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Chpt 21 Cardio drugs
| Inotropic | and agent used for force of cardiac contraction | |
| Preload | load or tension on the cardiac muscle, before contraction (higher the tension, stronger the contraction) | |
| Afterload | pressure in the aorta that must be overcome during systole (peripheral vascular resistance have significant effect on afterload) | |
| Pulmonary circulation | Picks up oxygen discards carbon dioxide | |
| Systemic circulation | carries oxygen and nutrients to all active cells and transports wastes to kidneys, liver and skin for excretion | |
| Endocardium | Thin inner lining around myocardium | |
| Myocardium | Heart muscle; middle layer | |
| Epicardium | Thin outer lining of myocardium | |
| Ischemia | Insufficient amount of oxygen delivered to heart | Coronary Heart Disease (CHD) |
| Arteriosclerosis | Hardening of an artery | Coronary Artery Disease (CAD) |
| Atherosclerosis | Blockage of an artery | Coronary Artery Disease (CAD) |
| Angina pectoris | Chest pain; Episodic, reversible oxygen insufficiency | Coronary Heart Disease (CHD) |
| Vasodilators | Produces vasodilation by direct action on vascular smooth muscle | Uses: to treat hypertension; Congestive Heart Failure (CHF); Post MI |
| Oldest frequently prescribe drugs for different types of angina are Organic Nitrates (stop acute angina attacks) | Nitrostat, Nitrobid (nitroglycerin) | Antianginal agents |
| Uses: Decrease cardiac oxygen in stable angina; Relaxes and increase oxygen in variant angina; Decrease arterial pressure and afterload | Nitrostat, Nitrobid (nitroglycerin) | Antianginal agent |
| Effects: last 1 hr; Direct absorption into circulation (bypass first pass metabolism in liver); Take 1 dose wait 5 min; Take additional 2 doses if pain has not subsided; Doses should be 5 min apart, no more than 3 Call 911 after 3rd dose | Sublingual nitroglycerin | Antianginal agent |
| Effects: Released slowly; apply hairless site daily (every 12-14 hrs); Do not apply near elbow, knees, fold of skin; Rotate sites | Transdermal Nitro | Antianginal agents |
| Effects: Use to prevent angina attacks vs. treat; Not for attacks in progress | Transdermal Nitro | Antianginal agents |
| Patient Info: Avoid carrying close to body and store in cool, dark place; Avoid alcohol | Nitroglycerin | Antianginal agents |
| Patient info: Seek emergency attention if pain insist after 3 tablets; May cause dizziness, severe hypotension and flushing | Nitroglycerin | Antianginal agents |
| Patient info: Do not drive/operate machinery; Discard unused tabs after 6 months | Nitroglycerin | Antianginal agents |
| isosorbide dinitrate (Isordil) | Organic Nitrate | Other Antianginal agents |
| isosorbide mononitrate (Imdur) | Organic Nitrate | Other Antianginal agents |
| Contracts smooth muscle and blood vessels; Increases B/P; Used in the tx of hypotension and shock | Epinephrine | Vasoconstrictors |
| Reduce nerve impulses in heart(sympathetic stimulation) which reduce heart rate and oxygen demand | Beta-Adrenergic Blockers | Antihypertensive agents |
| Prevent development of myocardial ischemia and pain | Beta-Adrenergic Blockers | Antihypertensive agents |
| doxazosin | (Cardura) | Beta-Adrenergic Blockers |
| propranolol | (Inderal) | Beta-Adrenergic Blockers |
| atenolol | (Tenormin) | Beta-Adrenergic Blockers |
| Most common antihypertensive drug class; May cause postural hypotension | Beta-Adrenergic Blockers | Antihypertensive agents |
| May cause dizziness; bronchospasms; May c/o insomnia, vivid dreams or depression | Beta-Adrenergic Blockers | Antihypertensive agents |
| Interfere w/movement of calcium ions through cell membranes | Calcium Channel Blockers | |
| Prevent Ca+ from entering heart muscles and blood vessels, result in smooth muscle relaxation | Calcium Channel Blockers | |
| Decrease B/P, increase cardiac output | Calcium Channel Blockers | |
| Used to treat pain of angina, to lower blood pressure, and treat arrhythmias | Calcium Channel Blockers | |
| Slows SA node impulse, relaxes blood vessels; used to treat migraines | Calcium Channel Blockers | |
| Adverse Effects: Dizziness, drowsiness, hypotension, fatigue, edema, constipation | Calcium Channel Blockers | |
| Adverse Effects: May cause sexual dysfunction in men; may reduce elimination of lip lowering medications leading to toxicity; Grapefruit juice may increase serum in drug | Calcium Channel Blockers | |
| diltiazem | (Cardizem) | Calcium Channel Blockers |
| verapamil | (Calan, Covera) | Calcium Channel Blockers |
| amlodipine | (Norvasc) | Calcium Channel Blockers |
| Use with caution in patients taking digoxin (lanoxin) (may increase serum levels of digoxin | verapamil (Calan) | Calcium Channel Blockers |
| Caused by severe prolonged lack of oxygen which kills an area of heart muscle | Myocardial Infarction (MI) | |
| Leading cause of death in industrialized nations | Myocardial Infarction (MI) | |
| Causes: CAD, clot formation in the cornonary artery, spasm of arteries, heavy exertion; abrupt increase in b/p | Myocardial Infarction (MI) | |
| Therapeutic Agents: Goal is to limit damage to myocardium; IV fluids; Nitroglycerin; Aspirin and thrombolytic drugs; Morphine sulfate; Beta-blockers and calcium channel blockers;oxygen | Myocardial Infarction (MI) | |
| atorvastatin | (Lipitor) | Antihypertensive agent |
| amlodipine | (Norvasc) | Antihypertensive agent |
| lisinopril | (Zestril) | Antihypertensive agent |
| digoxin | (lanoxin) | Antiarrhythmics (inotropics) |
| simvastatin | (Zocor) | Lipid Lowering agents |
| enalapril | (Vasotec) | Antihypertensive agent |
| warfarin sodium | (Coumadin) | Antigoagulants |
| pravastatin | (Pravachol) | Lipid Lowering agent |
| quniapril | (Accupril) | Antihypertensive agent |
| diltiazem | (Cardizem CD) | Antianginal agent |
| Chronotropic | an agent used for rate of cardiac contraction |
Created by:
Ggoosey
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