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49 Cards in this Set
- Front
- Back
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Adrenergic Agonists/Antagonists
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play a role on the sympathetic nervous system (agonist- enhance, antagonist-block)
alpha(1,2) and beta (1,2) receptors Release Norepinephrine, epinephrine, dopamine in the postsynaptic membrane. |
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Cholinergic
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Plays a role on the parasympathetic nervous system
- muscarinic: smooth muscle and slow heart rate - nicotinic: skeletal muscle Anticholinergic: cholinergic blockers Drugs that activate these receptors are Ach (both presynaptic and postsynaptic). |
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Alpha Adrenergic Receptors are found where?
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Vascular smooth muscle
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Beta adrenergic receptors are found where?
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smooth muscle and cardiac muscle
most receptors are beta |
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What are examples of Catecholamines and where are they located in the body
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Norepinephrine- released at nerve terminals
Epinephrine- Released at adrenal medulla Dopamine- released at sites of the brain, kidney, and GI tract. |
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Where are alpha 1 receptor agonists found and what do the cause
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- Located on blood vessels, muscles of iris, smooth muscle of GI and reproductive tract, liver cells, sweat glands, bladder sphincters.
Alpha 1=adrenergic- enhance sympathetic nervous system. - vasoconstriction, decreased GI motility, Sphincter contraction, increased sweat, decreased bile secretion |
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Where are alpha 2 agonist receptors located? What do they control? What are they used to treat?
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Located on presynaptic neurons, control neurotransmitters release.
Inhibit the sympathetic vasomotor center in the medulla oblongata. Used to treat hypertension |
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Where are beta 1 agonist receptors located. What do they do to the body? What are they used to treat
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- Located on the myocardium, sphincters, smooth muscle of GI tract and renal arterioles.
- Increase rate and force of heart contraction - Decrease digestion and GI motility - Increase glomerular filtration, decrease lipolysis Treat hypotension, cardiac arrest, circulatory shock |
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Where are beta 2- receptor agonist located? what do they do?
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- smooth muscle of bronchioles, skeletal muscle, blood vessels supplying heart, brain, kidneys, uterus, liver cells.
- Bronchodilation, increased muscle excitability, vasodilation, uterine relaxation Treat chronic obstruct airway disease, circulatory shock, premature labor, peripheral vascular disease |
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What is another term for adrenergic antagonist?
What do the alpha antagonists do generally? |
Sympatholytics
- block normal response - Block neurotransmitters from being released or get rid of them |
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What do alpha receptor antagonists do?
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opposite of alpha agonists
- vasodilation in arterioles and veins - Control hypertension, urine retention, peripheral vascular disease, adrenal medulla tumor |
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What do the beta receptors do generally?
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block the beta receptors to block all activation
treats hypertension, cardiac arrhythmias, MI, tachycardia, angina pectoris |
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What are the 5 classes of cardiac drugs?
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- rate of heartbeat
- rhythm of heartbeat - amount of blood output - strength of contraction |
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What is ischema?
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- not enough oxygen is being delivered to the heart to meet needs
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What is coronary artery disease?
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Arterioschlerosis is characterized by the thickening or hardening of the arterial walls.
Atheroschlerosis is a type of arteriosclerosis - Atheroschlerosis is build of up fatty plaque and cholesterol reducing or blocking blood flow. |
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What is angina pectoris? What are the 3 types?
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- chest pain usually due to ischema of the heart (poor oxygen to the blood)
Main cause is because of poor contractibility and coronary artery disease - Classical- chest discomfort when when exerting - Variant- rare, occurs at rest. - Unstable: angina that changes or worse- occurs at rest, severe onset, crescendo pattern |
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What is myocardial infarction?
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- caused by severe, prolonged lack of oxygen, kills an area of the heart muscle.
- Can be caused by coronary artery disease, spasms of arteries, heavy exertion, increase in BP. Leading cause of death. |
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What helps MI (what is the goal to treat)?
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- IV fluids
- Nitroglycerin (type of nitrate) - Aspirin and thrombolytic drugs - Morphine sulfate - Beta blockers and calcium channel blockers - Oxygen |
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What is the nitrate that can treat angina? What does it do? What are the adverse health effects?
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Nitroglycerin
- Dilates blood vessels in vascular smooth muscle - relaxes spasms of angina - Used to treat stable and variant angina - Adverse health effect: headache, hypotension, tachycardia |
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What happens to nitroglycerin when it enters the body?
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- Converted to Nitric Oxide by aldehyde dehydrogenase
- Nitric oxide then activates guanylyl cyclase and converts GTP to cGMP - cGMP decreases intracellular calcium- which relaxes smooth muscle. |
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What do these mean?
- Chronotropy - Dromoptropy - Inotropy - Lusitropy |
- Chronotropy: heart rate
- Dromoptropy: conduction velocity of AV node - Inotropy: force of the contraction - Lusitropy: myocardial relaxation |
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What is propanolol? What does it its mechanism of action? What is the purpose of it?
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- Nonselective beta blocker (beta 1 and 2)=blocks sympathetic nervous system
- decrease heart rate, decrease force of contraction (neg. isotropy), decrease renal secretion, increase airway resistance, increase vascular resistance. Work by decreasing heart rate so that the oxygen demand is lower to prevent MI and ischema, tachycardia |
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What are the side effects of propanolol?
What is another drug that is a beta blocker and treats hypertension |
- bradycardia, hypotension, diminished sex drive, impotence
- metoprolol- lopressor |
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Where are calcium channels concentrated in, where else are they present? What does blocking them achieve?
