PAT 202: WEEK ONE (1): CARDIOVASCULAR PHARMACOLOGY ASYNCHRONOUS PPT (THINK HTN, MI, HF, ANGINA, &/STROKE): PART TWO

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS ONE: ANALGESICS

medication: morphine

what are some indications for use

think specifically for cdv diseases

remember goal 5 of cardio pharm therapy was reducing pain and anxiety

morphine indications include

a. acute MI pain

b. chronic pain

c. relieve SOB

d. with HF can relieve PE

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS ONE: ANALGESICS

medication: morphine

t or f

morphine is indicated for sob and HF with PE

true

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS ONE: ANALGESICS

medication: morphine

MOA

(specifically the mu and kappa moa)

binds with mu and kappa receptors in brain and dorsal horn of spinal cord

mimicks our bodies own opioids

endorphins and enkephalis

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS ONE: ANALGESICS

medication: morphine

function of mu receptor

MU: found mostly in the brainstem and medial thalamys: cause RD, eurphoria, sedation, and decreased GI activity

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS ONE: ANALGESICS

medication: morphine

function of kappa receptor

kappa: found in the limbic system, brain stem, and spinal cord: spinal analgesia, sedation, dyspnea, dependence, dysphoria, and RD

When opioids attach (bind) to the receptors, the interaction triggers a series of chemical changes within and between neurons that lead to feelings of pleasure and pain relief.

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS ONE: ANALGESICS

medication: morphine

moa specifically the one r/t to alpha receptors

decrease the responsiveness of alpha adrenergic receptors

causing peripheral vasodilation

alpha-adrenergic receptors

Portions of the nervous system that, when stimulated, can cause constriction of blood vessels.

alpha-adrenergic receptors

Receptors to norepinephrine that generally produce an excitatory response

beta-adrenergic receptors

Portions of the nervous system that, when stimulated, can cause an increase in the force of contraction of the heart, an increased heart rate, and bronchial dilation.

alpha receptors cause vaso cxn

beta receptors cause vaso dilation

T OR F

TRUE

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS ONE: ANALGESICS

medication: morphine

DESIRED EFFECTS

profound analgesa

sedation

eurphoria

less anxiety and fear

less CO by

vasodilation--> less pvr and less volume---> less preload and less afterload---> less sv---: less co

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS ONE: ANALGESICS

medication: morphine

adverse effects

CNS depression

RD

cardiac arrest

dysphoria (unease, depresssion and anxiety)

hallucinations dizziness constiatipn anuse

itching sensation (pruritus)

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS ONE: ANALGESICS

medication: morphine

T OR F

itching sensation

cardiac arrest

hallucations

depression

anxiety are some adverse effects of morphine

TRUE

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS ONE: ANALGESICS

medication: morphine

morphine stimulated the cardiac musle

morphine causes constriction of what

pupils

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS ONE: ANALGESICS

medication: morphine

morphine is used for acute chest pain r/t to what

MI

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS ONE: ANALGESICS

medication: morphine

morphine is only used after what has failed

non narcotic analgesic pharmacology has failed

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: CCBS:

MEDICATION: DILITIAZEM

name some indications for use

1) stable angina

2) atrial dysarythmias

3) HTN

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: CCBS:

MEDICATION: DILITIAZEM

MOA FOR STABLE ANGINA

inhibits the transport of CA ions into myocardial cells (more ca is needed for contraction of any muscle to occur)

-----> thus decreases HR and force of contraction----> thus decreases CO----> thus decreases myocadial 02 demand

which will relief stable angina pain

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: CCBS:

MEDICATION: DILITIAZEM

MOA FOR HTN

inhibits ca ion transport into vascular smooth muscle channels (this is the smooth muscles of blood vessels)

thus decrease contraction of smooth muscle and relaxes smooth muscles

------> less afterload----> less svr----> less svr means less htn

less svr ---> less afterload----> less co----> less 02 demand for coronary arteries and more 02 supply for coronary arteries

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: CCBS:

MEDICATION: DILITIAZEM

T OR F

THIS MED INCREASES 02 SUPPLY TO CORONARY ARTERIES BY BLOCKING VASCULAR SM CHANNELS

TRUE

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: CCBS:

MEDICATION: DILITIAZEM

explain what CCB do for coronary muscles

dilating vessels by preventing sm contraction

reduces the workload on coronary arteries by reducing the bp (as vessels dilate)

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: CCBS:

MEDICATION: DILITIAZEM

ccb relax the sm causing dilation making them a major medication for which cdv disease

HTN

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: CCBS:

MEDICATION: DILITIAZEM

ccbs promotes sm dilation in which vessels?

both peripheral vesssels

and

coronary vessels

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: CCBS:

MEDICATION: DILITIAZEM

how does this specific drug help with atrial dysarthymias?

