Questions and Answers
What is Acute Heart Failure (HF)?
What are some adverse effects of Digitalis (Digoxin)?
Bradycardia, dysrhythmias, anorexia, nausea/vomiting, headache, blurred or yellow vision
What type of angina is caused by stress or exertion?
Classic (stable) angina
What distinguishes unstable angina from stable angina?
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What is the mechanism of action (MOA) of Nitroglycerin?
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Bradycardia is a common adverse reaction of Digitalis (Digoxin).
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Which of the following is a consideration when administering Clonidine?
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What is the MOA of Angiotensin-Converting Enzyme (ACE-I) Inhibitors?
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What does the acronym PUD stand for?
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What are the adverse reactions of Theophylline?
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The prototype drug for leukotriene receptor antagonists is _____.
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Mucolytics are intended for patients with asthma.
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What is the main use of Guaifenesin?
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Study Notes
Cardiovascular Pharmacology
- Acute Heart Failure (HF): Weakening and enlargement of heart muscle, inadequate blood pumping, failure of compensatory mechanisms, results in lung and peripheral congestion.
- Digitalis (Digoxin): Used for HF; narrow therapeutic range. Mechanism of action (MOA): Inhibits Na/K pump, increasing intracellular calcium to reduce heart rate (HR) and increase contractility. Adverse effects include bradycardia, dysrhythmias, and vision changes. Monitor potassium (K+) and creatinine levels; interactions with diuretics and antacids.
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Angina Types:
- Classic Angina: Induced by stress or exertion due to arterial narrowing.
- Unstable Angina: Frequent occurrence with increasing severity, unrelated to activity, due to partial artery occlusion.
- Variant Angina: Occurs at rest caused by vessel spasm.
Angina Treatment
- Nitroglycerin: Used for angina; enhances absorption when administered sublingually. Max of 3 doses every 5 minutes; call 911 if pain persists. MOA: Vasodilates, reducing myocardial oxygen demand. Considerations include risk of hypotension and needing to monitor blood pressure (SBP).
Antihypertensives
- Older Adults: 26% AMAB and 30% AFAB over 65 have hypertension; need for lifestyle modifications, including sodium reduction and weight loss.
- Clonidine: Alpha-2 agonist decreasing sympathetic activity, HR, and blood pressure (BP); avoid with beta blockers due to intensified bradycardia.
- Alpha-1 Blocker (Prazosin): Induces vasodilation, effective for African Americans; adverse reactions include orthostatic hypotension and dizziness.
- Carvedilol: Combines alpha-1 and non-selective beta-blocker effects. Caution in patients with heart failure or bradycardia.
- Hydralazine: Direct-acting vasodilator used for severe hypertension with potential adverse effects of tachycardia and lupus-like symptoms.
- ACE Inhibitors (Lisinopril): Inhibit conversion of angiotensin I to II, acting to decrease BP; adverse effects include cough and angioedema. Not recommended in pregnancy.
- Angiotensin II Receptor Blockers (Losartan): Similar action to ACE inhibitors but does not cause cough. Less effective in African Americans.
- Direct Renin Inhibitor (Aliskiren): Reduces BP by decreasing angiotensin levels; adverse effects include hyperkalemia.
Patient Education on Antihypertensives
- Importance of compliance and regular monitoring of BP and pulse; advise on gradual position changes and potential side effects.
Anticholinergics
- Act by blocking acetylcholine, leading to adverse effects such as dry mouth, dizziness, and tachycardia.
Antihistamines
- First-Generation (Diphenhydramine): Competes with histamine and has significant anticholinergic effects. Use caution in patients with glaucoma or asthma.
- Second-Generation Antihistamines (Cetirizine, Azelastine): Similar action with fewer anticholinergic effects, non-sedating.
Decongestants
- Pseudoephedrine: Used for nasal congestion; can raise BP and cause nervousness. Contraindicated in narrow-angle glaucoma.
- Oxymetazoline: Topical decongestant; limit use to 3-5 days to prevent rebound congestion.
Respiratory Drugs
- Bronchodilators (SABA - Albuterol): Used for acute asthma. Monitor for tachycardia and hypokalemia; contraindicated in COVID-19 patients.
- Long-Acting β2 Agonist (Salmeterol): Used for maintenance therapy, not for acute exacerbations.
- Anticholinergics (Ipratropium): Maintenance for COPD with dry mouth; not intended for acute relief.
- Sympathomimetic (Epinephrine): For acute bronchospasm and anaphylaxis; be cautious with existing coronary artery disease.
Methylxanthines
- Theophylline: Management of asthma; narrow therapeutic index with risks of dysrhythmias and seizures; caution with cimetidine.
Leukotriene Receptor Antagonists (Montelukast)
- Reduce inflammation and bronchoconstriction; caution for suicidal ideation.
Glucocorticoids
- Used for suppression of inflammation; side effects include oral thrush and hyperglycemia. Caution with existing health issues like diabetes and hypertension.
Mucolytics (N-acetylcysteine)
- Liquifies mucus; specific use for acetaminophen overdose, monitor for bronchospasm.
Mast Cell Stabilizer (Cromolyn)
- Long-term treatment for asthma and allergies; not effective in acute attacks.
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Description
Prepare for the NYU Pharmacology Exam 1 with these concise flashcards. This set includes crucial definitions and concepts related to heart failure and the role of Digitalis. Perfect for quick review and reinforcement of key pharmacological terms.
