06 Drug list Flashcards
Thiazides
Diuretic, Hydrochlorothiazide, Metolazone
Hypertension, Heart Failure, Nephrogenic DI (with low NA), act on Distal tube, raises plasma
Lowers Na reabsorb, Higher K+ loss, Low blood volume, Raise CG toxicity, less effective in lean individual. Loop D. more powerful than thiazides and usually for acute use
Side effects: hypokalemia, Lower glucose tolerance, photosensitivity, hearing loss (loop)
Loop Diuretic
Diuretic, Furosemide
Heart Failure, Acute hypertension, edema, act on Loop of Henle, Lowers plasma
Lowers Na reabsorb, Higher K+ loss, Low blood volume, Raise CG toxicity, less effective in lean individual. Loop D. more powerful than thiazides and usually for acute use
Side effects: hypokalemia, Lower glucose tolerance, photosensitivity, hearing loss (loop)
Potassium Sparing
Diuretic, Spironolactone, (Aldosterone antagonist)
Hypertension, Heart Failure
Act on Collecting tube, no K+ loss, VG combo Rx, block ALD, block Na chan
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Acetazolamide
Diuretic
Glaucoma, Reverse alkalosis, Mountain s
Proximal tube, Carbonic A inhibitor, low use
Mannitol
Diuretic
Acute renal failure, Lower cranial p. Rx excretion
Proximal tube, Freely filtered, Increase osmolarity
Captopril
ACEI
Hypertension, Heart Failure, ACE inhibitors
Lower AT-II, Lower TPR, Lower Aldosterone, Lower SNS, Raise bradykinin
Side Effects: Cough, hyperkalemia, altered taste, glossitis, food reduces absorp.
Contraindications/Cautions: Low GFR, pregnancy
Lisinopril
ACEI
Hypertension, Heart Failure, ACE inhibitors
Lower AT-II, Lower TPR, Lower Aldosterone, Lower SNS, Raise bradykinin
Side Effects: Cough, hyperkalemia, altered taste, glossitis, food reduces absorp.
Contraindications/Cautions: Low GFR, pregnancy
Enalapril
ACEI
Heart Failure, Hypertension (acute and chronic)
ACEI, iv emergency HT, prodrug, T1/2 6 hr
Losartan
ACEI
Hypertension, Heart Failure
Type AT1 blocker (ARB), as per ACEI but no cough
Aliskiren
ACEI
Hypertension
Direct renin inihibitor, Lower angiotensin I, no cough
Propranolol
Beta-Adrenoceptor Antagonist, A-M Beta1 selective
Hypertension, angina, arrhythmias, tremor, migraine, hyperthyroidism, panic stress
Beta, non-selective, LA-action, No ISA; v. useful group, depression, insomnia
Contrainidications: Heart Failure, asthma, diabetes
Pindolol
Beta-Adrenoceptor Antagonist
Angina, Hypertension (arrhythmia)
Beta, LA-action, ISA, angina commonly
Timolol
Beta-Adrenoceptor Antagonist
Glaucoma, Hypertension, Angina, Arrhythmia
Beta, no LA-action, no ISA, glaucoma (lower secretion)
Metoprolol
Beta-Adrenoceptor Antagonist
Hypertension, Arrhythmia, Heart Failure, Angina, MI
Beta1, LA-action, no ISA, Arrhythmia, common agent
Atenolol
Beta-Adrenoceptor Antagonist Hypertension, Angina (common), MI, (Heart Failure) Beta1, no LA-action, no ISA Contrainidication: Pregnancy Lindsey LOVES you!
