Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Cardiovascular Drugs (Insert Dari) EO 003.01 Part 19 AFAMS Lesson Overview (Insert Dari) Insert Dari Cardiac Therapy • Cardiac Glycosides • Antiarrythmics • Cardiac Stimulants - adrenergic and dopaminergic agents - phosphodiesterase inhibitors • Vasodilators used in cardiac diseases • Other cardiac drugs AFAMS Lesson Overview (Insert Dari) Insert Dari Antihypertensives Diuretics Peripheral Vasodilators Beta-blockers Calcium Channel Blockers Agents that Act on the ReninAngiotensin System Lipid Modifying Agents AFAMS 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 Insert Dari For each of these medications/classes students must obtain an understanding of: (1) Mechanism of Action (2) Indications (Uses) (3) Efficacy (4) Side Effects AFAMS AFAMS AFAMS AFAMS AFAMS C01 Cardiac Therapy (Insert Dari) AFAMS AFAMS Cardiac Glycosides: Digoxin (Insert Dari) Mechanism of Action Allows the heart to contract better. Insert Dari Indication • It is used to help a weak heart. • It is used to treat a fast heartbeat. Digitalis Purpura (foxglove) (Insert Dari) AFAMS Cardiac Glycosides: Digoxin (Insert Dari) Side Effects Insert Dari 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. AFAMS Cardiac Glycosides: Digoxin (Insert Dari) 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. Insert Dari AFAMS AFAMS Antiarrythmics: Amiodarone (Insert Dari) Mechanism of Action Decreases cardiac nerve stimulation, which slows down the heart beat. Insert Dari Indications (Use) Abnormal heart rhythm. AFAMS Antiarrythmics: Amiodarone (Insert Dari) 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 Insert Dari AFAMS Antiarrythmics: Amiodarone (Insert Dari) Important Points •Tell the patient to take the medication at the same time each day. •Can be taken with or without food. Insert Dari AFAMS AFAMS Adrenergic and Dopaminergic Agents (Insert Dari) Mechanism of Action Insert Dari Increased blood pressure and heart rate, pupil dilation and bronchodilation. Includes: Epinephrine Ephedrine Norepinephrine Dopamine Dobutamine These drugs are used to combat lifethreatening disorders, which include acute attacks of bronchial asthma, shock, cardiac arrest, and allergic reactions. In addition these drugs are used as nasal decongestants and appetite suppressants. AFAMS Adrenergic and Dopaminergic Agents (Insert Dari) Specific Indications Insert Dari 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. AFAMS Adrenergic and Dopaminergic Agents (Insert Dari) Side Effects •Dizziness •Headache •Excitable and Nervous •A fast heartbeat Important Points •Administered intravenously. AFAMS AFAMS Milrinone (Insert Dari) Mechanism of Action Causes vasodilation of cardiac vessels and increases the force of hearts contractions. Insert Dari Indication To help a weak heart. Side Effects •Headache. •Low blood pressure. AFAMS AFAMS Nitroglycerin Formulations (Insert Dari) Mechanism of Action Vasodilator of vessels to the heart. Insert Dari Indications Is 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. AFAMS 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. Side Effects Important Points Chest pain or pressure lasting more than 15 minutes. Get emergency medical care right away AFAMS AFAMS Adenosine (Insert Dari) Mechanism of Action Restores normal heart rhythm. Insert Dari Indication It is used to treat heart rhythm that is not normal. Side Effects Dizziness. • Flushing. • Headache. • Numbness and tingling of feet or hands. Important Points Administered intravenously. AFAMS C02 Anti-hypertensives (Insert Dari) AFAMS AFAMS Methyldopa (Insert Dari) Mechanism of Action Increases the contractility of the heart and causes vasodilation. Insert Dari Indications (Uses) It is used to treat high blood pressure Side Effects •Dizziness •Dry mouth •Headache •Feeling tired or weak Important Points Administered orally. AFAMS C03 Diuretics (Insert Dari) AFAMS AFAMS Diuretics (Insert Dari) Hydrochlorothiazide Spironolactone Furosemide Insert Dari Mechanism of Action Causes 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. AFAMS