Cardiac Pharma

Helpfulness: 0
Set Details Share
created 6 days ago by Kijana_Danielle_Gantenbei
4 views
Subjects:
pharmacology
show moreless
Page to share:
Embed this setcancel
COPY
code changes based on your size selection
Size:
X
Show:
1

K sparing diuretics

Spironolactone

Dyazide

Maxide

2

K sparing diuretics target

Duct tubules and late distal tubules

3

Considerations for Loop Diuretics

Hyperglycemia,

do not give w/ digoxin, lithium (increases effects), antihypertensives, gout, nephrotoxicity

May be used for pulm. edema

4

Loop diuretics can cause ----toxicity

ototoxicity

5

Hypokalemia manifests as

leg cramps, fatigue, vomiting

6

Hypomagnesemia manifests as

muscle twitching, tremors

7

Loop diuretics hypo

natremia, KALEMIA, magnesimia

8

Loop Diuretics target

Loop of henle

9

Thiazide diuretic considerations

Give early in day, normal kidney function, photosensitivity

10

Thiazide diuretics can cause hyper

calcemia, glycemia, uricemia, LDL

11

Thiazide diuretics can cause hypo

KALEMIA, natrimia, magnesemia

12

Thiazide Diuretics target

Distal convoluted tubule

13

Spironolactone

K sparing diuretic

14

Dyazide

K sparing diuretic

15

Maxide

K sparing diuretic

16

5 antihypertensive classes (Sympatholytic)

Beta adrenergic blockers

centrally acting alpha-2 antagonists

Alpha adrenergic blockers

Alpha 1

Beta 1

17

Metaprolol

Beta Blocker only Beta 1

18

Propanolol

Beta Blockers BETA 1 and 2

19

Atenolol

Beta Blocker

20

Prazosin

Alpha-1 adrenergic blocker

21

Doxazosin

Alpha-1 adrenergic blocker

22

Clonidine

Centrally acting alpha-2 agonist

23

Methyldopa

Centrally acting alpha-2 agonist

24

Lisinopril

ACE inhibitor

25

Captopril

ACE inhibitor

26

Valsartan

ARBS (Angiotensin 2 receptor blocker)

27

Lorsartan

ARBS (Angiotensin 2 receptor blocker)

28

Verapamil

Calcium channel blocker

29

Nifipedine

Calcium channel blocker

30

Diltiazam

Calcium channel blocker

31

Metoclopramide

Cholinergic Agonists (Parasympathetic increase)

32

Bethanechol

Cholinergic Agonists (Parasympathetic increase)

33

Pilocarpine

Cholinergic Agonists (Parasympathetic increase)

34

Atropine

Anticholinergics (Antiparasympathetic)

35

Benzotropine

Anticholinergics (Antiparasympathetic)

**Antiparkinsonism

36

Scopolamine

Anticholinergics (Antiparasympathetic)

**Motion sickness

37

Alpha 1

Cardiac, pupils, increase BP, bladder&prostate

38

Alpha 2

Vasodilation, decrease BP, decrease motility, decreased insulin secretion

39

Beta 1

Heart contractility, increase BP/HR

40

Beta 2

Decrease motility, bronchodilation, relax uterus, increase CBG/glycogenolysis

41

Epi (catachol.)

Direct Adrenergic Agonist--Produce sympathetic response, A1,B1,B2

42

Norepi. (catechol.)

Direct Adrenergic Agonist--Produce sympathetic response

43

Dopamine (catechol)

Direct Adrenergic Agonist--Produce sympathetic response

44

Phenylepherine (Noncatechol)

