Term
| Classes of drugs used for essential hypertension |
|
Definition
|
|
Term
| Classes of drugs used for HTN in CHF |
|
Definition
Diuretics
ACEi/ARBs
B blockers (only if compensated)
K sparing diuretics |
|
|
Term
| Classes of drugs used for HTN in diabetes mellitus |
|
Definition
ACEi/ARBs
CCBs
Diuretics
B blockers
A blockers |
|
|
Term
Hydralazine
effects
use
toxicity |
|
Definition
increases cGMP leading to vasodilation (arterioles>veins) reducing afterload
Use for severe HTN and CHF.
1st line for HTN in pregnancy
Side effects: compensatory tachycardia and lupus |
|
|
Term
Nifedipine
effects
use
toxicity |
|
Definition
block voltage dependent L type calcium channels leading to muscle relaxation
Greater action on vasculature than heart
Use for HTN, angina, Raynaud's
Side effects: cardiac depression, AV block, edema, flushing, dizziness constipation |
|
|
Term
Verapamil
effects
use
toxicity |
|
Definition
Block voltage-dependent L type calcium channels causing smooth muscle relaxation
more in heart than vasculature
HTN, angina, arrythmias, Raynaud's
Side effects: cardiac depression, AV block, edema, flushing, dizziness, constipation |
|
|
Term
Dilitiazem
effects
use
toxicity |
|
Definition
Blocks voltage gated L-type calcium channels causing muscle relaxation
Works on heart and vasculature equally
Used for HTN, angina, arrythmias, Raynaud's
Side effects: cardiac depression, AV block, edema, flushing dizziness, constipation |
|
|
Term
Nitroprusside
effects
use
toxicity |
|
Definition
increases release of NO causing increased cGMP
used for malignant HTN
short acting
can cause cyanide toxicity |
|
|
Term
Fenoldopam
effects
use
toxicity |
|
Definition
D1 agonist relaxing renal vasculature
Used for malignant HTN |
|
|
Term
Diazoxide
effects
use
toxicity |
|
Definition
Opens K channels causing hyperpolarization and relaxation of vasculature
Used for malignant HTN
Side effects: hypoinsulinema -> hyperglycemia |
|
|
Term
Nitroglycerin
effects
use
toxicity |
|
Definition
Release NO in smooth muscle causing increase in cGMP and relaxation
veins more than arteries
Used for angina, pulmonary edema
Side effects: reflex tach, hypotension, flushing, headache, "Monday disease" |
|
|
Term
Isosorbide dinitrate
effects
use
toxicity |
|
Definition
Release NO in smooth muscle causing increase in cGMP and relaxation
veins more than arteries
Used for angina, pulmonary edema
Side effects: reflex tach, hypotension, flushing, headache, "Monday disease" |
|
|
Term
| Effect on EDV of nitrates, b-blockers, and combo |
|
Definition
Nitrates: Decrease
B-blockers: Increase
Combo: No effect or decrease |
|
|
Term
| Effect on BP of nitrates, b-blockers, combo |
|
Definition
Nitrates: Lower
B-blockers: Lower
Combo: Lower |
|
|
Term
| Effect on contractility of nitrates, b-blockers, and combo |
|
Definition
Nitrates: Increase (reflex)
B-blockers: Decrease
Combo: No effect |
|
|
Term
| Effect on HR of nitrates, B-blockers, and combo |
|
Definition
Nitrates: Increase (reflex)
B-blockers: Decrease
Combo: Decrease |
|
|
Term
| Effect on ejection time of nitrates, B-blockers, combo |
|
Definition
Nitrates: Decrease
B-blockers: Increase
Combo: No Effect |
|
|
Term
| Effect on myocardial oxygen consumption of Nitrates, B blockers, and combo? |
|
Definition
Nitrates: Lower
B-blockers: Lower
Combo: Much Lower |
|
|
Term
Which calcium channel blocker is more like a nitrate?
