Cardiac Drugs

Question 1

Cardiac Glycosides (Digoxin)

Answer 1

Tx of HF & dysrhythmias. 0.5-2 therapeutic lvld, hypokalemia = increase toxicity, Hold <60 BPM, IV push 5 min, adverse = fatigue, anorexia, bradycardia. Toxic = HA vertigo, phtophobia, halos, tachycardia, AV heart block. Antidote = Digibind.

Question 2

Milrinone (Primacor) & Inamrinone (Inocor)

Answer 2

Short-term HF. Adverse = V. arrhythmias, hypotension, chest pain, HA, hypokalemia, tremors, thrombocytopenia. Reserved for pt not responding to ACE I or Digoxin.

Question 3

Direct Vasodilators - Nesiritide (Natrecor)

Answer 3

Acute HF for pt w/ dyspnea @ rest or minimal activity. Adverse = arrhythmias, hypotension, HA, fainting, anxiety. Reduce or Stop w/ hypotension. Need baseline creatinine level, cont. to monitor, can be nephrotoxic w/ acute HF

Question 4

Nitroglycerin or Isorbide (Isordi)

Answer 4

Tx of stable & unstable agina. Most common adverse = HA. Hypotension, tachycardia, contact dermatitis. Contraindicated = preexisting hypotension, head trauma, Increased ICP & pericardial tamponade. Adequate hydration. IV pump, hold systolic BP > 100. Store in dark place, replace Q6 mo. Admister up to 3 tabs SL every 5 min.

Question 5

Beta Blockers - Atenlol, Metoprolol, Propanolol

Answer 5

Tx: Angina (esp. exercise), hypotension, dysrhythmias, & MI. Unlabeled use migranes, tachycardia ass. w/ stage fright. Adverse = bradycardia, hypotension, 2&3 degree heart block, fatigue, lethargy, depression, wheezing, dyspnea, impotence, decreased libido, alt. glucose & lipids. Hold HR < 60. Withdraw gradually. NO Asthma or DM pt’s

Question 6

Calcium Channel Blockers - Amlodipine (Norvasc), Diltiazem (Cardizem), Ranolazine (Ranexa)

Answer 6

Mngt: angina, HTN, dysrhythmias, migranes & Raynaud’s. Adverse = bradycardia, tachycardia, heart block, dyspnea, wheezing, GI complaints, dermatitis. Reduce w/ liver disease & caution. Taper dose.

Question 7

Alpha Adrenergic Agonists - Clonidine (Catapres), Methyldopa (Aldomet)

Answer 7

Tx: Antihypertensive, Mngt of opiod w/drawl. Adverse: Most common is orthostatic. Adverse = brady or reflex tachycardia, sedation, dizziness, HA. Do not stop abruptly. Aldomet = common for PIH.

Question 8

ACE Inhibitor - CaptoPRIL, EnaPRIL, LinsinoPRIL, MoexPRIL, RamiPRIL

Answer 8

HTN MI, HF. Adverse = dry nonproductive cough, dizziness, fatigue, HA, hypotension, chest pain, tachycardia, hyperkalemia, hypermagnesemia. Serous = Angioedema. Monistor K+ & Mg+. Enhances thiazide diuretics.

Question 9

Angiotensin II Receptor Blockers (ARBS) - LoSARTAN, OlmeSARTAN, ValSARTAN

Answer 9

Anti-HTN, adjunctive therapy for HF. Adverse = HA, upper resp. infection, dizziness, GI complaints, fatigue. Potent vasodilator. Combo therapy for mngt of HTN.

Question 10

Direct-Acting Vasodilators - Hydralazine (Apresoline), Nitroprusside (Nipride)

Answer 10

Tx: Anti-HTN. Adverse = HA, dizziness, reflex tachycardia, hypotension, rebound HTN, hyperglycemia, Na+ & H2O retention. Monitor I&O’s, blood glucose. Nipride = emergency mngt of HTN, titrated IV infusion. VS frequent, cardiac monitor. Adverse effects eliminate use as drugs of first choice.