Cardio pharm 331
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| What is hypertension? | chronic high BP (@ least 3 visits documented)
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| What are the ranges for hypertension diagnoses? | Normal: less then or equal to 120/less then or equal to 80
Prehypertension: 120/80-139/89
Stage 1 Hypertension: 140/90-150/99
Stage 2 Hypertension: 160</100<
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| What are the three main causes of hypertension? | 1.vasoconstriction-too active sympathetic nervous system
2.too much Renin-angiotensin-aldosterone system action
3.Too much fluid
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| Which two areas of really dense capillary beds are affected by both diabetes and hypertension? | Eyes and kidneys
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| What are the 6 types of drugs used to treat hypertension? | 1.Diuretics
2.Beta blockers
3.ACE inhibitors
4.Angiotensin 2 receptor blockers
5.Calcium channel blockers
6.Vasodilators
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| What is the ending for diuretics? What part of hypertension do they treat? | -thiazide
Fluid retention
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| What is the ending for Beta blockers and what do they do? | -olol
Work to reduce the effect of sympathetic nervous system: slow down heart rate and cause vasodilation
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| What are the AE for beta blockers? | CNS effects (drowsy, dizzy)
GI upset
Arrythmia
Decreased exercise tolerence
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| What else are beta blockers used for besides hypertension? | Angina and arrhythmia
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| Who should you not give beta blockers to? | People with pulmonary problems, COPD, diabetes or thyroid problems
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| What is the ending for the ACE inhibitors and what do they do? | -pril
Block conversion of angiotensin 1 to angiotensin 2: vasodilate and reduce some fluid
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| What are the AE of ACEI? | slight increase in K+
COUGH and itching and rash (angiotensin 2 breaks down bradykinine, so histamine rxns!)
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| Who shouldn't use ACEI? | People with renal failure
pg and lact
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| What are the endings for angiotensin 2 receptor blockers and what do they do? | -sartan
Block angiotensin 2 receptors! Same as ACEI but without cough, bradykinine getting broken down
Results in vasodilation
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| What are the AE for angiotensin 2 receptor blockers? | muscle weakness, hypotension
No cough!
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| What are the Ca+ channel blockers and what do they do? | Diliazem
block Ca+ channels, vasodilate and prevent smooth muscle contractions
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| What are the AE of Ca+ channel blockers? | bradycardia and edema
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| What should you not take with Ca+ channel blockers? | grapefruit juice!!
and cyclosporine
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| What are the 4 vasodilators listed? | Diazoxie
Hydralazine
Minoxide
Nitroprusside (also for angina)
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| What else are Ca+ channel blockers used for? | Angina-prinzemetal only
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| What is congestive heart failure? | Heart no longer able to pump effectively- pooling blood, backing up in veinous system
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| What are some s/s CHF? | splenomegaly
hepatomegaly
cardiomegaly
decreased renal perfusion
GI upset
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| What are the 4 types of drugs used for CHF? | 1.vasodilators-Nitro and ACEI
2.Diuretics-fluid removal
3.Beta Agonists
4.Cardiac Glycosides-Digoxin!
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| What do Beta Agonists do? | Stimulate the heart-increase contraction strength
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| What are the 4 methods of action of digoxin? | 1.increase contraction strength of heart
2.decrease renin-fluid loss
3.decrease HR
4.Decrease conduction time in heart
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| Who should not have digoxin? | Acute MI
pg/lct
ventricular tachycardia or fibrulation
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| What are the AE of digoxin? | Nausea and vomiting important! First sign of toxicity
Yellow halos, visual disturbances
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| What should you monitor when giving digoxin? | HR and K+ levels, esp when giving with diuretics
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| What are the dr-dr interactions to watch for with digoxin? | Not to be given with diuretics
cholestyramine
bleomycin,methotrexate
quinidine
cyclosporine
all the meds that inhibit metabolism could lead to digitoxicity
other drugs block absorbtion of digoxin
fiber and chy
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| What is the definition of angina? | Chest pain caused by lack of O2 to tissues
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| What are the three types of angina? | 1.stable
2.unstable
3.prinzmetal
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| What are the three types of drugs used to treat angina? | 1.Nitrates (vasodilators)
2.Beta blockers
3.Ca+ channel blockers (prinzmetal only!)