Diuretics (Insert Dari) 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. AFAMS Diuretics (Insert Dari) Insert Dari Important Points •Spironolactone and Furosemide are available in a combination product. AFAMS C04 Peripheral Vasodilators (Insert Dari) AFAMS AFAMS Hydergine (Insert Dari) Mechanism of Action Dilates the cerebral and peripheral vessels. Insert Dari 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 AFAMS C07 Beta blocking agents (Insert Dari) AFAMS AFAMS 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). AFAMS 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. Insert Dari Important Points •Can be administered orally and intravenously. AFAMS C07 Calcium Channel Blockers (Insert Dari) AFAMS AFAMS Calcium Channel Blockers (Insert Dari) Mechanism of Action Causes vasodilatation of the peripheral and coronary arteries. Insert Dari Indications (Use) •It is used to treat chest pain or pressure. •It is used to treat high blood pressure. AFAMS 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. Insert Dari Important Points •Can be administered orally or intravenously. AFAMS C10 Agents that act on the Renin-Angiotensin System (Insert Dari) AFAMS AFAMS 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. Insert Dari 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. AFAMS 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. Insert Dari Important Points •Administered orally. AFAMS 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. Insert Dari Indications (Use) • It is used to treat high blood pressure. • It is used to protect kidney function in diabetic patients who have protein loss. AFAMS Angiotensin II Antagonists (Insert Dari) Side Effects •Feeling light headed or dizzy •May feel tired and weak •Headache Insert Dari Important Points Administered orally. AFAMS C11 Lipid Modifying Agents (Insert Dari) AFAMS AFAMS Statins (Insert Dari) •Atorvastatin •Rosuvastatin Insert Dari 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. AFAMS 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 Insert Dari Important Points Significant drug interactions do exist. AFAMS Fibrates (Insert Dari) Mechanism of Action Helps to lower cholesterol in the body. Insert Dari 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. AFAMS Questions? (Insert Dari) AFAMS 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. Insert Dari AFAMS 1. Match the following drugs with their class (Insert Dari) A)Digoxin B)Amiodarone C)Milrinone D)Dopamine Insert Dari 1)Antiarrythmic 2)Adrengeric/Dopaminergic Agent 3)Phosphodiesterase Inhibitor 4)Cardiac Glycoside AFAMS 1. Answer: Match the following drugs with their class (Insert Dari) A)Digoxin (4) Cardiac Glycoside B)Amiodarone (1) Antiarrythmic C)Milrinone (3) Phosphodiesterase Inhibitor D)Dopamine (2) Adrenergic/Dopaminergic Agent Insert Dari AFAMS 2. Which of the following drugs can cause a patient to see yellow or green halos? (Insert Dari) A)Amiodarone B)Digoxin C)Epinephrine D)Milrinone Insert Dari AFAMS 2. Answer: Which of the following drugs can cause a patient to see yellow or green halos? (Insert Dari) A)Amiodarone B)Digoxin C)Epinephrine D)Milrinone Insert Dari AFAMS 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. Insert Dari AFAMS 3. Answer: Match the following drugs with their mechanism of action? (Insert Dari) 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. AFAMS 4. Which of the following drugs is generally used to relieve chest pain? (Insert Dari) A)Epinephrine B)Nitroglycerin C)Hydrochlorothiazide D)Metoprolol Insert Dari AFAMS 4. Answer: Which of the following drugs is generally used to relieve chest pain? (Insert Dari) A)Epinephrine B)Nitroglycerin C)Hydrochlorothiazide D)Metoprolol Insert Dari AFAMS 5. Which of the following is NOT a side effect of a statin? (Insert Dari) A)Abnormal muscle pain B)Liver complications C)Tiredness D)Persistent cough Insert Dari AFAMS 5. Answer: Which of the following is NOT a side effect of a statin? (Insert Dari) A)Abnormal muscle pain B)Liver complications C)Tiredness D)Persistent cough Insert Dari AFAMS