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69 Cards in this Set
- Front
- Back
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Primary location and response of alpha-1?
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Vascular smooth muscle - vasoconstriction
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Primary location and response of alpha-2?
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CNS synapses - inhibits sympathetic signals and interneurons.
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Primary location and response of beta-1?
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Heart - Increases HR and force of contraction
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Primary location and response of beta-2?
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Bronchioles - Bronchodilates
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alpha-1 selective agonist and treats?
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Phenylophrine - Hypotension
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alpha-2 selective agonist(s) and treats?
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1) Clonidine - Tx hypertension
2) Tizanidine - Tx spasticity |
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Beta-1 selective agonist and treats?
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Dobutamine - Tx shock and heart failure
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Beta-2 selective agonist and treats?
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Albuterol - Tx asthma, bronchitis and emphysema
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Frequent sideE of alpha-1 agonists?
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1) Increased BP
2) HA 3) Reflex bradycardia |
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Frequent sideE of alpha-2 agonists?
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1) Dizziness
2) Drowsiness 3) Dry mouth |
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Frequent sideE of beta-1 agonists?
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1) Chest pain
2) Cardiac arrhythmias |
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Primary sideE of beta-2 agonists?
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1) Nervousness
2) Restlesness 3) Trembling |
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Adverse effects of mixed alpha- and beta- agonists?
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1) Increased CNS excitation -> nervousness, restlessness, anxiety
2) Excess stimulation of C.V. system |
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ending in -olol indicates?
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beta antagonist (beta blocker)
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ending in -phine indicates?
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alpha antagonist
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What kind of chemicals are norepinephrine and epinephrine?
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Endogenous catecholamines
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Principal application of alpha antagonists?
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To treat hypertension (unless they preferentially bind to alpha-2)
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The limited purpose of a non-selective alpha-antagonist?
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1) balance the effects of a chatecolamine secreting tumor - prevents hypertension
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Additional important function of beta blockers?
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Limits extent of myocardial damage following a heart attack.
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Adverse effects of B-antagonists?
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1) Bronchoconstriction
2) Excess depression of cardiac fxn |
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alpha antagonist
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Phentolamine
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alpha-1 select antagonist
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Prozasoin
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beta antagonist
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Propanolol
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beta-1 selective antagonist
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Metroprolol
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Adverse effects of alpha antagonists?
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1) Reflex tachycardia
2) OH |
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Primary goals of pharmacotherapy for CHF?
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1) Improve the hearts ability to pump blood
2) Decrease cardiac workload |
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How do you decrease the cardiac workload?
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1) Decrease pressure
2) Decrease volume |
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Digitalis?
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Positive inotropic agent - increases contraction force
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Agents that decrease cardiac workload?
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1) ACE inhibitors
2) Angiotensin II receptor blocker 3) B adrenergic blocker 4) Diuretic 5) Vasodilator |
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Prazosin?
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Vasodilator - alpha-1 blocker
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Explain the mechanism of a positive inotropic agent
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1) Inhibits the Na2+/K+ activity
2) This increase Na2+ in the cell 3) This decrease the Ca2+/Na2+ exchanger 4) Thus increasing the amount of Ca2+ in the cell 5) This allows increased muscle contractility |
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Major con of digitalis?
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It has a narrow therapeutic window
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Adverse sideE of digitalis?
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1) toxicity
2) arrhytmia |
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Phosphodiesterase inhibitor?
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Used for acute or severe heart failure. It has many sideE.
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Dopamine
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Also used for acute or severe heart failure. A B-1 agonist that does not increase HR.
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All of the "Other" P.I. agents?
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1) Phosphodiesterase (PDE) inhibitors
2) Dopamine 3) Dobutamine |
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Briefly describe the clot formation process
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Factor Xa converts prothrombing into thrombin. Thrombin converts fibrinogen into fibrin. Fibrin creates the clot.
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Briefly describe the clot breakdown process.
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Tissue plasminogen activator converts plasminogen into plasmin. Plasmin AKA fibrinolysis breaks down the clot yielding fibrin degredation products.
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The 3 types of treatment for overactive clotting?
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1) Anticoagulants
2) Antithrombotics 3) Thrombolytics |
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Primary anticoagulants?
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Heparin and oral anticoaguants
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Brief mechanism of heparin?
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potentiates the effects of antithrombin III. Increased antithrombin III reduces the tendency to clot.
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2 oral anticoagulants?
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1) Warfarin
2) Coumadin |
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Mechanism of oral anticoagulants?
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Impairs the Vit K-dependent synthesis of clotting factors
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Disadvantages of oral anticoagulants?
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1) Contra in pregers
2) Not effective for several days |
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General function of antithrombotics?
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inhibit platelet function
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Example of an antithrombotic?
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Aspirin
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Tissue plasminogen activator, or t-PA (alteplase)?
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Thrombolytic
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indication for t-PA?
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1) treat acute MI (12hrs)
2) treat ischemic CVA (3hrs) |
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Example of Statin?
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Lipitor
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Primary effect of statins?
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Decrease cholesterol and LDL
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Primary effect of fibric acids?
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Decreases triglycerides and VLDL
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Primary effect of niacin?
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Broad spectrum benefits to cholesterol profile
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Primary effect of ezetimibe?
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Decreases cholesterol absorption from gut.
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5 treatments for HTN?
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1) Diuretic
2) Vasodilator 3) Sympatholytic 4) Renin-angiotensin system blocker 5) Ca2+ channel blocker |
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Define diuretic
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Increases formation and excretion of urine
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3 types of diuretics?
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1) Thiazide
2) Loop 3) K+ sparing |
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Hydrocholorothiazide (HCTZ)
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a type of thiazide - Inhibits Na2+ reabsoption
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Lasix
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Loop diuretic - inhibits Na2+ reabsorption
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Furosemide
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Loop diuretic - inhibits Na2+ reabsorption
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Spironolactone
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K+ sparing diuretic
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Aldactone
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K+ sparing diuretc
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Serious sideE of diuretics?
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1) Volume depletion
2) Electrolyte imbalance - Loop+thiaze = hypo - K+ sparing = hyperkalemia 3) Impaired glucose metabolism - thiazide |
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Minoxidil
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Vasodilator - maintenance
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Nitropruside
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Vasodilator - emergent use
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How do vasodilators function?
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Directly inhibit vascular smooth muscle
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Lisinopril (-pril)
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Angtiotensin-converting enzyme inhibitor = Renin-angiontensin system inhibitors
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Losartan
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Angiotensin II inhibitors (blocks the receptor)
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Advantage of the Renin-angiotensin system inhibitors?
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Lower incidence of adverse effect than other anti-HTN drugs
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Ca2+ channel blocker work two ways:
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1) inhibit vascular contraction
2) inhibits cardiac contraction |
