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;
17 Cards in this Set
- Front
- Back
- 3rd side (hint)
|
What is the drug class, and rationale for use in HF for the prototype drug spironolactone (Aldactone)?
|
Drug Class: Aldosterone (retaines Na and bicarbonate, excretion of K+ and hydrogen ions) antagonist/K+ sparing diuretic
Rationale for Use in HF: ↓preload/afterload Therapeutic Effects: Weak diuretic and antihypertensive response when compared with other diuretics. Conservation of K+. |
Therapeutic: diuretics
Pharmacologic: K+ sparing diuretics Adverse/Side Effects: F and E: hyperkalemia |
|
|
What is the drug class, therapeutic effects, and rationale for use in HF for the prototype drug captopril (Capoten)?
|
Drug Class: Angiotensin (vasoconstrictive)-converting enzyme inhibitor
Rationale for Use in HF: ↓ preload/afterload Therapeutic Effects: ↓BP in HTN pts. Improved symptoms in pts with CHF (selected agents only). ↓ development of overt HF (enalapril only). Improved survival and ↓ development of overt CHF after MI (selected agents only). ↓ risk of death from cardiovascular causes or MI in pts with stable CAD (perindopril only). ↓ risk of MI, stroke or death from cardiovascular causes in high-risk pts (ramipril only). ↓ progression of diabetic nephropathy (captopril only). |
Therapeutic: antihypertensives
Pharmacologic: ACE inhibitors Adverse/Side Effects: Resp: cough CV: hypotension GI: taste disturbances Hemat: AGRANULOCYTOSIS Misc: ANGIOEDEMA |
|
|
What is the drug class, therapeutic effects, and rationale for use in HF for the prototype drug nesiritide (Natrecor)?
|
Drug Class: B-type natriuretic peptide (Effect of these peptides is a ↓ in CO and blood volume.)
Rationale for Use in HF: Reduces preload/afterload Therapeutic Effects: Dose-dependent reduction in pulmonary capillary wedge pressure (PCWP) and systemic arterial pressure in pts with HF with resultant ↓ in dyspnea. |
Therapeutic: none assigned
Pharmacologic: vasodilators (human B-type natriuretic peptide) Adverse/Side Effects Resp: APNEA CV: hypotension |
|
|
What is the drug class, therapeutic effects, and rationale for use in HF for the prototype drug losartan (Cozaar)?
|
Drug Class: Angiotensin (vasoconstrictive)-receptor blocker
Rationale for Use in HF: ↓preload/afterload Therapeutic Effects: ↓BP. ↓ progression of diabetic nephropathy (irbesartan and losartan only). ↓ cardiovascular death and hospitalizations due to CHF in pts with CHF (candesartan and valsartan only). ↓ risk of cardiovascular death in pts with left ventricular systolic dysfunction who are post-MI (valsartan only). ↓ risk of stroke in pts with HTN and left ventricular hypertrophy (effect may be ↓ in black pts) (losartan only). |
Therapeutic: antihypertensives
Pharmacologic: angiotensin II receptor antagonists Adverse Reactions/Side Effects: CNS: dizziness CV: hypotension Misc: ANGIOEDEMA |
|
|
What is the drug class, therapeutic effects, and rationale for use in HF for the prototype drug carvedilol (Coreg)?
|
Drug Class: β-Adrenergic blocker
Rationale for Use in HF: Use limited to ↓dose in otherwise stable pts; ↓ adrenergic overstimulation Therapeutic Effects: ↓HR/BP. Improved CO, ↓ progression of CHF and ↓ risk of death. |
Therapeutic: antihypertensives
Pharmacologic: beta blockers Adverse/Side Effects CNS: dizziness, fatigue, weakness CV: BRADYCARDIA, CHF, PULMONARY EDEMA GI: diarrhea GU: erectile dysfunction Endo: hyperglycemia |
|
|
What is the drug class, and rationale for use in HF for the prototype drug nifedipine (Adalat, Procardia)?