Sotalol
Beta-Adrenoceptor Antagonist
Arrhythmia
Beta, No LA-action, no ISA, block K+ (class III), Raise QT
Labetalol, Carvedilol
Beta-Adrenoceptro Antagonist
Hypertension, Heart Failure (carvedilol), Hypertensive crisis
Beta/Alpha, some Beta-agonist action (labetalol)
Verapamil
Calcium Channel Blocker Non-Dhp Hypertension, Angina, Arrhythmia Mainly Cardiac, Lowers Heart Rate, Edema, Constipation Drug Interactions: Cardiac Glycoside Contraindication/Caution: Heart Failure
Diltiazem
Calcium Channel Blocker Non-Dhp Hypertension, Angina, Arrhythmia Both cardiac and arterioles, Raises SNS, Lowers Heart Rate Contraindication/Caution: Heart Failure
Nifedipine
Calcium Channel Blocker Dhp Hypertension, Raynauds Disease, PAD Mainly arterioles, Raises Heart Rate, Edema, gingival hp. Contraindication: Heart Failure
Amlodipine
Calcium Channel Blocker
Dhp
Hypertension, Angina, Raynauds Disease, PAD
Mainly aterioles, Raises Heart Rate, Edema, Long acting
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Clonidine
Drug Acting on the Sympathetic NS
Hypertension, Opioid and nicotine withdraw (ADHD)
Alpha2, Lowers CNS sympathetic outflow, Lowers Norepinephrine release, rebound hypertension
Side effects: Dry mouth, sedation, impotence
Alpha-Methyl-Dopa
Drug Acting on the Sympathetic NS
Hypertension, Opioid and nicotine withdraw (ADHD)
Alpha2, Lowers CNS sympathetic outflow, Lowers Norepinephrine release, rebound hypertension
Side effects: Dry mouth, sedation, impotence
Alpha-methyl-dopa to Alpha-methyl-NE (alpha2 agonist, preg)
Phenoxybenzamine
Alpha-Adrenoceptor Antagonist
Pheochromocytoma (Acute and Chronic), Hypertension (Acute and Chronic)
Alpha1, irreversible
Side effects: Postural Hypotension, Reflex tachycardia, long acting
Phentolamine
Alpha-Adrenocetpor Antagonist
Pheochromocytoma, Acute Hypertension
Alpha, Competitive, Non-Selective
Side effects: Postural hypotension, Reflex Raise Heart rate
Prazosin
Alpha-Adrenoceptor Antagonist
Benign prostate hypertrophy, Hypertension (Acute and Chronic)
Alpha1, Competitive, No reflex tachycardia, First pass effect
Side effects: Postural hypotension, Nausea, Drowsiness
Terazosin
Alpha-Adrenoceptor Antagonist
Benign prostate hypertrophy, Hypertension (Acute and Chronic)
Alpha1, Competitive, No reflex tachycardia, First pass effect
Side effects: Postural hypotension, Nausea, Drowsiness
Dopamine
Misc. Agent
Shock to raised blood pressure (renal vasodil ?, D), Heart Failure
Alpha1, Beta1, D receptors, precursor to NE
Drug Interactions: MAOI
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Fenoldopam
Misc. Agent
Acute hypertension, Renal failure
D, A-receptor agonist
Side Effects: Raise Heart Rate, Raise ocular P., Lower K+
Hydralazine
Vasodilator
Hypertension, Heart Failure
Direct vasodilate, Mainly arterioles lowers TPR, Combo Rx
Side Effects: Reflex Raise SNS, flushing, palpitations, Lupus
Nitroprusside
Vasodilator
Actue Hypertension crisis and heart failure
Raise NO, Raise cGMP, veins and arterioles lowers TPR, iv only, toxic oral
Side effects: Cyanide toxicity, methhemoglobinemia
Minoxidil
Vasodilator
Hypertension, Heart Failure, Baldness
Open K+ channel, Hypertrichosis, Mainly arterioles, Lower TPR
Side effects: Reflex raise SNS, fluid retention, hyperglycemia
Diazoxide
Vasodilator
Hypertensive crisis
Open K+ channel, Hypertrichosis, Mainly arterioles, Lower TPR
Side effects: Reflex raise SNS, fluid retention, hyperglycemia
Digoxin
Cardiac Glycoside
Heart Failure, Arrhythmia
Inhibit Na/K ATPase, Raise [Ca++]i, Raise [Na+]i, Raise CO, Raise vagus activity, Low TI; kidney T 1/2 35 hr
