Cardiac Drugs

  1. Hydrochlorothiazide
    • Diuretic
    • Reduces plasma and ECF; decreases workload on the heart and TPR
    • Used for hypertension
  2. Atenolol/Metoprolol
    • Sympatholytic; beta receptor antagonist (beta blocker)
    • Inhibits beta1 receptors; decreases heart rate, contractility, bp, renin release, and sympathetic outflow from the brain
    • Used for hypertension
  3. Losartan
    • Angiotensin inhibitor (receptor blocker)
    • Blocks ang II recetpors, disrupting hypertensive effects; stops Ang II from increasing systemic vascular resistance, and increasing plasma volume (via aldosterone)
    • Used in hypertension, hear failure, and diabetic nephropathy
  4. Nifedipine/Diltiazem
    • Vasodilators (Calcium channel blockers)
    • Block Ca channels in smooth muscles which prevents contractions
    • Used to control hypertension
    • Nifedipine is more effective than diltiazem (class IV Ca channel blocker)
  5. Sodium Nitroprusside
    • Vasodilator
    • Causes peripheral vasodilation through direct relaxation of arterioles and venules; decreases both preload and afterload
    • Used in hypertensive emergencies,a cute MI, aortic dissection
  6. Fenoldopam
    • Vasodilator
    • selective dopamine agonist (D1 receptors); exerts hypotensive effects by decreasing peripheral resistance with increased renal blood flow
    • Acute treatment of severe hypertension
  7. Quinidine/Procainamide
    • Anti-arrhythmic drug: Class IA sodium channel blocker
    • Inhibits Na channels on myocardial cell membrane; decreases conduction velocity, excitability, and contractility; also block K channel, prolonging duration of AP
    • Used to treat atrial arrhythmias
  8. Esmolol
    • Anti-arrhythmic Drug: Class II beta-adrenergic receptor antagonist (beta-blocker)
    • Slows phase 4 depol in SA noda by blocking binding of catecholamins (epi and NE) to adrenergic receptors (binding of these normally increases heart rate)
    • Used in emergency treatment of PSVT, atrial fib, and atrial flutter
  9. Amiodarone
    • Anti-arrhytmic Drug: Classs III K channel blocker
    • Prolongs repol by blocking K channel; also blocks Na, Ca channels, and beta-receptors
    • Long half-life (15-30 days)
    • Used for atrial and vent arrhythmias
  10. Digoxin
    • Anti-arrhythmic drug: Class V
    • Inhibits Na-K-ATPase pump leading to increase in ICNa followed by increased Ca influx resulting in greater muscle contraction
    • Used to control ventricular heart rate moreso than to treat heart failure
  11. Nitroglycerin
    • Rapid acting nitrate
    • Quickly induces venous capacitance and decreases arteriole resistance; reduces preload and afterload; lowers O2 demand; also redistributes blood flow to ischemic areas to correct for myocardial O2 imbalance
    • Used to treat Angina, heart failure, prophylaxis, and hypertensive emergencies
  12. Lidocaine
    • Anti-arrhythmic drug: Class IB sodium channel blocker
    • depresses automatic impulse conduction through purkinjie fibers; decreases AP
    • Used for ventricular arrhythmia (suppresses spontaneous depols from ischemic tissues)
  13. Beta blockers
    • hypertension
    • decrease HR, decrease CO, decrease MAP
    • decrease inotropic state, decrease SV
  14. Ca Channel blockers
    • hypertension
    • Decrease HR, decrease CO, decrease MAP
    • Decrease inotropic state, decrease SV
    • Decrease venous tone, decrease VR, decrease SV
    • Decrease TPR
  15. Diuretics
    • Hypertension
    • Decrease blood volume, decrease VR, decrease SV, decrease CO, decrease MAP
  16. RAS blockers
    • Hypertension
    • decrease blood volume, decrease VR, decrease SV, decrease CO, decrease MAP
    • decrease venous tone, decrease VR, decrease SV
    • Decrease circulating factors, decrease TPR
  17. Alpha blockers
    • Hypertension
    • Decrease venous tone, decrease VR, decrease SV, decrease CO, decrease MAP
    • Decrease sympathetic innervation, decrease TPR
  18. Aspiring, thienopyridine, antithrombins, beta blockers, ACEI/ARBs, nitrates, aldosterone antagonists, lipid lowering agents, and fibrinolytics are all used to treat what?
  19. Of the following HMG-CoA reductase inhibitors (statins), which is the most potent:lovastatin, pravastatin, simvastatin (Zocor), atorvastatin (Lipitor), Crestor (rosevastatin)?
    Crestor--also the most expensive--62% reduction
  20. What are the respective side effects of the most common CV drugs?
    • Beta blockers: fatigue
    • Antiplatelet therapy: increased bleeding risk
    • ACEI: cough
    • Nitrates: headache
    • Statins: myalgias, rare serious myopathy, hepatotoxicity
    • Fibrates: myopathy
    • Niacin: flushing, hepatotoxicity
    • Anticoagulants: thrombocytopenia
    • Spironolactone: gynecomastia
  21. Which drugs have been shown to reduce mortality in patients with acute coronary syndromes and CHF?
    • Beta blockers (carvedilol, metoprolol succinate, bisoprolol)
    • ACEI/ARBs
    • Vasodilators (hydralazine, isosorbide)
    • Diuretics (aldosterone antagonists spironolactone and eplerenon)
Card Set
Cardiac Drugs