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46 Cards in this Set
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- Back
- 3rd side (hint)
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Automaticity |
The cells within the hearts electrical system can generate action potential or electrical impulses without being excited by an External stimuli |
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Conductivity |
The specialize cells of the heart can conduct an impulse rapidly through the system so that the muscle cells of the heart are stimulated at approximately the same time |
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Frank-starling’s law of the heart |
Pertains to the strength of the heart systolic contraction |
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Cardiac output |
The volume of blood ejected from the left ventricle every minute |
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Heart rate |
The heart of the heart has to work, the more oxygen it requires |
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Preload |
Amount of blood return to the heart so that it can be pumped throughout the body |
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Contractility |
The ability of myocytes to stretch |
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After load |
Resistance against which the heart has to beat |
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Hydrostatic pressure |
Driving force of heart tends to push fluid out of capillary |
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Oncotic pressure |
Pressure exerted by plasma proteins tends to pull fluid into capillary |
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Filtration pressure |
Net force on fluid determined by the balance between hydrostatic pressure (HP) and oncotic pressure (OP) |
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Heart contractility |
The ability of myocytes to depolarize |
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Stroke volume |
Amount of blood pumped out of the ventricle with each heartbeat |
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Cardiac output |
The amount of blood that is pumped every minute Stroke volume x heart rate= 5.2 L |
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Ace inhibitors |
• (-pril) • Blocks the conversion of angiotensin I to angiotensin II; an angiotensin two receptor blocker; blocking affects of angiotensin on blood vessels • act in the lungs to prevent ACE from converting Angiotensin I to angiotensin II • blocks the production of ACE enzyme in the lung Actions: •Blocks ACE (produced in the lungs) from converting angiotensin I to angiotensin II • decrease in blood pressure • decrease in aldosterone production • small increase in serum potassium **• sodium and fluid loss
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ACE inhibitor drugs |
• CaptoPRIL • RamiPRIL • EnalaPRIL • FosinoPRIL • LisinoPRIL • BenazePRIL • QuinaPRIL |
Think APRIL |
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Medical uses of ACE inhibitors |
Hypertension Congestive heart failure Myocardial infarction Prophylaxis of cardiovascular risk subjects Diabetic Nephropathy Scleroderma crisis |
Remember Home Care Makes Patients Definitely Strong |
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Side effects of ACE inhibitors |
*Cough (persistent dry cough) Allergic reactions Potassium elevation/proteinuria Taste change Oedema (angioedema) Photosensitivity Renal failure Indigestion Low BP Tachycardia Skin rash Hyperkalemia Bone marrow suppression Contraindications: Impaired renal function (IRF) Pregnancy (teratogenic) |
Remember CAPTOPRIL |
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Pharmacokinetics of ace inhibitors
Caution
Drug-to-drug interactions |
•Well absorbed, widely distributed, metabolized in the liver, excreted in the urine and feces
•CHF
•Allopurinol |
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Angiotensin II blockers (ARBS) |
• (-sartan) •Angiotensin II receptor blockers, Block the angiotensin II receptors from causing vasodilation Action: •selectively bind with the angiotensin II receptors and vascular smooth muscle and the adrenal cortex to block vasoconstriction in the release of aldosterone Indication: Best second choice after Ace inhibitors |
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Angiotensin II receptor blocker drugs |
•Losartan (Cozaar) •Azilsartan (Edarbi) •Candesartan •Eprosartan •Irbesartan •Olmesartan •Telmisartan •Valsartan |
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ARBs mechanism & action & indications |
• blocks the binding of angiotensin II to smooth muscle receptors • blocks the release of aldosterone from the adrenal glands |
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ARBs adverse effects & contraindications & cautions |
•Dizziness •URTI symptoms •diarrhea •muscle weakness •syncope •headache •GI complaints •skin rash or dry skin Contraindications •pregnancy •renal failure •allergy •lactation Cautions •hepatic or renal dysfunction •hypovolemia |
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Pharmacokinetics of ARBs Drug-to-drug interactions |
Well absorbed and undergo metabolism and the lever by the cytochrome P450 system. They are excreted in the feces and urine •phenobarbital |
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Alpha 1 receptors blocker (Antagonists Drugs) |
-zosin •tamsulosin •doxazosin •Prazosin •Alfuzosin •Terazosin |
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Alpha 1 receptors blocker mechanism & action & indications |
Mechanism: Blocks the alpha adrenergic receptors on the vascular endothelial smooth muscle cells from contracting Action: High bp Benign prostatic Hyperplasia |
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Alpha 1 receptors blocker adverse effects & contraindications |
•Orthostatic hypotension •headaches or nausea • swollen legs or ankles •sleep disturbance • tremor •rash •rarely, they may cause problems with elections in men
Contraindications •patients with urinary incontinence |
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BETA 1 BLOCKERS |
•(-olol) • leads to a decrease in heart rate and strength of contractions as well as vasodilation
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Beta 1 blocker Drugs |
•Atenolol •Metoprolol •Propranolol •Nadolol •Nebivolol •Bisoprolol •Acebutolol •Carteolol hydrochloride •Esmolol hydrochloride •Carvedilol •Labetalol |
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Vasodilator drug mechanism and action and indications |
