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CardiacDrugs

cardiac drugs

QuestionAnswer
Blood Pressure = Cardiac Output x Systemic Vascular resistance
Cardiac Output effects Cardiac Factors:Heart Rate,ContractibilityCirculating Volume: Salt, Aldosterone
Cardiac Factors: Heart Rate, Contractibility Drugs Beta-blockers,Calcium Channel Blockers, Centrally Acting adrenergics.
Circulating Volume: Salt, Aldosterone Drugs ACE Inhibitors,Diuretics
Systemic Vascular Resistance effects Hormones:vasodilators,vasoconstrictors,Peripheral sympathetic receptors:Constrictors,Dilators,CNS,Local
Hormones:Vasodilators,Vasoconstrictors effect and drugs Vasodilators,Prostaglandins,ACE inhibitors,Calcium Channel blockers,Angiotensin II blockers
Peripheral Sympathetic receptors: Constrictors,dilators effect Receptors Alpha 1.alpha1-blockers, Beta 1. Beta-blockers
CNS Centrally acting adrenergics
Local Peripherally acting adrenergics
Autonomic Nervous System Parasympathetic nervous system: Stimulates smooth muscle,cardiac muscle,glands. Sympathetic nervous system: Stimulates the heart,blood vessels skeletal muscle.
Andrenergic Drugs : 5 subcategories Centrally and peripherally acting adrenergic neuron blockers. Centrally acting a2-receptor agonists. Peripherally acting a1-receptor blockers. Peripherally acting B-receptor blockers. -cardioselective(B1receptors) -nonselective(both B1&B2 receptors)
Andrenergic Drugs : 5 subcategories cont'd. Peripherally acting dual a1-and B-receptor blockers
Adrenergic Drugs:MOA Centally acting a2-receptor agonists Stimulate a2-receptors in the brain Sympathetic ouflow from the CNS is decreased Norepinephrine production is decreased Stimulation of the a2-adrenergic receptors reduces renin activity in the kidneys. RESULT:DECREASED BLOOD PRESSURE
Adrenergic Drugs:MOA Centally acting a2-receptor agonists Prototype Drugs clonidine(Catapres) guanfacine(Tenex) methyldopa(Aldomet) -Drug of choice fo hypertension in pregnancy
Adrenergic Drugs:MOA Peripheral a1-blockers/antagonists Block the a1-adrenergic receptors RESULT:DECREASED BLOOD PRESSURE
Peripheral a1-blockers/antagonists Prototype Drugs (end in zosin) doxazosin(Cardura) prazosin(Minipress) terazosin(Hytrin)
Angiotensin Converting Enzyme Inhibitors ACE inhibitors MOA DECREASE PERIPHERAL VASCULAR RESISTANCE w/o: Increasing Cardiac Output,w/o increasing cardiac rate and w/o increasing cardiac contractility
Angiotensin Converting Enzyme Inhibitors ACE inhibitors Effects Dizziness, Orthostatic hypotension,GI Distress, nonproductive cough,headache.
Angiotensin Converting Enzyme Inhibitors ACE inhibitors Prototype drugs (end in pril) Captopril(Capoten) Enalapril(Vasotec) Benzapril(Lotensin) Lisinopril(Zestril) Quinapril(Accupril)
Angiotensin Converting Enzyme Inhibitors ACE inhibitors MOA on RAAS Renin-Angiotensin-Aldosterone System Inhibit angiotensin-converting enzyme,which is responsible for converting angiontensin 1(through the action of renin)to angiontensinII
Angiotensin Converting Enzyme Inhibitors ACE inhibitors MOA on RAAS cont'd. AngiotensinII is apotent vasoconstrictor and causes aldosterone secretion from the adrenals Aldosterone stimualtes water and sodium resorption RESULT: INCREASED BLOOD VOLUME,INCREASED PRELOAD,AND INCREASED BP.
Angiotensin Converting Enzyme Inhibitors ACE inhibitors MOA Block the angiotensin converting enzyme,thus preventing the formation of angiotensinII Also prevent the breakdown of the vasodilating substance,bradykinin RESULT:DECREASE SYSTEMIC VASCULAR RESISTANCE(AFTERLOAD),VASODILATON,AND THEREFORE DECREASE BP
ACE Inhibitors: Indications HTN,HF(either alone or in combination w/diuretics or other drugs),To slow progression of left ventricular hypertrophy after MI(cardioprotective),Renal protective effects in patients w/diabetes.Drugs of choice in HTN pt's w/HF.Drug of choice for Dibetics.
ACE Inhibitors Adverse Effects Fatigue,HA,Impaired taste,Dizziness,Mood Changes,possible hyperkalemia,dry,nonproductive cough,which reversed after therapy is stopped.Angioedema:rare but potentially fatal.1st dose hypotension may occur!
Angiotensin II Receptor Blocker (AII blockers or ARBs) Newer class, well tolerated,do not cause a dry cough,allow angiotensin I to be converted to angiontensin II,but block the receptors that receive angiotensinII,Block vasoconstiction and release of aldosterone.
Angiotensin II Receptor Blocker (AII blockers or ARBs) Indications HTN,Adjunctive drugs for the tx of HF,May be used alone or w/other drugs such as diuretics,Used primarily in pt's who cannot tolerate ACE inhibitors
Angiotensin II Receptor Blocker (AII blockers or ARBs) Prototype drugs (end in satran) Iosartran(Coazar,Hyzaar) valsartan(Diovan) eprosartan irbesartan
Angiotensin II Receptor Blocker (AII blockers or ARBs) Adverse Effects Upper respiratory infections,HA,may cause occasional dizziness,inability to sleep,diarrhea,dyspnea,heartburn,nasal congestion,back pain,fatigue,hyperkalemia much less likel to occur.
Calcium Channel Blockers MOA Cause smooth muscle relaxation by blocking the binding of Ca to its receptors,preventing muscle contraction.This causes decreased peripheral smooth muscle tone and decreased systemic vascular resistance.RESULTS:DECREASED BLOOD PRESSURE
Calcium Channel Blockers MOA Blocks Ca access to cells causing decreased contractility & decreased conductivity of the heart=decreased demand for oxygen
Calcium Channel Blockers Side effects Decrease BP,bradycardia, may precipitate A-V Block,HA,abdominal discomfort(constipation,nausea)peripheral edema.
Calcium Channel Blockers Prototype Drugs (Very Nice Drugs) Verapamil Nifedipine Ditiazem
B-blockers Act in the periphery, reduce heart rate due to B1-blockade.
B-blockers Prototype Drugs (end in olol) Inderal(Propanolol) Tenormin(Atenolol)
Created by: LauraHall
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