|
Drug Class: Calcium channel blocker
Rationale for Use in HF: Used limited to diastolic dysfunction HF; ↑ pliability of ventricle to allow more complete filling Therapeutic Effects: Systemic vasodilation, resulting in ↓BP. Coronary vasodilation, resulting in ↓ frequency and severity of attacks of angina.PO (Adults): 10-30 mg 3 times daily (not to exceed 180 mg/day) Monitor ECG periodically during prolonged therapy Angina: Assess location, duration, intensity, and precipitating factors of pts anginal pain. Geri: Assess fall risk and institute fall prevention strategies Hypertension: Encourage pt to comply with other interventions for HTN (↓weight, low-sodium diet, smoking cessation, moderation of alcohol consumption, regular exercise, and stress mgmt). Med controls but does not cure HTN. |
Therapeutic: antianginals, antihypertensives
Pharmacologic: calcium channel blockers Adverse Reactions/Side Effects CNS: headache CV: ARRHYTHMIAS, CHF, peripheral edema Derm: flushing Misc: STEVENS-JOHNSON SYNDROME |
|
|
What is the drug class, and rationale for use in HF for the prototype drug digoxin (Lanoxin)?
|
Drug Class: Cardiac glycoside (Often reserved for pts refractory to standard tx or with other comorbid conditions.)
Rationale for Use in HF: ↑ contractility Therapeutic Effects: ↑CO (positive inotropic effect) and ↓HR negative chronotropic effect). Do not give IM as causes severe pain at site and ↑CPK |
Therapeutic: antiarrhythmics, inotropics
Pharmacologic: digitalis glycosides Adverse/Side Effects CNS: fatigue CV: ARRHYTHMIAS, bradycardia GI: anorexia, N/V Toxicity/Overdose: In adults and older children, the first signs of toxicity usually include abdominal pain, anorexia, NV, visual disturbances, bradycardia, and other arrhythmias |
|
|
What is the drug class, and rationale for use in HF for the prototype drug coenzyme Q10 (ubiquinone)?
|
Drug Class: Complementary/alternative med
Rationale for Use in HF: Therapeutic Effects: ↑ contractility has the potential in HTN pts to ↓ systolic BP by up to 17 mm Hg and diastolic BP by up to 10 mm Hg without significant side-effects; survival benefit after cardiac arrest if adm in addition to commencing active cooling (32–34 degrees Celsius) |
|
|
|
What is the drug class, and rationale for use in HF for the prototype drug dopamine (Intropin)?
|
Drug Class: Inotrope: catecholamine (often reserved for pts refractory to standard tx or with other comorbid conditions)
Rationale for Use in HF: Used limited to short-term in acute care; ↑contractility Therapeutic Effects: ↑CO/BP, and improved renal blood flow. |
Therapeutic: inotropics, vasopressors
Pharmacologic: adrenergics Adverse/Side Effects CV: arrhythmias, hypotension |
|
|
What is the drug class, and rationale for use in HF for the prototype drug inamrinone (Inocor)?
|
Drug Class: Inotrope: noncatecholamine (Often reserved for pts refractory to standard tx or with other comorbid conditions)
Rationale for Use in HF: use limited to short-term in acute care; ↑ contractility Therapeutic Effects: ↑CO (inotropic effect). |
Therapeutic: inotropics (Negatively inotropic agents ↓ the force of muscular contractions. Positively inotropic agents ↑ the strength of muscular contraction)
Pharmacologic: bipyridines (causing an ↑ in myocardial contractility and to some extent arteriolar dilation) Adverse Reactions/Side Effects CV: arrhythmias, hypotension Hemat: thrombocytopenia. Misc: tachyphylaxis |
|
|
What is the drug class, and rationale for use in HF for the prototype drug furosemide (Lasix)?
|
Drug Class: Loop diuretic
Rationale for Use in HF: Reduecs preload Therapeutic Effects: Diuresis and subsequent mobilization of excess fluid (edema, pleural effusions - occurs when too much fluid collects in the pleural space (the space between the two layers of the pleura). It is commonly known as "water on the lungs." It is characterized by SOB, chest pain, gastric discomfort (dyspepsia), and cough)). ↓BP |
Therapeutic: diuretics
Pharmacologic: loop diuretics Adverse/Side Effects F and E: dehydration, hypocalcemia, hypochloremia, hypokalemia, hypomagnesemia, hyponatremia, hypovolemia, metabolic alkalosis. Hemat: APLASTIC ANEMIA (bone marrow greatly decreases or stops production of blood cells), AGRANULOCYTOSIS |
|
|
What is the drug class, and rationale for use in HF for the prototype drug hydrochlorothiazide (Esedrix)?
