Term
|
Definition
| Anti-anginal, vasodilator. Prototype drug of nitrates |
|
|
Term
|
Definition
| Releases nitric oxide in smooth muscle, which activates guanylyl cyclase and increases cGMP. This causes vascular smooth muscle relaxation |
|
|
Term
|
Definition
| Vasodilation decreases venous return, preload (decreased in cardiac work by decreased filling pressure and CO), intracardiac volume, and heart size. Increases coronary blood flow in some areas and in variant angina |
|
|
Term
| Clinical uses of Nitroglycerin |
|
Definition
| Acute angina (sublingual); angina prophylaxis (oral sustained release and transdermal); acute coronary syndrome (IV) |
|
|
Term
| Nitroglycerin pharmacokinetics |
|
Definition
| High first past effect (SL dose smaller than oral); high lipid solubility so rapidly absorbed; |
|
|
Term
|
Definition
| Tolerance, orthostatic hypotension, flushing, HA, compensatory SNS responses (tachycardia, Na/water retention). Synergistic hypotension if taken with phospodiesterase type 5 inhibitors for erectile dysfunction |
|
|
Term
|
Definition
| Anti-anginal, vasodilator. Available in immediate release and sustained release |
|
|
Term
|
Definition
| Stimulation of cGMP causes vascular smooth muscle relaxation |
|
|
Term
|
Definition
Causes vascular smooth muscle relaxation with prominent effect on the veins.
Reduces cardiac oxygen demand by decreasing preload; may modestly reduce afterolad. Coronary artery
dilation improves collateral blood flow to ischemic areas |
|
|
Term
| Clinical uses of Isosorbide |
|
Definition
| Prevention and treatment of angina (not acute episodes d/t slower onset of action. May be used in patients with heart failure |
|
|
Term
| Isosorbide Pharmacokinetkics |
|
Definition
| Similar to nitroglycerin. Metabolized in the liver |
|
|
Term
|
Definition
| Similar to nitroglycerin. Hypotension, headache, lightheadedness. Avoid use with phospodiesterase type 5 inhibitors for erectile dysfunction (syngeristic hypotension) |
|
|
Term
| Cardiac performance dependent upon: |
|
Definition
| Preload; afterload; contractility; heart rate |
|
|
Term
| Goal of heart failure treatment: |
|
Definition
| 1) increase contractility (Drugs: dig; bipyridines-PDE inhibitors-inamrinone; beta agonists-dobutamine) & 2) decrease workload (lifestyle change; drugs: ACEI; Beta blocker; vasodilators; diuretics |
|
|
Term
| digoxin: prototype of which class |
|
Definition
| cardiac glycoside (only one used in US) |
|
|
Term
| Digoxin: from what botanical source? |
|
Definition
|
|
Term
| Digoxin: improved mortality? |
|
Definition
| No improved mortality in CHF, however; useful for symptom relief & for patients not tolerant of ACEI |
|
|
Term
|
Definition
| Inhibits Na/K ATPase (the sodium pump); increases intracellular Na+, decreasing Ca++ expulsion from cell. Increased intracellular calcium enhances excitation/contraction coupling. NET: Increased cardiac contractility |
|
|
Term
| Digoxin Pharmacodynamics cautions |
|
Definition
| Increased cardiac contractility early, brief prolongation of action potential followed by shortening: if toxicity progresses, delayed after potentials lead to premature depolarizations and these ectopic beats may lead to Vfib. |
|
|
Term
|
Definition
| 60-85% bioavailability; Vd=6-8 L/Kg (lge: widely distributed to tissues, including CNS); protein binding= 20-40%; T1/2=36-40 hrs; 2/3 eliminated unchanged in urine- renal clearance proportional to Cr Cl: adjust dose in renal impairment |
|
|
Term
| Digoxin therapeutic window |
|
Definition
| Narrow therapeutic window: Conc > 2 ng/ml lead to toxicity while < 0.5 ng/ml may not be therapeutic. Maintain @ 1 ng/ml since mortality rate reduced when serum conc. < 0.9 ng/ml and increased mortality when serum conc. > 1.5 ng/ml. |
|
|
Term
|
Definition
| GI - N/V, anorexia; CNS - hallucinations, visual disturbances (color perception), CTZ stimulation; cardiac - arrhythmias, (v-tac, v-fib, AV junctional rhythm, PVBs, bigeminal rhythm, 2 deg AV block); Gynecomastia in men (rare) |
|
|
Term
| Digoxin: most important risk factor for toxicity |
|
Definition
| Renal Function: need routine monitoring for therapeutic levels and administer decreased dose in renal impairment |
|
|
Term
| Digoxin interactions with electrolytes |
|
Definition
| K+ - hyperkalemia inhibits binding to sodium pump and hypokalemia increases activity and may lead to toxicity; Ca++ - hypercalcemia increases risk for drug induced arrhythmia; Mg+ - decreased magnesium increase risk for toxicity |
|
|
Term
|
Definition
| Heart failure, Afib, Aflutter, PAT ** use only when ACEI and diurectics have failed to control symptoms |
|
|
Term
| Digoxin drug interactions |
|
Definition
| commonly used together with 1) Amiodarone or Warfarin: re/to protein binding & metabolism - watch therapeutic levels, and 2) Diuretics - watch electrolytes! |
|
|
Term
|
Definition
| Wolff-Parkinson-White syndrome and Afib |
|
|
Term
| Adenosine: antiarrhythmic membrane action |
|
Definition
| 1) calcium channel blocker, 2) sympatholytic action |
|
|
Term
|
Definition
| HIGH efficiency (90-95%) & short duration of action (T1/2= <10 seconds) |
|
|
Term
|
Definition
| Increase AV node refractory period and increase PR interval (useful in supraventricular arrhythmias) |
|
|
Term
|
Definition
| 1st choice treatment in adult patients without heart failure or SA or AV nodal disease when used to terminate supraventricular tachycardia |
|
|
Term
|
Definition
| nucleoside that occurs naturally throughout the body |
|
|
Term
|
Definition
| Activates inward K+ current and inhibits Ca++ current: NET- marked hyperpolarization & suppression of Ca++ dependent action potentials |
|
|
Term
| Adenosine: pharmacodynamics |
|
Definition
| as bolus: inhibits AV nodal conductin & increases AV nodal refractory period |
|
|
Term
|
Definition
| Drug of choice for prompt conversion of paroxysmal supraventricular tachycardia to a sinus rhythm |
|
|
Term
|
Definition
| Theophylline or caffeine (receptor blockers) decrease effectiveness, & dipyridamole (uptake inhibitor) potentiates effects |
|
|
Term
|
Definition
| flushing, SOB, chest burning, AV block, Afib, HA, hypotension, nausea, rare paresthesias |
|
|
Term
|
Definition
| Is an antidysrthmic that possesses electrophysiologic characteristics and lengthens the cardiac action potential and blocks myocardial potassium channels. This leads to slowe conduction and prolonged refractoriness. Prolong action potential by blocking K channels. |
