Pharmacology – Cardiovascular System

Angina Pectoris
chest pain caused by lack of oxygen reaching heart
dilate arteries and veins

Antianginal medications
given sublingual, buccal, or IV
take 1 want wait 5 minutes if pain occurs call EMS
may take 2 more every 5 minutes for a max of three minutes

Antianginal medications examples
Nitrates
nitroglycerin

Antianginal medications side effects
flushing
orthostatic hypotension

Anticoagulants
-for deep vein thrombosis prevention
-prevent clot formation by interrupting production of cofactors that help in the clotting process
-patient at risk for bleeding

Anticoagulants examples
warfarin
heparin (SQ)
enoxaparin (SQ)
antiplatelets

Antiplatelet
prevent platelets from clumping together to form clots

Antiplatelet examples
aspirin

Aspirin (salicyclic)
promise in increasing survival rate of heart attack if taken at initial symptoms

ADP receptor blockers
-prevent clots from forming
-provide long term prevention against clot formation

ADP receptor blockers examples
clopidogrel

Glycoprotein IIb/IIIa inhibitors
-prevents enzyme that aggregates platelets from working
-given prior to surgery to prevent clots

Glycoprotein IIb/IIIa inhibitors examples
Anciximab
integrilin
aggrestat

For patients on antiplatelets
-learn signs of bleeding
-avoid foods high in vit K

Thrombolytic
can dissolve blood clots

Thrombus
clot in blood vessel

Embolus
-clot that breaks loose and travels
-can cause MI, CVA, or pulmonary embolus

Symptoms of DVT
pain and swelling of extremity

tPA
-given within 60 minutes of onset of symptoms of stroke
-can minimize effects of stroke

Frequent testing required to monitor clotting time
PT
aPTT
INR

Antifibrinolytic medications
-help to form clots when patient hemorrhaging
-provide hemostasis

Antifibrinolytic medications examples
Amicar
Cyklokapron

Vitamin K
antidote for anticoagulant overdose

Protamine sulfate
antidote for heparin overdose

DDAVP
used in treatment of hemophilia

Hematopoietic stimulant medications
stimulate the growth of blood cells

Hematopoietic stimulant medications used to treat
enemias
low blood iron levels
patients on chemo

Hematopoietic stimulant medications examples
ferrous sulfate
cyanoconalamin (vit B12)
epogen
neupogen
neulasta
leukine

Hypertension caused by
poor heart action
atherosclerosis
kidney failure
narrowed blood vessels
chronic stress

Atherosclerosis
hardening of the heart

Hypertension treated by
ACE inhibitors
ARBs
Beta adrenergic blockers
diuretics
calcium channel blockers

ACE inhibitors
-stop enzyme that converts angiotensin I to angiotensin II
-stop constriction of blood vessels

ACE inhibitors examples
captopril
enalapril
fosinopril
*pril*

ARBs
-block the action of angiotensin thus preventing constriction of blood vessels
-used when ACE inhibitors are not tolerated

ARBs examples
Irbesartan
isosartan
valsartan
*sartan*

Beta-adrenergic blockers
decrease the fight or flight response

Beta-adrenergic blockers examples
atenolol
bisoprolol
nadolol
propranolol
*lol*

Diuretics
-clear excess fluid from body
-decreased peripheral vascular resistance

Thiazide diuretics
-most common
-decrease sodium and chloride reabsorbed by kidneys

Thiazide diuretics example
hydrochlorothiazide
chlorothiazide
*thiazide*

Potassium spraing diuretics
interrupts sodium and potassium exchange in distal tubule, sparing potassium loss

Potassium spraing diuretics examples
amiloride
spironolactone
triamterene

Loop diuretics
-most potent
-act on loop of henle to inhibit sodium and chloride reabsorption

Loop diuretics examples
bumetanide
Edecrin
furosemide
torsemide

Loop and thiazide diuretics cause loss of potassium
requires supplements

Calcium channel blockers
-dilate arteries to decrease peripheral vascular resistance
-reduce workload of the heart thus blood pressure

Calcium channel blockers examples
amlodipine
diltiazem
nifedipine
verapamil

Heart failure
heart muscle fails to push normal account of blood through body which leads to fluid backup which increase workload on the heart

Heart failure signs and symptoms
anxiety, restlessness
clammy skin
tachycardia
lower leg edema
forward leaning posture

Vasodilators
increase pressure to heart as to exert thus decreases oxygen demand

Vasodilators examples
isorbide
isorbide monoitrate
hydralazine

Cardiac glycosides
-help heart beat stronger and more efficiently
-combining with medications that decrease peripheral vascular resistance ideal

Cardiac glycosides examples
digoxin

Beta-adrenergic blockers (class II anti-arrhythmic)
slow electrical conduction of heart

Beta-adrenergic blockers (class II anti-arrhythmic) examples
atenolol
propranolol

Potassium channel blockers
-treat ventricular and supraventricular arrhythmias
-used in patients with internal defibrillators

Potassium channel blockers examples
amidorone
ibutilide
sotalol
bretylium tosylate

Calcium channel blocker (Class IV antiarrhythmic)
-dilate blood vessels
-decrease workload of heart
-used for very rapid arrhythmias

Calcium channel blocker (Class IV antiarrhythmic) examples
dilitazim
verapamil

Hyperlipidemia
excess fat deposits on walls of blood vessels

High density lipids
clean out blood vessels
GOOD

Low density lipids
deposit fat in vessels
NOT GOOD

Very low density lipids
wedge themselves into blood vessel walls
WORST

HMG Co-A reductase inhibitors
-decrease blood levels of lipids
-encourage liver to make less cholesterol
-increase number of LDL receptors

HMG Co-A reductase inhibitors examples
atorvastatin
crestor
simvastatin
*statin*

Bile acid sequestrants
lowers LDL levels by causing liver to make more bile acids from cholesterol

Bile acid sequestrants examples
Cholestyramine
Wechol
colestipol

Fibric acid derivatives
lower tryglyceride levels

Fibric acid derivatives examples
clofibrate
fenofibrate
fenofibric acid
genfibrozil

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