Cardiovascular Drugs Flashcards
It is a class of drug that acts as a diuretic that inhibits reabsorption of HCO3. It also decreases intraocular pressure, therby used for patients with glaucoma. Moreover, it is the DOC for acute mountain sickness. S/E: metabolic acidosis
One of the drugs under this classification can also decrease intracranial pressure
Proximal convoluted tubule diuretics
Carbonic anhydrase inhibitors
Acetazolamide, Brinzolamide
Mannitol (osmotic diuretic)
It is a class of drug that acts as a diuretic that inhibits the Na/K/2 Cl cotransport or NKCC receptor. They are also known as high-ceiling diuretics due to their potency. It is used for acute pulmonary congestion or edema
S/E: hyponatremia, hypocalcemia, hypokalemia, hyper-GUL, ototoxicity
Loop of Henle or loop diuretics
Bumetamide, Furosemide, Torsemide, Ethacrynic acid (most ototoxic)
It is a class of drug that acts as a diuretic that inhibits the reabsorption of Na and Cl or inhibits the Na/Cl co-transporter or NCC channel. This is the first-line drug for hypertension, since they cause vasodilation aside from diuresis. They are the DOC for patients with kidney stones or nephrolithiasis
S/E: hyponatremia, hypokalemia, hypercalcemia, hyper-GUL
Distal convoluted tubule diuretics
Thiazide diuretics
Hydrochlorothiazide, Chlorothiazide, Indapamide
It is a class of drug that acts as a diuretic that inhibits the aldosterone mediated reabsorption of Na and secretion of K. They prevent cardiac remodeling
S/E: hyperkalemia
Collecting tubule duct diuretic: potassium sparing diuretic
Aldosterone antagonists
Spironolactone, Eplerenone
It is a centrally acting alpha agonist that stimulate the alpha-2 receptors in the brainstem, reducing sympathetic outflow. It specifically is used for hypertensive urgency, administered sublingually
Clonidine
It is a class of drug that acts as a diuretic that inhibits Na channels
S/E: hyperkalemia
Collecting tubule duct diuretic: epithelial sodium channel inhibitors (ENAC)
Amiloride, triamterene
It is a centrally acting alpha agonist that stimulate the alpha-2 receptors in the brainstem, reducing sympathetic outflow. It is used by pregnant women and gives a positive result for Coombs test
Methyldopa
It is a centrally acting alpha agonist that stimulate the alpha-2 receptors in the brainstem, reducing sympathetic outflow. They are the old drugs of this classification
Guanfacine
Guanabenz
They are drugs that block beta-1 adrenergic receptors, reducing heart rate and cardiac contractility. These are not first-line drugs; they are only given if the patient has a compelling indication
These drugs have a side effect of hypotension, so these specific group of beta blockers are used to counteract hypotension
Beta blockers
Beta blockers with intrinsic sympathomimetic action
These drugs block the conversion of angiotensin I to angiotensin II. Their S/E is dry cough, due to the non-degradation of bradykinin. Just like spironolactone, they prevent cardiac remodeling.
C/I: AKI. DOC: CKD
All of these drugs are prodrugs, except two
Angiotensin converting enzyme (ACE) blockers
Lisinopril and captopril
These drugs competitively block angiotensin II receptors. They do not have the S/E of dry cough, making them preferrable for patient comfort. Just like spironolactone, they prevent cardiac remodeling.
C/I: AKI. DOC: CKD
Angiotensin II receptor blockers (ARBs)
These drugs bind to alpha-1 subunit of L-type calcium channel in muscle cell membrane reducing vascular smooth muscle contractility. It is vessel selective.
ADR: peripheral edema
Dihydropyridine CCB
These drugs bind to alpha-1 subunit of L-type calcium channel in muscle cell membrane reducing vascular smooth muscle contractility. It is cardioselective.
ADR: bradycardia
Non-dihydropyridine CCB
Diltiazem and verapamil (more selective)
This drug is a direct vasodilator that reduces intracellular calcium in vascular smooth muscle cells. It causes arteriolar dilation
Hydralazine
This drug is a direct vasodilator that causes potassium efflux with smooth muscle relaxation. It causes arteriolar dilation. It is now used for hirsutism
Minoxidil