Pharmacology Lesson 9: Select Cardiovascular Drugs

Flashcards covering select cardiovascular drugs including diuretics, ACE inhibitors, ARBs, beta blockers, and treatments for heart failure based on the pharmacology lecture.

Sino Atrial Node (SA)

The location where the electrical impulse spreads throughout the left and right atria, causing them to contract and expel blood into the ventricles.

RAAS (Renin-angiotensin aldosterone system)

A system triggered by decreased blood flow to the kidneys that causes arterial vasoconstriction and sodium retention to restore blood pressure.

Hypertension (HTN)

A sustained state of higher than normal blood pressure which can lead to damage in the brain, heart, kidneys, and eyes.

Normal Blood Pressure Category

Systolic blood pressure $<120$ and diastolic blood pressure $<80$.

Hypertensive Crisis

A blood pressure category defined as systolic $>180$ and/or diastolic $>120$.

Diuretics

Drugs that increase the excretion of sodium and water from the kidney to lower blood pressure and cause diuresis.

Thiazide Diuretics Action

Blocks the chloride pump to keep chloride and sodium in the tubule to be excreted in the urine, preventing reabsorption in the vascular system.

Hydrochlorothiazide Onset

The prototype thiazide and thiazide-like diuretic which has an oral onset of $2h$.

Loop Diuretics Action

Blocks the chloride pump in the ascending loop of Henle, causing decreased reabsorption of sodium and chloride.

Furosemide (Lasix)

The most common loop diuretic; it inhibits reabsorption of sodium and chloride from distal renal tubules and the loop of Henle.

Potassium-Sparing Diuretics

Drugs that cause a loss of sodium while retaining potassium by blocking the action of aldosterone in the distal tubule.

Spironolactone

A potassium-sparing diuretic prototype used for primary hyperaldosteronism and as adjunctive therapy for edema associated with heart failure.

ACE Inhibitors Action

Blocks ACE from converting angiotensin I to angiotensin II, leading to decreased blood pressure and a decrease in aldosterone production.

Captopril

An ACE inhibitor prototype indicated for hypertension, heart failure, diabetic nephropathy, and left ventricular dysfunction after an MI.

Angiotensin II Receptor Blockers (ARBs)

Selectively blocks the binding of angiotensin II to specific tissue receptors in vascular smooth muscle and adrenal glands to block vasoconstriction; often identified by the suffix "-sartan."

Losartan

The prototype ARB used alone or in combination therapy for the treatment of hypertension and diabetic nephropathy.

Renin Inhibitor

A class of drugs like aliskiren (Tekturna) that directly inhibits renin, leading to decreased plasma renin activity.

Calcium Channel Blockers Action

Inhibits the movement of calcium ions across cardiac and arterial muscle cell membranes, depressing the impulse and leading to slowed conduction.

Diltiazem

A calcium channel blocker prototype used for the treatment of essential hypertension in its extended-release form.

Beta Blockers

Drugs (suffix "-olol") that block beta-adrenergic receptors in the heart and kidneys, decreasing the influence of the sympathetic nervous system.

Metoprolol

A beta-blocker prototype indicated for stable angina pectoris, hypertension, and preventing reinfarction in myocardial infarction patients.

Nitroprusside (Nitropress)

A vasodilator used for hypertensive crisis that acts directly on vascular smooth muscle to cause vasodilation.

Cyanide Toxicity

A potential adverse effect of vasodilators that the nurse should monitor for, indicated by delirium or confusion.

Sympathetic Adrenergic Agonists (Vasopressors)

Agents such as dopamine or epinephrine that active alpha-receptors to increase vascular tone and blood pressure during hypotension.

Heart Failure

A condition in which the heart fails to effectively pump blood throughout the body.

Right-sided HF Symptoms

Includes elevated jugular venous pressure, splenomegaly, hepatomegaly, pitting edema, and decreased peripheral pulses.

Left-sided HF Symptoms

Includes anxiety, tachypnea, dyspnea, orthopnea, hemoptysis, and rales.

Cardiac Glycosides Action

Increases the force of myocardial contraction and renal perfusion while slowing heart rate and conduction velocity through the AV node.

Digoxin therapeutic level for Heart Failure

The normal level is between $0.5$ and $2.0\,ng/mL$.

Inotropic

A term for modifying the force of heart muscle contraction.

Phosphodiesterase Inhibitors

Cardiotonic agents like milrinone that increase myocardial cell cyclic adenosine monophosphate (cAMP) and calcium levels.