |
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What is LDL?
What is the goal in maintaining LDL and what does it put the patient at risk for? |
low density lipoproteins are transport mechanisms for lipids(triglycerides and cholesterol)they contain most of the cholesterol in the blood, known as "bad" d/t risk for CAD. Goal is to lower LDL and prevent atherosclerosis and CAD
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What else can reduce LDL?
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bile acid binding resins
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two basic components of asthma?
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bronchoconstriction and inflammation
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What is glucocorticoids?
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anti-inflammatory, antiasthmatics, lowers histamine, prostaglandins and leukotrienes, reduce mucus and edema secondary to decreasing vascular permeability
inhaled, oral or IV |
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what do antihistamines do?
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arrest effects of histamine by blocking its receptors
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what is histamine?
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an endogenous substance that affects a variety of organ systems
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Where is H1 located, what does it do and give an example of an H1 blocker?
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vasculature and lungs, stimulation causes vasodilation and increased capillary permeability, bronchoconstriction-benedryl
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Where is H2 located, what does it do and give an example of an H2 blocker?
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GI system, stimulation causes an increase in gastric acid release
pepcid |
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Antiemetics are used for?
Commonly seen with what Tx? 4 transmitters involved in vomiting reflex? |
to prevent vomiting.
in conjuntion with chemotherapy and prophylactic treatment of motion sickness. serotonin, dopamine, acetylcholine, histamine |
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Name a serotonin antagonist and what it does?
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Zofran, blocks serotonin in the CTZ, stomach, and small intestines
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What side effects do dopamine antagonists have?
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extrapyramidal effects
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Name a drug used to affect the endocrine system?
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ADH, key to regulating blood volume, BP and electrolyte imbalance, used to reverse ADH deficiency
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definition of Glucocorticoids
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increase production of glucose by enhancing carbohydrate metabolism, promoting glucogenesis, and reducing peripheral glucose utilization
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definition of Insulin
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substance that decreases blood glucose levels
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definition of glucagon
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substance that increases blood glucose levels
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insulin comes from what?
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beef or pork intestines, recombinant DNA technology
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Two different classes of insulin preperations
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natural-used as they occur in nature
modified-altered to increase their duration of action and thus decrease the frequency of administration |
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How is insulin administered?
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subcutaneously
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Oral hypoglycemics
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used to stimulate insulin secretion from the pancreas in patients with NIDDM
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Definition of D50W
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sugar solution given intravenously for acute hypoglycemia
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When is glucagon indicated?
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emergency treatment when IV is unobtainable
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What happens to women after menopause?
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estrogen levels drop significantly predisposing women to osteoporosis and CAD
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Side effects of Viagra
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used in combination with nitrates dangerously decreases preload
BP lowers AMI potential Nitrates contraindicated |
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Antibiotics are what?
mech of action(3) |
agent that kills or decreases the growth of bacteria
1-disrupts cell membrane 2-inhibit protein synthesis 3-antimetabolites |
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Antifungal and antiviral do what?
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inhibit growth
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Many disease processes affect the ________, ________, and _________of essential dietary nutrients.
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production, distribution, utilization
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