-
Hydrochlorothiazide
- Diuretic
- Reduces plasma and ECF; decreases workload on the heart and TPR
- Used for hypertension
-
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
-
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
-
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)
-
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
-
Fenoldopam
- Vasodilator
- selective dopamine agonist (D1 receptors); exerts hypotensive effects by decreasing peripheral resistance with increased renal blood flow
- Acute treatment of severe hypertension
-
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
-
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
-
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
-
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
-
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
-
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)
-
Beta blockers
- hypertension
- decrease HR, decrease CO, decrease MAP
- decrease inotropic state, decrease SV
-
Ca Channel blockers
- hypertension
- Decrease HR, decrease CO, decrease MAP
- Decrease inotropic state, decrease SV
- Decrease venous tone, decrease VR, decrease SV
- Decrease TPR
-
Diuretics
- Hypertension
- Decrease blood volume, decrease VR, decrease SV, decrease CO, decrease MAP
-
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
-
Alpha blockers
- Hypertension
- Decrease venous tone, decrease VR, decrease SV, decrease CO, decrease MAP
- Decrease sympathetic innervation, decrease TPR
-
Aspiring, thienopyridine, antithrombins, beta blockers, ACEI/ARBs, nitrates, aldosterone antagonists, lipid lowering agents, and fibrinolytics are all used to treat what?
CVD
-
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
-
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
-
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)
|
|