|
|
Term
| Amiodarone Electrophysiologic Characteristics |
|
Definition
| Class I = rapidly blocks sodium channels. Class II = applies antisympathetic action. Has similar class IV negative inotropic effect in nodal tissue |
|
|
Term
| Amiodarone Pharmacokinetics |
|
Definition
| Oral: time to peak concentration = 3 - 7 hrs. Primary excretion site = bile |
|
|
Term
| Amiodarone FDA Labeled Indications |
|
Definition
| Ventricular arrhythmia, Life-threatening; Treatment and Prophylaxis |
|
|
Term
| Amiodarone FDA Non-labeled Indications |
|
Definition
| Advanced cardiac life support, Angina, Atrial Fibrillation (prophylaxis), Fetal Tachycardia, Heart Failure, MI, Myocarditis, Supraventricular arrhythmia |
|
|
Term
|
Definition
| Hypotension, Bradyarrhythmia, Photosensitivity, Thyroid Dysfunction, Dizziness, Coordination Problems, Visual Disturbance, Malaise / Fatigue |
|
|
Term
| Amiodarone Monitoring Considerations |
|
Definition
| Liver Enzymes may become elevated due to medication, Thyroid function labratories should be measured at baseline and every 6 months |
|
|
Term
|
Definition
| a nonselective beta-adrenergic blocking agent with alpha 1-adrenergic blocking activity and no intrinsic sympathomimetic activity |
|
|
Term
|
Definition
| The beta-adrenergic blocking activity decreases cardiac output, exercise- and/or isoproterenol-induced tachycardia, and reflex orthostatic tachycardia. Has minimal inverse agonist activity. |
|
|
Term
| Carvedilol Common Side Effects |
|
Definition
| Hypotension, Bradyarrhythmia, Peripheral Edema, Abnormal Weight Gain, Hyperglycemia, Dizziness, Fatigue, Erectile Dysfunction |
|
|
Term
|
Definition
| Initial Response Orally = 1hr Peak Response Orally = 5-7 hours |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Digoxin - related to protein binding, Warfarin |
|
|
Term
|
Definition
| Type I agents are considered Na blockers. They slow or block conduction and abolish abnormal pacemakers depended on Na |
|
|
Term
|
Definition
| Potassium Blocker - prolongs action potential duration. |
|
|
Term
|
Definition
| Prolongs action potential by blocking K channels, also blocks Na channels and will slow HR and AV conduction |
|
|
Term
| Amiodarone Pharmacokinetics |
|
Definition
| Multi faceted, initial 3-5 days, then very long, levels in tissues may be detected up to a year after discontinuation |
|
|
Term
| Amiodarone Extra cardiac effects |
|
Definition
| Dose related pulmonary firbrosis, abnormal LFT's, hyper or hypothyroidism due to T4 to T3 conversion blockage, blue / gray skin color |
|
|
Term
|
Definition
| Potassium Sparing Diuretic |
|
|
Term
|
Definition
| Blocks epithelial sodium channels in the late distal convoluted tubule and collecting duct which inhibits sodium reabsorption from the lumen. This effectively reduces intracellular sodium, decreasing the function of Na+/K+ ATPase, leading to potassium retention and decreased calcium, magnesium, and hydrogen excretion. |
|
|
Term
|
Definition
| Blood pressure, serum electrolytes (esp K+), renal function, weight and I&O |
|
|
Term
| Triamterene Contraindications |
|
Definition
| With other potassium sparing diuretics, anuria, severe hepatic disease, hyperkalemia, severe or progressive renal disease, and pregnancy (Cat. C) |
|
|
Term
| Triamterene Adverse Reactions |
|
Definition
| Hypotension, edema, CHF, bradycardia, dizziness, headache, fatigue, constipation, nausea and dyspnea |
|
|
Term
|
Definition
| Antiarrhythmic Agent Class II and III and Beta Blocker |
|
|
Term
|
Definition
| Class II Beta blocking agents (decrease Sympathetic effects on heart). Class III- Potassium Channel Blockers, they create prolongation of action potential duration, which results in effective refractory period and reduces ability to respond to tachycardia |
|
|
Term
| Sotalol Adverse Reactions |
|
Definition
| Bradycardia, palpitation, chest pain, fatigue, dizziness, lightheadedness, weakness, and dyspnea |
|
|
Term
|
Definition
| Blood Pressure, heart Rate and advise pt’s with diabetes to monitor glucose levels closely, do not discontinue abruptly |
|
|
Term
| Sotalol Drug Interactions |
|
Definition
|
|
Term
| Sotalol Bioavailability and metabolism |
|
Definition
| Good bioavailability, no hepatic metabolism, excreted in kidneys unchanged. Impaired renal function can result in increased drug accumulation |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Inhibits Vitamin K dependant synthesis of clotting factors II, VII, IX, and X by blocking available Vitamin K in the body through the inhibition of VKOR |
|
|
Term
|
Definition
| Bleeding, Warfarin necrosis, Osteoporosis, purple toe syndrome |
|
|
Term
|
Definition
| Prevention of venous thrombus. Also used in prevention of clots forming in atria d/t A. Fib or artificial valve repair |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Inhibits platelet aggregation by binding to glycoprotein IIB/IIIA receptors on platelet surfaces, a receptor used for binding with fibrin |
|
|
Term
| Abciximab Adverse effects |
|
Definition
| Bleeding, thrombocytopenia |
|
|
Term
|
Definition
| Prevention of thrombus formation in coronary arteries. Used during percutaneous coronary intervention w/ or w/out stent placement to prevent ischemic complications during and immediately after PCI procedures. |
|
|
Term
| Warfarin reversal agent(s) |
|
Definition
| Vitamin K, fresh frozen plasma |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Inhibits prostaglandin synthesis, thromboxane A2 |
|
|
Term
|
Definition
| Primary prophylaxis of myocardial infarction (325mg), use in caution when prescribed as an adjunt to risk factor management by smoking cessation and lowering of cholesterol and bp. Secondary prevention of vascular events |
|
|
Term
|
Definition
| Increases risk of bleeding |
|
|
Term
|
Definition
| Powerful parenteral vasodilator |
|
|
Term
|
Definition
| Dilates both arterial and venous vessels by release of nitric oxide |
|
|
Term
| Nitroprusside Route of Adminstration |
|
Definition
|
|
Term
| Nitroprusside Adverse Reactions |
|
Definition
| Excessive hypotension. Also, with uptake of nitroprusside cyanide is released therefore patients susceptible to cyanide accumulation which can lead to metabolic acidosis, arrythmias, or death |
|
|
Term
| Nitroprusside Clinical Indications |
|
Definition
| Used in hypertensive emergencies and heart failure |
