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25 Cards in this Set
- Front
- Back
loop diuretics
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inhibit Na+,K+,2Cl- cotransporter in Loop of Henle
used for rapid relief of dyspnea and fluid retention |
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furosemide
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loop diuretic
SE: hypoTN, ototoxicity hypoK, hypoMg, hyperuricemia, hyperglycemia, metabolic alkalosis effective even w/ renal dysfcn |
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thiazides
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block Na+,Cl- cotransporter on distal tubule
long duration so used for mild CHF and HTN! |
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hydrochlorothiazide
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hypercholesterolemia, hypertriglyceridemia, hypoK, hypoMg, hypoNa, hyperCa, metabolic alkalosis
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K+ sparing diuretics
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inhibit Na+ reabsorption in distal tubule by competing at aldosterone R
weak Rx used with other diuretics to prevent hypoK in HF pt |
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spironolactone
eplerenone |
SE: hyperK, gynecomastia (male breasts), irreg menstruation
competes w/ aldosterone R to block Na+ reabsorption (Na+ in urine so no gradient for K+ entry) |
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inotropes
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improve contractility by increasing intracellular calcium
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digoxin
(cardiac glycoside) |
inhibits sarcolemmal Na+,K+ ATPase pump; slows conduction, increases refractoriness at AVnode, enhances vagal tone
used in HF w reduced contractility and atrial fib SE: arrhythmia exacerbated by low K, Mg, high Ca or poor renal clearance, blurred vision, color disperception, n/v, anorexia |
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sympathomimetic amines
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bind to cardiac B1 receptor > increase adenylate cyclase > increase cAMP > increase calcium in myocyte
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dopamine
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used for HF and shock
low dose: acts on renal B1 and mesenteric vessels > vasodilatation, increase renal blood flow |
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dobutamine
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dopamine analog for B1, B2, A
no peripheral R change (B2=a) used for HF w/o hypoTN, short term Tx SE: tachyarrhythmia |
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isoproterenol
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synthetic epi analog, B-agonist
used in EF for bradycardia or heart block, but not in myocardial ischemic pt |
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milrinone
(phosphodiesterase inhibitor) |
inhibits phosphodiesterase > increased cAMP use > more Ca in cell > increased contractility
used only when standard treatment fails SE: serious ventricular arrhythmias, systemic dilation |
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beta blockers
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1gen: non selective
2gen: higher affinity for B2 3gen: selective/non + a1 block (causing vasodilation) used for ischemic hd, CHF, HTN, tachyarrhythmias SE: bronchospasm, vasospasm, conduction block, high triglyceride, low HDL, fatigue, insomnia, depression not for decompensated pt, but do not stop if already on it |
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metoprolol
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2gen beta blocker
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carvedilol
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3gen beta blocker
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labetolol
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3gen beta blocker
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emolol
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2gen beta blocker
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ACE Inhibitors
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used for HF, HTN, postMI, slow progression of renal disease in diabetics
SE: hypoTN, hyperK, renal insuff, cough, angioedema renal excretion (lower dose w/ dysfcn) not for pregnant |
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captopril, enalapril, lisinopril, ramipril, trandolapril
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ACE inhibitors
do not allow ACE to convert Angiotension I > no aldosterone released; inhibits breakdown of bradykinin (a vasodilator) all pt w/ LV dysfunction |
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Angiotension Receptor Blockers (ARBS)
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used like ACEI when ACEI cannot be used (w/ cough), used for pt w/ refractory symptoms on Bblocker/ACEI
compete w/ Angiotension II for AT1 and 2 > less SNS, aldosterone, Na reabsorption |
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candesartan, valsartan, losartan
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ARBS
HF, HTN, slow progression of kidney disease in diabetics |
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nitrates
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used for HF w/ severe renal dysfunction and risk of hyperK
causes vasodilation by conversion to NO near sm muscle membrane *low dose: vdilation > pooling > less return > less filling *high dose: a+vdilation SE: hypoTN, reflex tachycardia, flushing, headache rapid development of tolerance |
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hydrazaline
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used for HF w/ renal dysfcn and hyperK
potent and direct arteriole vasodilator SE: headaches, flushing, palpitations, nausea, anorexia, myocardial ischemia, lupus-like syndrome |
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do not use in HF pt
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NSAID - Na retention and peri vasoconstriction
most antiarrhythmic - neg inotropic and proarrhythmic non-dihydropyridine Ca-channel blockers: neg inotropic |