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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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