CV meds Flashcards
May cause hypokalemia, myositis, and is hepatotoxic
Gemfibrozil
This antihypertensive should not be used in raynaud’s or peripheral vascular disease
Atenolol
Concommitant alcohol use results in severe hypotension. This medication is also potentitated by aspirin
Nitroglycerin
In hypothyroidism, this medication must be decreased. In hyperthyroidism and high fever, this medication dosage should be lowered
Digoxin
Inotropic and chronotropic medication that is a class II antiarrhythmic
Beta-blockers (atenolol, propranolol)
This medication should not be abruptly stopped because of risk of rebound hypertension and tachycardia. It s also contraindicated in asthma, AV blocks, and severe bradycardia
Carvedilol (beta-blocker)
Hydrochlorothiazide
i. ) Clinical Use
ii. ) Mechanism
a. ) HTN
b. ) CHF & Edema
c. ) Urolithiasis prevention & idiopathic hypercalciuria
d. ) Nephrogenic Diabetes Insipidus
a. ) Thiazide diuretic that acts in the DISTAL tubules & Ascending loop of henle. b. ) Increases sodium & potassium excretion c. ) Decreases hypercalciuria
Hydrochlorothiazide
iii. ) Side Effects
iv. ) Contraindications
a.) Hyponatremia, Hypokalemia, Hypomagnesemia
b.) Hyperglycemia
c.) Hyperlipidemia
d.) Hyperuricemia (imparied renal function)
e.) Hypercalcemia
Mneumonic = HyperGLUC + hypoM(i)NK
**Sulfa drug allergies
a. ) Anuria b. ) Electrolyte imbalances c. ) Sulfa allergies d. ) hepatic failure e. ) SLE f. ) DM
Hydrochlorothiazide
v. ) Interactions
vi. ) Monitoring Parameters
a. ) Supplement with minerals (Mg, K)
b. ) Avoid large calcium doses (to prevent hypercalcemia)
c. ) Interferes with anticoagulants
d. ) Potentiates digoxin and lithium toxicity
e. ) Interferes with oral hypoglycemics
f. ) NSAIDs decrease effects
a.) Monitor Calcium levels
This medication should not be given to people with ventricular arrhythmias but is used clinically in atrial fibrillation
Digoxin
This antihypertensive may also be used to treat urolithiasis because it reduces hypercalciuria
Hydrochlorothiazide
Carvedilol
i. ) Clinical Use
ii. ) Mechanism
a. ) Mild-to-Severe Heart failure (left ventricular dysfunction)
a. ) Non-selective Beta-Blocker
Carvedilol
iii. ) Side Effects
iv. ) Contraindications
a. ) Fatigue
b. ) Hypotension, dizziness
c. ) Hyperglycemia
d. ) Weight gain
e. ) Diarrhea
a. ) Asthma b. ) AV block c. ) Severe bradycardia d. ) Severe hepatic dysfunction
Carvedilol
v.) Interactions
vi.) Monitoring Parameters
v. ) Interactions
a. ) Inhibited by Fluconazole, Ketoconazole, NSAIDs & Sulfonamides
b. ) Serum levels increased by Clonidine and Cimetidine
vi. ) Monitoring Parameters
* *do NOT abruptly withdrawal Beta blockers -> rebound hypertension and tachycardia
Class III antiarrhythmic with some Class I and Class II effects
Amiodarone
Class I = Sodium Channel Blockers
Class II = Beta-blockers
Class III = Potassium Channel Blockers
Nitroglycerine
i. ) Clinical Use
ii. ) Mechanism
i. ) Clinical Use
a. ) Angina
b. ) Acute MI & Hypertensive Crisis (IV)
c. ) CHF
d. ) Topically applied for Raynaud’s syndrome
ii. ) Mechanism
a. ) Releases Nitric Oxide causing vasodilation
Nitroglycerine
iii. ) Side Effects
iv. ) Contraindications
iii. ) Side Effects
a. ) Postural Hypotension
b. ) Reduced efficacy over time
c. ) Reactive Tachycardia
d. ) Increased Oxygen consumption
iv. ) Contraindications
a. ) Discontinue if Blurry Vision or a Dry Mouth Occurs
b. ) Severe Anemia (because oxygen consumption is increased)
c. ) Glaucoma
d. ) Hypotension (because it vasodilates and may lower BP)
e. ) Hypertrophic Cardiomyopathy
Nitroglycerine
v.) Interactions
v. ) Interactions
a. ) Concommitant alcohol use results in severe hypotension
b. ) Potentiated by aspirin
c. ) Hypotension with calcium channel blockers and sildenafil (viagara)
d. ) Interferes with heparin
e. ) N-acetylcysteine helps reduce nitrate tolerance
***Titrated Withdrawal to prevent rebound angina
Amiodarone
i. ) Clinical Use
ii. ) Mechanism
i. ) Clinical Use
a. ) Serious ventricular arrhythmias
b. ) Chemical cardioversion of atrial fibrillation