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- Concentrated in SA and AV nodes; blood vessels smooth muscle.
- Blocking reduces force of contractions (neg. inotropy) and prevents tachycardia - Vasodilation - it interferes with the movement of calcium through cell membranes- Ca goes out of cell=relaxation |
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What do calcium channel blockers treat?
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- lower pain of Angina
- lower blood pressure |
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What is the drug that acts as a calcium channel blocker?
What is the mechanism of action? What does it treat? Class 4 What is another drug that is a calcium channel blocker and treats hypertension |
- Verapamil
- Acts on the AV node to slow conduction, dilates the coronary arteries - Stabilize dysrhythmias and treat angina and hypertension - nifedipine |
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Adverse health effects of Verapamil?
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- dizziness, vertigo, depression, sleepiness, headache, edema, hypotension, constipation, nausea
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What are the types of dysrhythmias?
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- Bradycardia: less than 60 beats/min
- Tachycardia: 150-250 beats/min - Atrial flutter: 200-350 - Atrial fibrillation: more than 350 |
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What drug treats atrial fibrillation/flutter and tachycardia- Class IA? How does it work?
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- Quinidine (quinidex) Class IA
- Procainamide - Blocking fast sodium into the cell - Depresses myocardium and conduction system- decrease force of contraction and decrease heart rate |
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What treats tachycardia, atrial fibrillation/flutter- Class III. How does it do this?
What is a major side effect? |
- Amiodarone- Class III
- Blocks potassium and sodium channels to prolong heart's resting stage- delayed depolarization. Blue grey discolouration- long term use of amiodarone. May go back, but may go back completely normal. |
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What is ACLS? What colour is the code?
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- Advanced Cardiac Life Support
- Combination of manual defibrillation and cardiac drugs (epinephrine, atropine) |
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What is the name of the class II drug?
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- Propanolol (inderal)
- Amiodarone |
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What is the name of class IB
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Lidocaine (xylocaine)
Phenytoin (Dilantin) |
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What does epinephrine do?
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treat cardiac arrest and cardiac dysrthymias.
Epinephrine- increase peripheral resistance and vasoconstriction to get blood shunted to body's core =cardiac rate and output. |
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What is atropine?
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Cholinergic (parasymp)
Antagonist for muscarinic Ach receptor -Bradycardia, asystole, pulseless electrical activity in cardiac arrest. - Blocks vagus nerve, slowing cardiac contractility- increases heart rate |
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BP
Normal: Prehypertension Hypertension |
Normal: 120/80
Hypertension: 140-159/90-99 |
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What are 6 classes of drugs to treat hypertension (antihypertensive drugs). Explain briefly what each do to lower blood pressure
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Diuretics: reduce blood volume
Beta blockers: slow heart rate, vasodilator Vasodilators: dilate vessels Calcium channel blockers: vasodilator, slow heart rate and conduction ACE inhibitors: vasodilator, increase renal blood flow Angiotensin-receptor blockers: block vasoconstriction |
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What do diuretics do?
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Promote water loss in urine= reduce blood volume/pressure
5 ways: 1.) By carbonic anhydrase 2.) Osmotic 3.) Thiazide 4.) Loop 5.) Potassium-sparing diuretics |
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How does the drug (name) affect carbonic anhydrase's job?
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- Acetazolamide
- Blocks the Conversion of carbon dioxide to bicarbonate ions.--> less Na reabsorbed because less H+ being secreted, less water absorbed, more water and Na in urine - Treats seizures, ocular pressure in glaucoma, treat altitude sickness. |
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Osmotic Diuretics- how do they work, what drug does this?
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- less water reabsorbed in loop and collecting duct,
less Na reabsorbed in prox. tubule. - Mannitol |
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What do Thiazide Diuretics do? Other than hypertension what does it treat?
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Inhibit Na reabsorption (block symporter) in distal tubule=more urine with water, Cl, K, HCO3
help with edema and hypertension |
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What are loop diuretics?
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Act on ascending loop of hence
Blocks Na-K-Cl symporter = no Na,Cl reabsorption Furosemide |
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What are potassium-sparing diuretics? Other than hypertension what does it treat? what is the drug that does this.
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- prevent Na reabsorption in distal tubule
- Hepatic cirrhosis with ascites (fluid in peritoneal cavity), edema of heart failure Amiloride |
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What do ACE inhibitors do? Is it the primary choice? What are two drugs under this category
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Inhibit enzyme (angiotensin-converting enzyme) which decreases angiotensin II= lower blood volume and BP.
Treat severe hypertension and CHF- drug of choice for primary hypertension Benazepril-Lotensin Ramipril-Altace |
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What are Angiotensin-receptor blockers?
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Inhibits angiotensin II binding to angiotensin 1 receptor.
blocks vasoconstriction and alosterone secretion. - Losartan |
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What is congestive heart failure?
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Heart pumps at insufficient rate
Kidneys retain water and sodium Fluid accumulates in interstitial space |
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What are the three classes of drugs to treat CHF?
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1.) Cardiac glycosides
2.) Beta antagonist 3.) Phosphodiesterase Inhibitor: increase inotropy, cause vasodilation. prolong availability of cAMP= pos. inotropy |
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What do cardiac glycosides do? Name drug- what plant is it from?
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Increase cell calcium to enhance contractility of heart
- inhibits Na ATPase, causing rise in intracellular Na. Ca is prevented from exiting Lots of intracellular Ca=release of Ca from sarcoplamic ret. enhances cardiac inotropy Digoxin- from foxglove, oleander, lily of valley |
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