Glossary of cardio pharm

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5 major side effects for hydrochlorothiazide
hypokaleia, slight hyperlipidemia, hyperuricemia, hypercalcemia, hyperglycemia
4 major side effects for loop diruetics
potassium wasting, metabolic alkalosis, ototoxicity, hypotension
clonidine side effects (2)
dry mouth, severe rebound hypertension
methyldopa side effects (2)
sedation, positive Coombs test
hexamethonium side effects (4)
severe orthostatic hypotension, blurred vision, constipation, sexual dysfunction
reserpine side effects (4)
sedation, depression, nasal stuffiness, diarrhea
guanethidine side effects (4)
orstastic/exericse hypotension, sexual dysfunction, diarrhea
prazosin side effects (3)
1st-dose orthostatic hypotensoin, dizziness, headache
beta-blocker major side effects (6)
asthma, impotence, sleep problems, bradycardia, chf, av block
hydralazine side effects (4)
lupus like snydrome, reflex tachycardia, angina, salt retention
minoxidil side effets (5)
hair, pericardial effusion, reflex tachycardia, angina, salt retention
vasodilator: calcium blocker side effects (3)
flushing, constipatipn, nausea
nitroprusside major side efect
cyanodie toxicity
captopril side effects (8)
hyperkalemia, cough, angioedema, proteinuria, taste changes, hypotension, pregnancy (fetal renal damage), rash
ARB side effect (losartan)
fetal renal toxicity, hyperkalemia
two drugs that cause hyperkalemia
losartan and captopril
what do you have to do wit hhydralazine and minoxidil?
use beta blockers to treat reflex tachy, diuretic to block salt retention
mechanism of hydralazine
increase cGMP, smooth muscle relaxation, vasodilatoin, afterload reduction
what is dilation is hydralazine selective for
clinical use for hydralazine (2)
severe hypertension, CHF
mechanism for clonidine
alpha2 agonist
mechanism for methyldopa
alpha2 agonist
mechanism for prazosin
alpha1 blocker
mechanism for reserpine
decrease norepi
mechanism for guanethidine
decrease norepi
block ach receptor
name 3 calcium channel blockers
nifedipine, verapamil, diltiazem
mechanism of calcium blockers
block voltage-dependent calcium channels on cardiac/smooth muscle and reducing muscle contractility
rank vascular smooth muscle block by calcium blocker
rank heart smooth muscle block by calcium blocker
use for calcium blockers
hypertension, angina, arryhtmia (not nifedipine)
calcium blocker toxicity (3)
cardiac depression, peripheral edema, flushing,
mechanism for nitro drugs
vasodilate by releasing nitric oxide, increase cGMP, smooth muscle relaxation, decrease preload
rank the preference for dilation in nitro drugs
veins > arterioles
clinical use for nitro drugs (4)
angina, pulmonary edema, aphrodisiac, erection enhancer
name side effects for nitro (4)
tachycardia, hypotension, headache, monday disease
define monday disease
build tolerance to nitro during work, resensitize on weekend and get tachy and dizziness
goal of antianginal therapy
reduce myocardial oxygen consumption
name 5 determinants of antianginal therapy
end diastolic volume, blood presure, heart rate, contractility, and ejection time
how does nitro effect end diastolic volume, blood pressure, contractility, heart rate, and ejection time
decrease, decrease, increase (reflex), increase (reflex), decrease
how does beta-blocker affect diastolic volume, blood pressure, contractility, heart rate, ejection time
increase, decrease, decrease, decrease, increase
name 3 factors that combo beta-blockers + nitrates will decrease
blood pressure, heart rate, and overall myocardial oxygen consumption
for calcium channel blockers, what drug is similar to nitro
for calcium channel blockers, what durg is similar to beta-blockers
define bioavailability, protein bound percentage, where ecreted, and 1/2 life for digoxin
75%, 20-40%, kidney, 40 hours
mechanism for digoxin
block na/k atpase, increase na, slow na/ca antiport, increaes ca, positive inotrope
how does digoxin affect arryhtmia
vagal effects increase PR, decrease QT, T wave inversion on ECG
name 2 uses for digoxin
CHF (increase contractility) and a fib (decrease conduction at AV node)
5 major general digoxin side efects
nausea, vomiting, diarrhea, blurry yellow vision, arryhtmia
name 3 contraindications with digoxin
renal failure, quinidine (will displace dig on protein, potentiate effect), hypokalemia (potentiate effect)
what is the antidote for digoxin
slowly normalize K, lidocaine, cardiac pacer, anti-dig FAB fragments
describe function that all class I antiarryhtmics have
decrease slope of phase 4 depolarization
define state dependency and state what drugs are state dependent
class I antiarryhtmics. selectively depress tissue what is depolarized
name 4 class Ia drugs
quinidine, amiodarone, procainamide, disopyramide
name 3 mechanisms of class Ia
increase AP duratoin, increase ERP, increase QT interval
what do you use class Ia for?
atrial and ventricular arryhtmias
quinidine toxicities
cinchonism: headache, tinnitisum, thrombocytopenia plus torsades
procainamide toxicity
reversible lupus like side effect
name 3 class IB drugs
lidocaine, mexiletine, tocainide
mechanism for class IB
decrease AP duration.
where does class IB affect?
affect ischemic or depolarized purkinje ventricular tissue.
what is class IB useful for?
acute ventricular arryhtmias (post-MI) and digitalis induced arryhtmia
name 4 side effects of class IB
local anesthetic, cns stimulation, cns depression, cardiovascular depression
name 3 class IC drugs
flecainide, encainide, propafenone
name mechanism of class IC
no effect on AP
what is class IC sueful for?
v-tach that progress to V fib and also for SVT. usuaully only good for refractory tachyarryhtmias
class IC toxicities
proarryhtmitic, especially post-mI (contraindiciated)
name 5 class II antiarrythmiycs
propanolol, esmolol, metoprolol, atenolol, timolol
mechanism of class II drugs
decrease camp, decrease CA, decrease slope phase 4, increase PR interval at AV node
what is a short acting class II
name 5 side effects of class II drugs
mask hypoglycema, impotence, asthma, CV effects (bradycardia, av block, chf). sleep
name 4 class III drugs
sotalol, ibutilide, bretylium, amiodarone
mehcanism of class III
increase AP duration, incrase ERP, increase QT, used when others fail
sotalol toxicity
torsades, excessive beta-block
ibutilide toxicity
bretylium toxicity
new arrhythmias, hypotension
amiodorone toxicity
hypothyrodism/hyperthyrodism, pulmonary fibrosis, hepatic toxicity, corneal deposits, skin deposits (photodermatitis), neurologic defects, constipation, bradycardia, heart block, chf
what 3 tests to do before using amiodarone?
name 2 class IV antiarrhytmics
verapamil, diltiazem
mechanism for class IV
affect AV nodal cells, decrease conduction velocity, incrase ERP, increase PR.
what is class IV used for
prevent nodal arryhtmias (SVT)
what are 4 general side effects for class IV
constipation, flushing, edema, cv (chf, av block, sinus node depression)
bepridil toxicity
adenosine function
drug of choice in diagnosisng/abolishing AV nodal arryhtmias
potassium function
depress ectopic pacemaker, esp in dig toxicity
magnesium function
torsades and dig toxicity use

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