|
|
Term
|
Definition
| Require successively higher doses to achieve the same pharmacologic effect (not dependent on route). Need a nitrate free period daily |
|
|
Term
|
Definition
| Direct oral thrombin inhibitor; seemingly superior to Warfarin for prevention and therapy in thrombotic disease due to its broader therapeutic window and being less effected by diet and other drugs |
|
|
Term
|
Definition
| Dabigatran etexilate mesylate is changed to Dabigatran after oral administration and is a substrate for P-glycoprotein efflux pump to prevent stroke and systemic embolism in nonvalvular atrial fibrillation through prolongation of PTT and thrombin time |
|
|
Term
|
Definition
Bleeding:
Gastrointestinal
Renal impairment may result in decreased drug clearance, necessitating dose adjustment in this population |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Metabolized by CYP2D6 with high first pass metabolism to block beta 1 receptors, which decreases cardiac output and myocardial oxygen demand, and thus lowers peripheral vascular resistance, lowering blood pressure, decreasing anginal pain |
|
|
Term
|
Definition
| Withdrawl sydrome after abrupt discontinuation, resulting in nervousness, tachycardia, and increased angina and blood pressure, sometimes resulting in MI |
|
|
Term
|
Definition
Has less effect on bronchoconstriction than some other drugs in the beta classes
Does not cause profound postural hypotension
Reduces mortality in those with heart failure |
|
|
Term
|
Definition
| Irreversibly binds to the Adenosine Diphosphate (ADP) receptor on platelet membranes, preventing ADP's ability to stimulate platelet activation & aggregation. |
|
|
Term
| Special Considerations for the use of Clopidogrel |
|
Definition
| Clopidogrel is a prodrug that requires activation by the cytochrome P450 enzyme isoform CYP2C19. Therefore, drugs that interfere with CYP2C19 function such as omeprazole should be used with caution. Some individuals may be unable to metabolize (aka; are resistant to) clopidogrel. |
|
|
Term
| Clopidogrel Pharmacokinetics |
|
Definition
| Onset of action is approx. 5 hours; activity lasts for the lifetime of the platelet (7-10 days) |
|
|
Term
|
Definition
| Unstable angina, non-ST elevation acute MI (NSTEMI) when given in combination with aspirin, ST-elevation acute MI (STEMI), thrombotic stroke, peripheral artery disease |
|
|
Term
|
Definition
| Bleeding; fatal thrombotic thrombocytopenic purpura. Contraindicated during active peptic ulcer disease and intracranial hemorrhage. Discontinue 5 days prior to surgery if antiplatelet effect is not desired. |
|
|
Term
Clopidogrel Drug/Drug
Interactions |
|
Definition
| Use with other antiplatelet agents, warfarin or NSAIDs may increase risk of bleeding. Concurrent use with omeprazole, esomeprazole, nifedipine, and amlodipine may result in decreased antiplatelet effect causing increased risk of thrombotic events |
|
|
Term
|
Definition
| Stimulates the conversion of plasminogen into plasmin, a fibrinolytic enzyme. Specifically acts only on plasminogen that is bound to fibrin; therefore is active only at a formed thrombus. |
|
|
Term
|
Definition
| tissue plasminogen activator (t-PA) |
|
|
Term
| Indications for use of Alteplase |
|
Definition
| Acute MI, non-hemorrhagic stroke. Also used to treat thrombotic occlusions in central venous access devices. |
|
|
Term
| Contraindications that must be ruled out prior to use of Alteplase |
|
Definition
| Intracranial bleeding, recent head trauma or intracranial surgery, uncontrolled hypertension, intracranial neoplasm, active internal bleeding, elevated INR |
|
|
Term
|
Definition
| GI bleeding, intracranial hemorrhage |
|
|
Term
| LMWH (low-molecular-weight heparin action |
|
Definition
| Indirect thrombin inhibitor, binds to antithrombin and enhances its inactivation of factor Xa. Also to a lesser extent, it enhances antithrombin's inactivation of thrombin. |
|
|
Term
|
Definition
| a heterogeneous mixture of sulfated mucopolysaccharides. Binds to endothelial cell surfaces and a variety of plasma proteins. Its biologic activity is dependent upon the endogenous anticoagulant anththrombin. Antithrombin inhibits clotting factor proteases, especially thrombin (IIa), IXa and Xa, by forming equimolar stable complexes with them. Inhibits activated factor X but has less effect on thrombin than the HMW species. |
|
|
Term
|
Definition
| enoxaparin, dalteparin & tinzaparin |
|
|
Term
|
Definition
| Weight-based dosing result in predictable pharmocokinetics and plasma levels in patients with normal renal function. LMW heparin levels are not generally measured except in the setting of renal insufficiency, obesity and pregnancy. LMW heparin levels can be determined by anti-Xa units. Peak therapeutic levels should e 0.5-1 unit/mL for twice-daily dosing, determined 4 hours after administration, and approximately 1.5 units/mL for once-daily dosing. SQ injection. |
|
|
Term
|
Definition
| The major adverse effect is bleeding. Heparin is of animbal origin and should be used cautiously in patients with allergy. Increased loss of hair and reversible alopecial have been reported. Long term therapy is associated with osteoporosis and spontaneous fractures. |
|
|
Term
|
Definition
| Contraindicated in patients with heparin-induced thrombocytopenia (HIT), active bleeding, hemophelia, significant thrombocytopenia, severe hypertension, intracranial hemorrhage, and advanced hepatic or renal disease |
|
|
Term
|
Definition
| Beta1-selective agonist that increases cAMP synthesis, used in patients with heart failure. This parenteral drug produces an increase in cardiac output together with a decrease in ventricular filling pressure. Some tachycardia and an increase in myocardial oxygen consumption have been reported. Therefore the potential for producing angina or arrhythmias in patients with coronary artery disease is significant. |
|
|
Term
|
Definition
| increases cardiac contractility, output. Used for acute decompensated heart failure, intermittent therapy in chronic failure reduces symptoms. |
|
|
Term
|
Definition
| IV only, duration a few minutes |
|
|
Term
| Dobutmanie toxicity and Interactions |
|
Definition
| Toxicity: Arrhythmias, Interactions: additive with other sympathomimetics |
|
|
Term
|
Definition
Stops the production of the enzyme thromboxane A2 by irreversibly inactivating the cyclooxygenase enzyme.