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| What are the cautions and contraindications for nitrates? | caution: absorbs very rapidly!
Contra: bleeding problems, head trauma, anemia
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| What are the cautions with Beta Blockers? | Avoid using with diabetics and people with thyroid problems
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| What drug should you not mix with vasodilators? | Any ergot derivatives
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| What is the most common AE of vasodilators? | Pounding headache-rebound hypertension
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| What is the definition of arrythmia? | Abnormal sinus rhythm
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| What are the 6 types of arrhythmia? | 1.tachycardia
2.bradycardia
3.atrial flutter
4.Partial ventricular and partial atrial contractions
5.Atrial or ventricular fibrulation
6.Heart blocks or bundle branch blocks
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| What is the common AE of all the drugs used to treat arrhytmias? | Can also cause arrhythmias
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| What are the four drugs/types used to treat arrythmias and what do they do? | Class 1: lidocaine-block Na+
Class 2: Beta Blockers-depress phase 4
Class 3:Amiordorones-K+ blockers, works on phase 3
Class 4:Diltiezem, Ca+ blockers
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| What are the AE for amiodarone? | Pulmonary and hepatic toxicity
Corneal and visual changes
arrythmias and cardiac arrest
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| What are the cautions for amiodarone? | Do not mix with digoxin or quinidin, careful with prolonged QT interval, renal or hepatic disease
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| What are the AE of diltiezem? | Bradycardia and peripheral edema
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| What is the definition of hyperlipideama? | too much LDL and triglycerides
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| What are the 4 types of drugs used to treat hyperlipideama? | 1.Bile Acid Sequesterants-cholestyramine, metamucil
2.HMG-COA reductase inhibitors (-statins_
3. Cholestertol Absorption inhibitors: Ezetimibe
4.Others (-fib-)
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| What do bile acid sequestrants do? | Force you to not recycle bile acids, use blood cholesterol to make new bile acids.
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| What are the AE of Bile Acid Seq.? | malabsorption of fat soluble vitamins, increased bleeding time, GI upset
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| What should you check when giving Bile Acid Seq? | PT and PTT-clotting time
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| What do the -statins do? | Inhibit enzyme that makes cholesterol
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| What is the main AE of -statins? | rhabdomyolysis
dark brown urine
kidney damage
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| What should you be careful with when taking -statins? | grapefruit juice! (also the Ca+ blockers)
Alcohol!
Monitor liver enzymes
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| What are the AE of Ezetimibe? | myalgia and arthralgia
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| What should you avoid when taking cholesterol absorbtion inhibitors? | antacids
cyclosporins
warfarin
cholestyramine
fibrates
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| What is the main AE of niacin? (lipid lowering agent) | Flushing of face
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| Wha are the 5 anticoagulants and antiplatelet drugs? | 1.Asprin
2.Warfarin/coumadin
3.Heparin
4.Low Molecular Wt. Heparin
5.Angiomax, acova, antithrombin
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| What does asprin do? | lowers # of overall platelets
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| What are the s/s asprin tox? | tinnitus, blood in stool
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| What does warfarin do? | prevents new clots from forming, blocks vitamin K
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| What is the antidote to warfarin? | Vitamin K
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| What does heparin do? | prevents prothrobin from becoming thrombin, interferes with the cascade
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| What are the AE of heparin? | hair loss, chills, bruising and bleeding, renal fx impaired, osteoporosis
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| What is the difference between heparin and l.m.w. heparin? | LMW heparin only works on factor Xa-much fewer AE, no bleeding precautiouns
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| What should you be careful of when on coumadin? | Vitamin K in diet-no green leafy veggies
Shaving, brushing teeth, careful of bleeding!
Don't take with other anticoagulants, asprin, penicillin
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| What are the three types of anemia? | megaloblastic
iron deficiency anemia
pernicious anemia
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| What are the drugs used to treat anemia? | synthetic erythropoeitins (all -poeit)
stimulate RBC synthesis
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| What are the cautions with the -poetins | Allergy to any type of human or mammal cell derived stuff
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| Normal H and H? | female: 36-44/ 12-15
Male: 38-50/ 13-17
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| Who should not take erythropoeitins? | CHF
hypertension
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