-
vasodilator SE
HA, flusing, tachy, lupus-like syndrome (~10%)
-
BAS contraindications
hte (enterohepatic recycling, phospatidic acid phosphatase)
-
digoxin toxicity more likely in
hypokalemia / electrolyte imbalance
-
Niacin contraindications
arterial bleeding (decreases platelets slightly), hepatic issues (dose-related LFT increase)
-
bblocker contraindications
non-selective + asthma, 2nd deg HB, bradycardia, acute HF
-
metoprolol tartrate dosing
50-200mg PO BID
-
valsartan dosing
80-320mg PO qd
-
olmesartan dosing
20-40mg PO qd
-
DRI side effects
diarrhea, GERD, hyperkalemia
-
BB cardioselective (beta-1 only)
atenolol, metoprolol
-
BB non-cardioselective (beta-1 and 2)
propanalol
-
BB mixed alpha/beta
labetalol, carvedilol
-
BB least lipophilic
atenolol, (labetolol)
-
BB most lipophilic
propranolol, (metoprolol)
-
-
atenolol/metoprolol dosing
50-200mg PO qd
-
carvedilol IR dosing
6.25-25mg PO BID
-
carvedilol ER dosing
20-80mg PO qd
-
PCB SE
fatal pulmonary toxicity (report SOB/cough), blue-grey skin
-
verapamil dosing
80-120mg PO TID
-
diltiazem dosing
120-480mg PO qd
-
amlodipine dosing
5-10mg PO qd
-
fenofibrate dosing
50-200mg PO qd
-
-
gemfibrozil dosing
600-1200mg PO qd
-
I/P MOA
act on adrinergic receptors. alpha-1 receptors increase IP3 which increases vascular tone (vasoconstriction). beta-1 receptors activate G proteins that increase cAMP levels, resulting in increased myocardial contractile force.
-
beta1-selective ionotropes
dobutamine (also a vasodilator)
-
alpha1-selective pressors
norepinephrine, phenylephrine (pure)
-
PDE-3 SE
hypotension secondary to vasodilation (can last for hours due to long half life), thrombocytopenia (much less often with milrinone).
-
PDE-3 vs. beta agonists
PDE-3 not direct positive chronotropes (better for tachy pts/CAD). In CHF b-receptors are frequently down-regulated to to high endogenous chatecholamine compensatory mechanisms, so PDE-3 inhibitors are clinically much stronger.
-
alpha-2 Agonists drugs
clonidine, guanabenz, guanfacine, methyldopa (prodrug)
-
alpha-2 agonsits MOA
agonize central alpha-2 receptors (inhibits adenylyl cyclase activity), producing a decrease in peripheral resistance, HR, BP.
-
alpha-2 agonists SE
sedation, dry mucus membranes, bradycardia, hypotension, constipation, nausea
-
alpha-1 antagonists groups/drugs
selective = prazosin, terazosin, doxazosin. non-selective (used in mgmt of pts w/ pheochromocytoma) = phentolamine, phenoxybenzamine
-
alpha-1 antagonists MOA
antagonize peripheral alpha-1 adrinergic receptors (stimulate phospholipase C activity), causing vasodilation
-
alpha-1 antagonists SE
orthostatic hypotension, HA, somnolence, palpitations (reflex tachycarda), nasal congestion, dizziness
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