Pharmacology: Beta Blockers, Calcium Channel Blockers, ACE Inhibitors, and ARBs

Flashcards covering key pharmacology concepts for Beta Blockers, Calcium Channel Blockers, ACE Inhibitors, and ARBs based on lecture notes.

According to the Vaughan Williams classification system, which class do beta blockers belong to?

Class II

What is the cardioprotective quality of beta blockers?

They prevent catecholamine-mediated actions on the heart by reducing or blocking sympathetic nervous system (epinephrine and norepinephrine) stimulation to the heart and the heart's conduction system.

What are the four intended cardiac effects of beta blockers?

Reduced heart rate (-chronotropy), delayed AV node conduction, reduced myocardial contractility (-inotropy), and decreased myocardial automaticity (-dromotropy).

In which anatomical locations are $\beta_1$ receptors found?

Heart, Intestine, Kidney, Brain, and Eyes.

In which anatomical locations are $\beta_2$ receptors found?

Bronchial Smooth Muscle, Vascular Smooth Muscle, and Liver.

What response occurs when catecholamines stimulate $\beta_1$ receptors in the Juxtaglomerular (JG) cells of the kidney?

Increase in renin production and conversion of angiotensin 1 to Angiotensin 2 to increase BP.

What is an example of a first-generation nonselective beta blocker?

Inderal (propranolol).

Which beta blocker is classified as a third-generation vasodilating agent?

Bystolic.

What are the contraindications for administering beta blockers?

Atrioventricular block and brady dysrhythmias.

Why must beta blockers be used with caution in diabetic patients?

They mask the symptoms of low blood sugar.

According to the Vaughan Williams classification, which class do calcium channel blockers belong to?

Class IV

Which calcium channel blockers are classified as Type I Non-dihydropyridines?

Verapamil and Diltiazem.

Which calcium channel blocker has a specific contraindication for reflex tachycardia?

Nifedipine.

What key dietary teaching points should be provided to patients taking calcium channel blockers?

Teach patients not to take with grapefruit juice and to increase fluids and fiber to prevent constipation.

What effect do ACE inhibitors and ARBs have on heart rate?

They have NONE (no effect on HR), which makes them suitable for people with underlying bradycardia.

How do ACE inhibitors and ARBs affect electrolyte balance, and what related instruction should be given to patients?

They inhibit aldosterone secretion, causing the body to excrete $H_2O$ and $Na$ while keeping $K^+$ (risk of hyperkalemia); patients should be taught to avoid potassium-containing salt substitutes.

What common suffix do Angiotensin Receptor Blockers (ARBs) end in?

"sartan"

What common suffix do Angiotensin Converting Enzyme Inhibitors (ACEi) end in?

"pril" (or APRIL).

Which specific ARBs are indicated for diabetic neuropathy?

irbesartan and losartan.

What are the contraindications for ACE inhibitors?

History of angioedema, second or third semester pregnancies, and renal artery stenosis.

What critical nursing implication must be followed regarding the first dose of an ACE inhibitor?

Monitor BP closely (especially after the first dose) due to the risk of postural/first-dose hypotension, and teach the patient to change positions slowly.

How do ACE inhibitors alter peripheral vascular resistance and cardiac parameters?

They decrease peripheral vascular resistance without decreasing cardiac output, without increasing cardiac rate, and without increasing cardiac contractility.