Term
| Contraction of actin-myosin filaments initiated by: |
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Definition
| Causing Calcium dependent calcium release |
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Term
| Inhibits the Na-K ATPase. More intracellular sodium allows less calcium to leave the cell. |
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Definition
Digoxin (digitalis)
More calcium within the cell = stronger contractility
Toxicity: Blurry yellow vision
Hyperkalemia, bradycardia |
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Term
Non-DHP calcium channel blockers
and their side effects |
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Definition
Verapamil
Diltiazem
Works primarily in the heart AV nodal cells to slow conduction
Side effects: constipation, flushing, edema, AV block (sinus node depression) |
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Term
| Brain naturitic peptide analog. Ventricle myocytes secrete this when heart volume increases. |
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Definition
Nesiritide
Increased excretion of sodium and water. Will decrease preload but can cause significant hypotension |
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Term
| Drug cocktails to use for CHF (chronic) |
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Definition
Digoxin (doesn't help prove mortality)
ACE inhibitors
ARB
Loop Diuretics (to get rid of retained water)
B-blockers (to lower o2 demand) |
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Term
| Drug cocktails to use for CHF (acute) |
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Definition
Loop diuretics
Morphine
Nitrates
Oxygen
Positioning & Pressors
"LMNOP" |
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Term
| Phases of ventricular muscle action potential |
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Definition
Phase 0: Na rapid depolarization
Phase 1: Na deactivation
Phase 2: Ca plateau
Phase 3: K depolarization
Phase 4: K resting depolarization |
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Term
| Phases of pace maker action potential |
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Definition
Phase 4: Na slow depolarization with Ifunny channels
Phase 0: Ca influx
Phase 3: K efflux
No plateau with pacemaker cells.
No phase 1 and 2 |
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Term
| General Classes of cardiac anti-arrythmics |
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Definition
Class 1: Na channel blockers
Class 2: Beta Blockers
Class 3: K channel blockers
Class 4: Ca channel blockers
"No Bad Boy Keeps Clean" |
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Term
| Class 1A Sodium Channel Blockers |
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Definition
DQP - "double quarter pounder"
Disopyramide
Quinidine
Procainamide
Procainamide used for wolf parkinson white
Procainamide can cause reversible drug induced lupus
Quinidine can cause cinchonism: headache tinnitus, thrombocytopenia. ALSO TORSADES DE POINTES due to inc. QT interval |
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Term
| Class 1B Na channel blockers |
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Definition
LTM "Lettuce tomato mayo"
Lidocaine
Tocainide
Mexiletine
Lidocaine can be used for tachyarrythmias
Phenytoin falls into class 1B category
Decreases AP duration |
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Term
| Class 1C Na Channel blockers |
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Definition
EFP- "extra fries please)
Encainide
Flecainide
Propafenone
Useful in Vtachs
No effect on AP duration |
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Term
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Definition
Beta blockers:
Propranolol (nonselective)
Esmolol
Metroprolol
Atenolol
Timolol
Esmolol can slow down the ventricular rate during atrial fibrilltion
Works at the AV nodal cells (by dec slope of phase 4) to inc PR interval
Works at B-adrenergic cells to dec inotropy
toxicity: exacerbation of asthma (bronchospasm), tachycardia (masks hypoglycemia) CNS effects.
Treatment for overdose: glucagon |
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Term
| Class 3 Potassium channel blockers |
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Definition
Sotalol
Amiodarone
Ibutilide
Bretylium
Dofetilide
Commonly used for arrythmias, at phase 3 by prolonging the QT interval
Amiodarone commonly used for Wolf parkinson white.
Check your PFT, LFT, TFT's: Amiodarone causes pulmonary fibrosis, hepatotoxicity and hyper/hypothyroidism (bc its made of iodine. Can also get photodermatitis (SAT)
Sotalol and ibutilide - cause Torsades de pointes by inc QT interval |
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Term
| Class 4 Ca Channel Blockers (non DHP channels) |
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Definition
Verapamil
Diltiazem
Elongates the Phase 0 at the NODAL cells, also prolonging the PR interval
Toxicity: Constipation, flushing, edema, Heart block (Careful if you tie it with Beta blockers causing a complete heart block) |
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Term
| Drug used for abolishing supraventricular tachycardia. Very short acting |
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Definition
Adenosine
Pushes all of the K out of the cell causing extreme hyperpolarization. Cause stoppage of heart
Toxicity: Flushing, hypotension, chest pain/burning
Reversed by theophylline |
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Term
| Drugs given during prolonged codes |
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Definition
Ca - stabilize myocardium potential
HCO3 - to address lactic acidosis
During prolonged arrest theres acidosis that occurs, so then K+ leaves the cell as H+ enters to compensate for the acidosis. Hyperkalemia can cause |
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Term
| Peripheral vascular smooth muscle contraction MOA |
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Definition
Contraction:
Calcium enters the cell, encounters calmodulin and creates a calcium-calmodulin complex that phosphorylates myosin light-chain kinase.
