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47 Cards in this Set
- Front
- Back
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Digoxin
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Cardiac glycoside; long term use
Inhibits Na/K ATPase; increases intracellular Ca++ Results in (+) inotropy |
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Digitoxin
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Cardiac glycoside; long term use
Inhibits Na/K ATPase; increases intracellular Ca++ Results in (+) inotropy Can be used as digoxin substitute in patients with renal disease because it is metabolized by liver |
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Ouabin
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Cardiac glycoside; long term use
Inhibits Na/K ATPase; increases intracellular Ca++ Results in (+) inotropy |
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Dobutamine
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Beta1 agonist; short term use
Results in PKA activation + inotrope, chronotrope, lusitrope |
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Milrinone
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PDE3 inhibitor; short term use only
Inhibit metabolism of cAMP by PDE3 Inodilator |
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Inamrinone
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PDE3 inhibitor; short term use only
Inhibit metabolism of cAMP by PDE3 Inodilator |
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Levosimendan
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Stabilizes Ca++ bound conformation of TnC
Not approved for use in US For short term use only |
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Carvedilol
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Mixed beta and alpha-1 antagonist; long term use
Normalize receptor expression |
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Metoprolol
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Beta antagonist; long term use
Normalize receptor expression |
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Bisoprolol
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Beta 1 antagonist; long term use
Normalize receptor expression |
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Amiloride
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K sparing diuretic
Competitive inhibition of ENaC Results in decreased Na reabsorption and increased K reabsorption |
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Spironolactone
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K sparing diuretic
Competitive inhibition of MR Results in decreased Na reabsorption and increased K reabsorption |
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Mannitol
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Osmotic agent
Increases osmolarity of tubular fluid |
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Acetazolamide
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Primary site of action: PCT
Noncompetitive/reversible inhibition of PCT cell carbonic anhydrases Results in decreased bicarbonate reabsorption and subsequent decreased Na reabsorption AE: Metabolic acidosis Has sulfa moiety |
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Furosemide
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Primary site of action: TAL
Competitive inhibition of TAL cell NKCC2 (Na/K/2Cl) transporter Results in decreased Na reabsorption and loss of positive transepithelial potential (decrease Mg/Ca reabsorption) Has sulfa moiety |
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Thiazides
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Primary site of action: DCT
Competitive inhibition of DCT cell NCC1 (Na/Cl) transporter Results in modest decrease in Na reabsorption and increased Ca reabsorption Has sulfa moiety |
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Conivaptan
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Competitive inhibition of V1R and V2R
Results in decreased aquaporin insertion into apical membrane which increases water excretion |
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Tolvaptan
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Competitive inhibition of V2R
Results in decreased aquaporin insertion into apical membrane which increases water excretion |
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Lixivaptan
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Competitive inhibition of V2R
Results in decreased aquaporin insertion into apical membrane which increases water excretion |
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Quinidine
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Class IA Na and K ch blocker
AE: Anticholinergic effect DDI w/digoxin for CYP metabolism (pharmacokinetic) |
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Procainamide
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Class IA Na and K ch blocker
AE: Hypotension and lupus like symptoms If acetylated in liver, metabolite only has K ch activity |
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Lidocaine
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Class IB Na ch blocker
AE: Na ch blocking in CNS can cause seizure, dizziness DDI potential bc of metabolism via liver |
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Flecainide
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Class IC Na ch blocker
TX of emergency supraventricular and ventricular arrthymias AE: Can be pro-arrthymic in some patients Not useful if problem is repol |
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Bisoprolol
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Beta 1 blocker selective (Class II)
SA node: Decr slope of phase 4 and depol AV node: Prolongs repol Effect: Decr automaticity (SA) and incr refractory period (AV, therefore decr re-entry) |
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Atenolol
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Beta 1 blocker selective
