PharmacologyHSC1149
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| most antiarrhythmics __ pulse rate and blood pressure | lower
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| procainamide & quinidine can cause | tachycardia
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| antiarrhythmic agents can __ existing arrhythmias or cause new arrhythmias | worsen
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| when other cardiac drugs are administered concomitantly there can be an additive or __ effect | antagonistic
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| propanolol (Inderal) & atenolol (Tenormin) are in the class of | beta-adrenergics blockers
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| verapamil (Calan, Isoptin) are in the class of | calcium channel blockers
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| disopyramide (Norpace), quinidine, & procainamide (Pronestyl) all have __ mechanism of action | similar
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| antihypertensives do not __ hypertension | cure
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| antihypertensives only __ hypertension | control
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| if antihypertensive medication is stopped, blood pressure will return to __ __ to those before treatment w/medication | levels similar
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| defined as systolic range 120-139 and diastolic 80-89; new category to identify patients who are at higher cardiovascular risk based on BP | pre-hypertension
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| lifestyle changes are the only management of blood pressure at the | pre-hypertension stage
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| most frequently prescribed diuretic for high blood pressure. | hydrochlorathiazide
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| peripheral vasodilator | hydralazine (Apresoline)
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| central-acting alpha-adrenergic agent | methyldopa (Aldomet)
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| angiotensin-converting enzyme (ACE) inhibitor | enalapril (Vasotec) & lisinopril (Prinivil, Zestril)
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| calcium channel blocker | amiodipine (Norvasc)
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| beta-adrenergic blocker | metoprolol (Lopressor)
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| thiazide diuretic | hydrochlorathiazide (HydroDIURIL)
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| cardiac glycoside; administration PO: tablets, liquid-filled capsules; elixir; intermediate duration; trade name for digoxin | Lanoxin, Lanoxicaps
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| cardiac glycoside; administration: IV, dosage varies; maximum dose 0.125mg (long-term in older adults) | digoxin
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| antiarrhythmic; administration PO, 50mg/day or IV 5-10mg; beta blocker; trade name for atenololª | Tenormin
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| antiarrhythmic; administration PO, 10-30mg/3-4x/day or IV 0.5-3mg; beta blocker; trade name for propranololª | Inderal
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| antiarrhythmic; administration PO, 240-480mg or IV 2.5-10mg; calcium channel blocker; trade name for verapamilª | Isoptin, Calan
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| antiarrhythmic; administration IM or IV diluted (check IV dilution directions); local anesthetic-type; trade name for lidocaine | Xylocaine
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| antiarrhythmic; administration IV or PO dose varies; antiarrhythmic & vasodilator; for Medication Guide now required; trade name for amiodarone | Cordarone
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| antiarrhythmic; administration PO dose varies IV/IM for emergency; local anesthetic, anticholinergic; trade name for procainamide | Pronestyl, Procanbid
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| antiarrhythmic; administration PO 150-300mg q8h; membrane stabilizer for ventricular arrhythmias; trade name for propafenone | Rythmol
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| antiarrhythmic; administration PO 225-425mg q12h; membrane stabilizer for ventricular arrhythmias; trade name for propafenone | Rythmol SR
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| antiarrhythmic; administration PO tabs, ER, IV, IM dose varies; myocardial depressant, anticholinergic | quinidine
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| antiarrhythmic; administration PO 150mg q6h; myocardial depressant, anticholinergic properties, not for older adults; trade name for disopyramide | Norpace
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| antiarrhythmic; administration PO 300mg q12h; myocardial depressant, anticholinergic properties, not for older adults; trade name for disopyramide | Norpace CR
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| atenololª, propranololª, & verapamilª: the (ª) denotes contraindications for patients with | other heart conditions
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| are contraindicated for patients w/bradycardia, heart block, & CHF | beta blockers
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| adrenergics (i.e. epinephrine/isoproterenol), anticholinergics, & tricyclic antidepressants are __ of beta blockers | antagonists
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| diuretics & other hypertensives (i.e. calcium channel blockers) as well as phenothiazine/other tranquilizers, potentiate the __ effect of propranolol | hypotensive
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| cimetidine (Tagamet) will __ __ of propranolol | slow metabolism
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| use of propranolol with other cardiac drugs (i.e. quinidine) may potentiate __ effects | toxic
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| when used with propranolol, they may precipitate hypotension, dizziness, confusion, &/or sedation | alcohol, muscle relaxants, & sedatives
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| are contraindicated for patients w/heart block (causes bradycardia), severe heart failure,hypotension, certain arrhythmias, or angina | calcium channel blockers
