Flashcards
Cardiovascular Pharm
Cards in this deck (41)
- 1WHAT ARE THE 5 ADRENERGIC RECEPTORS?Alpha 1 & Alpha 2
Beta 1 & Beta 2
Dopamine - 2ACTIVATION OF ALPHA 1 RECEPTORSAlpha 1 Activation= Vasoconstriction:
1. Delay absorption of local anesthetics
2. Control superficial bleeding
3. Elevate blood pressure
Adverse effects: hypertension, tissue necrosis with intravenous (IV) extravasation, and bradycardia. - 3ACTIVATION OF ALPHA 2 RECEPTORSActivation of peripheral alpha2 receptors: no therapeutic applications.
- 4ACTIVATION OF BETA 1 RECEPTORSHeart- positive inotropic effect
(+) heart rate and force of contraction,
(+) cardiac output = (+) tissue perfusion.
Enhancing impulse conduction through the atrioventricular (AV) node
Restore cardiac function in cardiac arrest
Adverse effects of beta1 activation: altered heart rate or rhythm and angina pectoris. - 5ACTIVATION OF BETA 2 RECEPTORSBeta 2 Activation
Bronchodilation
FOR: asthma and delay of preterm labor
adverse effect: hyperglycemia (mainly in diabetic patients) and tremor - 6EPINEPHRINE Uses & MOAFor: Management of cardiac arrest , control superficial bleeding, delay anesthetic absorption
*Treatment of choice for anaphylactic shock
MOA: Activation of all four adrenergic receptors:
alpha 1, alpha 2, Beta 1, Beta 2 receptors - 7EPINEPHERINE Adverse EffectsHypertension (severe)
Cardiovascular effects: Anginal pain, tachycardia, Dysrhythmia
Angina- increased cardiac work and oxygen deman
Necrosis, Hyperglycemia - 8EPINEPHERINE Nursing ConsiderationsUse with caution in pt with hyperthyroidism, cardiac dysrhthmias, heart disease, or hypertension, angina pectoris, diabetes
- 9NOREPINEPHERINE Uses & MOAFor: Hypotensive states and Cardiac arrest
MOA: Activation of 3 adrenergic receptors:
alpha 1, alpha 2, Beta 1 receptors
***Similar to epinephrine BUT, does NOT activate B2 receptors - 10NORPEPINEPHERINE Adverse EffectsHypertension (severe)
Cardiovascualr effects: anginal pain, tachycardia, dysrhythmias
Angina- increased cardiac work and demand
Necrosis - 11NOREPINEPHERINE Nursing ConsideraionsUse with caution in pt with hyperthyroidism, cardiac dysrhthmias, heart disease, or hypertension, angina pectoris.
- 12DOPAMINE UsesShock- B1 in heart receptors increase cardiac output, improve tissue perfusion. Dope Kidney receptors dilate renal blood vessels, improve renal perfusion.
Alpha1 receptors- vasoconstriction may decrease renal perfusion, overriding dopamine activation. Thus monitoring urine output essential
Heart Failure- B1 alleviate symptoms of reduced perfusion and reduced CO. increases myocardial contractility. - 13DOPAMINE MOADose Dependent Receptor specificity: Dopamine, Beta1 and at high doses Alpha1
Low dose= dopamine only
Mod dose= dopamine + Beta1
High dose= dopamine + Beta1 + alpha 1 - 14DOPAMINE Adverse EffectsTSAE: tachycardia, dysrhythmias, anginal pain (from B1 activation)
- 15DOBUTAMINE Use and MOABETA 1 AGONIST
For: improvement of hemodynamic status in patients with heart failure
MOA: selective activation of Beta 1 adrenergic receptors - 16DOBUTAMINE AE & ContraindicationsAE: Tachycardia & dysrhythmias.
GREAT caution in patients with heart disease, hyperthyroidism, tachydysrhythmias, hypertension.
Caution w/ angina pectoris, tricyclic antidepressants, general anesthetics. - 17PHENYLEPHRINENON-CATECHOLMINE
MOA: selective ALPHA 1 AGONIST
Use: Elevate blood pressure - 18NAME THE ANTI-DYSRHYTHMIC DRUGS1) AMIODARONE
Class III:
- potassium channel blocker
2) ADENOSINE
Class IV:
- calcium channel blocker - 19AMIODARONE Therapeutic UsesANTIDYSRHYTMIC
For: Atrial & Ventricular Dysrhythmias
Class III:
- Prolong action potential duration and delays repolarization - 20AMIODARONE Adverse EffectsANTIDYSRHYTHMIC
Cardiac: sinus bradycardia, dcereased contractility;
Ophthalmic, smurf skin, photosensitivity
TOXICITIES: thyroid, pulmonary, cardiac, liver, dermatologic - 21ADENOSINE Use & MOAANTIDYSRHYTHMIC
For: Supraventricular Tachycardia
- decreases automaticity in the SA Node and slows conduction through the AV node
Prolongs PR Interval
MOA: Inhibits cAMP induced calcium influx= suppresses calcium- dependent action potentials in the SA & AV Nodes
- 22ADENOSINE Adverse EffectsANTIDYSRHYTHMIC
Minimal b/c rapidly cleared from blood.