The platelets are then not able to make more cyclooxygenase reducing the likelihood of aggregation. |
|
|
Term
|
Definition
| GI upset, (avoid other NSAIDS which can further increase this risk), increased risk for bleeding and bruising, in high doses ringing in the ears and vertigo |
|
|
Term
|
Definition
Low doses: angina (no effect on oxygen supply or demand) and CAD (81mg).
High doses: Non-steroidal antiinflammatory for analgesia, fever reducer. (325mg and higher)
AVOID in Children as can cause Reyes Syndrome |
|
|
Term
|
Definition
Arterial and venous vasodilator that relaxes the smooth muscles of the vessels to reduce blood pressure.
Used only in hypertensive emergencies and severe CHF and is available only in IV form.
Works very quick and extremely short half life. Effects disapate after 1-10 minutes of discontinuation. |
|
|
Term
|
Definition
| Severe hypotension, metabolic acidosis, arrhythmias |
|
|
Term
LMWH= Low Molecular Wt. Heparin
Drugs |
|
Definition
Enoxaparin/Lovenox
Dalteparin
Tinzaparin |
|
|
Term
|
Definition
Endogenous anticoagulant that inhibits the following clotting factor proteases:
-Thrombin
-Factor IXa
-Factor Xa
*Antithrombin slowly binds to these proteases to block clotting |
|
|
Term
|
Definition
Low molecular wt heparin binds with Antithrombin and ACCELERATES Antithrombin's ability to inhibit activated Factor Xa
Inhibiting Factor Xa decreases clotting.
Accelerates the speed of antithrombin blocking factor Xa by 1,000 fold
*Excreted in Kidneys |
|
|
Term
|
Definition
S/E:
-Bleeding (esp in elderly women & renal pts)
-Allergy
-Reversible Alopecia (hair loss)
-Osteoporosis (long term use)
-Heparin Induced Thrombocytopenia (HIT)
-Diarrhea, nausea
-Anemia
-Incr. liver function tests
-Fever |
|
|
Term
|
Definition
|
|
Term
|
Definition
Do NOT use with:
-pts w/ HIT
-Heparin allergy
-Active bleeding
-Hemophilia
-Purpura (hemorrhages on skin)
-Severe HTN
-Intracranial hemmorhage
-Infective endocarditis
-Active TB
-GI ulcers
-threatened abortion
-Visceral carcinoma
-Liver or Renal disease |
|
|
Term
Difference between High Molecular Wt Heparin &
Low Molecular Wt Heparin |
|
Definition
High Molecular Wt Heparin:
Inhibits ALL 3 clotting factor proteases (thrombin, factor IXa & factor Xa)
-Requires monitoring (PTT)
Low Molecular Wt Heparin:
Inhibits factor Xa (& very minimally inhibits thrombin)
-Does NOT require monitoring w/ PTTs |
|
|
Term
|
Definition
Beta 1 selective agonist:
-increases heart contractility (incr. CO)
-decreases ventricular filling pressure in heart
*produces hypertensive, vasodilative effects (by stimulating beta receptor)
*Inotropic drug |
|
|
Term
|
Definition
|
|
Term
|
Definition
S/E:
-Angina
-HTN
-Tachycardia
-Headache |
|
|
Term
|
Definition
| Natural occuring nucleoside; slows impulse formation in SA node, acts on AV node to slow conduction and inhibit reentry pathways |
|
|
Term
|
Definition
| Chest discomfort, dyspnea, flushing of skin, abdominal discomfort, Cardiac arrest, Cardiac dysrhythmia, bronchospams in asthmatics |
|
|
Term
|
Definition
| conversion of Paroxysmal supraventricular tachycardia to sinus rhythm, ACLS, coronary arterty bypass graft |
|
|
Term
|
Definition
| Inhibits sodium-potassium ATPase,increasing intracellular sodium concentration leading to increased intracellular calcium concentration; strengthens myocardial contraction. Acts on CNS to enhance vagal tone, slowing conduction through SA/AV nodes |
|
|
Term
|
Definition
| Headache, cardiac dysrhymias, heart block |
|
|
Term
|
Definition
| Heart failure, paroxysmal supraventricular tachycardia, A-fib, A-flutter |
|
|
Term
|
Definition
| Selectively and irreveribly binds to ADP preventing the activation of GPIIb/IIIa complex required for platelet aggregation. Duration is 7-10 days (lifespan of platelet) |
|
|
Term
|
Definition
| Bleeding due to inability to clot. Increased bleeding times post-op, after falls, bruising. |
|
|
Term
|
Definition
| Post PTCA to prevent coagulation at stent site. Prophylactic for recent MI, arteriosclerotic disease, chronic heart failure. |
|
|
Term
|
Definition
| Breaks plasminogen into plasmin. Plasmin dissolves clots. High affinity for fibrin. Clot specific. |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Disolving of clots in Acute MI, DVT, PE |
|
|
Term
|
Definition
| (Antiarrythmic) Has both non-cardioselective β-adrenergic receptor blocking (class 2) and cardiac action potential prolongation (class 3) action. It is a racemic mixture of D- and L-sotalol. Prolongs the PR and QT interval. |
|
|
Term
|
Definition
| Treatment of life threatening ventricular arrhythmias - Decreases the threshold for cardiac defibrillation. Maintenance of sinus rhythm in patients with A fib. Used in pediatric patients with supraventricular and ventricular arrhythmias. |
|
|
Term
|
Definition
| Has few direct drug interactions. Dose related incidence of torsades de pointes. Prolonged QT interval. Heart failure patients can experience further depression of left ventricular function. |
|
|
Term
| Sotalos (Pharmacokinetics) |
|
Definition
| Well absorbed orally with approximately 90 to 100% bioavailability. Not metabolized in the liver Excretion is predominantly by the kidney. Lower doses are necessary in renal impairment. |
|
|
Term
|
Definition
| (Potassium-sparing diuretic) Inhibits the reabsorption of sodium in exchange for potassium and hydrogen ions by exerting a direct effect on the distal renal tubule. |
|
|
Term
| Triamterene (Pharmacokinetics) |
|
Definition
| Metabolized in the liver, but major route of elimination is renal. Need to monitor electrolytes |
|
|
Term
|
Definition
| Hyperkalemia, abnormal electrolytes, metabolic acidosis, gynecomastia, kidney stones. Use with indomethacin has been reported to cause acute renal failure. Use with caution with patients with liver disease. |
|
|
Term
| Metoprolol Clinical Application |
|
Definition
| HTN, heart failure, Angina, arrhythmias, Post MI, glucoma, Migrane HA, situational anxiety, hyperthyroidism |
|
|
Term
|
Definition
Beta 1 selective - decrease CO, slow AV conduction, and decrease rentin release.