Direct Adrenergic Agonist--Produce sympathetic response

45

Metaproterenol

Direct Adrenergic Agonist--Produce sympathetic response

46

Albuterol

Direct Adrenergic Agonist--Produce sympathetic response Beta 1 and 2

47

Amphetamines

Indirect Adrenergic Agonist--Produce sympathetic response

48

Adrenergic Antagonists

Blocks adrenergic neurotransmitter--beta blocker

49

ISA-- Intrinsic sympathomimetic activity

Ability to bind with beta receptor to prevent strong agonists from binding

50

Carvedilol

beta blocker

51

Hydrochlorothiazide

Thiazide diuretic

52

Furosemide

loop diuretic

53

Proximal tubules %%%

50-55%

54

Loop of henle %%%

35-40%

55

Distal tubules %%%

5-10%

56

Loop (high ceiling) details

Peripheral edema

Good for kidney insufficiency

Very effective, fast

digoxin toxicity

57

Loop (high ceiling) side effects

Ototoxicity

photosensitivity

Hypo-kal, nat, calc, chlor

hyperglycemia, uricemia

58

Thiazide details

no renal failure

admin early

no NSAIDS

NO DIGITALIS

risk digoxin

Herbal interactions- ginko, licorice

photosensitivity

59

Thiazide side effects

not immediate diuresis

GI distress

hypercalcemia

hyperglycemia, uricemia

hypo kal, mag, nat, chlor

60

K sparing details

ED

weaker

INTERFERE WITH ALDOSTERONE

caution kidney function

61

K sparing side effects

hyperkalemia, glycemia, uricemia

hyponat, calc, mag

GI distress

Photosensitivity

62

Osmotic Diuretics

Enhances concentration

Proximal tubule and loop of henle

ICP & IOP

63

Mannitol

Crystalization, osmotic diuretic

64

Triamterene and hydrochlorothiazide

K sparing and K wasting to enhance diuretic effect and retain K

65

Hyperkalemia w/ ACE inhibitor

Life threatening

66

Alcohol increases renin secretions T/F

T

67

Meds less effective for African American people

Beta blockers and ACE inhibitors

Low renin hypertension

68

Asian descent Beta blockers

Twice as effective

69

Six Classes Antihypertensives

-Diuretics

-Sympatholytics (sympathetic DEPRESSANTS)

-Direct acting arteriolar vasodilators

-ACE inhibitors

- ARBS

- Calcium Channel Blockers

70

5 groups of Sympatholytics

- Beta adrenergic blockers

- Centrally acting alpha-2 agonists

- alpha blockers

- Adrenergic neuron blockers

- Alpha1 and beta1 adrenergic blockers

71

Beta blocker action

Reduce HR, contractility and renin release

72

How to treat HTN in african americans

Beta blockers with diuretics

73

Nonselective beta blockers

Propranolol-- beta 1 (Heart) & beta 2 (lungs, constriction)

74

Cardioselective beta blockers

Atenolol & metoprolol-- Beta 1 only-- preferred

75

Beta blockers in asthma?

Caution

76

What is the real value in beta blocker selectivity?

Maintaining renal blood flow and minimizing hypoglycemia

77

Metoprolol Beta blocker info

better for high renin

risk of bradycardia, hypotension, acute HF, ED

78

Centrally acting alpha 2 AGONISTS

methyldopa and clonidine

--decrease epi, renin and norepi--

79

Centrally acting alpha 2 AGONISTS details

-minimal effect on cardiac output & renal blood flow

- NOT given w/ beta blockers (bradycardia)

80

May cause sodium retention

Centrally acting alpha 2 agonists

methyldopa, clonidine

81

Sympatholytic available in transdermal patch--7 days

methyldopa -- centrally acting alpha 2 agonist

82

Centrally acting alpha 2 agonist details

normal antihypertensive side effects

NOT for impaired hepatic function

Diuretic may be concurrent for retention

83

Centrally acting alpha2 agonist NOT used during pregnancy

Clonidine

84

Helps maintain renal blood flow and used for HTN in people with lipid imbalance

Alpha adrenergic blockers

85

Decrease VLDL and LDL, increase HDL

Alpha adrenergic blockers

86

Safe for diabetics

alpha or beta blockers?

Alpha

87

Prazosin details

Alpha 1 adrenergic blocker

HTN and BPH

May not work for 4 wks

Selective

sodium and water retention

Highly protein bound, may displace

88

Doxazosin details

Alpha 1 adrenergic blocker

Selective

may cause sodium and water retention

89

Selective vs nonselective Alpha blockers

Selective- HR only slightly increased-- DILATE VASCULATURE -- better for long term

Nonselective-- Tachycardia--good for acute HTN due to dramatic decrease in BP

90

Alpha blocker interactions

NSAIDS (edema) and Nitrates (Syncope)

91

Adrenergic neuron BLOCKERS (peripherally acting sympatholytics)

Block release of norepi @ nerve endings

HTN

92

Last line of defense for chronic HTN due to ortho HypoTN?

Adrenergic neuron blockers

93

Adrenergic neuron blocker details

Retention

Ortho HypoTN

94

LABETalol

Alpha 1 and beta 1 blockers

95

LABETalol

Alpha 1- vasodilation (STRONGER)

Beta 1 - HR moderately decreased, AV contractility

96

Alpha-beta blocker details

Too much can have an effect on beta 2 and cause AV block

Ortho. hypoTN

GI distress

dry mouth

97

Alpha adrenergic blockers contraindicated in..