Side Effects: Tachycardia, Visual halo, Nausea, Vomiting
T: VT/VF; AV block
Interactions: Raise toxicity, Ca++ blockers ie verapamil, diuretics, quinidine, CAs, Amiod
Lisinopril, Losartan
ACEI/ARBs
Hypertension, Heart Failure
Lower pre/afterload, Raise use HF, break neurohumoral cycle
Dobutamine
Beta1
Heart Failure (acute), Cardiac stimulant
IV, Raise CO, tolerance, may cause angina
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Milrinone, Amrinone
Inh. PDE3 Heart Failure (chronic and acute) Lower pre/afterload, Raise cAMP, [raise mortality, oral]
Metoprolol, Carvedilol, Bisoprolol
Beta Blockers
Heart Failure (only these are FDA approved), Angina, Arrhythmias, Hypertension
Lower SNS activity, Lower afterload, Raise use Heart Failure
Contrainidications/Cautions: Heart Failure if unstable, Bronchospasm, Severe decreased heart rate (low reserve)
Hydralazine, Bidil et al
Vasodilators
Hypertension, Heart Failure
Lower preload, Lowers afterload, Decrease mortality, not primary Rx
Nesiritide
Beta-naturiuretic peptide
Severe decomp Heart Failure (Class IV, acute, iv)
Raise cGMP to vasodilation, Lowers pre/afterload, 20 minutes
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Thiazides, Furosemide et al
Diuretics
Hypertension, Heart Failure
Lower Pre/afterload, Lower congestion (furosemide)
Drug Interactions: CG
Nicotine
Ganglionic Agent
Insecticide, Cigarettes
N-agonist, (blocker)
Toxicity: Convulsions, vomiting, cardiovascular system
Trimethapan
Ganglionic Agent
Lower Blood pressure during surgery, Nn-antagonists (competitive)
Not oral
Side Effects: PHT, mydriasis
Mecamylamine
Ganglionic Agent
Lower Blood pressure during surgery, Nn-antagonists (competitive)
Active Orally
Side Effects: PHT, mydriasis
Succinylcholine
Neuromuscular Junction Agent
NMJ paralysis, Depolarizing block, Short acting due to plasma AchE
Fasciculations, Not reversible, Atypical AchE, Malignant H, Hyperkalemia (delayed, burn/trauma)
Tubocurarine
Neuromuscular Junction Agent
NMJ paralysis, Competitive blockers, Small/fast nerves first (face/hands), then trunk, respiratory muscles last, Flaccid paralysis, Can reverse block with AchE inhibitors
Nm, Some histamine release and ganglia block
Gallamine
Neuromuscular Junction Agent
NMJ paralysis, Competitive blockers, Small/fast nerves first (face/hands), then trunk, respiratory muscles last, Flaccid paralysis, Can reverse block with AchE inhibitors
Nm, some M-receptor block
Other competitive agents eliminated: kidney and liver
Mivacurium
Neuromuscular Junction Agent
NMJ paralysis, Competitive blockers, Small/fast nerves first (face/hands), then trunk, respiratory muscles last, Flaccid paralysis, Can reverse block with AchE inhibitors
Short acting, 10-20 minutes, slight histamine release
Mivacurium hydrolysed by AchE, liver
Rocuronium
Neuromuscular Junction Agent
NMJ paralysis, Competitive blockers, Small/fast nerves first (face/hands), then trunk, respiratory muscles last, Flaccid paralysis, Can reverse block with AchE inhibitors
Fast onset (1-2 minutes), short-intermediate duration (30-40 minutes)
Kidney,
Pancuronium
-less histamine, more potent than tubocurarine,
-lack of ganglionic blockage
Neuromuscular Junction Agent
NMJ paralysis, Competitive blockers, Small/fast nerves first (face/hands), then trunk, respiratory muscles last, Flaccid paralysis, Can reverse block with AchE inhibitors
Dantrolene
Neuromuscular Junction Agents Malignant hyperthermia, Cerebral palsy Inhibit SR Ca release, Malignant H Drug of Choice Lindsey LOVES you!
Atracurium
Hoffman deg (cisAtracurium), safer for patients with renal or liver disease