* *Not a 1st line antiarrhythmic because of significant toxicity
ii. ) Mechanism
a. ) class III antiarrhythmic (potassium channel blocker) but it also mimics class I (sodium channel blockers) and class II (beta-blockers) meds
b. ) Delays depolarization in the SA node
Amiodarone
iii. ) Side Effects
iv. ) Contraindications
v. ) Interactions
a. ) Has a very long half-life
b. ) May alter thyroid function
iii. ) Side Effects
a. ) Hypotension, Bradycardia, CHF
b. ) Pulmonary Fibrosis
c. ) Hepatoxicity
d. ) Hypothyroidism/Hyperthyroidism (Amiodarone is 40% iodine by weight)
e. ) Skin deposits (grey/blue) resulting in photodermatitis
f. ) Corneal Deposits
iv. ) Contraindications
a. ) Sinus-node dysfunction
b. ) Second- or third-degree AV block
c. ) Bradycardia causing syncope
d. ) Breastfeeding
Amiodarone
v.) Interactions
a. ) Has a very long half-life
b. ) May alter thyroid function
Antihypertensive that reduces the efficacy of salbutamol and salmeterol
Propranolol
Contraindicated with glaucoma, and should be discontinued at the onset of blurry vision and/or dry mouth
Nitroglycerin
Side effects is most notably affecting the thyroid because 40% of its molecular weight is iodine. Therefore administration of this medication requires vigilant monitoring of thyroid function
Amiodarone (anti-arrhythmic)
Antihypertensive and chronotropic that enhances the effects of digitalis
Atenolol
Spironolactone
i. ) Clinical Use
ii. ) Mechanism
i. ) Clinical Use
a. ) Hyperaldosteronism
b. ) Hypokalemia
c. ) CHF with edema (can be paired with ACE inhibitor)
d. ) Hirsutism
ii. ) Mechanism
a. ) Potassium-sparing Aldosterone Receptor Antagonist in the distal renal tubules
b. ) Increases sodium and water excretion while sparing potassium
This cholesterol medication potentiates warfarin and increases the risk of myopathy when combined with statins
Gemfibrozil
Used to treat bradycardia, uveitis, and hyperhydrosis
Atropine (Muscarinic Antagonist)
Can be applied topically for Raynaud’s Syndrome because it increase nitric oxide release and subsequent vasodilation
Nitroglycerin
Spironolactone
iii. ) Side Effects
iv. ) Contraindications
iii. ) Side Effects
a. ) Hyperkalemia leading to arrhythmias
b. ) Gynecomastia & Antiandrogen effects
iv. ) Contraindications
a. ) Renal Impairment & Anuria
b. ) Hyperkalemia
Spironolactone
v. ) Interactions
vi. ) Monitoring Parameters
v. ) Interactions
a. ) Avoid potassium supplements & other potassium-sparing diuretics
vi. ) Monitoring Parameters
a. ) Potassium levels
Atropine
i. ) Clinical Use
ii. ) Mechanism
i. ) Clinical Use
a. ) Bradycardia & Heart Block
b. ) Uveitis
c. ) Hyperhydrosis
d. ) Organophosphate poisoning (components of insecticides)
e. ) PUD
ii. ) Mechanism
a. ) Muscarinic (Acetylcholine) Antagonist
*Acetylcholinesterase inhibitors (excess acetylcholine) cause the following symptoms: Diarrhea, Urination, Miosis, Bronchospasms, Bradycardia, Excitation of skeletal muscles, Lacrimation, Sweating, & Salivation.
Because Atropine is a muscarinic antagonist, it can be used as the antidote to AchE inhibitors, or for conditions such as bradycardia and hyperhydrosis
Atropine
iii. ) Side Effects
iv. ) Contraindications
iii. ) Side Effects
a. ) Dry mouth/eyes
b. ) Blurred vision & Photophobia (Mydriasis)
c. ) Confusion & hallucinations (CNS excitability)
d. ) Tachycardia & Ventricular fibrillation
iv. ) Contraindications
a. ) Closed-Angle Glaucoma (causes mydriasis)
b. ) IHD
Atropine
v.) Interactions
Antidotes
v. ) Interactions
a. ) Counteracts bradycardia drugs
Antidotes: physostigmine & pilocarpine
This cardiovascular medication inhibits Na-K pump in myocardial cells that corresponds with an increase in intracellular calcium and a longer action potential
Digoxin
Lisinopril
i. ) Clinical Use
ii. ) Mechanism
i. ) Clinical Use
a. ) HTN
b. ) CHF
c. ) Prevention of Diabetic Nephropathy
ii. ) Mechanism
a. ) ACE inhibition - Suppresses the synthesis of Angiotensin II (vasoconstrictor) & prevents the breakdown of bradykinin (a potent vasodilator)