Renal insufficiency

98

Water retention is a problem with

Alpha blockers

99

Hydralazine

Alpha-beta blocker

100

Direct acting arteriolar vasodilators

POTENT antihypertensives

Increase blood flow to brain and kidneys

101

Hydralazine

Direct acting arteriolar vasodilator

Moderate HTN crisis

Tachycardia

Beta blockers concurrent

102

Nitroprusside

Direct acting vasodilator

EMERGENCY

Arterial and venous

103

Direct acting vasodilator details

GI Bleeding, reflex tachycardia, edema, congestion, tingling, numbness, excess hair growth

104

Nitroprusside details

Tachy, palpitations, restlessness, nausea, confusion

105

ACE inhibitor details

nausea, vomiting, dizziness, diarrhea, headache, fatigue

Ortho hypoTN

106

Captopril details

Dizziness & lightheadedness

NOT FOR PREGNANT WOMEN

Treats post MI, diabetic neuropathy, HTN, HF

107

Cough?

ACE inhibitors

108

ACE details

Hyperkalemia

Tachycardia

ANGIOEDEMA

NOT TAKE WITH K SPARING DIURETICS

109

ARBS

Block angiotensin II from receptors, cause vasodilation and decrease peripheral resistance

110

Lorsartan

ARBS

111

Valsartan

ARBS

112

Not safe during pregnancy?

ARBS

113

Lisinopril details

Treats AMI, HTN, HF

114

Lisinopril electrolyte imbalance

Hyperkalemia

115

Losartan details

HTN, diabetic neuropathy, prevents stroke, proteinuria,

116

Lorsartan (ARBS) may cause

typical antihypertensive SE, edema, nasal congestion, pharyngitis, nausea

117

Valsartan cautioned in

HF, renal/hepatic, hyperkalemia, pregnancy

118

ARBS are potent...

Vasodilators

119

Calcium channels...

increase contractility

increase peripheral resistance

increase BP

120

Verapimil and diltiazam (calcium blockers) act on

arterioles and heart

121

Nilfiedipine

Calcium channel blocker

122

Amlodipine

Calcium channel blocker

123

Nifedipine details (Calcium channel blocker)

used for HTN

decreases BP in older adults w/ low renin

POTENT

Associated with death and profound hypoTN, extended release unless ACUTE

124

Verapimil (calcium channel blocker) details

POTENT

used for HTN

ED, nausea, constipation

125

Vasodilation may cause

peripheral edema

126

Better for lowering BP in african americans..

Calcium blockers

127

Calcium blocker details

flushing

ankle edema

antihypertensive side effects

AV block

128

Amlopidine (calcium channel blocker) details

NSAIDS may increase renal disfunction

drowsiness, anxiety, flushing, fatigue, dizziness, weakeness,

129

WHich diuretic is most potent?

Loop

130

Adrenergic blockers are also called

Sympatholytics

131

Adrenergic agonists are also called

Sympathomimetics

132

Adrenergic meds are

high alert because they can cause harm

133

Alpha 1 adrenergic

peripheral vasoconstriction

134

Alpha 2 adrenergic

vasodilation

135

Beta 1 adrenergic

Myocardial contractility

136

Beta 2 adrenergic

bronchodilation, decrease in motility, increased glycogenolysis/CBG, decreased uterine contraction

137

3 ways neurotransmitters inactivated

Reuptake (Most important)

Enzymatic transformation/degradation

Diffusion away from receptor

138

Types of sympathomimetics

Direct

Indirect

mixed

139

Pseudoephedrine

Mixed adrenergic agonist- stimulates release of epi, but acts directly on beta and alpha 1 receptors

vasoconstriction

140

Epi acts on

Alpha 1, beta 1 and beta 2

141

Epi selective or nonselective?

Nonselective

142

Noncatecholamines

Phenylephrine, metaproterenol, ALBUTEROL

143

Albuterol is selective for..

beta 2

144

Epi can increase OR decrease blood

glucose

145

Epi contraindications

TCAs

MAOIs

Beta blockers

146

adrenergic agonists contraindicated in

closed angle glaucoma,

cardiac dysrhythmia

Cardiogenic shock

147

Norepi and dopamine IV considerations

Infiltration can cause necrosis

148

Continuous use of adrenergic agonists may cause

rebound congestion

149

Alpha 2 central agonist, methyldopa, due to new meds

Not used

150

Side effects of central acting alpha agonists

drowsiness, headache, nasal congestion, nightmares, constipation, ED, hepatic enzymes

151

Types of adrenergic antagonists

Indirect

Selective

Nonselective

Direct

152

Alpha antagonists

Vasodilation

153

Beta blockers

Decrease heartrate, and therefore, BP

154

Propanolol is

Nonselective, beta 1 and 2-- can be used for migraines

155

Atenolol suppresses

RAAS

156

Atenolol contraindicated in

Sick sinus, asthma, bradycardia, heart block, AHF

NSAIDS

157

Beta blockers should be tapered for..

1-2 weeks

158

Adrenergic neuron antagonists/blockers

HTN

Decreases epi/norepi and may cause depression