Which calcium channel blocker is more like a beta blocker? |
|
Definition
Nifedipine is more like a Nitrate
Verapamil is more like a beta blocker |
|
|
Term
What -ol drugs are contraindicated in angina?
Why? |
|
Definition
Pindolol and acebutolol
They are partial agonists |
|
|
Term
Statins
effects
use
toxicity |
|
Definition
Inhibit HMG-CoA reductase, no mevalonate
Really lower LDL
Slight increase of HDL
Slight decrease of TG
Side effects: hepatotoxic, rhabdomyolysis |
|
|
Term
|
Definition
Inhitibs lipolysis in adipose tissue and reduces hepatic VLDL secretion into circulation
Lowers LDL
Increases HDL
Slightly lowers TG
Side effects: flushing, hyperglycemia, hyperuricemia |
|
|
Term
Cholestyramine
effects
use
toxicity |
|
Definition
prevent intestinal reabsorption of bile acids
Decrease LDL
Very slight increase in HDL
Very slight increase in TG
Side effects: tastes bad, GI discomfort, ADEK deficiency, cholesterol gallstones |
|
|
Term
Colestipol
effects
use
toxicity |
|
Definition
prevent intestinal reabsorption of bile acids
Decrease LDL
Very slight increase in HDL
Very slight increase in TG
Side effects: tastes bad, GI discomfort, ADEK deficiency, cholesterol gallstones |
|
|
Term
Colesevelam
effects
use
toxicity |
|
Definition
prevent intestinal reabsorption of bile acids
Decrease LDL
Very slight increase in HDL
Very slight increase in TG
Side effects: tastes bad, GI discomfort, ADEK deficiency, cholesterol gallstones |
|
|
Term
Ezetimbe
effects
use
toxicity |
|
Definition
Prevent cholesterol reabsorption at the brush border
Decrease LDL
Side effects: hepatotoxic |
|
|
Term
Fibrates
effects
use
toxicity |
|
Definition
Upregulate lipoprotein lipase leading to increased TG clearance
Slightly lower LDL
Slightly raise HDL
Drastically lower TG
Side effects: myositis, hepatotoxic, cholesterol gallstones |
|
|
Term
Digoxin
(cardiac glycoside)
effects
use
toxicity |
|
Definition
Inhibit Na/K pump leading to less Na/Ca exchange and thus greater Calcium current causing longer depolarization
Stimulates vagus
Used in CHF and a-fib
Side effects:
cholinergic + blurry yellow vision
EKG: increase PR interval, decreased QT, scooping, T wave inversion
Arrythmias, hyperkalemia
Worse in renal failure
treat with anti-dig Fab fragment, normalizing K, Mg, or lidocaine |
|
|
Term
Nesiritide
effects
use
toxicity |
|
Definition
B-type naturietic peptide causes increased cGMP and vasodilation
Use for acute heart failure
Side effects: hypotension |
|
|
Term
Quinidine
effects
use
toxicity |
|
Definition
Increase AP duration
Increase refractory period
Increase QT interval
Use for both atrial and ventricular arrythmias
Side effects: cinchonism (headache, tinnitus), thrombocytopenia, torsdades de pointes |
|
|
Term
Procainamide
effects
use
toxicity |
|
Definition
Increase AP duration
Increase refractory period
Increase QT interval
Use for both atrial and ventricular arrythmias
Side effects: Reversible lupus, thrombocytopenia, torsdades de pointes |
|
|
Term
Disopyramide
effects
use
toxicity |
|
Definition
Increase AP duration
Increase refractory period
Increase QT interval
Use for both atrial and ventricular arrythmias
Side effects: thrombocytopenia, torsdades de pointes |
|
|
Term
Lidocaine
effects
use
toxicity |
|
Definition
Decreased AP duration
Used for ventricular arrhythmias post MI or from digitalis
Side effects: local anesthetic, CNS effects, cardiovascular depression |
|
|
Term
Mexiletine
effects
use
toxicity |
|
Definition
Decreased AP duration
Used for ventricular arrhythmias post MI or from digitalis
Side effects: local anesthetic, CNS effects, cardiovascular depression |
|
|
Term
Tocainide
