Cardiopulm - Cv Pharmacology 2

Front 1

• What classification of meds are the "-pril" meds?
  
• What do they do?
• What effect does this have?
• What effect does this have on the heart?

Back 1

• ACE inhibitors
  
• Prevent conversion of angiotensin I into angiotensin II
  
• Prevents internal mechanisms fo ↑ BP, causing a relative vasodilation
• ↓ preload, ↓ afterload
  

Front 2

What are rehab concerns for patients on ACE inhibitors?

Back 2

• SEs are minimal (Dry, unproducting "ACE" cough, allergic rxn)
  
• Takes a few weeks, but exercise tolerance should improve
• ↓ PAP, ↓ PCWP, ↑ CO
  

Front 3

• What type of drug are Na⁺-channel blockers?
• What are three classifications of Na⁺-channel blockers? What does each do?

Back 3

• Anti-arrhythmics
• Ia: slows conduction, prolongs refractory period for longer diastole
• Ib: minimally slows conduction, shortens refractory period for briefer diastole
• Ic: moderate effect on conduction, no effect on refractory period
  

Front 4

• What type of drugs are "-olol" drugs?
• How might these drugs be used as anti-arrhythmics?
  
• When, in particular, are these used?
• What other drugs may be used as arrhythmics as a 2º use?

Back 4

• β-blockers
  
• Decreases automaticity, prolongs refractory period, slows HR and conduction
  
• Atrial dysrhythmias
• Ca²⁺-channel blockers

Front 5

• What are 2 anti-arrhythmics that prolong repolarization?
  
• What effect does this have?
• What kind of toxicity can these create?
• What negative effect can these have?

Back 5

• Amiodarone, Bretillium
  
• ↓ conduction, ↓ excitability, ultimately results in ↓ HR
  
• Liver toxicity
• May initially cause dysrhythmias

Front 6

What type of drugs are dopamine and dobutamine?

What type of receptors do these stimulate? What effects do these have?

Back 6

• Sympathomimetics
  
• β-1 stimulation, resulting in Ca²⁺ influx, ↑ SA node activity, and ultimate ↑ in conduction and contractility
  
• β-2 stimulation, resulting in bronchiole smooth muscle dilation
  
• α-1 stimulation, resulting in ↑ peripheral arteriole constriction, ↑'ing BP
  

Front 7

• What are α-1 receptors responsible for?
  
• What do α-1 blockers do, then?
• What net effect does this have on the heart?
• What are potential rehab concerns?

Back 7

• α-1 activity triggers arteriole smooth muscle contraction
  
• Block vasoconstriction, creating a relative vasodilation
• ↓ afterload as a result of ↓ TPR
  
• Hypotension/orthostatic hypo, BP may be low but should respond to exercise normal

Front 8

• What type of drug is atropine?
  
• What does it do?
• For whom would it be used?

Back 8

• Anti-cholinergic
  

Blocks vagal stimulationIn those w/ brady or other dysrhythmias

Front 9

What are the 3 types of diuretics?

Back 9

• Loop-Diuretics are the strongest diuretics, they act on the ascending Loop of Henle
  
• Thiazides, which inhibit Na⁺ resorption
  
• K⁺-sparing diuretics, which are weaker. They excrete fluid, but spare K⁺, thus better preserving normal electrolyte levels
  

Front 10

• What is the generic name of Lasix? What type of drug is it?
  
• What are potential SEs of Lasix?
• What are potential rehab concerns for pts taking Lasix?

Back 10

• Furesomide; loop-diuretics
• Orthostatic hypo, electrolyte imbalance, weakness, fatigue, irritability
• Lower BP, but should have normal response to exercise; pt needs to be sure to maintain therapeutic dose in blood stream

Front 11

• What classification of meds are Heparin and Coumadin?
  
• What are the three 1º reasons these meds are given to pts?
• What are risks for pts on these meds?

Back 11

• Anticoagulants
  
• Mechanical heart valves, A-fib, presence of DVTs
• ↑ risk of excessive bleeding, thus falls are potentially disastrous

Front 12

• How does Heparin work? Why does this work?
• What are the 2 types of Heparin? How are tehy administered?
• How does Coumadin work? Why does this work?

Back 12

• Inactivates thrombin; It works b/c thrombin activated fibrinogen into fibrin, which then forms polymers and clots
• Unfractionated (by IV) and low molecular weight (LMW) (SubQ stomach injection, less req'd for same therapeutic effect)
• By inhibiting Vit. K function; It works b/c Vit. K is req'd for synthesis of clotting factors

Front 13

• What type of drug is "low-dose" aspirin? What constitutes "low-dose?"
  
• What are two types of thrombolytics?

Back 13

• Antithrombotics; ~80 mg/day
  
• Steptokinase and tPA

Front 14

• What types of meds are "-statins?"
  
• What are potential SEs of statins?
• What is of note regarding these SEs?
• What types of meds are fibric acids?

Back 14

• LDL-lowering meds
  
• Myopathy, pain, wkns, paresthesias
• May progress, but are reversible upon cessation of meds
• TriG-lowering meds