Week 3 Cardiovascular pharmacology

Pregunta	Respuesta
Blood pressure regulation	BP=CO X TPR
Angiotensin converting enzyme inhibitors	drugs which end in pril ACE= stops conversion of angiotensin 1- angiotensin 2, stops fluid retention, stops vasoconstriction, dilates bv
ACH inhibitor and nursing	contraindicated in renal failure, angioedema renal artery stenosis monitor bp, renal function, K concentration
Angiotensin converting enzyme inhibitor Adverse effects	Cough most common hypotension hyperkalaemia angioedema
What are risk factors of kidney impairment of ACE?	interferring with RAAS system, as increase in renin levels, decrease in blood flow
Angiotensin II receptor antagonists	ends in sartan similar to ACE except NO COUGH used as second line drug similar side effects to ACE expect cough and angioedema, as stops production of vasoconstrictor and aldosterone
Thiazide diuretics and nursing	act on distal convoluted tubule adverse affects: POSTURAL HYPOTENSION electrolyte disturbances gout contraindications: severe renal impairment
Thiazide diuretics	e.g. hydrochlorothiazide, indapamide effects by: diuretic effect by acting on DCT, reduces BP, and vasodilatory effect
Calcuim channel blockers	3 major classes verapamil: centrally acting, reduce HR, contraction, cause constipation (do not use with beta blockers) diltiazem: effects on HR and contraction Dihydropyridines: nifedipine, amlodipine, lercanidipine peripherally actin, can cause flushing, palpitations, edema. uses: hypertension, IHD, tachyarrhythmias
Calcium channel blockers and nursing	diltiazem and verapamil rarely used unless for controlling heart rate some have short half lives and are given as SUSTAINED RELEASE
Beta blockers uses	ends in lol hypertension, reduce HR, IHD, CHF, rapid AF, essential tremor, migraine prophylaxis act on cardiac tissue, reduce, CO, HR, renin release in kidneys
Beta blockers adverse effects and contraindications	exacerbation of asthma, peripheral vasucular disease, bradycardia, heart block contrainidications, acute asthma (as attach to beta 2 receptor in lungs and airways), hypotension, bradycardia
Heart failure definition	heart incapable of insufficient blood pumping for needs of tissues at usual filling pressure symptoms: decrease co, dizziness, fatigue
ACE/ARB in heart failure	increase dose, until max tolerated dose to benefit pt specific to hf dose may be limited by: hyprkalaemia, renal impairment, hypotension
Loop diuretics	act on loop of henle in nephron reduction of sodium reabsorption e.g. frudimide, reduce fluid volume, which reduces fluid overload and improves symptoms, NO EFFECT IN LONG TERM
Beta blockers in HF	contraindicated in acute HF, but demonstrated benefit in chronic HF.
Loop diuretic advantages and adverse effects	Advantages: rapid onset, relief of symptoms adverse effects: polyuria, frequency, incontinence, postural hypotension, severe deafness if given IV too rapidly aim is to reduce lowest dose necessary
Digoxin	decreases HR very low therapeutic index adverse effects: nausea, vomiting, visual changes, cardiac arrhythmias requires digoxin concentrations
Aldosterone antagonists mechanism and adverse effects	spirinolactone or epleronone works on aldosterone receptor to reverse fluid retention, fibrosis, is k sparring results in diurectic effect more gradual than loop diuretic adverse effects: hyperkalaemia, dehydration, renal impairment, gynaecomastia
Sacubitril/valsaran- angiotensin receptor neprilysin inhibitor	new drug breaks down vasodilators by increasing blood flow should be used within 36 hours of ACE inhibitors and ARNI increase bradykini which results in increase in angioedema
Nitrates mechanism and adverse effects	nitric oxide peripheral vasodilation= reduce cardiac work, decrease o2 dilate coronary arterioles= increase o2 adverse effects: hypotension, headache, tolerance ( need nitrate free period, 6-8 hrs as losses effect.
Angina drugs	relieve symptoms acutely nitrates rapid onset prevent symptoms beta blockers, nitrates (long-acting), calcium channel blocers reduce risk of IHD anti-platelet, lipid lowering, ACE-I/ARB
Beta blockers and calcium channel blockers in angina	beta blockers and verapamil should be never combined (risk of heart block, HF, bradycardia) beta blocker and diltiazem, should be combined with caution usually dose titrated until symptoms resolved
Nitrates	short acting nitrates- GTN quick onset given in acute chest pain, sublingual, spray, IV long acting - isosorbide mononitrate, only works b/w 6-8 hrs of nitrate free period

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Week 3 Cardiovascular pharmacology

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	Creado por Elizabeth Then hace más de 7 años