effects
use
toxicity |
|
Definition
Decreased AP duration
Used for ventricular arrhythmias post MI or from digitalis
Side effects: local anesthetic, CNS effects, cardiovascular depression |
|
|
Term
|
Definition
Increase AP duration
Increase refractory period
Increase QT interval
Use for both atrial and ventricular arrythmias
Side effects: thrombocytopenia, torsdades de pointes |
|
|
Term
|
Definition
Decreased AP duration
Used for ventricular arrhythmias post MI or from digitalis
Side effects: local anesthetic, CNS effects, cardiovascular depression |
|
|
Term
|
Definition
prolongs refractory period in AV node
Used for V-tach that progress to V-fib or intractable SVT
Last resort
Side effects: proarrythmic especially post MI |
|
|
Term
Flecainide
effects
use
toxicity |
|
Definition
prolongs refractory period in AV node
Used for V-tach that progress to V-fib or intractable SVT
Last resort
Side effects: proarrythmic especially post MI |
|
|
Term
Propafenone
effects
use
toxicity |
|
Definition
prolongs refractory period in AV node
Used for V-tach that progress to V-fib or intractable SVT
Last resort
Side effects: proarrythmic especially post MI |
|
|
Term
|
Definition
Beta blockers
decreased cAMP and thus Ca currents leading to decreased nodal conduction
Increase in PR interval
Used for V-tach, SVT, slowing ventricles during a-fib and flutter
Side effects: impotence, worse asthma, bradycardia/heart block, CNS effects |
|
|
Term
| Class III anti-arrythmics |
|
Definition
Block K channels
Increase AP duration
Increase refractory period
Increase QT
Used when others fail |
|
|
Term
Ibutilide
effects
use
toxicity |
|
Definition
Block K channels
Increase AP duration
Increase refractory period
Increase QT
Used when others fail
Side effects: torsades de points |
|
|
Term
Sotalol
effects
use
toxicity |
|
Definition
Block K channels
Increase AP duration
Increase refractory period
Increase QT
Used when others fail
Side effects: torsades, excessive beta blockade |
|
|
Term
Bretylium
effects
use
toxicity |
|
Definition
Block K channels
Increase AP duration
Increase refractory period
Increase QT
Used when others fail
Side effects: new arrythmias, hypotension |
|
|
Term
Amiodarone
effects
use
toxicity |
|
Definition
Block K channels, alters lipid membranes so also class I and II effects
Increase AP duration
Increase refractory period
Increase QT
Used when others fail
Side effects: pulmonary fibrosis, hepatotoxic, thyroid dysfunction, corneal deposits, blue/gray skin deposits (photo dermatitis), CNS |
|
|
Term
Dofetilide
effects
use
toxicity |
|
Definition
Block K channels
Increase AP duration
Increase refractory period
Increase QT
Used when others fail |
|
|
Term
|
Definition
Calcium channel blockers
Decrease conduction velocity
Increase refractory period
Increase PR interval
Used to prevent nodal arrythmias (SVT)
Side effects: constipation, flushing, edema, CHF |
|
|
Term
Adenosine
effects
use
toxicity |
|
Definition
Causes K to leave cells making them hyper polarized and less calcium influx
Drug of choice for SVTs
VERY short acting
Side effects: flushing, hypotenstion, chest pain
Blocked by Theophylline |
|
|
Term
Esmolol
effects
use
toxicity |
|
Definition
Short acting beta blocker (Class II anti-arrythmic)
Beta blockers
decreased cAMP and thus Ca currents leading to decreased nodal conduction
Increase in PR interval
Used for V-tach, SVT, slowing ventricles during a-fib and flutter
Side effects: impotence, worse asthma, bradycardia/heart block, CNS effects |
|
|
Term
|
Definition
| Effective in torsades de pointes and digoxin toxicity |
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