PAT 202 WEEK 1 & 2: CARDIAC PHARMACOTHERAPY
QUESTIONS WITH VERIFIED ANSWERS
What are the Overall Pharmacological Goals of Cardiac Pharmacotherapy? - Answers -
1. Treating symptoms
2. Decreasing heart workload & O2 demands
3. Improving oxygenation
4. Improving cardiac function
5. Reducing pain & anxiety
What are 2 main Pharmacological Goals For Client With Angina? - Answers - 1) Reduce
frequency of angina episodes
2) Terminate incidents of acute angina pain once in progress
What are 4 different mechanisms For Client With Angina? - Answers - 1) Slow HR
2) Dilate veins so heart receives less blood
-↓ preload
3) Cause heart to contract with less force
-↓ contractility
4) Dilate arterioles to lower BP
-↓ afterload
--Gives heart less resistance when ejecting blood
What are the 5 main Pharmacological Goals For Treatment of Acute MI? - Answers - 1)
Restore perfusion to damaged myocardium ASAP (w/ thrombolytics)
2) Reduce myocardial O2 demand (w/ nitrates and beta blockers)
3) Control or prevent associated dysrhythmias (w/ beta blockers and antidysrhythmics)
4) Reduce post-MI mortality (w/ aspirin and ACEIs)
5) Control MI pain and anxiety (w/ narcotic analgesics)
What are 3 primary Pharmacological Goals For Treatment of HF? - Answers - 1)
reduction of preload
2) reduction of SVR (↓ afterload) [afterload = SVR]
^Both 1. and 2. provide symptomatic relief but do not reverse HF progression
3) Inhibition of both the RAAS and vasoconstrictor mechanisms of SNS
-results in significant reduction in morbidity & mortality from HF
What are the Indications, Mechanism of Action, Desired Effects, and Adverse Effects of:
Morphine (Opioid)? - Answers - Indications:
-acute MI pain, acute and chronic pain
-relieve SOB assoc. with HF and pulmonary edema
, Mechanisms of action:
-binds with mu and kappa receptors in brain and dorsal horn of spinal cord
-mimics endogenous opioids such as endorphins and enkephalins (also stimulate opioid
receptors)
-↓ responsiveness of alpha-adrenergic receptors: peripheral vasodilation
Desired effects:
-profound analgesia
-sedation, euphoria
-↓ anxiety and fear
-↓ cardiac workload: ↓ preload, ↓ afterload
Adverse effects:
-CNS depression → respiratory depression, cardiac arrest
-dysphoria (restlessness, depression, and anxiety)
-hallucinations, dizziness, constipation, nausea
-itching sensation
How does morphine decrease preload and afterload? - Answers - Causes peripheral
vasodilation - bld pooling, decrease preload into heart and decrease afterload/ pressure
the LV has to push against to get bld into systemic circulation
What are the Indications, Mechanism of Action, Desired Effects, and Adverse Effects of:
Diltiazem (Calcium Channel Blockers (Selective for Vessels))? - Answers - Indications:
-stable angina, atrial dysrhythmias, HTN
Mechanisms of action:
-inhibits transport of calcium into myocardial cells
-->decreases HR and force of contraction, decreasing O2 demand of myocardium
-blocks vascular smooth muscle channels
-->↑ O2 supply in coronary arteries
-->↓ O2 demand by decreasing afterload (SVR)
Desired effects:
-relaxes both coronary and peripheral blood vessels
Adverse effects: (related to how the drug works)
-related to vasodilation
-H/A, dizziness, edema of ankles and feet
What are the Indications, Mechanism of Action, Desired Effects, and Adverse Effects of:
Amlodipine (Calcium Channel Blockers (Selective for Vessels))? - Answers -
Indications:
-chronic stable angina, variant angina (Prinzmetal's angina), HTN
Mechanisms of action:
QUESTIONS WITH VERIFIED ANSWERS
What are the Overall Pharmacological Goals of Cardiac Pharmacotherapy? - Answers -
1. Treating symptoms
2. Decreasing heart workload & O2 demands
3. Improving oxygenation
4. Improving cardiac function
5. Reducing pain & anxiety
What are 2 main Pharmacological Goals For Client With Angina? - Answers - 1) Reduce
frequency of angina episodes
2) Terminate incidents of acute angina pain once in progress
What are 4 different mechanisms For Client With Angina? - Answers - 1) Slow HR
2) Dilate veins so heart receives less blood
-↓ preload
3) Cause heart to contract with less force
-↓ contractility
4) Dilate arterioles to lower BP
-↓ afterload
--Gives heart less resistance when ejecting blood
What are the 5 main Pharmacological Goals For Treatment of Acute MI? - Answers - 1)
Restore perfusion to damaged myocardium ASAP (w/ thrombolytics)
2) Reduce myocardial O2 demand (w/ nitrates and beta blockers)
3) Control or prevent associated dysrhythmias (w/ beta blockers and antidysrhythmics)
4) Reduce post-MI mortality (w/ aspirin and ACEIs)
5) Control MI pain and anxiety (w/ narcotic analgesics)
What are 3 primary Pharmacological Goals For Treatment of HF? - Answers - 1)
reduction of preload
2) reduction of SVR (↓ afterload) [afterload = SVR]
^Both 1. and 2. provide symptomatic relief but do not reverse HF progression
3) Inhibition of both the RAAS and vasoconstrictor mechanisms of SNS
-results in significant reduction in morbidity & mortality from HF
What are the Indications, Mechanism of Action, Desired Effects, and Adverse Effects of:
Morphine (Opioid)? - Answers - Indications:
-acute MI pain, acute and chronic pain
-relieve SOB assoc. with HF and pulmonary edema
, Mechanisms of action:
-binds with mu and kappa receptors in brain and dorsal horn of spinal cord
-mimics endogenous opioids such as endorphins and enkephalins (also stimulate opioid
receptors)
-↓ responsiveness of alpha-adrenergic receptors: peripheral vasodilation
Desired effects:
-profound analgesia
-sedation, euphoria
-↓ anxiety and fear
-↓ cardiac workload: ↓ preload, ↓ afterload
Adverse effects:
-CNS depression → respiratory depression, cardiac arrest
-dysphoria (restlessness, depression, and anxiety)
-hallucinations, dizziness, constipation, nausea
-itching sensation
How does morphine decrease preload and afterload? - Answers - Causes peripheral
vasodilation - bld pooling, decrease preload into heart and decrease afterload/ pressure
the LV has to push against to get bld into systemic circulation
What are the Indications, Mechanism of Action, Desired Effects, and Adverse Effects of:
Diltiazem (Calcium Channel Blockers (Selective for Vessels))? - Answers - Indications:
-stable angina, atrial dysrhythmias, HTN
Mechanisms of action:
-inhibits transport of calcium into myocardial cells
-->decreases HR and force of contraction, decreasing O2 demand of myocardium
-blocks vascular smooth muscle channels
-->↑ O2 supply in coronary arteries
-->↓ O2 demand by decreasing afterload (SVR)
Desired effects:
-relaxes both coronary and peripheral blood vessels
Adverse effects: (related to how the drug works)
-related to vasodilation
-H/A, dizziness, edema of ankles and feet
What are the Indications, Mechanism of Action, Desired Effects, and Adverse Effects of:
Amlodipine (Calcium Channel Blockers (Selective for Vessels))? - Answers -
Indications:
-chronic stable angina, variant angina (Prinzmetal's angina), HTN
Mechanisms of action:
