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Questions and Answers
What is Acute Heart Failure (HF)?
What is Acute Heart Failure (HF)?
What are some adverse effects of Digitalis (Digoxin)?
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?
What type of angina is caused by stress or exertion?
Classic (stable) angina
What distinguishes unstable angina from stable angina?
What distinguishes unstable angina from stable angina?
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What is the mechanism of action (MOA) of Nitroglycerin?
What is the mechanism of action (MOA) of Nitroglycerin?
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Bradycardia is a common adverse reaction of Digitalis (Digoxin).
Bradycardia is a common adverse reaction of Digitalis (Digoxin).
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Which of the following is a consideration when administering Clonidine?
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?
What is the MOA of Angiotensin-Converting Enzyme (ACE-I) Inhibitors?
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What does the acronym PUD stand for?
What does the acronym PUD stand for?
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What are the adverse reactions of Theophylline?
What are the adverse reactions of Theophylline?
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The prototype drug for leukotriene receptor antagonists is _____.
The prototype drug for leukotriene receptor antagonists is _____.
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Mucolytics are intended for patients with asthma.
Mucolytics are intended for patients with asthma.
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What is the main use of Guaifenesin?
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.
