CHAPTER 11 Cardiovascular Drugs
Quiz Yourself
1. Beta-blocker drugs block all beta1 and beta2 receptors. Cardioselective beta-blocker
drugs
are more selective in their action and block only beta1 receptors in the heart and beta2 receptors
in the blood vessels (but not in the bronchi).
2. [Only need to give one example of a drug from each category.]
diuretic drugs (discussed in Chapter 7)
beta-blocker drugs
carteolol (Cartrol)
nadolol (Corgard)
penbutolol (Levatol)
pindolol (Visken)
propranolol (Inderal)
timolol (Blocadren)
cardioselective beta-blocker drugs
acebutolol (Sectral)
atenolol (Tenormin)
betaxolol (Kerlone)
bisoprolol (Zebeta)
metoprolol (Lopressor, Toprol-XL)
nebivolol (Bystolic)
alpha/beta-blocker drugs
carvedilol (Coreg)
labetolol (Normodyne, Trandate)
alpha-blocker drugs
doxazosin (Cardura)
prazosin (Minipress)
mecamylamine (Inversine)
terazosin (Hytrin)
calcium channel blocker drugs
amlodipine (Norvasc)
clevidipine (Cleviprex)
diltiazem (Cardizem)
felodipine (Plendil)
isradipine (DynaCirc)
nicardipine (Cardene)
nifedipine (Adalat CC, Procardia)
nisoldipine (Sular)
verapamil (Calan, Covera-HS)
ACE inhibitor drugs
benazepril (Lotensin)
captopril (Capoten)
enalapril (Vasotec)
enalaprilat
fosinopril (Monopril)
lisinopril (Prinivil, Zestril)
moexipril (Univasc)
perindopril (Aceon)
quinapril (Accupril)
ramipril (Altace)
trandolapril (Mavik)
angiotensin II blocker drugs
candesartan (Atacand)
eprosartan (Teveten)
irbesartan (Avapro)
losartan (Cozaar)
olmesartan (Benicar)
telmisartan (Micardis)
valsartan (Diovan)
renin inhibitor drugs
aliskiren (Tekturna)
aldosterone receptor inhibitor drugs
eplerenone (Inspra)
peripheral vasodilator drugs
hydralazine (Apresoline)
minoxidil
3. Bile acid sequestrant drugs are given orally; they bind with bile, forming an
insoluble complex that is excreted in the feces, taking the cholesterol with it.
Because the bile is not reabsorbed, the liver must draw cholesterol from the
blood to produce a new supply of bile. This lowers the level of cholesterol in the
blood.
4. Digitalis drugs exert two therapeutic effects on the heart; they have a positive
inotropic effect that causes the heart to contract more forcefully, and they have a
negative chronotropic effect that causes the heart to beat more slowly.
5. Vincent van Gogh’s painting, The Starry Night, could show evidence that the
painter suffered from digitalis toxicity. It is known that he had mania and epilepsy;
he may have been treated with digitalis for lack of a more specific drug available at
that time. His depiction of yellow-green halos around the stars in this painting is a
common visual side effect of patients with toxic levels of digitalis. Because digitalis
was given in its crude form at that time, overdoses were common, as doses could
not be calculated accurately and digitalis is well known for its low therapeutic index.
6. Symptoms of digitalis toxicity can be treated in one of three ways: (1) Decrease the
dose of
the digitalis drug, (2) give the digitalis drug less frequently or, in severe cases,
(3) administer
an antidote drug to reverse the toxic effects of the digitalis drug.
7. The suffix –olol is common to generic betablocker drugs.
The suffix –pril is common to generic ACE inhibitor drugs.
The suffix –sartan is common to generic angiotensin II blocker drugs.
The suffix –azosin is common to generic alpha-blocker drugs.
The suffix –statin is common to HMG-CoA reductase inhibitor drugs.
8. Nitroglycerin can be administered by these five routes: sublingually as a tablet, translingually
as a spray, inhaled as vapors through the nose, orally as a sustainedrelease capsule or
tablet, transdermally as a patch, or topically as an ointment (measured in inches), or
intravenously.
9. Nitrate drugs, beta-blocker drugs, and calcium channel blocker drugs.
10. Digoxin immune Fab.
11. lidocaine (Xylocaine)
12. a. Cardioselective beta-blocker drug used to treat hypertension and angina pectoris
b. HMG-CoA reductase inhibitor drug used to treat hypercholesterolemia
c. Anticholinergic drug used to treat bradycardia
d. Combination calcium channel blocker drug and HMG-CoA reducase inhibitor
drug used to treat hypertension and hypercholesterolemia
e. Digitalis drug used to treat congestive heart failure and atrial fibrillation
f. Calcium channel blocker drug used to treat hypertension and angina
pectoris
g. Antiarrhythmic drug used to treat cardiac asystole
h. Antiarrhythmic drug used to treat ventricular fibrillation
i. Angiotensin II receptor blocker drug used to treat hypertension
j. Cardioselective beta-blocker drug used to treat hypertension
k. Nitrate drug used to treat angina pectoris
l. HMG-CoA reductase inhibitor drug used to treat hypercholesterolemia
m. ACE inhibitor drug used to treat hypertension
n. Combination drug used to treat hypercholesterolemia
13. angiotensin-converting enzyme; congestive heart failure; digoxin; fragment, antibody
binding; hypertension
Clinical Application Questions
1. a. Lower the level of cholesterol in your blood
b. HMG-CoA reductase inhibitor drugs or “statin” drugs
2. a. congestive heart failure
b. No
c. Furosemide, a diuretic drug, will help the body excrete the excess fluid of
peripheral and pulmonary edema in the urine. Furosimide 20 milligrams,
intravenous, twice a day.
d. Digoxin.
e. It makes the heart pump more slowly but more strongly.
f. 0.25 milligrams on even days
g. Nitroglycerin ointment [instead of Nitro paste] one inch every 6 hours.
h. Isosorbide 2.5 milligrams sublingual, three times a day.
i. A digoxin level
3. a. propranolol
b. Beta-blocker drug
c. 20 mg
d. Inderal
e. Hypertension, ventricular arrhythmias caused by digitalis toxicity, tachycardia,
and atrial flutter and fibrillation
4. a. Lipitor
b. atorvastatin
c. HMG-CoA reductase inhibitor drug
d. 10 mg
5. a. Procardia XL
b. nifedipine
c. calcium channel blocker drug
d. 90 mg
6. Each prescription was filled by a different pharmacist (different pharmacist’s initials),
each was assigned a different prescription number (Rx #), the prescription bottle on
the left includes the words “by mouth,” the prescription bottle on the left is for 50 mg
while the one on the right is for 100 mg, each has a different number of refills good
until a different date.
7. a. amiodarone, Zoloft, Cardizem CD, Toprol-XL, Mavik, iron sulfate
b. The trade names for amiodarone are Cordarone and Pacerone. Zoloft, Cardizem,
Toprol-XL, and Mavik are trade name drugs. [Do not need to do this for iron
sulfate.]
c. Zoloft and iron sulfate
d. Amiodarone is used to treat ventricular tachycardia. Cardizem is used to treat
hypertension and tachycardia. Toprol-XL is used to treat hypertension. Mavik is
used to treat hypertension.
e. Amiodarone 200 milligrams twice a day for one week and then once a day
thereafter
Zoloft 25 milligrams once a day
Cardizem CD 360 milligrams once a day
Toprol-XL 100 milligrams once a day
Mavik 2 milligrams once a day
Iron sulfate 325 milligrams once a day