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36 Cards in this Set
- Front
- Back
Sodium Channel Blockers
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Indications: ventricular dysrhythmias
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Potassium Channel Blockers
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Used for dysrhythmias that are difficult to treat
Life-threatening ventricular tachycardia or fibrillation, atrial fibrillation or flutter—resistant to other drugs Sustained ventricular tachycardia |
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Calcium Channel Blockers
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Similar effect as ß blockers
Useful in breaking reentrant circuit First-line drugs for treatment of angina, hypertension, & supraventricular tachycardia |
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adenosine
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Slows conduction through the AV node
Used to convert paroxysmal supraventricular tachycardia to sinus rhythm Very short half-life—less than 10 seconds Only administered as fast IV push May cause asystole for a few seconds Other adverse effects minimal |
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terazosin
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Management of severe HF when used with cardiac glycosides & diuretics
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ACEi's
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Drugs of choice in hypertensive patients with HF
Drugs of choice for diabetic patients Remember dry cough & 1st dose hypotension |
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ARBs
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do not cause dry cough
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CAIs
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blocks H+ ions in proximal tubules
Used when other diuretics not effective Metabolic acidosis reduces diuresis in 2-4 days |
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Loop Diuretics
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Rapid onset of action so particularly useful when rapid diuresis is needed
Distinct advantage over thiazide diuretics as they work when creatinine clearance decreases To increase renal excretion of calcium in patients with hypercalcemia In cases of HF resulting from diastolic dysfunction |
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Vasodilators
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Directly relax arteriolar &/or venous smooth muscle
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Osmotic Diuretics
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To reduce intracranial pressure
NOT indicated for peripheral edema |
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Mannitol
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IV only & danger of crystalization/need filter
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Potassium-Sparing Diuretics
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Work in collecting ducts & distal convoluted tubules
Relatively weak when compared with thiazide & loop diuretics May be used as adjuncts to thiazide diuretics (synergistic) Certain cases of HF: especially hyperactive R-A-R Cardioprotective/prevents remodeling |
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Thiazide Diuretics
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Action primarily in the distal convoluted tubule
Should not be used if creatinine clearance > 30-50 Metolazone is used with creatinine clearance =10 |
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Anticoagulants
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Inhibit the action or formation of clotting factors
Prevent clot formation Do not lyse existing clots |
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Antiplatelet drugs
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Inhibit platelet aggregation
Prevent platelet plugs |
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Hemorheologic drugs
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Alter platelet function
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Thrombolytic drugs
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Lyse (break down) existing clots
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Hemostatic or antifibrinolytic drugs
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Promote blood coagulation
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Heparin
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Monitored by activated partial thromboplastin times (aPTTs)
Indications: MI, PE, DVT, ischemic CVA Antidote for heparin OD: protamine sulfate. |
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Statins
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First-line drug therapy for hypercholesterolemia
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Bile Acid Sequestrants
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Prevent resorption of bile acids from small intestine; excreted in bowel movement
May be used along with statins |
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Niacin
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Vitamin B3
Lipid-lowering properties require much higher doses than when used as a vitamin Effective, inexpensive, often used in combination with other lipid-lowering drugs |
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Fibric Acid Derivatives
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Believed to work by activating lipase
Suppress release of free fatty acid from adipose tissue, inhibit synthesis of triglycerides in liver, & increase secretion of cholesterol in the bile Increase HDL by as much as 25% |
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ezetimibe
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Inhibits absorption of cholesterol & related sterols from the small intestine
Currently recommended only when patients have not responded to other therapy |
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Crystalloids
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Fluids given IV that supply water and electrolytes
Help to maintain osmotic gradient between extravascular and intravascular compartments Plasma-volume expanders caused by sodium concentrations |
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Colloids
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Protein substances
Increase COP For colloids to be effective total protein level must be in the range of 7.4 g/dL. If it drops below 5.3 g/dL fluid shifts out of the blood vessels and into the tissues. |
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Centrally acting alpha2-receptor agonists
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Stimulate alpha2-adrenergic receptors in the brain
Decrease sympathetic outflow from the CNS Decrease norepinephrine production Stimulate alpha2-adrenergic receptors, thus reducing renin activity in the kidneys Results in decreased blood pressure Usually used after other drugs have failed because of adverse effects clonidine (Catapres) methyldopa (Aldomet) |
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Peripheral alpha1-blockers/antagonists
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Block alpha1-adrenergic receptors
So, circulating norepinephrine is blocked from stimulating the receptors And, blood pressure is decreased doxazosin (Cardura) terazosin (Hytrin) |
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Dual-action alpha1- & beta-receptor blockers
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Block alpha1-adrenergic receptors
Reduction of heart rate (beta1-receptor blockade) Vasodilation (alpha1-receptor blockade) carvedilol (Coreg) & labetalol |
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Calcium Channel Blockers:Mechanism of Action
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Cause smooth muscle relaxation by blocking the binding of calcium to its receptors, preventing muscle contraction
Results in Decreased peripheral smooth muscle tone Decreased systemic vascular resistance Decreased blood pressure |
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Statin adverse effect
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myopathy
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B-type Natiuretic Peptides:Mechanism of Action
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Vasodilating effects on arteries and veins
Indirectly increases cardiac output Suppresses renin-angiotensin system Diuresis |
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Phosphodiesterase Inhibitors
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Work by inhibiting the enzyme phosphodiesterase
Results in: Positive inotropic response Vasodilation Given when patient does not respond to treatment with digoxin, diuretics, and/or vasodilators |
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hydrochlorothiazide
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most commonly prescrbed
least expensive |
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metolazone
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thiazide diuretic...
used with renal dysfunction |