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;
72 Cards in this Set
- Front
- Back
|
Congestive heart failure
|
Heart fails as a pump
Left ventricle is no longer able to maintain normal cardiac function |
|
|
Congestive heart failure treatment goal
|
Alleviate symptoms
Slow progression Improve survival |
|
|
Angiotensin Converting Enzyme Inhibitor
(ACE inhibitor) |
Inhibit angiotensin converting enzyme
|
|
|
Angiotensin converting enzyme action
|
When low BP is detected, renin is released from the kidneys
Renin converts angiotensinogen to angiotensin 1 Angiotensin converting enzyme coverts angiotensin 1 to angiotensin 2, causing VASOCONSTRICTION and increased BP |
|
|
ACE inhibitor adverse effects
|
Dry cough
Headache Dizziness |
|
|
ACE inhibitor drug interactions
|
Corticosteroids antagonize the antihypertensive effects by causing sodium and fluid retention
Acetazolamide when taken with ACE inhibitors cause hypotension and hypovolemia (Decreased Blood volume) |
|
|
Captopril
|
Treats hypertension
ACE inhibitor |
|
|
Enalapril
|
Treats hypertension
ACE inhibitor |
|
|
Lisinopril
|
Treats hypertension
ACE inhibitor |
|
|
Angiotensin Receptor Blockers (ARB)
|
Receptor antagonists, without increasing bradykinin levels
|
|
|
ARB adverse effects
|
Very few due to no increase in bradykinin levels
|
|
|
ARB drug interactions
|
Corticosteroids antagonize the antihypertensive effects by causing sodium and fluid retention
Acetazolamide when taken with ACE inhibitors cause hypotension and hypovolemia (Decreased Blood volume) |
|
|
Losartan
|
Treats hypertension
Angiotensin Receptor Blockers (ARB) |
|
|
Valsartan
|
Treats hypertension
Angiotensin Receptor Blockers (ARB) |
|
|
What is choroidal effusion?
|
Accumulation of fluid in the supra choroidal space,
Leading to movement of the uveal tract in the anterior direction causing sudden IOP spike |
|
|
Promethazine
|
Phenothiazine
Lacks dopamine antagonistic properties H1 receptor blocking agen Antihistamine action causing sedative and antiemetic effects |
|
|
What does Methylphenidate treat?
|
Narcolepsy and ADHD
|
|
|
Methylphenidate (Ritalin)
|
CNS stimulant
Increases dopamine levels in synapse space in CNS Schedule 2 drug |
|
|
Methylphenidate adverse effects
|
GI effects
Anorexia Insomnia Nervousness ANGLE CLOSURE |
|
|
What does Dextroamphetamine treat?
|
Narcolepsy and ADHD
|
|
|
Dextroamphetamine
|
Amphetamine CNS stimulant
Schedule 2 medication Releases catecholamines into synaptic spaces |
|
|
Adverse effects of Dextroamphetamine
|
ANGLE CLOSURE
|
|
|
Migraine headaches
|
Neurovascular mechanism leading to hypo perfusion to certain areas of the brain
Hyper-excitable cortex CNS disorder with genetic predisposition |
|
|
Sumatriptan
|
Similar to serotonin
Activates receptors on cranial arteries and veins reducing vascular inflammation Fast acting, but short duration |
|
|
What does Sumatriptan treat?
|
Migraine
|
|
|
Sumatriptan adverse effects
|
Paresthesia (Prickling)
Warm/cold sensation |
|
|
Beta-blockers
|
Block beta adrenergic receptors responsible for increasing cardiac action
|
|
|
Propranolol
|
Beta blocker
Reduces incidence of sudden arrhythmic death |
|
|
Metopropolol
|
Beta blocker
Selective Beta-1 adrenergic receptors Decreases heart rate and contractility |
|
|
Carvedilol
|
Beta blocker
Non-selective Short duration of action |
|
|
Atenolol
|
Beta blocker
|
|
|
Diuretic
|
Increases urine output but increasing sodium excretion
Inhibits reabsorption of sodium, leading to decreased blood volume and venous pressure Decrease in cardiac filling, stroke volume, and cardiac output, leading to a fall in arterial pressure |
|
|
Thiazide Diuretics
|
Most common
Less efficacy than loop diuretic Increases sodium delivery to to distal segments of distal tubule, causing increases in potassium loss |
|
|
Chlorothiazide
|
Thiazide Diuretics
|
|
|
Hydrochlorothiazide
|
Thiazide Diuretics
|
|
|
Loop diuretic
|
Inhibits sodium-potassium-chloride co-transport in thick ascending limb
VERY effective |
|
|
Furosemide
|
Loop diuretic
|
|
|
Potassium-Sparing Diuretics
|
Do not act DIRECTLY on sodium transport