Myosin-Phosphate binds to actin to contract
Relaxation:
GTP broken down to cGMP via gaunylyl cyclase.
cGMP activates Activated Myosin Phosphorylase
Activated Myosin Phosphorylase cleaves myosin phosphate, and relaxation occurs
Normally cGMP is returned to GTP via cGMP phosphodiesterase. Can cause muscle relaxation by inhibiting cGMP phosphodiesterase (sildenafil) |
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Term
| Inhibits Angiotensin converting enzyme |
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Definition
ACE Inhibitors
Lisinopril
Captopril
Enalapril
Side effects:
Extra bradykinin levels causes cough (dry hacking cough)and angioedema (swelling of lips/tongue)
Proteinuria
Taste Changes
Hypotension
Pregnancy problems (kidney problems in infant)
Rash
Hyperkalemia (bc no Aldosterone)
Increases levels of renin (loss of feedback)
Decreases GFR by preventing constriction of efferent arterioles |
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Term
| Directly blocks angiotensin at its receptors |
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Definition
Angiotensin receptor blockers (ARBs)
sartan
Side effects:
Angioedema |
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Term
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Definition
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Term
| Increases cGMP to cause smooth muscle dilation (Acts more arterioles than veins) |
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Definition
Hydralazine
Used for hypertension crisis and pregnancy
Side effects:
Reflex tachycardia (frequently given with B-blocker to prevent)
Drug induced Lupus (anti-histone) |
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Term
Opens potassium channels and hyperpolarizes smooth muscle, resulting in relaxation of vascular smooth muscle.
Causes hypertrichosis |
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Definition
Minoxidil
Use: severe hypertension, topical application for hair loss. |
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Term
| Dihydropyridine Calcium Channel Blockers |
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Definition
Nifidipine
"-dipines"
Used for: Hypertension, angina, raynaud, esophageal spasm |
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Term
| Vasodilate by releasing Nitric Oxide in smooth muscle. Dilate veins more than arteries to reduce preload |
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Definition
Nitrates:
Nitroglycerin, isosorbide dinitrate
Used for : Angina, pulmonary edema, erection enhancer
Toxicity: reflex tachycardia (from drop in BP), thiocyanate toxicity |
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Term
| Antihypertensive therapy safe in pregnancy |
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Definition
Hydralazine
Methyldopa (D1
labetolol
DHP CCB (nifedipine) |
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Term
| Antihypertensive options for patients with primary hypertension |
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Definition
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Term
| Antihypertensive options for patients with CHF |
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Definition
Diuretics (furosemide)
ACE inhibitor/ARB
B-blocker
Aldosterone antagonist
Avoid because of dec inotropy:
B-blocker
CCB |
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Term
| Antihypertensive options for patients with DM |
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Definition
ACE inhibitors/ARB (to prevent diabetic proteinuria)
Avoid/be careful with:
B-blocker (masks hypoglycemia tachycardia) |
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Term
| Antihypertensive options for patients with BPH |
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Definition
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Term
Antianginal therapy
Goal is to reduce myocardial O2 demand |
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Definition
Nitrates and beta blockers together
Can also add ACE inhibitors
As long as you address the myocardial O2 demand |
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Term
| Lowers LDL the best out of all the drugs. Causes hepatotoxicity and rhabdomyolysis (muscle aches) |
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Definition
HMG-CoA reductase inhibitors:
Lovastatin
pravastatin
stimvastatin
atorvastatin
-statins" |
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Term
| Lipid lowering agent: Raises HDL by inhibiting release of VLDL into circulation. |
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Definition
Niacin
Side effects, causes a lot of flushing to face and body
Can decrease side effects with baby-asprin.
Hyperuricemia (exacerbates gouty attacks) |
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Term
| Lipid lowering agent: Prevents intestinal absorption of bile acids |
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Definition
Cholestyramine
Colestipol
Don't used much because they taste bad and people get GI problems (diarrhea).
Cholestyramine can bind C-diff. toxin
Can cause gallstone formations (because you are taking fat out of the system without taking cholesterol out too) |
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Term
| Lipid lowering agent: Inhibits Cholesterol absorption in small intestine at brush border |
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Definition
Ezetimibe
Can be replacement for someone who cannot tolerate statins. Won't effect fat soluble vitamin absorption |
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Term
| Lipid lowering agent: Lowers triglicerides by upregulating Lipoprotein Lipase (LPL) |
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Definition
Fibrates:
gemfibrozil
clofibrate
Combining statin with fibrate can get even worse rhabdomyolysis. Be very careful with this
Can cause gallstone formations (because you are taking fat out of the system without taking cholesterol out too) |
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Term
| Lipid lowering agent: Lowers triglyceride through food source. |
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Definition
omega 3 fatty acids:
Salmon
Flax seed oil |
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Term
| Used for malignant hypertension treatment. Is a dopamine D1 receptor agonist to relax vascular smooth muscle |
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Definition
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Term
K channel opener that relaxes vascular smooth muscle.
Causes hypertrichosis |
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Definition
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