afams cardiovascular drugs (insert dari) eo 003.01 part 19
TRANSCRIPT
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Cardiovascular Drugs(Insert Dari)
EO 003.01 Part 19
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Lesson Overview(Insert Dari)
Cardiac Therapy
• Cardiac Glycosides
• Antiarrythmics
• Cardiac Stimulants- adrenergic and dopaminergic agents- phosphodiesterase inhibitors
• Vasodilators used in cardiac diseases
• Other cardiac drugs
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Lesson Overview(Insert Dari)
Antihypertensives
Diuretics
Peripheral Vasodilators
Beta-blockers
Calcium Channel Blockers
Agents that Act on the Renin-Angiotensin System
Lipid Modifying Agents
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What I need to know as a pharmacy technician(Insert Dari)
In this lecture we will cover the drugs listed in the ANA Formulary which are classified according to the ATC system under
(C) Cardiovascular Drugs
For each of these medications/classes students must obtain an understanding of:
(1) Mechanism of Action
(2) Indications (Uses)
(3) Efficacy
(4) Side Effects
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C01 Cardiac Therapy (Insert Dari)
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Cardiac Glycosides: Digoxin (Insert Dari)
Mechanism of Action
Allows the heart to contract better.
Indication
• It is used to help a weak heart.
• It is used to treat a fast heartbeat.
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Digitalis Purpura (foxglove)(Insert Dari)
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Cardiac Glycosides: Digoxin (Insert Dari)
Side Effects
Signs of too much drug•Hallucinations•Inability or change in ability to think logically and clearly. •Sudden changes in vision (objects may have yellow/green halos). •A heartbeat that does not feel normal. •Bloody or black tarry stools.
Other side effects•Loose stools (diarrhea).•Dizziness. •Headache.•Upset stomach.
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Important Points
•Can be given intravenously or orally.
•Should be kept in original container to prevent degradation of product.
•Many drug interactions exist, it is important that a pharmacist speak with a patient who is starting this medication for the first time.
Cardiac Glycosides: Digoxin (Insert Dari)
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Antiarrythmics: Amiodarone(Insert Dari)
Mechanism of Action
Decreases cardiac nerve stimulation, which slows down the heart beat.
Indications (Use)
Abnormal heart rhythm.
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Side Effects
Serious – need to seek medical attention
•Cough, coughing up blood and difficulty breathing.
•Change in energy levels (up or down)
•Change in vision
•Signs of liver problems: right abdomen pain, yellowing of the skin.
•A burning, numbness, or tingling feeling that is not normal.
Less Serious
•Upset stomach
•Headache
Antiarrythmics: Amiodarone(Insert Dari)
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Important Points
•Tell the patient to take the medication at the same time each day.
•Can be taken with or without food.
Antiarrythmics: Amiodarone(Insert Dari)
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Adrenergic and Dopaminergic Agents(Insert Dari)
Mechanism of Action
Increased blood pressure and heart rate, pupil dilation and bronchodilation.
Includes: Epinephrine Ephedrine
Norepinephrine Dopamine
Dobutamine
These drugs are used to combat life- threatening disorders, which includeacute attacks of bronchial asthma, shock, cardiac arrest, and allergic reactions.
In addition these drugs are used as nasal decongestants and appetite suppressants.
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Adrenergic and Dopaminergic Agents(Insert Dari)
Specific Indications
Epinephrine – anaphylaxis and when the heart stops beating.
Ephedrine – to treat low blood pressure (pseudoephedrine used to treat a stuffy nose).
Norepinephrine – to treat low blood pressure.
Dopamine – used to help a weak heart.
Dobutamine – used to help a weak heart.
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Side Effects
•Dizziness
•Headache
•Excitable and Nervous
•A fast heartbeat
Important Points
•Administered intravenously.
Adrenergic and Dopaminergic Agents(Insert Dari)
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Milrinone(Insert Dari)
Mechanism of ActionCauses vasodilation of cardiac vessels and increases the force of hearts contractions.
Indication
To help a weak heart.
Side Effects
•Headache.
•Low blood pressure.
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Nitroglycerin Formulations(Insert Dari)
Mechanism of Action
Vasodilator of vessels to the heart.
IndicationsIs used to treat chest pain or chest pressure.
Many different formulations exist: oral tablets, patch, spray, cream and injection.
Injection may also be used to treat a weak heart.