|
Drug Class: Thiazide diuretic
Rationale for Use in HF: Reduces preload Therapeutic Effects: ↓BP in HTN pts and diuresis with mobilization of edema. Lab Test Considerations: Monitor electrolytes (especially potassium), blood glucose, BUN, serum creatinine, and uric acid levels before and periodically throughout therapy. |
Therapeutic: Antihypertensives, diuretics
Pharmacologic: thiazide diuretics Adverse Reactions/Side Effects: F and E: hypokalemia |
|
|
What is the drug class, and rationale for use in HF for the prototype drug nitroglycerin?
|
Drug Class: Vasodilator (nitrate) (Often reserved for pts refractory to standard tx or with other comorbid conditions)
Rationale for Use in HF: ↓preload Therapeutic Effects: Relief or prevention of anginal attacks. ↑CO. ↓BP. |
Therapeutic: antianginals
Pharmacologic: nitrates Adverse/Side Effects CNS: dizziness, HA CV: hypotension, tachycardia |
|
|
What is the drug class, and rationale for use in HF for the prototype drug hydralazine (Apresoline)?
|
Drug Class: Vasodilator (nonnitrate) (Often reserved for pts refractory to standard tx or with other comorbid conditions)
Rationale for Use in HF: ↓preload/afterload Therapeutic Effects: ↓BP in HTN pts and ↓afterload in pts with CHF. |
Therapeutic: antihypertensives
Pharmacologic: vasodilators Adverse/Side Effects CV: tachycardia F and E: sodium retention Misc: drug-induced lupus syndrome |
|
|
What is the drug class, and rationale for use in HF for the prototype drug tolvaptan (investigational)?
|
Drug Class: Vasopressin antagonists (investigational)
Rationale for Use in HF: ↓preload/afterload Therapeutic Effects: tx for fluid retention and hyponatremia (↓blood sodium levels) associated with CHF |
|
|
|
What is the Ca channel blocker prototype drug?
|
Quinidine (Quinidex, Quinaglute)
Therapeutic Effects: Suppression of arrhythmias. Monitor ECG, pulse, and BP continuously throughout IV adm and periodically during oral adm. IV adm is usually discontinued if any of the following occur: arrhythmia is resolved, QRS complex widens by 50%, PR or QT intervals are prolonged, or frequent ventricular ectopic beats or tachycardia, bradycardia, or hypotension develops. Pt should remain supine throughout IV adm to minimize hypotension. Toxicity and Overdose: Serum quinidine levels may be monitored periodically during dose adjustment. Therapeutic serum concentrations are 2-6 mcg/ml. Toxic effects usually occur at concentrations >8 mcg/ml. S/sx of toxicity or cinchonism include tinnitus, hearing loss, visual disturbances, HA, nausea, and dizziness. These may occur after a single dose |
Therapeutic: antiarrhythmics (class IA)
Adverse/Side Effects: CNS: dizziness CV: HYPOTENSION, TORSADES DE POINTES GI: anorexia, abdominal cramping, diarrhea, NV Hemat: AGRANULOCYTOSIS |
|
|
What is the prototype class 1B drug?
|
lidocaine (not available in oral form because it undergoes first pass metabolism in the liver)
Therapeutic Effects: Control of ventricular arrhythmias. Local anesthesiaAntiarrhythmic: Monitor ECG continuously and blood pressure and respiratory status frequently Toxicity and Overdose: Serum lidocaine levels should be monitored periodically during prolonged or high-dose IV therapy. Therapeutic serum lidocaine levels range from 1.5 to 5 mcg/ml. S/sx of toxicity include confusion, excitation, blurred or double vision, NV, ringing in ears, tremors, twitching, seizures, difficulty breathing, severe dizziness or fainting, and unusually slow HR. during adm |
Therapeutic: anesthetics (topical/local), antiarrhythmics (class IB)
Adverse/Side Effects CNS: SEIZURES, confusion, drowsiness EENT: mucosal use: decreased or absent gag reflex. CV: CARDIAC ARREST Local: stinging Misc: ALLERGIC REACTIONS, INCLUDING ANAPHYLAXIS |