Mechanism: Act directly on the alpha receptors or vascular smooth muscles to cause muscle relaxation, leading to vasodilation, and drop in blood pressure Action: decreasing systemic arterial pressure and in reducing total coronary resistance Indications: Most are used for severe, malignant, emergency hypertension Administered IV Nitroglycerin helps widen the blood vessels so more blood gets your heart muscle Action: stimulate the production of nitric oxide to cause dilation of peripheral blood vessels |
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Vasodilator drug adverse affects & contraindications & |
• reflex tachycardia • cyanide toxicity (increase and nitric oxide) • related to changes in blood pressure •G.I. upset
Contraindications: • patient using other into hypertensive drugs •patients taking Viagra •allergy, •pregnancy, •lactation, •cerebral insufficiency |
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Vasodilator drug pharmacokinetics & caution & drug-to-drug interactionsCentrally acting drugs |
Pharmacokinetics •Rapidly absorbed and widely distributed, metabolized in the liver, and primarily excreted in the urine Caution • peripheral vascular disease, CAD, CHF, or tachycardia Drug-to-drug interactions • based on individual drug |
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Centrally acting antihypertensive drugs |
Action: • blocks alpha receptors in the Medulla • stimulates alpha-2 adrenoceptors in the brain stem -this action results in reduce sympathetic outflow from the central nervous system and decreases in peripheral resistance, renal vascular resistance, heart rate, and blood pressure - Prototypes: drugs •Clonidine • Guanfacine • Methyldopa
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Centrally acting drug side effects & contraindications |
•a2- adrenoceptor agonists include Sedation • dry mouth and nasal mucosa • bradycardia (sympathetic withdrawal) • orthostatic hypotension • impotence • swollen tongue Contraindications •allergies •liver disease |
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Antihypotensive drugs |
-sympathetic adrenergic agonist or vasopressors
• dobutamine •dopamine • ephedrine •epinephrine • isoproterenol • orepinephrine |
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Antihypotensive drug mechanisms and action and indication |
Indication: hypotension Actions: activates alpha receptors and arteries and veins to produce vasoconstriction, an increase in vascular tone and an increase in blood pressure Indications: symptomatic treatment of orthostatic hypotension |
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Antihypotensive drug adverse effects and contraindications |
•Increased heart rate •increase blood pressure •ventricular ectopic activity nervousness •headache •nausea/vomiting •palpitations •low platelet counts (thrombocytopenia)
Contraindications • supine hypertension CAD • pheochromocytoma • urinary retention |
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Beta 1 blocker mechanism & action & indications |
Mechanism of cardioselective beta 1 blockers: •targets the heart only Drugs: •Atenolol •Metoprolol •Esmolol Action: •arrhythmias •increase contractility •decrease work load •decrease bp •decrease hr •angina •CHF Mechanism of non-cardioselective beta blockers: •target beta 1 & beta 2 (lungs and blood vessels) Drugs •Labetalol •Carvedilol •propranolol •nadolol Action: •all above •migraine headaches •anxiety |
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Beta 1 blocker adverse effects & contraindications |
Beta 1 cardioselective: •arrhythmias Beta 2 cardioselective: •constrict bronchial tree Beta 2 noncardioselective contraindications: •patients with asthma |
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Calcium channel blockers |
• relaxes muscle contraction or other autonomic blockers Actions • inhibits the movement of calcium ions across the membrane‘s of cardiac and arterial muscle cells, depressing the impulse leading to: -decrease BP -decreased myocardial contractility and cardiac workload -dilation of arterioles -decreases myocardial oxygen consumption Mechanism: • blocks the calcium channels during action potential Indications: • high bp (especially in African Americans) • coronary artery disease • coronary spasm • angina (chest pains) • abnormal heart rhythms • hypertrophic cardiomyopathy • diastolic heart failure (preserved left ventricular function)
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Calcium channel blocker adverse effects and contraindications |
• Headache • constipation • rash • nausea • flushing • Edema (fluid accumulation and tissues) • drowsiness • Low BP • related effects on cardiac output • G.I. symptoms • cardiovascular symptoms Contrasindications • pre-existing cardiac conduction disorders (atrioventricular block, sick sinus syndrome) • symptomatic hypotension • acute coronary syndrome • renal or hepatic dysfunction • pregnancy • lactation • allergy |
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Calcium channel blocker pharmacokinetics and drug-to-drug interactions |
• well absorbed, metabolized in the liver, and excreted in the urine Drug to drug interactions: •cyclosporine |
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Calcium channel blocker drugs |
•Dihydropyridines: -dipine •Amlodipine •Nifedipine •Felodipine •Isradipine •Nicardipine •Nisoldipine •Non-dihydropyridines: 1.) Benzothiazepines: -azem • diltiazem 2.) Phenylalkylamines: -amil • verapamil |
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Diuretic drugs |
Loop diuretics (-Emide): •bumetanide •ethacrynic acid •Furosemide •torsemide
Osmotic diuretics: Mannitol
Potassium sparing diuretics: •Amiloride • Spironolactone •Eplerenone •Triamterene •Potassium •Canrenoate
Thiazides: • Bendroflumethiazide •hydrochlorothiazide |
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Diuretics mechanism & action and indications |
Act on blocking reabsorption of sodium at four major sites in the nephron Diuresis
Indications: • hypertension • heart failure • Hypocalciuria • diabetes insipidus
Action: • hypokalemia •hyponatremia •hyperuricemia •hypovolemia |
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Vasodilator drugs |
• most of the vasodilators are reserved for use in severe hypertension, malignant hypertension, or hyper tensive emergencies •Diazoxide- IV for hospitalized patients with severe hypertension; increases blood glucose levels •hydralazine- maintains increased renal bloodflow, safe to be used in pregnant women if needed •minoxidil- used only for severe and unresponsive hypertension •nitroprusside- used for hypertensive crisis; maintain hypertension during surgery •nitrates |
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