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Nitroglycerin Formulations(Insert Dari)
Side Effects
• Dizziness or passing out.
• Headache.
• Fast or slow heartbeat.
• Blurred eyesight.
• Dry mouth.
• Sweating a lot, pale skin.
• Upset stomach or throwing up.
Important PointsChest pain or pressure lasting more than 15 minutes. Get emergency medical care right away
Side Effects
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Adenosine(Insert Dari)
Mechanism of Action
Restores normal heart rhythm.
IndicationIt is used to treat heart rhythm that is not normal.
Side Effects
Dizziness.
• Flushing.
• Headache.• Numbness and tingling of feet or hands.
Important PointsAdministered intravenously.
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C02 Anti-hypertensives(Insert Dari)
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Methyldopa(Insert Dari)
Mechanism of ActionIncreases the contractility of the heart and causes vasodilation.
Indications (Uses)
It is used to treat high blood pressure
Side Effects•Dizziness •Dry mouth •Headache •Feeling tired or weak
Important Points
Administered orally.
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C03 Diuretics(Insert Dari)
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Diuretics(Insert Dari)
Hydrochlorothiazide
Spironolactone
Furosemide
Mechanism of ActionCauses the kidneys to release more water through the urine, thus decreasing blood volume and decreasing blood pressure.
Indications•It is used to treat high blood pressure.•It is used to get rid of extra fluid.
Sprinolactone and Furosemide are also used to treat a weak heart.
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Diuretics(Insert Dari)
Side Effects
All diuretics:
•Feeling dizzy, rise slowly from a sitting or laying down position.
Furosemide and hydrochlorothiazide:
•Symptoms of low potassium, which include muscle cramps and a heartbeat that does not feel normal.
Spironolactone:
Enlarged breasts in men and changes to menstrual cycle for women.
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Diuretics(Insert Dari)
Important Points
•Spironolactone and Furosemide are available in a combination product.
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C04 Peripheral Vasodilators(Insert Dari)
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Hydergine (Insert Dari)
Mechanism of Action
Dilates the cerebral and peripheral vessels.
Indication (Use)
Although classified as a vasodilator, it is used to treat dementia due to insufficient cerebral blood flow.
Side Effects
• Slow heart rate
• Feeling dizzy or lightheaded upon standing.
• Blurred vision
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C07 Beta blocking agents(Insert Dari)
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Beta-blockers (Insert Dari)
Mechanism of Action
Decreases the amount of work the heart has to do (slows the heart rate) and decreases blood pressure.
Indications (Use)
• To treat high blood pressure
• May be used after a heart attack to try and prevent a second heart from occurring.
• Used to treat a weak heart (heart failure).
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Beta-blockers (Insert Dari)
Side Effects• May worsen symptoms of asthma in
patients. • Patients may feel a decrease in
energy when they first start this type of medication.
• May cause dizziness or light headedness when standing up.
• May decrease sexual function in men.
Important Points• Can be administered orally and
intravenously.
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C07 Calcium Channel Blockers(Insert Dari)
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Calcium Channel Blockers(Insert Dari)
Mechanism of Action
Causes vasodilatation of the peripheral and coronary arteries.
Indications (Use)
• It is used to treat chest pain or pressure.
• It is used to treat high blood pressure.
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Calcium Channel Blockers(Insert Dari)
Side Effects
• Dizziness and light headedness when standing up or in general.
• Headache
• Shortness of breath
• Feeling tired or weak.
Important Points
• Can be administered orally or intravenously.
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C10 Agents that act on the Renin-Angiotensin System
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ACE Inhibitors(Insert Dari
Mechanism of Action Angiotensin-converting enzyme (ACE)
inhibitors block production of the hormone, angiotensin II, a compound in the blood that causes narrowing of blood vessels and increases blood pressure. By reducing production of angiotensin II, ACE inhibitors allow blood vessels to widen, which lowers blood pressure and improves heart output.
Indications (Use)
• It is used to treat high blood pressure.
• It is used to help heart function after a heart attack.
• Is used to help a weak heart.
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ACE Inhibitors(Insert Dari
Side Effects
• A bothersome cough that doesn’t go away.
• Feeling light headed or dizzy.
• Swelling of the lips and face (rare but serious).
• May feel tired or weak.
Important Points
• Administered orally.