Inhibit aldosterone-sensitive sodium reabsorption resulting in LESS potassium and hydrogen ions being exchanged for sodium |
|
|
Spironolactone
|
Potassium-Sparing Diuretic
|
|
|
CAI Diuretics
|
Weakest of diuretics
|
|
|
Diuretic drug interactions
|
NSAID reduce diuretic activity
Beta blockers increase drugs ability to increase blood sugar and lipids Steroids increase blood potassium levels |
|
|
Cardiac Glycosides (Inotropic Drugs)
|
Block sodium potassium ATPase causing increases in intracellular sodium and calcium resulting in more calcium binding to Troponin-C, therefore increasing contractility
|
|
|
Digoxin
|
Cardiac glycoside
|
|
|
Digoxin Adverse effects
|
Color vision disturbances
Flickering/flashing of lights Colored spots Blurred vision Sensitivity to glare |
|
|
Digoxin drug interactions
|
NSAIDS increase plasma Digoxin levels and half life
Tetracyclines and Macrolides increase serum levels of ORALLY administered Digoxin Beta blockers increase risk of bradycardia Prednisone induces hypokalemia and increase risk of Digoxin toxicity |
|
|
Arrhythmia
|
Heart beats with an irregular or abnormal rhythm
|
|
|
Supraventricular Tachycardia
|
Extra conducting material in heart resulting in re-entry of currents in atria and ventricle producing heart rates of 140-250
|
|
|
Sinus tachycardia
|
Form of Superventricular tachycardia
|
|
|
Ventricular Tachycardias
|
Result when electrical impulses generated in the heart's ventricle interfere with impulses generated by sinoatrial node
|
|
|
Class 1 Anti-Arrhythmic drugs
|
Block voltage sensitive sodium channels, causing a decrease in excitability and conduction velocity
|
|
|
Class 1 Anti-Arrhythmic drug toxicities
|
Induces ventricular arrhythmia, nausea, vomiting, diarrhea
|
|
|
Class 2 Anti-Arrhythmic Drugs
|
Prolong the AV conduction and decreases heart rate and contractility
Propranolol, Metoprolol |
|
|
Class 3 Anti-arrhthmic Drugs
|
Prolong duration of action potential by blocking potassium channels during depolarization of cardiac cells
Amiodarone |
|
|
Propranolol, Metoprolol
|
Beta Blockers
Class 2 Anti Arrhythmic Drugs |
|
|
Amiodarone
|
Class 3 Anti Arrhythmic Drugs
|
|
|
Amiodarone adverse effects
|
Time and dose dependent
Puntate opacities in cornea Lenticular changes in anterior and sub capsule including small yellow opacities Optic neuropathy |
|
|
Class 4 Anti Arrhythmic Drugs
|
Calcium channel blockers
Slow conduction in the AV node Verapamil, Diltiazem, Nifedipine |
|
|
Verapamil
|
Class 4 Anti Arrhythmic Drugs
Calcium channel blocker |
|
|
Diltiazem
|
Class 4 Anti Arrhythmic Drugs
Calcium channel blocker |
|
|
Nifedipine
|
Class 4 Anti Arrhythmic Drugs
Calcium channel blocker Inhibits transmembrane influx of calcium into cardiac muscle and smooth muscle |
|
|
Calcium channel blocker Drug Interactions
(Verapamil, Diltiazem) |
Beta blockers have an additive effect on reduction of heart rate, cardiac conduction, and cardiac contractility
Erythromycin has an additive effect in inhibiting CYP450 |
|
|
What is Nifedipine used for?
|
Heart arrhythmia and Angina
|
|
|
Angina
|
Chest pain from inadequate coronary blood flow to the myocardium. Myocardium becomes hypoxic, triggering pain receptors in the heart
|
|
|
Antianginal drugs
|
Vasodilators= Calcium channel blockers, Nitrodilators
Cardioinhibitory drugs= Beta blocker, Calcium channel blockers |
|
|
Nitrodilators
|
Treat angina
Mimic action of endogenous nitric oxide by vasodilation, anti-thrombosis, anti-inflammatory effects |
|
|
Nitrodilator adverse effects
|
Increased IOP
|
|
|
Anti-hypertensive drugs in order of typical response in therapy
|
Ace inhibitors
Beta blockers Calcium channel blockers Diuretics |
|
|
Alpha blockers
|
Block effect of sympathetic nerves on blood vessels by binding to alpha adrenergic receptors on vascular smooth muscle causing dilation of arteries and veins
Effective against primary hypertension |
|
|
Alpha blockers adverse effects
|
Blurred vision
Conjunctivitis |
|
|
Alpha blockers drug interactions
|
Additive effect when used along with beta blockers
Additive effect when taken with CNS active agents such as opiods or alcohol |
|
|
Prazosin
|
Alpha blocker
Treats hypertension |
|
|
Terazosin
|
Alpha blocker
Treats hypertension |
