Cardiovascular

Cardiovascular Acetazolamide Hydrochlorothiazide Adenosine Labetalol Amiloride Mannitol Amiodarone Methyldopa Amlodipine Minoxidil Carvedilol Nesiritide Clonidine Nitroglycerin Digoxin Nitroprusside Diltiazem Propafenone Dofetilide Quinidine Enalapril Sotalol Esmolol Spironolactone Fenoldopam Valsartan Furosemide verapamil Hydralazine Acetazolamide Diuretic – Parasthesia Carbonic anhydrase inhibitor – Urinary stone formation Inhibits interconversion of carbonic acid & bicarbonate ↑ NaHCO3 excretion Inhibit aqueous humor formation Hyperchloremic metabolic acidosis – Tx open-angle glaucoma – Mtn sickness – Metabolic alkalosis Adenosine Antiarrhythmic – Transient asystole Purine nucleoside, cardiac node membrane stabilizer Opens K channels & blocks Ca influx in SA & AV nodes Slows AV conduction ↑ AV refractory period – Terminate SVT Amiloride K-sparring diuretic – Hyperkalemia Epithelial Na channel blocker Blocks Na Channel distal tubule & collecting duct – Inhibits Na reabsorption & K excretion – Prevent & Tx hypokalemia Amidarone Antiarrhythmic – Hypo/hyperthyroidism Cardiac ion channel blocker – Photosensitivity – Blue-gray skin – Corneal microdeposits Blocks K, Na, Ca channels & β receptors – Pulmonary fibrosis – Prolongs repolarization – ↑ refractory period – Slows HR – ↑ PR & QT intervals – SVT, VT, VF Amlodipine Antihypertensive, antianginal – HA Dihydropyridine Ca channel – Edema blocker – Hypotension Ca channel blocker in – Effects ↑ w/ grapefruit juice vascular smooth m. – Arteriolar vasodilation & ↑ coronary blood flow – HTN – Angina pectoris Carvedilol Antihypertensive & heart – Orthostatic hypotension failure Tx – Dizziness Nonselective adrenergic – Bradycardia receptor agonist Blocks β1, β2, α1 receptors – Cause vasodilation – HTN – Heart failure ↓ remodeling Clonidine Antihypertensive – Abrupt w/drawal severe rebound HTN α2 receptor agonist – Sedation – Dry mouth Central α2 receptor agonist – ↓ sympathetic outflow from vasomotor center – Inhibits pain neurotransmission in spinal cord – HTN – Opioid w/drawal Digoxin Cardiac stimulant – Arrhythmias Digitalis glycoside – N, V – Blurred vision Inhibits Na/K ATPase – Yellow vision – ↑ IC Ca & cardiac contractility – ↓ AV conduction – ↑ AV refractory period – Heart failure – Serum levels assess dosage & toxicity Diltiazem Vasodilator, antiarrhythmic – Dizziness Non-dihydropyridine Ca – Hypotension channel blocker – Peripheral edema – Constipation Block Ca channels in cardiac – Gingival hyperplasia tissue & vascular smooth m. – Vasodilation – Grapefruit juice ↑ serum levels – ↓ HR & conduction – ↓ contractility – HTN – Angina pectoris – SVT Dofetilide Antiarrhythmic – QT prolongation K channel blocker – Torsade de pointes Blocks delayed K channels in cardiac tissue – Slows repolarization & prolongs refractory period – ↑ QT interval – AF, A flutter – Monitor QT interval during initial dose titration Enalapril Antihypertensive – Cough & angioedema ACE inhibitor Inhibits bradykinin degradation Inhibits ACE &formation of AT II – Hypotension – Vasodilation – ↓ aldosterone secretion – Taste disturbances – ↑ CO – ↓ V remodeling – ↑ survival in heart failure – HTN – Heart failure – Post-MI – ↓ progression of diabetic nephropathy Esmolol Antiarrhythmic – Hypotension Class II – Bradycardia Selective β1 blocker Blocks SNS stim. SA &AV nodes – ↓ HR – ↓ AV conduction – ↑ AV refractory period – Sinus tachycardia & SVT during/after surgery – Rapidly metabolized by plasma esterase Fenoldopam Antihypertensive – ↓ serum K levels Monitor for hypokalemia D1-like receptor agonist D1 receptor agonist – Arteriolar vasodilation Afferent & efferent renal arterioles – ↑ renal blood flow – Hypertensive emergencies Furosemide Loop-acting diuretic – Hypokalemia Membrane ion transport inhibitor – Metabolic alkalosis – Hyperuricemia Inhibits Na/K/2Cl cotransporter in – Hypomagnesemia ascending loop of Henle – Blocks NaCl reabsorption – ↑ ototoxicity of aminoglycoside ABX – Edema – Heart failure – HTN – Hypercalcemia – ↑ Ca excretion – ↑ Na/K exchange in collecting duct Hydralazine Antihypertensive. heart failure – Edema Vasodilator – Reflex tachycardia & MI – Lupus syndrome Alters IC Ca metabolism – Relaxes arteriolar smooth m. vasodilation – ↓ afterload – Heart failure in combo w/ isosorbide dinitrate More effective than ACEI in black people – Moderate-severe HTN Hydrochlorothiazide Antihypertensive – Hypokalemia Thiazide diuretic – Metabolic alkalosis – Hyperuricemia & gout Inhibits NaCl transporter in distal tubule – ↓ excretion of lithium – ↑ excretion Na, K, Cl – ↓ Ca excretion – HTN – Nephrogenic DI – Nephrolithiasis Labetolol Antihypertensive – Postural hypotension – Abrupt w/drawal cause Adrenergic α & β life-threatening HTN, receptor antagonist arrhythmias, or MI Selective α1 & nonselective β1, β2 blockers – HTN Mannitol Diuretic – Electrolyte imbalances Osmotic Diuretic – Transient volume expansion Pulmonary edema or heart failure Osmotic attraction of edematous & ocular fluid Filtered by glomerulus – ↑ electrolyte excretion – Oliguric renal failure – Cerebral edema – ↑ ICP – Acute glaucoma Methyldopa Antihypertensive – Positive direct Coomb’s test Adrenergic α2 receptor agonist Converted to active form methyl-norepinephrine which activates central α2 receptor agonist – ↓ SNS outflow from vasomotor center – HTN – HTN in pregnancy Minoxidil Antihypertensive, hair growth – Systemic admin. stimulant Reflex tachycardia Vasodilator, K channel opener Angina pericarditis Pulmonary HTN Opens K channels in vascular hypertrichosis smooth m. – Hyperpolarization – m. relaxation – vasodilation Stim. resting hair follicle growth follicles – Severe HTN – Topical for alopecia Nesiritide Heart failure Tx – Hypotension Recombinant human B-type natriuretic peptide Activate guanylate cyclase ↑ cGaMP – Dilates venous & arterial smooth m. – ↓ venous pressure, cardiac preload, vascular congestion, & dyspnea – Decompensated heart failure Nitroglycerin Antianginal – HA Organic nitrate – Hypotension – Syncope – Reflex tachycardia Releases NO in vascular smooth m. – Vasodilation – ↑ vasodilative effect of – ↑ coronary blood flow sildenafil, tadalafil, vardenafil – ↓ myocardial O2 demand – Angina pectoris Sublingual or lingual admin. Short half-life Nitroprusside Antihypertensive – CN toxicity Vasodilator – Hypotension – HA Relaxes venous & arteriolar smooth m. – Metabolized to CN & thiocyanate Tx toxicity w/ sodium nitrite & sodium thiosulfate – HTN crisis – Acute heart failure or cardiogenic shock – Controlled hypotension during pregnancy Propafenone Antiarrhythmic – Proarrhythmic 1st 2 wks Class IC Na channel blocker Monitor ECG when starting Tx – GI disturbances Blocks Na channel in cardiac tissue – ↑ digoxin levels – ↓ conduction & prevent re- entry – ↑ PR, QRS, & QT duration – SVT & life-threatening V arrhythmias Quinidine Antiarrhythmic – Cinchonism Class IA Na channel blocker Blurred vision Tinnitus Photophobia Blocks Na & K channels in cardiac tissue – ↑ levels w/ – ↓ conduction Amiodarone – ↑ QRS & QT duration Cimetidine Diltiazem – SVT & VT Verapamil Grapefruit juice – D-isomer = quinine, used to treat malaria pts Sotalol Antiarrhythmic – Torsades de pointes Class III K channel blocker Blocks K channels in cardiac tissue – Prolongs repol. – ↑ refractory period & ↑ QT interval Blocks adrenergic β receptors – SVT & life-threatening arrhythmias Spironolactone K-sparring diuretic – Gynecomastia Aldosterone antagonist – Impotence – Hyperkalemia Blocks aldosterone receptors – ↑ Na excretion – ↓ K excretion – Primary hyperaldosteronism – HTN – hypokalemia Valsartan Antihypertensive Angiotensin receptor antagonist Blocks AT II receptor in vascular smooth m. & adrenal cortex – Vasodilation & ↓ aldosterone secretion – HTN – Nephropathy – Less cough & angioedema than ACEI Verapamil Antihypertensive, antianginal – Peripheral edema Non-dihydropyridine Ca channel – Constipation blocker – Gingival hyperplasia Blocks Ca channels in cardiac m. & vascular smooth m. – Vasodilation – ↓ HR & conduction – ↓ contractility Suppress contractility more than other Ca channel blockers – HTN – Angina pectoris – SVT – Prevent migraine HA.

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