Cardiology Medications

Question 1

Spironolactone

Answer 1

K+ sparing diuretic
tx of HF (often synergistically with loop diuretic)
DCM

SE: hyperkalemia (caution with ACE-I or ARB)

Question 2

Hydrochlorothiazide (HCTZ)

Answer 2

thiazide diuretic
tx for HTN (a first choice for African American without CKD)
DCM

SE: hypokalemia, gout, dyslipidemia
contra: sulfa sensitivity

Question 3

Furosemide (Lasix)

Answer 3

loop diuretic
tx for HF
mitral stenosis and regurgitation (decrease fluid overload)
DCM

SE: hypokalemia

Question 4

“-pril”

Answer 4

ACE Inhibitors (ie. lisinopril)
inhibits RAAS
tx for HF
aortic and mitral regurgitation
HTN
DCM (underdosing is a common error) - many start on captopril TID

SE: hyperkalemia, angioedema and acute renal failure
contra: renal artery stenosis, pregnancy

Question 5

“-sartan”

Answer 5

ARBs (Angiotensin II Receptor Blockers)
inhibits RAAS
tx for HF
HTN

SE: hyperkalemia, angioedema and acute renal failure
contra: renal artery stenosis, pregnancy

*essentially works the same as ACE-I

Question 6

“-dipine”

Answer 6

Ca2+ channel blockers (CCB) (ie. nifedipine)
vasodilators (decrease peripheral resistance)
tx of aortic regurgitation if ACE-I isn’t helping
stable angina/UA/NSTEMI/STEMI if sxs not relieved by beta-blocker or nitrates
HTN
Prinzmetal’s angina
HCM

SE: cardiodepressant, dizziness, h/a
contra: cardiac dysfunction, acute MI

*especially effective in black population

Question 7

“-olol”

Answer 7

Beta-blockers (ie. carvedilol, metropolol, propanolol)
tx of HF once pt is stable from ACE-I
first line for chronic angina (stable/UA/NSTEMI/STEMI)
HTN
DCM if sxs persist
HCM

SE: bradycardia, bronchospasm
contra: asthma, heart block, ADHF

• avoid abrupt cessation
• great for post MI, stable HF, increased CAD risk and often used in pregnancy

Question 8

methyldopa

Answer 8

Central Alpha Agonist
tx of HTN

SE: hepatitis, anticholinergic effects, hemolytic anemia
contra: liver failure

*most commonly used anti-HTN in pregnancy

Question 9

“-zosin”

Answer 9

Alpha Blocker
tx of HTN

SE: orthostatic hypotension, reflex tachycardia

*great for benign prostatic hypertrophy (BPH)

Question 10

aliskiren (tektuma)

Answer 10

Direct Renin Inhibitor
tx of HTN

SE: hyperkalemia, hypersensitivity rxns, renal impairment
contra: ACE-I or ARB in DM pts, pregnancy

Question 11

Statins

Answer 11

HMG-CoA reductase inhibitors (ie. lipitor, crestor)
first line tx for increasing LDL
dose range usually 10-80mg

SE: myopathy, elevated LFTs
take CoQ10 to decrease risk of myopathy

Question 12

Fibrates

Answer 12

stimulates lipoprotein lipase causing decreased VLDL secretion
decrease TGs
increase risk of myopathy when in combo with statin

Question 13

Nicotinic Acid (niacin)

Answer 13

Vitamin B3 OTC
decreased VLDL production
increase HDL

SE: cutaneous flushing

Question 14

Cholestyramine (Questran)

Answer 14

Bile acid sequestrants
increase fecal loss of bile salt-bound LDL
decreases LDL (not as much as statins)
*may INCREASE TGs (avoid in hypertriglyceridemia pts)

SE: constipation, flatulence, dyspepsia (indigestion)

Question 15

Ezetimibe (Zetia)

Answer 15

cholesterol absorption inhibitor
works on brush border of small intestines
decreased LDL
*often used in conjunction with other agents

Question 16

Omega 3 Fatty Acids

Answer 16

salmon, flax seed, soybean/canola oil and nuts
decrease TGs

AHA recommends 1g/day for CHD and 2-4g/day for hypertriglyceridemia