AE last less than 1 min.
* must be given IV
Sinus bradycardia, dyspnea (from bronchoconstriction), hypotension, facial flushing (from vasodilation) - 23ATROPINE Use & MOAMUSCARINIC ANTAGONIST
1) Heart: Increase HR ; Treats symptomatic bradycardia
2) Exocrine Glands: Decrease secretions of exocrine glands
3) Smooth muscle relaxation
myadriasis (pupil dilation)
MOA: competitive blockade at muscarinic receptors. All responses are from preventing receptor activity by endogenous Acetylcholine - 24ATROPINE Adverse EffectsMUSCARINIC ANTAGONIST- ANTICHOLINERGIC
AE: Dry mouth, blurred vision, photophobia, intraocular pressure, urinary retention, constipation, antihydrosis, tachycardia, asthma. - 25ATROPINE Drug-Drug InteractionsDrug-Drug Interactions:
Antihistamines
other muscarinic antagonists
High risk patients: glaucoma, UT obstruction, tachycardia - 26MUSCARINIC RECEPTORS: LocationsHeart, Arterioles
GI Tract, Gallbladder
Lungs, Liver
Urinary Bladder, Penis
Lacrimal Glands, Eye - 27WHAT TYPES OF DYSRHTHMIAS MIGHT PHARMACEUTICALS TREAT?SUPRAVENTRICULAR
- Atrial fibrillation/ flutter
Sustained SVT
VENTRICULAR
- sustained VT
- ventricular fibrillation
PVC
Torsde de Pointes - 28NIACIN Use & MOAANTILIPIDEMIA
Prophylaxis for Atherosclerotic Cardiovascular Disease
MOA: Reduces LDL & TG levels and increases HDLs.
Acts in liver and adipose tissue to inhibit synthesis of TGs , thus decreasing LDLs. - 29NIACIN Adverse EffectsHEPATOTOXICITY (severe liver damage)
hyperglycemia,
hyperuricemia= (+) uric acid
GI distress
Skin: intense flushing and itching. (take aspirin 30 min before dose)
* slow titration up on dose due to adverse effects
NEVER use w/ chronic liver disease, gout Caution w/ diabetes, peptic ulcer disease - 30ATORVASTATIN Therapeutic UseTreat Hyperlipidemia/ Dyslipidemia, Hypercholesterolemia,
Prevention of CV events,
MI & stroke prevention in DM2,
Increase HDLs - 31ATORVASTATIN MOAMOA: Inhibition of HMG-CoA Reductase
- enzyme pivitol to cholesterol synthesis
Outcome= reduction of LDL & TG, Increase in HDL - 32ATORVASTATIN Adverse EffectsPregnancy Category X
Hepatotoxicity
Myopathy/Rhabdomolysis - 33ATORVASTATIN Patient EducationMost effective when given at night.
If meds stopped serum levels will return to pretreatment levels within weeks.
- Life long treatment.
Diet modification and exercise enhance therapeutic effects. - 34CLOPIDOGREL Therapeutic IndicationsANTIPLATELET
prevention of atherothrombotic events in patients with ACS , unstable angina or MI. prevent blockage of coronary artery stents, reduce thrombotic events (MI, stroke, vascular death). - 35CLOPIDOGREL MOAP2Y12 ADP RECEPTOR ANTAGONIST
Prevents ADP stimulated platelet aggregation
- irreversible antiplatelet effect
platelet function and bleeding time return after 7-10 days after last dose - 36CLOPIDOGREL Adverse EffectsBleeding
Thrombotic thrombocytopenic
purpura (TTP)
neurologic
renal dysfunction
fever - 37ASPIRIN MOABlocks Thromboxane A2 which normally stimulates activation of new platelets and platelet aggregation.
- Causes irreversible inhibition - 38ASPIRIN Therapeutic IndicationsIschemic stroke, transient ischemic attacks, acute MI, previous, MI, Chronic stable angina, unstable angina.
- 39ASPIRIN Adverse Effectsbleeding risks, GI bleeds, Renal impairment, tinnitis, salicylate toxicity
- 40DESCRIBE SALICYLATE TOXICITYsalicylate toxicity --> respiratory acidosis, metabolic acidosis, renal failure, altered mental status
- 41ASPIRIN ContraindicationsNO Pediatrics patients!!!!
d/t risk for Reyes syndrome, Encephalopathy, and fatty liver degeneration
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- Graduate NURSING PHARMACOLOGY (Nursing Pharmacology) Flashcards on Cardiovascular Pharm, created by Kate Parvey on 15/07/2017.
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- Kate Parvey
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