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Cardiovascular Medications
Exam 2
68
Medical
Graduate
03/13/2012

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Cards

Term
Name 5 heart-related conditions that can be treated medically
Definition
Ischemia
Heart Failure
Arrhythmia
HTN
Lipid Disorders
Term
Problem with electrical conduction system causing irregular heartbeat
Definition
Arrhythmia
Term
What is the difference between ischemia and infarction.
Definition
Ischemia is reversible and infarction is not. Infarction is death of tissue
Term
These type of drugs restore balance of supply and demand. They help increase circulation to the heart while increasing exercise tolerance also.
Definition
Anti-ischemic drugs
Term
Name 5 factors involved in anti-ischemic drugs
Definition
1. Occlusion (can correct with bypass or stent)
2. Systolic wall tension (afterload, radius, and wall thickness)
3. Ionotropic state
4. Preload
5. Heart Rate
Term
The load in the ventricle has to work against to push the blood out
Definition
Afterload
Term
Can you change wall thickness with medications?
Definition
No
Term
The force of muscle contraction
Definition
Ionotropic state
Term
Stretch of myocardial cells when ventricles are full of blood
Definition
Preload
Term
If you decrease heart rate what happens to perfusion time
Definition
Increase
Term
Name 3 medications that decrease demand on the heart
Definition
Beta blockers
Calcium channel blockers
Nitrates
Term
This type of medication decreases heart rate (resting and exercise), decrease ionotropic state, and decreases VO2.
Definition
Beta Blockers
Term
This type of beta blocker is newer and is specific to beta 1
Definition
Metoprolol, atenolol
Term
These muscles have more beta-2 blockers than the heart.
Definition
Respiratory
Term
When this is blocked, you will decrease the force and rate of contraction
Definition
Beta 1
Term
An alpha and beta blocker
Definition
Labetalol
Term
Found in vascular smooth muscle. When blocked, you will get vasodilation (helps address ischemia)
Definition
Alpha 1
Term
Name 6 side effects of beta blockers
Definition
1. Bradycardia
2. AV blockade
3. CHF
4. Sedation
5. Fatigue
6. Asthmatic attacks in pts with respiratory disorders
Term
What 2 things to calcium channel blockers do
Definition
Decrease ionotropic state
Peripheral vasodilation (reduced afterload)
Term
With this, you may need to worry about BP bottoming out. The heart is not having to work as hard to get the blood out.
Definition
Peripheral vasodilation provided by calcium channel blockers
Term
Name 8 side effects of calcium channel blockers
Definition
Constipation
Edema
Nausea
Flushing
Dizziness
CHF
AV blockade
Sinus node depression
Term
Nitroglycerin and related compounds. Primarily a venodilator reducing preload. Arterial dilator reducing afterload. Minor coronary dilator, sublingual or patch, flushing or hypotension.
Definition
Nitrates
Term
Name 4 side effects of nitrates
Definition
Tachycardia
Orthostatic Hypotension
Throbbing Headache
Dizziness
Term
Name 4 types of drugs that increase supply on the heart.
Definition
Thrombolytic
Antiplatelet
Anticoagulant
Vasodilators (nitrates and calcium channel blockers minor effect)
Term
These drugs restore acute occlusion (thrombus or coronary vessel), use within 3-4 hours of MI, streptokinase, recombinant tissue plasminogen activator (TPA). Production of plasmin. Increases potential for bleeding.
Definition
Thrombolytic drugs
Term
What is the main side effect for thrombolytic drugs
Definition
Bleeding potential
Term
This medication should be used 3-4 hours of MI and can have an impact on the body for 4-6 weeks after the meds are taken
Definition
Thrombolytic Drugs
Term
This is a prophylactic drug that will decrease the likelihood of platelet aggregation.
Definition
Antiplatelet Drugs
Term
Includes aspirin and dipyridamole. Newer glycoprotein IIb/IIIa inhibitors that block platelet receptors. Newer antiADP drugs
Definition
Antiplatelet Drugs
Term
These are prophylactic drugs that inhibit the production of thrombin. Early on you could take heparin via IV and later you can take warfarin (coumadin) orally (effect of vitamin K)
Definition
Anticoagulants
Term
Use __ with pts on beta blockers
Definition
RPE
Term
Monitor INR with pts on these types of meds
Definition
Anticoagulants
Term
Antiplatelet and anticoagulants may be used post-MI to prevent what?
Definition
Further injury especially for pts who did not get to the hospital in time for clot-buster meds
Term
What all should medications do to help with heart failure (9)
Definition
1. Restore balance of work required and strength of heart
2. Break vicious cycle of dilation and weakness
3. Diuretics
4. Positive ionotropic drugs
5. Vasodilators
6. Calcium-channel blockers
7. ACE inhibitors
8. Morphine
9. Beta Blockers
Term
This type of medication helps to decrease blood volume which decreases the load on the heart so that it has less pressure to work against.
Definition
Diuretics
Term
This medication can be used acutely for pulmonary edema or chronically for maintenance
Definition
Diuretics
Term
Name 4 side effects of diuretics
Definition
Dehydration
Hypotension
Hypokalemia
Hyperuricemia
Term
What is a popular positive ionotropic drug?
Definition
Digitalis
Term
This medication increases intracellular calcium and also decreases HR and conduction (may be used for atrial fibrillation).
Definition
Digitalis
Term
This drug comes with a high risk of toxicity, nausea, fatigue, confusion, arrhythmia. Can be used chronically
Definition
Digitalis
Term
These type of drugs are used in critical care and given parenterally to increase contractility and BP.
Definition
1. Sympathomimetic
- Dopamine (inotropin) for hypotension
- Dobutamine (dobutrex) for selective beta 1
2. Amrinone (incor) and milrinone (primacor)
- Decreases breakdown of cyclic AMP
- Increases effectiveness of dopamine and dobutamine
Term
These medications decrease the work of/on the heart. They work as smooth muscle relaxants. They include arterial dilators to reduce afterload and venous dilators to reduce preload. Both reduce systolic wall stress.
Definition
Vasodilators
Term
Arterial dilators reduce what?
Definition
Afterload
Term
Venous dilators reduce what?
Definition
Preload
Term
Name 3 types of Vasodilators
Definition
Venodilators
Arteriodilators
Combination
Term
Give an example of a venodilator
Definition
Nitrate
Term
Give an example of a arteriodilator
Definition
Minoxidil
Term
Give an example of a combination veno/arteriodilator
Definition
Nitroprusside
Term
These types of medications prevent conversion of AI to AII. Its preferred for suppressed LV function and improves diastolic function. It is not used with severly compromised renal function.
Definition
ACE inhibitors
Term
In what 2 ways do ACE inhibitors effect angiotensin 2
Definition
Vasocontriction
Retention of sodium and water
Term
Name 5 side effects of Na Channel blockers
Definition
Headache
Tinnitus
Cardiac depression
GI upset
Allergic reaction (thrombocytopenic purpura)
Term
Dime-sized bruises
Definition
Thrombocytopenic purpura
Term
These are beta blockers that decrease the spontaneous activity due to sympathetic stimulation. They lengthen the refractory period and slow the conduction of the heart.
Definition
Class 2 Antiarrhythmics
Term
Used for supraventricular arrhythmias or PVCs
Definition
Class 2 antiarrhythmics
Term
Name 3 class 2 antiarrhythmics
Definition
Atenolol
Labetolol
Metaprolol
Term
These are K+ channel blcokers that prolong the refractory period by prolonging action potential. They slow repolarization and stabilize HR and conduction. Used for refractory V-tach and history of V-fib.
Definition
Class 3 Anti-arrhythmics
Term
AICD and catheter ablation are alternatives to this
Definition
Class 3 anti-arrhythmics
Term
These are Ca channel blockers that decrease spontaneous depolarization of SA node and slow the conduction thru AV node.
Definition
Class 4 anti-arrhythmics
Term
What is an example of an anti-HTN med?
Definition
Diuretic
Term
Anti-HTN meds inhibit the SNS. Name 3 places
Definition
Central
Ganglion
peripheral
Term
RAAS (renin-angiotensin activating system) is also an anti HTN med. What is it?
Definition
ACE inbibitor
All receptor antagonist
Term
What 3 things do diuretics do?
Definition
Decrease vascular volume
Loss of potassium
Potassium-sparing diuretics are also available
Term
What do centrally-acting anti-HTN meds do?
Definition
-Bind to CNS autoreceptors
-Inhibit sympathetic output
-Decrease vasoconstriction
Term
What do ganglionic blocker anti-HTN meds do?
Definition
Prevent neurotransmission at sympathetic ganglia. Also inhibits parasympathetic transmission
Term
What do peripheral blocker anti-HTN meds do?
Definition
Beta blockers (reduce HR and contractility. Alpha blockers (reduce vasoconstriction)
Term
These have a direct effect on vascular smooth muscle. Arterial ones reduce afterload and venous ones reduce preload. Some are only used for hypertensive crisis with monitoring because it really increases BP and you could have a stroke.
Definition
Vasodilators
Term
-HMG-CoA reductase inhibitors
-Decrease LDL (increase LDL receptor activity, inhibit cholesterol synthesis)
-Increase HDL
Definition
Lipid Disorders
Term
What must you monitor closely when pts are on lipid meds or Niacin?
Definition
Liver enzymes
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