There are two types of calcium channel blockers, dihydropyridines and non-dihydropyridines. Dihydropyridines such as amlodipine and nifedipine control blood pressure or angina. Non-dihydropyridines such as diltiazem and verapamil can also control blood pressure and angina and be used as part of a rate and rhythm control as well.

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: CCBS:

MEDICATION: DILITIAZEM

CCB that are given ER capsules are given how FQ

once daily usually

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: CCBS:

MEDICATION: DILITIAZEM

IF GIVEN via IV what nsg interveniton is there

monitor

continuously

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: CCBS:

MEDICATION: DILITIAZEM

CCB name the

a. pregnancy class

b. metabolized by

c. well absorbed or not

d. half life

pregnancy class C

metabolized by liver

well absorbed by GI tract

half life of 3.5 to 9h

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: CCBS:

MEDICATION: AMLODIPINE

indications for use

1) chronic stable angina

2) variant angina

3) HTN

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: CCBS:

MEDICATION: AMLODIPINE

explain how CCB help with angina

CCB decrease hr and svr

which means

decrease afterload

decrease co

decrease myocardial 02 demand

decrease angina

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: CCBS:

MEDICATION: AMLODIPINE

explain how this ccb helps with HTN

blocks ca ion into the cm of coronary and peripheral vascular vessels--> causing dilation of vessels----> decreases svr/pvr---> decreases bp---> tx HTN

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: CCBS:

MEDICATION: AMLODIPINE

what are two main desired affects of amlodipine

1) relaxes peripheral vascular sm

2) dilates coronary vascular arteries

--> increasing 02 delivery

---> decreasing angina

relaxes and dilates both myocardial (including coronary) smooth muscle and vascular smooth muscle (peripheral blood vessels)

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: CCBS:

MEDICATION: AMLODIPINE

increased dilation of coronary arteries has 2 what affects

increased myocardial oxygen delivery

decreased angina

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: CCBS:

MEDICATION: AMLODIPINE

adverse effects of amlodipine

dizziness

flushing

hypotension

H/A

peripheral edema

dysrhytmias

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: CCBS:

MEDICATION: AMLODIPINE

an adverse effect of amlodpine is peripheral edema t or f

true

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: CCBS:

MEDICATION: AMLODIPINE

T OR F

amlodpine can cause drysarthymias

true

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: VASODILATORS

MEDICATION: NITROGLYCERIN

why would this medication be given for angina

the goal of anginal tx is to terminate acute attacks of angina and prevent future episodes

this medication helps reduce cardiac wl by acting as s vasodilator thus decreasing svr-->decreasing afterload---> decreasing co---> decreased heart wl and 02 demand

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: VASODILATORS

MEDICATION: NITROGLYCERIN

nitroglycerin is one of the most oldest and widely used ________ nitrates

organic nitrate

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: VASODILATORS

MEDICATION: NITROGLYCERIN

nitroglycerin can be given via many routes

name some

sublingual

oral

ER

translingual

IV

transmucousal

transdermal

topical

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: VASODILATORS

MEDICATION: NITROGLYCERIN

if given sublingually peak plasma levels are reached within how long

4 minutes

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: VASODILATORS

MEDICATION: NITROGLYCERIN

chest pain that does not resolve within 2-3 doses is an indication of what

MI

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: VASODILATORS

MEDICATION: NITROGLYCERIN

nitroglycerin can only be given how many times

3 TIMES

5 MINS APART

NO MORE THAN 3 TIMES IN 15 MINS

3!!!!!!!!

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: VASODILATORS

MEDICATION: NITROGLYCERIN

t or f this medication rapidly absorbed and well metabolized by the liver

TRUE

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: VASODILATORS

MEDICATION: NITROGLYCERIN

the half life of this med is what

1-3 minutes

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: VASODILATORS

MEDICATION: NITROGLYCERIN

when giving iv administration of nitroglycerin what an important nsg intervention

use glass bottles as plastic bottles SIGNIFICANTLY ABSORN NITRATES reducing the dose the pt needed

cover iv bottle bc exposure to light can cause degredation

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: VASODILATORS

MEDICATION: NITROGLYCERIN

when giivng nitroglycerin topically what is a nsg intervention the nurse should be aware of

use gloves when giving nitrate bc topical paste and ointment can lead to self administration of the drug