Angina: decrease the oxygen consumption by decreasing the HR and contractility
HTN: reduces renin to lower HR and BP
CHF: Slows progression and reduce morality in moderate to severe CHF.
Arrhythmias: suppress Na and Ca currents to suppress abnormal pacemakers |
|
|
Term
|
Definition
| bradycardia, CHF, AV block, fatigue, vivid dreams, cold hands, acute cardiac decompensation, bronchospasms, depression, sweating, tremors |
|
|
Term
| Metoprolol considerations |
|
Definition
Discontinue medication gradually over 1-2 weeks to decrease sensitivity to catecholamines
Use cautiously for CHF since the negative inotropic activity may worsen CHF |
|
|
Term
|
Definition
Direct thrombin inhibitor
Prolong PTT and thrombin time |
|
|
Term
| Dabigatran clinical application |
|
Definition
| Reduce stroke risk and systemic embolism with nonvalvular A fib. |
|
|
Term
| Dabigatran considerations |
|
Definition
Increased effects when combined with ketoconazole, amiodarone, quinidine, and clopidogrel
Increased GI bleeding and bleeding in elderly patient compared to warfarin
No antidote - may require dialysis if overdosed
Adjust for renal impairment
Significant advantages over Warfarin - immediate anticoagulation, no lab monitoring, few drug interactions |
|
|
Term
|
Definition
Bleeding
No antidote- may require dialysis if overdosed |
|
|
Term
|
Definition
| Blockade of formation of Vitamin K DEPENdent clotting factors (i.e. no vitamin K = none of the vitamin K related clotting factors) |
|
|
Term
|
Definition
|
|
Term
|
Definition
-MUST monitor INR
-Anticipate dose adjustments for certain antibiotics
-Anticipate interactions with many other drugs with special focus on the one that increase anticoagulant effect (p. 610)
-antidote is Vitamin K |
|
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Term
|
Definition
| -monocolonal antibody (hence "-mab") directed against glycoprotein IIb/IIIa complex which inhibits normal adhesion of platelets to self and endothelial surface |
|
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Term
|
Definition
| Most notably used after PCI (percutaneous coronary intervention=angioplasty or stenting) in the setting of coronary artery disease and acute coronary syndromes |
|
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Term
|
Definition
| Class 3 antiarrhythmic. Has both beta-adrenergic receptor blocking (class 2) and action potential-prolonging (class 3) actions. The beta-adrenergic blocking action is not cardioselective. Both classes prolong the effective refractory period. |
|
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Term
|
Definition
| Well absorbed orally with 100% bioavailability. Excreted by kidneys. Half-life 12 hours. |
|
|
Term
|
Definition
| Dose-related torsades de pointes, patients with overt heart failure may experience further depression of left ventricular function |
|
|
Term
| Sotalol Clinical Applications |
|
Definition
| life-threatening ventricular arrhythmias, maintenance of sinus rhythm in atrial fibrillation, treatment of SVT and ventricular arrhythmias in pediatrics |
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Term
|
Definition
| reduces platelet aggregation by inhibiting the ADP pathway of platelets; it irreversibly blocks the ADP receptor on the platelets. Unlike aspirin, it has no effect on prostaglandin metabolism |
|
|
Term
| Clopidogrel Clinical Uses |
|
Definition
| approved for patients with unstable angina, or non-ST-elevaton acute MI (NSTEMI) in combination with aspirin; for patients with ST-elevation MI (STEMI); or recent MI, stroke, or established peripheral arterial disease. |
|
|
Term
| Clopidorgrel Pharmakinetics |
|
Definition
| for NSTEMI, dosage is a 300mg loading dose, following by 75mg daily, with a daily dose of aspirin. For STEMI dose is 75mg daily without aspirin. It is 75mg per day for stroke and PVD. |
|
|
Term
| Clopidorgrel Adverse Effects |
|
Definition
| Generally well tolerated. Rarely associated with neutropenia. Thrombotic thrombocytopenic purpura has been reported. Mild nausea/vomiting can occur. |
|
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Term
|
Definition
| Preferentially activate plasminogen that is bound to fibrin, which theorectially confines fibrinolysis to the formed thrombus and avoids systemic activation |
|
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Term
|
Definition
| PE with hemodynamic instability, severe DVT such as the superior vena cava syndrome, and ascending thrombophlebitis of the iliofemoral vein with severe lower extremity edema. Very small doses can be used to unclot central lines such as PICCs |
|
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Term
|
Definition
| Given intra-arterially for PVD. Using given IV in case of stroke or acute MI at 60mg for the first hour then 40mg at a rate of 20mg/hr. |
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|
Term
| Alteplase Adverse Effects |
|
Definition
| Bleeding from punture wounds or sites, bleeding gums, headache, dizziness, shortness of breath. More rarely seen side effects include confusion, fainting, fever, a fast heart rate. |
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Term
|
Definition
Antihypertensive
action is not conclusive – but does appear to convert to
alpha-methylnorepinephrine (potent alpha-2 agonist) which lowers arterial
pressure by stimulation of alpha receptors decreasing sympathetic outflow and
Blood Pressure. Cardiac output is maintained without cardiac acceleration and
in some patients heart rate is slowed, normal or elevated plasma rennin may
decrease in course of therapy |
|
|
Term
| Methyldopa Pharmacokinetics |
|
Definition
Absorption – systemic
Metabolism – Hepatic
Excretion – Renal |
|
|
Term
| Methyldopa Adverse Effects |
|
Definition
Asthma,dizziness, headache, sedation, impotence, reduced libido, CHF, heart block,
pancreatitis, aplastic anemia, bone marrow depression, neutropenia, leucopenia,
thrombocytopenia, abnormal liver function tests, hepatotoxicity, jaundice |