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| calcium channel blockers when used w/other cardiac drugs (i.e.) digoxin) can potentiate __ & __ effects | good; adverse
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| calcium channel blockers have a(n) __ __ w/barbiturates, salicylates, phenytoin/rifampin, & lithium | antagonistic effect
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| calcium channel blockers, when taken w/diuretics, ACE inhibitors, beta-blockers, & quinidine, | potentiate hypotensive effect
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| adverse effects are potentiated when calcium channel blockers are taken with | grapefruit juice
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| occur in nature or can be prepared synthetically; act directly on myocardial contractions; primarily used in treatment of CHF | cardiac glycosides
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| cardiac glycosides are called __ because they strengthen the heartbeat | cardiotonic
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| cardiac glycosides are sometimes used w/antiarrhythmic agents to slow heart rate in certain kinds of __ or atrial fibrillation/flutter | tachycardia
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| in patients w/CHF cardiac glycosides act by increasing force of __ __ w/out increasing O2 consumption, thereby increasing cardiac output | cardiac contractions
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| result of cardiac glycosides increasing efficiency of the heart, the heart beats slowly, __ __, & diuretic action decreases edema | size shrinks
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| most commonly used cardiac glycosides are | digitalis products
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| most commonly used digitalis product digoxin (Lanoxin) is used because administration available orally/parenterally & has | intermediate duration of action
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| process of establishing correct therapuetic dose of digitalis for maintaining optimal functioning of heart w/out toxic effects | digitalization
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| careful monitoring of cardiac rate/rhythm w/EKG, cardiac function, side effects, & blood digitalis is required to determine __ __ __ of digitalis | therapuetic maintenance dose
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| checking the __ __ before administering digitalis is an important part of the monitoring process | apical pulse
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| if apical pulse rate is below 60, digitalis should be | withheld until physician consulted
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| includes variety of drugs that act in different ways to suppress various types of cardiac arrhythmias, incl atrial/ventricular tachycardias, atrial fibrillation/flutter, & arrhythmias that occur w/digitalis toxicity or during surgery & anesthesia | antiarrhythmic agents
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| assessment of type of arrhythmia, frequency, cardiac/renal/other pathological condition(s), & current signs/symptoms are factors in the __ of antiarrhythmic agent | choice
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| most of the antiarrhythmic agents have potential for __ BP & __ heartbeat | lowering; slowing
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| signs of hypotension & bradycardia, when antiarrhythmic agents are administered, can lead to | cardiac arrest
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| antiarrhythmic agents which may cause tachycardia, instead of intended effects of slowing heart rate | procainamide & quinidine
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| when other cardiac drugs are administered w/antiarrhythmic agents concomitantly, cardiac effects may be | additive or antagonistic
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| antiarrhythmic agents can __ existing arrhythmias or cause new arrhythmias | worsen
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| very important, for patients taking antiarrhythmic agents, especially for hyperkalemia | electrolyte surveillance
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| combat arrhythmias by inhibiting adrenergic (sympathetic) nerve receptors | beta-adrenergic blockers
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| non-selective beta-blocker, effective in mngmt. of some arrhythmias & loss effective w/others; used in treatment of hypertension & some forms of chronic angina | propranolol (Inderal)
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| selective beta-antagonist, used w/caution & in low doses may be used in patients w/lung conditions that cause bronchospasms | atenolol (Tenormin)
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| counteract arrhythmias by suppressing action of calcium in contraction of heart muscle, thereby reducing cardiac excitability & dilating main coronary arteries | calcium channel blockers
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| calcium channel blockers are used in treatment of | angina & hypertension
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| antiarrhythmic similar to procainamide & quinidine, which is a synthetic agent that decreases myocardial excitability, inhibits conduction, & may depress myocardial contracitility | disopyramide (Norpace)
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| disopyramide (Norpace) has significant __ properties | anticholinergic
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| 2nd choice behind alternative agents (i.e. IV amiodarone) for treatment of ventricular arrhythmias | lidocaine
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| primarily used as prophylactic therapy to maintain normal rhythm after conversion by other methods; usually administered orally in antiarrhythmic therapy | procainamide (Pronestyl)
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| procainamide (Pronestyl) __ anticholinergic properties | possess
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| one of oldest antiarrhythmic agents; acts by decreasing myocardial excitability & may depress myocardial contracitility | quinidine (Quinaglute, Cardioquin)
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| quinidine (Quinaglute, Cardioquin) is used primarily in __ therapy | prophylactic
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| defines as SBP of >140 or DBP of >90 | hypertension