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: VASODILATORS

MEDICATION: NITROGLYCERIN

nitroglycerin is a pregnancy class what

C

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: VASODILATORS

MEDICATION: NITROGLYCERIN

indications for use

taken with in an acute anginal episode or just prior to physical activity

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: VASODILATORS

MEDICATION: NITROGLYCERIN

MOA

is a precursor of NO

NO relaxes vascular smooth muscle causing vasodilation

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: VASODILATORS

MEDICATION: NITROGLYCERIN

desired effects OF Nitroglycerin

produces vasodilation : venous greater than arterial

decreases venous return (bc of lower bp), decreases preload through vasodilation

decresing svr decreasing afterload

decreasing co

decreasing myocaridal 02 demand

RAPIDLY terminating nagina by increasing 02 supply

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: VASODILATORS

MEDICATION: NITROGLYCERIN

when 02 demand decreases what increases

02 supply

its a seesaw affect with 02 demand and supply

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: VASODILATORS

MEDICATION: NITROGLYCERIN

adverse effecrs

usually cdv in nature and r RARELY life threatning

H/A common and may be severe

reflex tachycardia

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: VASODILATORS

MEDICATION: NITROGLYCERIN

T OR F

nitroglycerin adverse effects are usually lifethreatning when cdv related

FALSE

they are

RARELY

life threatning when cdv in nature

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: VASODILATORS

MEDICATION: NITROGLYCERIN

reflex tachycardia is an adverse effect of this medication t or f

TRUE

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: B1 ADRENERGIC RECEPTOR BLOCKER (BETA BLOCKER0

MEDICATION: METAPROLOL

1. what is a b1 adrenergic receptor blocker

B1 = think one heart (found in the heart)

are adrenergic receptors which bind for catecholamine (epi and norepi) to regulate hr and contractility

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: B1 ADRENERGIC RECEPTOR BLOCKER (BETA BLOCKER0

MEDICATION: METAPROLOL

MOA:

selectively blocks b1 receptors thus preventing catecholamine binding

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: B1 ADRENERGIC RECEPTOR BLOCKER (BETA BLOCKER0

MEDICATION: METAPROLOL

when metaprolol binds to b1 receptors it

it has one specific effect on our nerve impulses to the heart

what is this specific effect

slows conduction velocity across myocardium

what is conduction velocity

the speed at which an action potential is propagated along the length of an axon

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: B1 ADRENERGIC RECEPTOR BLOCKER (BETA BLOCKER0

MEDICATION: METAPROLOL

bc metaprolol

a. slows conduction velocity across the myocardium (slowing down the speed/rate at which neurons polarize the myocardial cells) what

"characteristic" of the heart will be affected

the heart rate

slower polarization means

slower beating of the heart per minute

aka: heart rate

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: B1 ADRENERGIC RECEPTOR BLOCKER (BETA BLOCKER0

MEDICATION: METAPROLOL

when we reduce HR of the heart we reduce what other things in term of workload

reduce

myocardial workload

and

reduce 02 demans

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: B1 ADRENERGIC RECEPTOR BLOCKER (BETA BLOCKER0

MEDICATION: METAPROLOL

when we would metaprolol

what is indicated for

think about the 2 desired effects this medication has

1) reduce myocaridal 02 demand -----> used for angina and MI

2) reduce HR ---> would be used for HTN and MI

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: B1 ADRENERGIC RECEPTOR BLOCKER (BETA BLOCKER0

MEDICATION: METAPROLOL

why is this medication used after an MI occurs

what is its purpose here

an MI puts the heart undress stress and causes heart damahe

we want to prevent futher heart damage in any way we can

one way to do this is to stop

is to block harmful effects of catecholamines: to reach a target HR here is between 60 and 90bpm

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: B1 ADRENERGIC RECEPTOR BLOCKER (BETA BLOCKER0

MEDICATION: METAPROLOL

what is the target HR when using metaprolol

60 to 90

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: B1 ADRENERGIC RECEPTOR BLOCKER (BETA BLOCKER0

MEDICATION: METAPROLOL

what are some adverse effects for using metaprolol

1) bradycardia (its desired effect is decreased HR so this makes sense)

2)hypotension (BP = hr x co) less hr means less BP (easy math)