|
|
Term
|
Definition
alpha-1 selective adrenoreceptor that blocks in the neck of urinary bladder and prostate gland producing smooth
muscle relaxation that contributes to lowering bladder outlet obstruction without
affecting contractility – it also causes vasodilation resulting in lowering B/P
and can cause orthostatic hypotension |
|
|
Term
Terazosin
Pharmacokinetics |
|
Definition
Absorption – complete bioavailability
Distribution – protein binding
Metabolism – Hepatic – minimal first pass
Excretion - Renal and Fecal – not dialyzable,
elimination ½ life -12-14 hrs |
|
|
Term
|
Definition
orthostatic hypotension, syncope, palpitations, peripheral edema, nausea, dizziness,
headache, nasal congestion, priapisim |
|
|
Term
|
Definition
| irreversibly inhibits platelet COX; results in antiplatelet effect that lasts 8-10 days |
|
|
Term
|
Definition
| GI intolerance, gastric and duodenal ulcers, increased risk of bleeding. High doses can result in tinnitus, vertigo, and respiratory alkalosis. Reyes syndrome can occur with aspirin use in children. |
|
|
Term
|
Definition
| Prevents platelet aggregation. Prophylaxis/decreases incidence of TIAs, unstable angina, coronary artery thrombosis with MI, and thrombosis after CABG |
|
|
Term
|
Definition
| activates guanylyl cyclase via release of nitric oxide, resulting in both venous and arterial dilation and a decrease in PVR |
|
|
Term
|
Definition
| Hypotension. An accumulation of cyanide is possible, resulting in metabolic acidosis, arrhythmias, and excessive hypotension. |
|
|
Term
| Nitroprusside Pharmacokinetics |
|
Definition
Rapidly lowers blood pressure.
Effects disappear 1-10 minutes after discontinuation.
Given by IV infusion only.
Solution is sensitive to light and must be covered with opaque foil. |
|
|
Term
| Nitroprusside Clinical Uses |
|
Definition
| Hypertensive emergencies, severe heart failure. |
|
|
Term
| Warfarin Pharmacokinetics |
|
Definition
| 100% bioavailability, small VD virtually stays in the plasma albumin, Half-life in plasma is 36 hours, and no urinary excretion of unchanged drug. Levorotatory S-warfarin is four times more potent than dextrorotatory R-warfarin. |
|
|
Term
|
Definition
| Blocks Æ´-carboxylation of glutamate residues in prothrombin and factors VII, IX, and X as well as the endogenous anticoagulant proteins C and S. Prevents reductive metabolism of inactive vitamin K epoxide back into its active hydroquinone form. |
|
|
Term
|
Definition
| Teratogenic! Readily crosses placenta and can cause a hemorrhagic disorder in the fetus, as well as abnormal bone formation. Patients on warfarin are at risk for bleeding. Monitor PT/INR. |
|
|
Term
|
Definition
| A glycoprotein IIB/IIIA receptor inhibitor. A chimeric monoclonal antibody directed against the IIb/IIIa complex including the vitronectin receptor. Inhibits fibrinogen, van Willebrand factor, and other adhesion molecules from binding to activated platelets and prevents aggregation. |
|
|
Term
|
Definition
| Indicated as an adjunct to percutaneous coronary intervention to prevent cardiac ischemic complications. |
|
|
Term
|
Definition
| Releases nitric oxide in smooth muscle, which activates guanylyl cyclase and increases cGMP |
|
|
Term
|
Definition
| Sublingual: immediate treatment of angina. IV: treatment of severe, reoccurant rest angina. Buccal, oral, and transdermal: more long term maintenance treatment of angina |
|
|
Term
|
Definition
| othrostatic hypotension, tachycardia, throbbing headache |
|
|
Term
|
Definition
| Hwn eusing slow release NTG, must have period of nitrate free at least 8 hours to prevent tolerance. High first pass effect. Highly lipid soluable ensures rapid absorptions. |
|
|
Term
|
Definition
| Isosorbide dinitrate: organic nitrate that induces relaxation of vascular smooth muscle that results in dilatation of peripheral arteries and veins, affecting veins more than the arteries. Venous dilatation reduces left ventricular end-diastolic pressure and pulmonary capillary wedge pressure (preload), while widening of the arterioles causes a reduction in systemic vascular resistance, systolic arterial pressure and mean arterial pressure (afterload) Isosorbide Mononitrate:is the major active metabolite of isosorbide dinitrate, and is an organic nitrate used to prevent angina. It exerts its effect by relaxing vascular smooth muscles resulting in dilatation of peripheral arteries and veins |
|
|
Term
|
Definition
| acute treatment of anginal attacks, prophylactic management of angina pectoris |
|
|
Term
|
Definition
| dizziness, headache, hypotension, tachycardia, paradoxic bradycardia, syncope, flushing, tolerance. |
|
|
Term
| Isosorbide Pharmacokinetics |
|
Definition
| 100% bioavailable. Peak 30-60 min. half life 5 hours |
|
|
Term
|
Definition
| Direct thrombin inhibitor |
|
|
Term
| Dabigatran (Pradaxa) Clinical uses |
|
Definition
| Prevention or prophylaxis of stroke and systemic embolism for patients with nonvalvular atrial fibrillation |
|
|
Term
|
Definition
| Bleeding. There is an increased risk of gastrointestinal bleeding compared with warfarin. There is also an increased risk in patients older than 75 years. |
|
|
Term
| Dabigatran (Pradaxa) Pharmacokinetics |
|
Definition
| The half-life of dabigatran is 12-17 hours. Patients with renal failure will have a longer half-live and may require a dose adjustment. |
|
|
Term
|
Definition
| Selective Beta 1 receptor blocker. This lowers the heart rate and blood pressure and reduces the release of renin. |
|
|
Term
|
Definition
| Treatment of hypertension, arrhythmias, and heart failure (especially following a MI) |
|
|
Term
|
Definition
| Bradycardia, fatigue, vivid dreams, and cold hands |
|
|
Term
| Low Molecular Weight Heparins (LMWH) MOA |
|
Definition
| LMWH bind to antithrombin III. This binding inhibits factor Xa and thrombin. Thrombin inhibition prevents the formation of fibrin clots. |
|
|
Term
| Low Molecular Weight Heparins (LMWH) ADR |
|
Definition
