Cardiac HTN hyperlipidemia Flashcards
(17 cards)
DIURETICS
Thiazide
Loop
Potassium sparing
ADR’s
hctz, chlorathalidone, indapamide, metolozone
furosemide, torsemide, bumetanide
trimaterene, spironolactone, amiloride, inspra
hypotension, decreased GFR, hypo/hyperkalemia, electrolyte abnormalities, metabolic alkalosis, hyponatremia
DIURETICS
Inspra
Thiazide- caution with
Loop potential for cross sensitivity with
new, potassium sparing, many interactions (NSAIDS, grapefruit juice, azoles, CCB’s
ACEI ARB BB K+ replacement (SO MANY CARDIC MEDS)
hyperlipidemia, high dose increase hypokalemia, uric acid levels, CV outcomes
sulfa
ACEI
how they work?
Lowers? without lowering?
Strong evidence for:
What do these end in?
Caution with?
SE
inhibit ACE decrease angiotensin and aldosterone
lower PVR without CO or GFR
decrease risk CV cerebro-vascular risk HF slows renal disease, decrease remodeling after MI, reduce affect of diabetes on kidneys, improve insulin sensitivity
PRIL
AA asians- angioedema
cough, angioedema
ARB
end with?
Combined with?’
How many times a day?
artan (losartan, valsartan)
hctz
once a day
CCB
Examples: Type I type II
Metabolized by
Caution with
ADR
Patient education
I- diltiazem, verapamil
II- dipine or pidine endings (nifedipine/procardia, **amlodipine/norvasc, felodipine)
Liver
LIVER PATIENTS (pregnancy C)
constipation, dizziness, gingival hyperplasia
no NSAIDS, alcohol
GERD sx increase (decreased SM)
Alpha 2 agonist
example
how it works
clonidine
vasodilator centrally
Alpha blockers
Action
Treat
Examples- most end with??
block alpha receptors- vasodilatoin
HTN BPH raynauds migraine
OSIN- prazosin, terazosin (HTN)
alfuzosin, silodosin, tamulosin (BPH)
doxazosin (HTN, BPH)
Beta blockers
action
block effects catecholamines
selective non selective
mainly HTN post MI
Pregnancy
drugs of choice
avoid?
methyldopa, beta blockers, vasodilators
acei, arb
HYPERLIPIDEMIA
Groups
CAD
Familial LDL>190
LDL 70-189 (no CAD, have diabetes)
LDL 70-189 (no CAD or diabetes, but 10 year risk)
HMG CoA reductase inhibitors
Fibrates
Bile acid sequestrants
Other
statins
MOST HAVE FIBR in the name- gemifibrozil, micronized fenofibrate, bezafibrate
MOST HAVE COL or CHOL- cholestyramine, colestipol, colesevelam
Niacin, zetia
HMG CoA reductase inhibitors (STATINS)
block synthesis?
decrease
Pregnancy?
Why two are okay in with interactions like azoles?
Interactions?
ADRS?
Contraindicated in?
Children?
cholesterol
LDL
category X
fluvastatin, rosuvastatin
SO MANY- cardiac (verapimil, diltiazem-ccb) azole, erythromycin, fluoxetine, protease inhibitors, rifampin, phenytoin, phenobarbital, cyclosporin
Myalgia, fatigue, muscle soreness- stop therapy
Active liver disease
Pravastatin only FDA
Intensity of statin therapy
High decrease ldl >50
Mod decrease ldl 30-50
Low (usually not on) decrease <30
Fibrates
effective at lowering?
Good for which patients?
Do not produce substantial reduction in?
Adr?
Interactions?
triglycerides
DM type II, familial lipid
LDL
n/d, cholelithiasis, phototox, CONSTIPATION
CONCURRENT USE statins/niacin- HEPATOTOXICITY
WARFARIN** protein binding displacement
Bile acid sequestrants
Action
Not metabolized by
Okay with what patients?
Can be used with?
ADR?
Interactions?
increase bile acid secretion, enhance conversion cholesterol to bile, increase uptake ldl
bind in intestine, not in liver
LIVER disease patients
Fibrates
constipation, bloating
Interferes with absorption of meds
Niacin
adjunctive with
give what 30 min prior
ADR
Interactions
bile acid sequestrant or statin
aspirin to reduce flushing
flushing, abdominal, increase PUD
ALCOHOL (hepatotoxicity)
STATINS, FIBRATES (increase risk of hepatotoxicity or myalgia although see above can be used with statin)
Zetia
pregnancy?
not recommended
category C