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Angiotensin II Antagonists(Insert Dari)
Mechanism of Action
The angiotensin II receptor blockers (ARBs) block the effects of angiotensin II on cells in the heart and blood vessels. Similar to ACE inhibitors, ARBs can widen blood vessels and lower blood pressure.
Indications (Use)
• It is used to treat high blood pressure.
• It is used to protect kidney function in diabetic patients who have protein loss.
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Angiotensin II Antagonists(Insert Dari)
Side Effects
• Feeling light headed or dizzy
• May feel tired and weak
• Headache
Important Points
Administered orally.
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C11 Lipid Modifying Agents(Insert Dari)
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Statins(Insert Dari)
• Atorvastatin
• Rosuvastatin
Mechanism of Action
Prevents the body from producing cholesterol.
Indications (Uses)
• It is used to lower cholesterol.
• It is used to prevent heart attacks and slow the progression of heart disease.
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Statins(Insert Dari)
Side Effects
Rare but can occur
• Abnormal muscle pain (patient should see a physician immediately and stop taking the medication).
• Liver problems, pain in the right abdomen and dark urine (should also see a physician immediately.
More common
• Tiredness
Important Points
Significant drug interactions do exist.
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Fibrates(Insert Dari)
Mechanism of Action
Helps to lower cholesterol in the body.
Indications
• Is used to treat high cholesterol.
Side Effects
• Abnormal muscle pain.
• Feelings tired or weak.
• Upset stomach.
• Headache.
Important Points
• Can be taken in combination with a statin.
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Questions? (Insert Dari)
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In-class Assignment(Insert Dari)
This assignment will consist of 5 questions which are to be completed individually. Once complete the instructor will review the answers with the class.
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1. Match the following drugs with their class(Insert Dari)
A) Digoxin
B) Amiodarone
C) Milrinone
D) Dopamine
1) Antiarrythmic
2) Adrengeric/Dopaminergic Agent
3) Phosphodiesterase Inhibitor
4) Cardiac Glycoside
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1. Answer: Match the following drugs with their class
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A) Digoxin (4) Cardiac Glycoside
B) Amiodarone (1) Antiarrythmic
C) Milrinone (3) Phosphodiesterase Inhibitor
D) Dopamine (2) Adrenergic/Dopaminergic Agent
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2. Which of the following drugs can cause a patient to see yellow or green halos?
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A) Amiodarone
B) Digoxin
C) Epinephrine
D) Milrinone
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2. Answer: Which of the following drugs can cause a patient to see yellow or green halos?
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A) Amiodarone
B) Digoxin
C) Epinephrine
D) Milrinone
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3. Match the following drugs with their mechanism of action?
(Insert Dari) A) Metoprolol
B) Hydrochlorothiazide
C) Verapamil
D) Ramipril
(1) Decreases the amount of work the heart has to do (slows the heart rate) and decreases blood pressure.
(2) Causes vasodilatation of the peripheral and coronary arteries.
(3) Causes the kidneys to release more water through the urine, thus decreasing blood volume and decreasing blood pressure.
(4) Block production of the hormone, angiotensin II, a compound in the blood that causes narrowing of blood vessels and increases blood pressure.
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3. Answer: Match the following drugs with their mechanism of action?
(Insert Dari) (A) Metoprolol - (1) Decreases the amount
of work the heart has to do (slows the heart rate) and decreases blood pressure.
(C) Verapamil - (2) Causes vasodilatation of the peripheral and coronary arteries.
(B) Hydrochlorothiazide - (1) Causes the kidneys to release more water through the urine, thus decreasing blood volume and decreasing blood pressure.
(D) Ramipril (4) Block production of the hormone, angiotensin II, a compound in the blood that causes narrowing of blood vessels and increases blood pressure.
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4. Which of the following drugs is generally used to relieve chest pain?
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A) Epinephrine
B) Nitroglycerin
C) Hydrochlorothiazide
D) Metoprolol
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4. Answer: Which of the following drugs is generally used to relieve chest pain?
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A) Epinephrine
B) Nitroglycerin
C) Hydrochlorothiazide
D) Metoprolol
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5. Which of the following is NOT a side effect of a statin?
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A) Abnormal muscle pain
B) Liver complications
C) Tiredness
D) Persistent cough
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5. Answer: Which of the following is NOT a side effect of a statin?
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A) Abnormal muscle pain
B) Liver complications
C) Tiredness
D) Persistent cough
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