3)bronchospasm is negligible with bb's EXCEPT for asthmatic pts which can make their asthma worse

note: take care with higher doses of bb's

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

the first line of drugs for chronic angina is

METAPROLOL

bc it reduces that 02 work demand

reducing myocardial associated chest pain

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: B1 ADRENERGIC RECEPTOR BLOCKER (BETA BLOCKER0

MEDICATION: METAPROLOL

what is a very important thing to remind pts who take metaprolol

DO NOT ABRUPTLY STOP TAKING

*can cause

tachycardia

Mi

htn bc = bp = co x hr

angina

due to sudden abruption of stopping b2 receptors---> rebound tachycardia sns activation now

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: ACE INHIBITORS

name the medication here

ENALAPRIL

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: ACE INHIBITORS

what does this class of medications do

block the raas system

by blocking the conversion of ang 1 to ang 2 in the lungs by ace enzyme

less thirst

less vasocxn

less aldosterone

less adh

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: ACE INHIBITORS

angiotension 2 causes intense what

intence vasoconstriction

increases pvr

increaases htn

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: ACE INHIBITORS

renin is screted by specialized cells in the kidneys in response to what

1) low bp picked up by mechanoreceptors

2) low na levels picked up by chemoreceptors

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: ACE INHIBITORS

what is an important thing to remember ace I in regards to a certain inflammatory mediator

ACE I like elanapril

stop bradykinin degredation

bradykinin

causes bv dilation: helps reduce bp

but causes sm bronchiole contraction---> dry cough

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: ACE INHIBITORS

most common ace I with a prolonged half life is which drug

elanapril

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: ACE INHIBITORS

T OR F

elanapril can be used alone or with other drugs

true

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: ACE INHIBITORS

ELANAPRIL may produce the first dose phenomenon: what is this phenomenon

PROFOUND HYPOTENSION CAUSING SYNCOPE

NEED TO WATCH OUT FOR THIS

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: ACE INHIBITORS

elanpril is pregnancy category

a

b

c

d

D

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: ACE INHIBITORS

elanapril prevents intense vasoconstriction

this decreases SVR

what is this a factor of

CO

svr/pvr r factors of CO

decrease CO

decrease myocardial 02 demand

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: ACE INHIBITORS

how do ace I decrease blood volume

block

aldosterone and adh

Preload

volume of blood in ventricles at end of diastole

Afterload

the amount of resistance to ejection of blood from the ventricle

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: ACE INHIBITORS

because ACE I decrease blood volume

which specific characteristic of the heart do they decrease

PRELOAD (blood volume decreased ---> elss blood volume in the ventricles at the end of diastole)

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: ACE INHIBITORS

MEDICATION: ENALAPRIL

what are some indications for this medication

HTN: reduces HTN by decreasing blood volume and svr (both of which are factors of HTN)

HF: decreaeses afterload by decreasing SVR

decreases preload by decreasing BV

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: ACE INHIBITORS

MEDICATION: ENALAPRIL

desired effect of enalapril

1. how does this medication decrease the 02 demands of the heart

THINK DIRECT EFFECTS

THEN THINK ITS DIRECTLY INDIRECT INDUCED EFFECTS

DIRECT EFFECTS

a. decreases BV

b. decreases SVR

a. decreases BV---> decreases HTN & preload---> decreases 02 demand on the heard and less cardiac remodelling

b. decreases SVR---> decreases afterload----> decreass CO------> decreases 02 demand on the heart

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: ACE INHIBITORS

MEDICATION: ENALAPRIL

WHAT ARE SOME ADVERSE EFFECTS

think of it interaction with

a. kidneys and aldosterone

b. kidneys and adh

c. thirst

d. sns activation

a. hyperkalemia (raas excretes k keeps na-if we inhibit raas less K leaving)

b. hypotension

c. headache

d. dizziness

e. peristant cough r/t to inhibited bradykinin degredation

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: ACE INHIBITORS

MEDICATION: ENALAPRIL

ENLAPRIL

CAN CAUSE 3 LIFE THREATNING THINGS WHAT ARE THEY

angioedema (edema of the deeper layers of skin d/t to fluid retention)

neutropenia (too few neutrophils)

agranylocytosis (too low granulocytes- these are your phils)

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: ACE INHIBITORS

MEDICATION: ENALAPRIL

what specific other HTN medication

should this medication not be taken with or is care needed

K SPARING DIURETIC

increased risk of HYPERKALEMIA

due to both medications being

"k sparing"

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: NEPRILYSIN INHIBITOR/ARB

what is this medication called

sacubitril/valsartan (combination drug)

- CARDIOVASCULAR DISEASE PHARMACOLOGY-

CLASS: NEPRILYSIN INHIBITOR/ARB

MEDICATION: SACUBITRIL/VALSARTAN

when was this medication approved

2015

called ARNI

CLASS: NEPRILYSIN INHIBITOR/ARB

MEDICATION: SACUBITRIL/VALSARTAN

specifically the angiotenson receptor neprulsyin inhibitor is called what

SACBUTRIL

CALLED

ARNI

CLASS: NEPRILYSIN INHIBITOR/ARB

MEDICATION: SACUBITRIL/VALSARTAN

what are some indications for using this medication

USED FOR HF

it is an arb combination

so

reduces afterload

reduces preload

which are both essential for the tx of the HF

reduces mortality

and hospitliazations in clients with HF

CLASS: NEPRILYSIN INHIBITOR/ARB

MEDICATION: SACUBITRIL/VALSARTAN

what is the MOA of this drug

what does it specifically do

the MOA

1) inhbits the enzyme NEPRILYSIN HENCE The name neprilysin inhibitor

- CARDIOVASCULAR DISEASE PHARMACOLOGY-CLASS: NEPRILYSIN INHIBITOR/ARB

MEDICATION: SACUBITRIL/VALSARTAN

this drug inhibits the neprilysin enzyme

what does this enzyme do in general

and what happens when we inhibit this enzyme

this enzyme

is a enzyme in our body that generally degrades NP peptides

the NP peptides are the ones which keep K and excrete h20 and water (when we inhibit the breakdown of these peptides) we make sure these peptides stay well and functioning to

reduce bv

reduce bp

reduce preload

- CARDIOVASCULAR DISEASE PHARMACOLOGY-CLASS: NEPRILYSIN INHIBITOR/ARB

MEDICATION: SACUBITRIL/VALSARTAN

this drug

a. blocks ang 2 via which drug

b. blocks np degredation via which drug

a. blocks ang 2 via valsartan (the arb)

b. blocks np degredation via sabuitral (NI)

- CARDIOVASCULAR DISEASE PHARMACOLOGY-CLASS: NEPRILYSIN INHIBITOR/ARB

MEDICATION: SACUBITRIL/VALSARTAN

explain specifically

what

only

sacbuitral does

inhibits neprilysin---> increaes cardioproductive NPS by reducing their enzymatic breakdown

- CARDIOVASCULAR DISEASE PHARMACOLOGY-CLASS: NEPRILYSIN INHIBITOR/ARB

MEDICATION: SACUBITRIL/VALSARTAN

explain what valsartan does and its desired effect

it is an arb

meaning

it blcoks ang 2 receptors

thus ang 2 cant do its job

---> less aldosterone

----> less adh

---> vasodilation (meaning less svr meaning less afterload meaning less co meaning less 02 and workload to the heart)

- CARDIOVASCULAR DISEASE PHARMACOLOGY-CLASS: NEPRILYSIN INHIBITOR/ARB

MEDICATION: SACUBITRIL/VALSARTAN

desired effects of this drub

decreased preload by reducing bv

decreaes afterload by reducinv svr/pvr

concentration of NPS (remember these are our favourite pro cardiac enzymes)---> thus cardiac efficiency improves

- CARDIOVASCULAR DISEASE PHARMACOLOGY-CLASS: NEPRILYSIN INHIBITOR/ARB

MEDICATION: SACUBITRIL/VALSARTAN

adverse effects

hyperkalemia (no raas meaning k sparing)

hypotension

dizziness

- CARDIOVASCULAR DISEASE PHARMACOLOGY-CLASS: NEPRILYSIN INHIBITOR/ARB

MEDICATION: SACUBITRIL/VALSARTAN

this drug is used for what

think of its desired effects

htn

angina (due to decreasing 02 demand)

hf due to decreased preload and afterload

- CARDIOVASCULAR DISEASE PHARMACOLOGY-CLASS: NEPRILYSIN INHIBITOR/ARB

MEDICATION: SACUBITRIL/VALSARTAN

ARNI may replace which drug for monotherapy

ACE INHIBITOR think elinapril

- CARDIOVASCULAR DISEASE PHARMACOLOGY-CLASS:

CARDIAC GLYCOSIDES

what is the name of the medication here

DIGOXIN

DI-GO-XIN

What is a glycoside?

a glycoside is an acetal or ketal formed from the reaction of cyclic monosaccharides with alcohols in the presence of acid

- CARDIOVASCULAR DISEASE PHARMACOLOGY-CLASS:

CARDIAC GLYCOSIDES

MEDICATION: DIGOXIN

what is the indication for this drug?

* used primarly for HF

* can stabilize some dysrhythmias