Class II |
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Carvedilol
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Non selective beta blocker and alpha 1 blocker
Class II |
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Metoprolol
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Beta 1 blocker selective
Class II |
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Dofetilide
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Class III K ch blocker
Prolongs repolarization and increases APD AE: Torsades de pointes and early afterdepolarizations Extensive renal clearance |
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Sotalol
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Mixed class II (b-blocker)/III (K channel blocker) activity
Racemic mixture Decreased automaticity, decreased AV conduction and increased AV refractoriness AE: Usually with overdose, bradycardia and torsades de pointes Extensive renal clearance |
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Amiodarone
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Mixed class I-IV activity
Decr automaticity, conduction velocity and incr refractoriness Low incidence of torsades de pointes AE: Hypo- or hyperthyroidism due to similarity on structure to thyroxine (iodine moieties); heart block; hypotension; pulmonary fibrosis; elevated liver enzymes |
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Dronedarone
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Related to amiodarone; mixed class I-IV activity
Less toxic bc lacks iodine moieties and decr lipophilicity |
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Verapamil
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Cardiac CCB
Tx of supraventricular arrthymias AE: AV block and hypotension with high doses DDI with beta blocker which results in HF CCB can incr digoxin levels via competition for renal excretion |
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Diltiazem
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Cardiac CCB
Tx of supraventricular arrthymias AE: AV block and hypotension with high doses DDI with beta blocker which results in HF CCB can incr digoxin levels via competition for renal excretion |
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Adenosine
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Promotes increased K channel opening and decreased Ca channel opening in SA and AV nodes
Leads to increased refractoriness, decreased APD and slowed automaticity Given IV only for supraventricular arrhythmias (extremely short ½ life) |
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K and dialysis
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Restore K+ levels for proper AP generation
Hypokalemia: early and delayed depolarizations Hyperkalemia: decreased conduction velocity |
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Nifedipine
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VSMC arterial vasoD
MOA: Block LTCC AE: Causes reflex tachycardia which aggrevates MI, flushing Beneficial DDI: Beta blocker to prevent reflex tachycardia |
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Amlodipine
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VSMC arterial vasoD
MOA: Block LTCC Slower metabolism exhibits less reflex tachycardia |
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Minoxidil
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K ch opener in VSMC
AE: HA and flushing; reflex tachycardia if use as monotherapy Off target: Reduces male pattern baldness |
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Sitaxsentan
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Competetive antagonism of ETAR
AE: HA, flushing, teratogenic |
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Bosentan
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Competitive antagonism of ETAR and ETBR
AE: HA, flushing, teratogenic, liver toxicity |
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Hydralazine
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MOA: Membrane hyperpol or Ca release from SR
Predominantly vasoD arteries Used w/other antihypertensives for HTN and w/nitrates for HF Acetylation in liver causes low oral bioavail AE: Rapid reflex tachycardia |
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Prazosin
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Antagonize VSMC alpha1 receptor thereby decr Ca mobilization
AE: Hypotension with reflex tachycardia, Na and H2O retention Use with beta blockers and diuretics to prevent AEs |
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Losartan
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ARB
Antagonism of AT1R, blocks downstream effects of AT1R stimulation, allows AngII stimulation of AT2R |
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Valsartan
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ARB
Antagonism of AT1R, blocks downstream effects of AT1R stimulation, allows AngII stimulation of AT2R AE: HyperK, precipitate renal failure in patients with bilateral renal artery stenosis, teratogenicity, incr renin secretion |
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Candesartan
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ARB
Antagonism of AT1R, blocks downstream effects of AT1R stimulation, allows AngII stimulation of AT2R AE: HyperK, precipitate renal failure in patients with bilateral renal artery stenosis, teratogenicity, incr renin secretion |
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Aliskiren
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DRI
Decr renin activity, blocks downstream effects of angiotensinogen, no impact on bradykinin AE: Possible hyperK in conjunction with ACE inhibitors/ARBs/K sparing diuretics, teratogenicity |
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Nesiritide
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B type natriuretic peptide
Tx of HF, short term IV only because it is a peptide AE: Hypotension from vasorelaxation effects |