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| strong & consistent relationship between BP and | risk of cardiovascular disease
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| increases risk of MI, heart failure, stroke, & kidney disease; requires aggressive treatment | high BP
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| patients w/pre-hypertension are at a higher risk for developing __ hypertension in later years | sustained
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| purpose of __ __ is to encourage patients to initiate/continue healthy lifestyle practices, rather than antihypertensive drug therapy | pre-hypertension classification
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| medications used in treatment/mngmt. of all degrees of hypertension | antihypertensives
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| if antihypertensives are to be DC, dosage should be gradually reduced, as abrupt withdrawal can cause | rebound hypertension
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| stages of hypertension | mild, moderate, severe
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| stage of hypertension, other physical factors (esp. other cardiac/renal complications), & effectiveness are the factors that determined | antihypertensive agent prescribed
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| antihypertensive side effects are common & __ __ signs must be monitored closely | vital signs
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| most common side effect of antihypertensive agents is | hypotension, postural
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| side effect common to many of the antihypertensive agents | bradycardia
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| antihypertensive agent which causes tachycardia | hydralazine (Apresoline)
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| lowers BP by decreasing vasoconstriction; no significant changes in heart rate/cardiac output | ACE inhibitors
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| good choice for patients w/ other serious conditions, incl. heart failure, diabetes, renal disease, & cerebrovascular disease | ACEIs
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| ACEIs can be used for patients w/hypertension & nephropathy because they __ __ of the renal disease | slow progression
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| side effect of ACEIs can be __ so requires monitoring of serum potassium levels periodically | hyperkalemia
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| ACEIs taken w/diuretics can potentiate __; watch BP closely | hypotension
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| ACEIs taken w/NSAIDs & salicylates antagonize effects of ACEIs & increase | deterioration of renal function
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| similar to ACEIs but they both block hormone causing vasocontriction they interrupt different sites | ARBs
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| losartan (Cozaar) & valsartan (Diovan) block effects of __, decreasing BP w/out marked change in heart rate | angiotensin II
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| low dose thiazide diuretics w/ARBs significantly improves | hypertensive efficacy
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| side effects include dizziness, URIs & hyperkalemia | angiotensin receptor blockers (ARBs)
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| central-acting alpha-adrenergic agent used for moderate-severe hypertension; administered w/diuretic; drug of choice for hypertension is pregnant women because of safety for fetus | methyldopa (Aldomet)
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| peripheral vasodilator, sometimes used for treating moderate-severe hypertension (esp. w/CHF) because increases heart rate & cardiac output; generally used w/another hypotensive agent & diuretic | hydralazine
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| tachycardia/palpations, orthostatic hypotension, & edema/weight gain are | side effects of hydralazine
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| patients w/systematic lupus erythematous, renal disease, coronary artery disease, rheumatic heart disease hydralazine drug therapy is | contraindicated
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| hydralazine used in pregnancy is normally contraindicated, although many regards as hypertensive of choice during | preeclampsia
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| central-acting alpha-adrenergic agent; used mainly to treat hypertension, but also successful in nicotine/opiate withdrawal, vascular headaches, glaucoma, ulcerative colitis, Tourette's. & pain mngmt for severe pain in cancer patients | clonidine (Catapres)
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| peripheral-acting alpha-adrenergic blocker; primary use to treat hypertension; other agents in its class used to treat benign prostatic hypertrophy (BPH) | Prazosin (Minipres)
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| medications used in treatment of angina, to dilate coronary arteries & stop attacks, or control frequency when administered prophylactically | coronary vasodilators
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| insufficient blood supply to part of the body | ischemia
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| ischemia can results in | acute pain
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| most common type of angina | pectoris
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| chest pain resulting from decreased blood supply to heart muscle; obstruction/constriction of coronary arteries | angina pectoris
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| nitrates, beta-blockers, & calcium channel blockers are the coronary vasodilators used in __ & __ mngmt of angina | treatment; prophylactic
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| nitrates most commonly used for relief of acute angina pectoris, as well as for long-term prophylactic mngmt are | nitroglycerin & isosorbide (Isordil, Sorbitrate)
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| if initial single dose of nitroglycerin doesn't provide relief during acute attack, additional tablets may be administered at 5min intervals but no more than 3 doses given in | 15 min period
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