Chp 11 II Cardiovascular drugs

  1. Heart Failure Drugs can improve the heart by indirectly reducing the cardiac workload (decrease preload) and reduce edematous fluid (preload) with
  2. Heart Failure Drugs can improve the heart by directly increasing heart contractions with
    cardiac glycosides
  3. Heart Failure Drugs can improve the heart by reducing sympathetic stimulation to the heart with
  4. ________ are the most commonly used for initial treatment of heart failure. What is it's mechanism of action and what are the adverse side effects?

    Reduce systemic or peripheral (body) or pulmonary (lung) edema

    –Loss of electrolytes (potassium) and xerostomia
  5. What is the prototype for Cardiac Glycosides and what is the mechanism of action on CHF
    • digoxin (Lanoxin)
    • Used for CHF and heart arrhythmias

    • Increased constriction of smooth muscle
    • Increase cardiac output
    • Improve circulation
  6. Positive ionotropic effect is the ability to
    increase heart contraction
  7. What are the adverse side effects of digoxin
    • Carefully monitor serum levels
    • Hypokalemia (low potassium)—heart arrhythmias
    • Visual disturbances
  8. Vasodilators are useful in the treatment of HF because they reduce __, which decreases ______, and dilate arteries, which increases _______. Name one
    • BP
    • edema
    • cardiac output

    hydralazine (Apresoline)
  9. What is the prototype ACE inhibitor used for CHF and what is its primary function
    • captopril (Capoten)
    • lower peripheral resistance (reduces load on the heart/afterload) and reduce blood volume by increasing Na+ and H2O excretion

    –Slows or prevent the progression of heart failure
  10. What medication is used in the treatment of CHF after standard treatments have been tried and what is the prototype drug used
    Beta 1 blockers

    Carvedilol (Coreg)
  11. What is the prototype Sympathomimetic drug used in the treatment of CHF
    Dobutamine (Dobutrex)
  12. The sinoatrial (SA) node is a
    a small mass of tissue in the right atrium paces the heart by stimulating the nerves with an electrical impulse that originates here
  13. Arrhythmia occurs when there is a change in _______ either the _______, or the rate of _________
    • the rhythm of the heart
    • impulse rhythm does not start in the SA node
    • heartbeats is abnormal (normally 70-80), or it is not under automatic control
  14. Most common arrhythmia is _________ where the ________
    • atrial fibrillation
    • heart is beating without regard for impulses originating in the SA node
  15. Antiarrhythmic Drugs suppress the arrhythmia by ________ or __________
    blocking either autonomic function or Blocking calcium, potassium, or sodium channels
  16. What are the four classes of Antiarrhythmic Drugs
    • –Class I: sodium (Na) channel blockers
    • Class IA, IB, IC
    • –Class II: beta-adrenergic blockers
    • –Class III: potassium (K) channel blockers
    • –Class IV: calcium (Ca) channel blockers (CCBS)
  17. Class I antiarrhythmic drugs are the ________. What are the prototype drugs?
    • largest group
    • Quinidine (Quinaglute)- class 1-A
    • Lidocaine (Xylocaine) - class 1-B, used in ventricular arrhythmias
  18. What are the Class II Antiarrhythmic Drugs
    • metaprolol (Lopressor)
    • propanolol (Inderal)
  19. What is the mechanism of action of Class III Antiarrhythmic Drugs, what cases are they used in and what is the prototype drug
    potassium channel blockers; prolong the action potential duration and refractory period

    • For supraventricular and ventricular arrhythmias
    • amiodarone (Cordarone)
  20. What are the Class IV Antiarrhythmic Drugs prototype drugs and what cases is it used in
    diltiazem (Cardizem) and verapamil (Calan)

    Treats supraventricular arrhythmias
  21. Are there special precautions with patients with controlled arrhythmias?
    There are no special precautions when treating a patient with controlled arrhythmias. The patient’s pulse should be taken to determine normal rate and rhythm
  22. The low dose of epinephrine injected in dental anesthesia stimulates ___ receptors and causes ________
    • β2
    • dilation of the blood vessels supplying the heart (coronary arteries).
  23. In normal healthy patients the maximum amount of EPI is ____ mg ____ cartridges per appointment and in patients with clinically significant cardiovascular impairment ___ mg __ cartridges per appointment
    • 0.2, 11
    • 0.04, 2
  24. Both Triglycerides and Cholesterol are insoluble in blood, so they are transported in blood in the form of
  25. ________ are the most common lipid
  26. Highest amount of cholesterol is carried to various sites of the body by ___ which is considered the _____ cholesterol
    • LDL low-density lipoprotein
    • Bad
  27. ____ transports cholesterol to the liver, where it is eventually removed from the body and is considered the ____ cholesterol
    • HDL
    • good
  28. A high cholesterol level (hypercholesterolemia) contributes to the development of
  29. Lipid-lowering drugs are indicated in patients with _________ because of multiple risk factors
    high risk or coronary artery disease
  30. What is the mechanism of action of HMG-CoA Reductase Inhibitors (or “Statin” Drugs), prototype drug and adverse side effects
    • Primarily reduces LDL-C
    • Inhibit HMG-CoA reductase, which results in less cholesterol formation

    • –Hepatotoxicity
    • –Myopathy (muscle weakness)
  31. What are the drug interactions with Statin drugs
    • –Erythromycin + clarithromycin/increase statin levels
    • –Grapefruit juice
  32. What drugs were used prior to the discovery of the statin drugs and what is the mechanism of action
    • Bile Acid Sequestrants
    • These drugs bind bile acids, which contain high amounts of cholesterol
  33. Fibric Acid Drugs reduce ________ but can displace _______ and the prototype drug is
    triglyceride levels

    • other highly protein-bound drugs (e.g., warfarin) from their receptors, causing elevated plasma levels
    • gemfibrozil (Lopid)
  34. Nicotinic Acid (Niacin):
    • Lowers triglycerides and LDL-C and increases HDL-C
    • Contraindicated in diabetics and people with peptic ulcer disease
    • Gastric irritation, glucose intolerance, flushing, skin problems, myalgia
  35. What combination drugs are the latest approach to drug management for LDL-C reduction? These drugs ______
    • amlodipine/atorvastatin (Caduet)
    • ezetimibe/simvastatin (Vytorin)

    block the absorption of cholesterol (cholesterol absorption inhibitors) from food and also reduce the cholesterol that the body makes in the liver
  36. Anticoagulant Drugs _______ and prevent the occurrence of a ________. The prototype drugs are ________ and the indication are for
    • retard coagulation
    • thrombus

    • –Heparin: injectable
    • –Warfarin (Coumadin): oral and injectable

    • –Thromboembolic disorder
    • –Artificial heart valves
  37. Warfarin is metabolized by ______ in liver. _______  inhibit these enzymes
    • CYP3A4 enzymes
    • Erythromycin, clarithromycin (Biaxin)
  38. With Warfarin INR (International Normalized Ratio) of _____ is recommended for periodontal debridement procedures
    < 3 to 4
  39. What are some antiplatelet drugs
    • Aspirin
    • Clopidogrel (Plavix)
    • Dipyridamole (Persantine)
    • –Prevent thrombosis associated with artificial heart valves
Card Set
Chp 11 II Cardiovascular drugs
Chp 11 II Cardiovascular drugs