| Bleeding is the major adverse effect of heparin. Elderly women and patients with renal failure are more prone to hemorrhage. Long term heaprin therapy is associated with osteoporosis, spontaneous fractures and mineralocorticoid deficiency. |
|
|
Term
|
Definition
| Weight-based dosing of the LMW heparins results in predictable pharmokinetics and plasma levels in patients with normal renal function. Clearance of LMWH is primary renal so monitor patients in renal failure. LMWHs have a weaker effect on platelet activation and are associated with a lower incidence of heparin-induced thrombocytopenia compared to unfractionated heparin. |
|
|
Term
|
Definition
Blocks IKr, INa, ICa-L channels
Beta adrenoceptors |
|
|
Term
|
Definition
Prolongs action potential duration and QT interval by blockade of IKr
Slows heart rate and AV node conduction by blockade of INa and I Ca
Low incidence of torsades de pointes
Extracardiac effects-causes peripheral vasodilation |
|
|
Term
| Amiodarone Clinical Applications |
|
Definition
Serious ventricular arrythmias and suprventricular arrythmias
Low doses are effective in maintaining normal sinus rhythm in pts with A-Fib and is effective in the prevention of recurrent V-tach. |
|
|
Term
|
Definition
Symptomatic Bradycardia
Heart block in pts with preexisting sinus or AV node disease
Peripheral vasodilation
Pulmonary and Hepatic toxicity
Hyperthyroidism or Hypothyroidism-blocks the peripheral conversion of thyroxine to triiodothyronine. It also has a potential source of large amounts of iodine. |
|
|
Term
|
Definition
| Nucleoside, activation of inward K+ current and inhibition of C+ current resulting in hyperpolarizaation and suppression of C+ dependent action potentials |
|
|
Term
|
Definition
| Drug of Choice for SVT, efficacy 90-95%, <10 second 1/2 life, 6mg bolus followed by an additional 12mg bolus if needed to convert to a sinus rhythm |
|
|
Term
|
Definition
| flushing, SOB, chest burning, high-grade AV block(short lasting), Afib, less common=HA, hypotension, nausea, paresthesias |
|
|
Term
|
Definition
| Competitively blocks Beta-1 receptors |
|
|
Term
|
Definition
Slows heart rate
Reduces blood pressure
Redces heart failure mortality
Poorly understood effects |
|
|
Term
|
Definition
Chronic Heart Failure: To slow progression
Reduce mortality in moderate to severe heart failure |
|
|
Term
|
Definition
Bronchospasm
Bradycardia
AV block
Acte Cardiac Decompensation |
|
|
Term
|
Definition
| Sinus node=decreased rate, Atrial Muscle=decreased refractory period, AV node=decreased conduction, increased refractory period whcih increases the force of ventricular contraction, ECG=increased PR interval, decreased QT interval, eliminated renally, K+ dependent |
|
|
Term
|
Definition
| Treatment of Afib, Aflutter, Paroxysmal Atrial tachycardia |
|
|
Term
|
Definition
| cardiac glycoside, widely distributed to tissue including CNS, 2/3 excreted by kidneys, 1/2 life=36-40 hours with normal renal function. Watch for Dig toxicity including cardiac, GI, and CNS effects |
|
|
Term
|
Definition
| Direct acting sympathomimetic. Primarily an agonist at beta1 adrenergic receptors with minor beta2 and alpha1 stimulatory effects. Clinical actions reflect both beta agonism by the (+) isomer and the alpha agonism by the less potent (-) isomer. Agonism at the beta1-adrengeric receptor predominates and increases myocardial contractility and stroke volume=increase cardiac output. |
|
|
Term
|
Definition
| cardiogenic shock, acute heart failure |
|
|
Term
| Dobutamine Pharmacokinetics |
|
Definition
| Administered IV; Onset of action within 2 minutes, peak pharmacodynamic activity can be delayed up to 10 minutes. The plasma half-life is 2 minutes. Requires dose titration. Liver metabolism. |
|
|
Term
|
Definition
| Inhibits cyclooxygenase which prevents synthesis of thromboxane A2, which causes platelets to change shape and aggregate. Thus inhibiting platelet aggregation for the life of the platelet. ADRs include bleeding and renal insufficiency as a result of decreased prostaglandin synthesis. Interacts with other anticoagulants, so caution simultaneous use. |
|
|
Term
|
Definition
| Vasodilator used to treat hypertensive emergencies. Produces effect by relaxing smooth muscles of arterioles and veins which in turn decreases peripheral vascular resistance. This leads to decreased blood pressure, but also compensatory tachycardia so is often used in combination therapy with other antihypertensives. |
|
|
Term
|
Definition
| Drugs used to treat angina. Release nitric oxide in smooth muscle, which activates guanylyl cyclase and increases cGMP. |
|
|
Term
|
Definition
| Smooth vascular relaxation, especially in vessels. Can cause relaxation of other smooth muscles but not as significant. Vasodilation decreases venous return and heart size. May increase coronary flow in some areas and in variant angina. |
|
|
Term
| Nitroglycerin toxicity and interactions |
|
Definition
| Orthostatic hypotension, tachycardia, headache. Can cause synergistic hypotension when used with phosphodiesterase type 5 inhibits. |
|
|
Term
|
Definition
| Used to treat angina. Releases nitric oxide in smooth muscle, which activates guanylyl cyclase and increases cGMP (similar to NTG). Has slightly longer duration of action compared to NTG. Effective by the sublingual route. Used for acute episodes of angina. HIgh first-pass effect so sunglingual dose is much smaller than oral dose. |
|
|
Term
|
Definition
| Drug used to treat angina. It is the 5-mononitrate metabolite of isosorbide dinitrate. Available for oral use as prophylaxis for angina. |
|
|
Term
| LMWH- Low Molecular Weight Heparin |
|
Definition
| Binds to endothelail cell surfaces and plasma proteins to activate antithrombin which inactivates factor Xa some thrombin. |
|
|
Term
|
Definition
| enoxaparin (lovenox), dalteparin (Fragmin) Tinzaparin (Innohep). |
|
|
Term
|
Definition
| Short molecules that are better at inactivating factor Xa than thrombin. |
|
|
Term
|
Definition
