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