WorksheetsCardio Drugs
Total questions: 20
Worksheet time: 11mins
Nitroglycerin
*Anti-Anginal Drug that relaxes (smooth muscle) blood vessels
Organic Nitrate
Beta Blocker
Na+ Channel Blocker
Alpha1-Blocker
Propranolol
*Anti-Anginal/Anti-HTN/Anti-Arrhythmic Drug that decreases HR, BP, and O2 demand by blocking B1&B2 Receptors
Organic Nitrate
Beta Blocker
Na+ Channel Blocker
Alpha1-Blocker
Carvedilol
*Anti-HTN Drug that reduceds heart failure mortality by decreasing HR, BP, and O2 demand by blocking A1,B1,B2 Receptors
Organic Nitrate
Beta Blocker
Na+ Channel Blocker
Alpha1-Blocker
Verapamil/Diltiazem
*Anti-Anginal/Anti-HTN (mild-moderate) /Anti-Arrhythmia Drug that works by blocking L-type Calcium channels in the heart or vascular smooth muscles to cause vasodilation/relaxation
*Vasodilation = Decreased BP = Decreased Afterload = Decreased O2 demand
Ca++ Channel Blocker
Beta Blocker
Na+ Channel Blocker
Alpha1-Blocker
Nifedipine and Amlodipine are different from the other two Ca++ Channel Blockers (Verapamil, Diltiazem) because
Nifedipine/Amlodipine only effect Vascular Smooth muscle whereas Verapamil/Diltiazem have both cardiac and vascular smooth muscle effects
Nifedipine/Amlodipine have both cardiac and vascular smooth muscle effects whereas Verapamil/Diltiazem only effect Vascular Smooth muscle
Amniodarone (a widely used anti-arrhythmic drug) works by:
Prolonging PR & QT intervals by delaying replarization (blocks K+ efflux)
Slows impulse conduction to prolong QT interval by delaying Repolarization (blocks Na+ channels)
Slows depolarization in slow AP cells by (blocks Ca++ channels in heart that depend on Ca++ for contraction)
Activating Adenosine receptors to hyperpolarize cardiac cells (increase K+ efflux)
Quinidine/Lidocaine (Anti-Arrhythmic drugs) work by:
Prolonging PR & QT intervals by delaying replarization (blocks K+ efflux)
Slows impulse conduction to prolong QT interval by delaying Repolarization (blocks Na+ channels)
Slows depolarization in slow AP cells by (blocks Ca++ channels in heart that depend on Ca++ for contraction)
Activating Adenosine receptors to hyperpolarize cardiac cells (increase K+ efflux
Adenosin (Anti-Arrhythmic drug) works by:
Prolonging PR & QT intervals by delaying replarization (blocks K+ efflux)
Slows impulse conduction to prolong QT interval by delaying Repolarization (blocks Na+ channels)
Slows depolarization in slow AP cells by (blocks Ca++ channels in heart that depend on Ca++ for contraction)
Activating Adenosine receptors to hyperpolarize cardiac cells (increase K+ efflux)
Verapamil/Diltiazem (Anti-Arrhythmic drugs) work by:
Prolonging PR & QT intervals by delaying replarization (blocks K+ efflux)
Slows impulse conduction to prolong QT interval by delaying Repolarization (blocks Na+ channels)
Slows depolarization in slow AP cells by (blocks Ca++ channels in heart that depend on Ca++ for contraction)
Activating Adenosine receptors to hyperpolarize cardiac cells (increase K+ efflux
Cautions of Amnidoarone (Anti-arrhythmic drug):
Photosensitivity with blue/grey skin deposits
Avoid Grapefruit (an inhibitor)
because it prolongs the already long half-life
Avoid Diuretics that reduce K+
Cardiotoxicity (sinus arrest/AV block that can precipitate heart failure)
Dyspnea & sinus bradycardia
Cautions of Quinidine/Lidocaine (Anti-arrhythmic drugs):
Photosensitivity with blue/grey skin deposits
Cinchonism (blurred vision/vertigo)
Avoid Diuretics that reduce K+
Cardiotoxicity (ventricular arrythmias/torsades de pointes)
Hypertension
Hypokalemia is bad for the heart because Potassium is necessary for cardiac muscle contraction. With too little Potassium, the heart can develop arrhythmias.
Which drugs could potentially cause hypokalemia?
Hydrochlorothiazide
(Thiazide Diuretics)
Furosemide
(Loop Diuretics)
Spironolactone (Potassium-Sparing Duiretics)
Enalapril (ACE inhibitor)
Losartan (ARBs)
Hyperkalemia is bad for the heart because Potassium is necessary for cardiac muscle contraction. With too much Potassium, the heart can develop arrhythmias.
Which drugs could potentially cause hyperkalemia?
Hydrochlorothiazide
(Thiazide Diuretics)
Furosemide
(Loop Diuretics)
Spironolactone (Potassium-Sparing Duiretics)
Enalapril (ACE inhibitor)
Losartan (ARBs)
Nitroglycerin (an Organic nitrate) dilates veins and arteries by causing vascular relaxation (cGMP dephosphorylates myosin --> can't bind with actin = no contraction)
What are adverse effects of Nitroglycerin?
Nitrate tolerance (allow 8-10 hours a day without Nitroglycerin)
Excessive Vasodilation (headaches, facial flushing)
Orthostatic Hypotension
Reflex Bradycardia
Blood pressure is controlled by the sympathetic nervous system and the renin angiotensin system.
Arterial BP = Cardiac Out x Peripheral Resistance
What is peripheral resistance determined by?
HR, contractibility, and blood volume
arteriolar constriction
Your patient has been prescribed Enalapril (an ACE inhibitor) to treat their hypertension. However, they have developed a bothersome dry cough due to increased bradykinin.
What drug would you likely switch them to that would also target the RAAS system to reduce high BP, but without bradykinin effects (the cough)?
Valsartan
(ARB)
Amlodipine
(Ca++ Channel Blocker)
Hydrochlorothiazide (Thiazide Diuretic)
Captopril
(a different ACE inhibitor)
Clonidine and Methyldopa stimulate a2 receptors on neurons in the brain to reduce sympathetic nerve input to the Cardiovascular System.
Reduced HR = Reduced BP
*Adverse Effects: dry mouth/withdrawal/sedation
What drug class are Clonidine and Methyldopa in?
CNS a2-receptor Agonist
a1-receptor Blocker
Beta-Blocker
Direct Vasodilator
What drug will treat symptoms of heart failure but not reduce mortality?
(hint: It inhibits the Na+/K+ ATPase and Potassium Must be watched!)
Enalapril
(ACE Inhibitor)
Losartan
(ARB)
Isosorbide Denigrate (Direct Vasodilator)
Digoxin (Cardiac Glycoside)
Which diuretic is the only one that will NOT cause low levels of potassium?
(but it may cause high levels of potassium)
Furosemide
Hydrochlorothiazide
Spirolactone
DIRECT VASODILATORS
1. Hydralazine (treats hypertension & reduces heart failure mortality) dilates _____ to reduce BP
2. Isorbide dinitrate (reduces heart failure mortality) dilates _____ to reduce BP
1. arteries (decreases afterload)
2. veins (decreases preload)
1. veins (decreases preload)
2. arteries (decreases afterload)