| good for home use, does not require PTT monitoring, fixed dose based on body wt, long halflife leads to Q day or BID dosing Sub Q only. |
|
|
Term
|
Definition
| DVT prevention s/p TKA, THA and Abdominal surgery, treatment of DVT with or without PE and prevnetion of ischemic complications in STEMI, unsatble angina and non-Q wave MI. |
|
|
Term
|
Definition
| ADRs- Bleeding, immune-mediated thrombocytopenia, severe neurologic damage when used with spinal or epidural anesthesia or LP. Overdose treated with protamine sulfate. |
|
|
Term
|
Definition
| beta 1 selective adrenergic agonist- only used for heart failure, increases myocardial contractility |
|
|
Term
|
Definition
| ADRs- tachycardia, monitor BP and ECG for changes. |
|
|
Term
|
Definition
| Do not use with MAO inhibitors or tricyclic antidepressants |
|
|
Term
|
Definition
| Brand: Pradaxa MOA: Inhibits free and clot-bound thrombin and thrombin-induced platelet aggregation through direct, competetive inhibition of thrombin. NO ANTIDOTE, increased risk of bleeding: in pt's older than 75, kidney disease, hx of GI bleeding, taking with asa, NSAIDS and bld thinners |
|
|
Term
|
Definition
| MOA: Beta 1 selective blocker TX: HTN, angina, MI, heart failure, arrhythmia ADR: depression, impotence, fatigue, block s/s hypoglycemia, abrupt withdrawal can precipitate mycordial ischemia |
|
|
Term
|
Definition
| An anticoagulant that blocks the formation of Vitamin K dependent clotting factors (namely prothrombin). This drug takes approximately 4-5 days to become effective. Can bridge with lovenox during that time. Has many drug-drug interactions such as (but not limited to) antibiotics, digoxin, and amiodarone. You need to dose coumadin accordingly if your patient is taking those drugs concurrently. ADR: Pregnancy category X (use lovenox instead) and bleeding. Warfarin has a small therapeutic window and you need frequent monitoring of INR levels. Therapeutic levels range from 2-3. |
|
|
Term
|
Definition
| Reduce platelet aggregation by inhibiting ADP pathway of platelets(irreversibly block).No effect in prostangladins metabolism (unlike Aspiring).Considered one of the drugs used as standard practice to prevent thrombosis in pts undergoing coronary stent placement. |
|
|
Term
|
Definition
| Fewer adverse effects than Ticlopidine, rarely associated with neutropenia. Thrombotic thrombocytopenic purpura has been reported. |
|
|
Term
|
Definition
Tissue plasminogen activator produced by recombinant
DNA technology. MOA: activates plasminogen bounded to fibrin,confines fibrinolysis to the formed thrombus, avoiding systemic activation. |
|
|
Term
|
Definition
Used in pulmonary embolism, myocardial infarction, and stroke.In
ischemic stroke must be administered as early as possible after the onset of
symptoms (within the first three hours of the event). |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Antiarrhythmic to treat atrial & ventricular arrhythmias, with both Class 2 (beta blocking-non cardio selective) properties and Class 3 (potassium channel blocking) with prolongation of action potential properties. |
|
|
Term
|
Definition
| Absorption-oral/IV- High bioavailability (90-100%), Distribution- No protein binding, Metabolism- No liver metabolism, Excretion- Kidney ( 66-88% unchanged), Half Life- 12 hours |
|
|
Term
|
Definition
| Toxicity can occur even at therapeutic dosing, especially in those with renal impairment., Monitor serum electrolytes including magnesium and calcium, renal function and blood glucose. |
|
|
Term
|
Definition
ADR-causes
beta-adrenergic blockade and lengthening of action potential duration, which
predisposes patients to dysrhythmias. Toxicity results in bradycardia, mild
hypotension, and a prolonged QTc interval, syncope, CNS depression, seizures, death.
Most commonly seen---bradycardia, chest pain, palpitations, fatigue, dizziness,
lightheadedness, weakness, and dyspnea. |
|
|
Term
|
Definition
| A potassium-sparing diuretic, inhibits the reabsorption of sodium in exchange for potassium and hydrogen ions by exerting a direct effect on the distal renal tubule |
|
|
Term
| Triamterene Pharmacokinetics |
|
Definition
| Absorption- oral- peak at 3hours, Distribution- 67% protein bind, Metabloism- conjugation, metabolite is hydroxytriamterene, Excretion- Kidney less than 50% |
|
|
Term
|
Definition
| CHF, fluid retention from liver failure, and HTN |
|
|
Term
|
Definition
| Dehydration due to the diuretic effect. Electrolyte abnormalities, most commonly hyperkalemia. Diarrhea, nausea, vomiting, interstitial nephritis, blood dyscrasias, nephrolithiasis, photodermatitis. Avoid use if renal impaired |
|
|
Term
|
Definition
| An antiarrhythmic drug that slows HR and AV node conduction and also has action as a vasodilator. Works by prolonging action potential duration. It is used for ventricular and supraventricular arrhythmias. PO or IV administration. Hepatic metabolism. Drug effects can be maintained for 1-3 mos. after d/c and can be measured in tissue up to 1 year after d/c. |
|
|
Term
|
Definition
| Dose-related pulmonary fibrosis, bradycardia, heart block, abnormal liver function tests, blue-ish skin discoloration, hypothyroidism or hyperthyroidism due to it being a possible source of inorganic iodine. |
|
|
Term
|
Definition
| A nonselective beta-blocker with some alpha blocking ability. It has higher affinity for beta receptors. It is also a vasodilator. Used to treat HTN and can reduce mortality in heart failure pts. It is especially useful for pts with HTN and heart failure. |
|
|
Term
|
Definition
| Bronchospasms, bradycardia, AV block, fatigue |
|
|
Term
|
Definition
Activates alpha 2 receptors.
Reduces sympathetic outflow/norepinephrine release
Used in HTN.
can cause sedation and anemia. |
|
|
Term
|
Definition
Selectively blocks alpha 1 receptors.
Decreases smooth muscle tone of the prostate and prevents sympathetic vasoconstriction.
Used in HTN and BPH. |
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|
