Cardiac Drugs

Question 1

THIAZIDE DIURETIC:
Hydrochlorthiazide
Chlorthalidone, Indapamine, Metolazone

• MOA?
• Use?
• SE?

Answer 1

MOA: inhibit Na/Cl transporter in DCT

Use:
• HTN (first line), HF
• Hypercalceuria, Renal calcium stones
• Nephrogenic DI

SE:
• Hypokalemic metabolic alkalosis (K wasting)
• Hyper GLUC (hyperGlycemia, hyperLipidemia, hyperUricemia, hyperCalcemia)

Question 2

LOOP DIURETIC:
Furosemide
Bumetanide, Torsemide, Ethacrynic acid

• MOA?
• Use?
• SE?

Answer 2

MOA: inhibit Na/K/2Cl transporter in TAL

Use:
• HTN, HF, pulmonary edema
• Hypercalcemia, Acute renal failure, Anion overdose

SE:
• Hypokalemic metabolic alkalosis (K wasting)
• OH DANG (Ototoxicity, Hypokalemia, Dehydration, Allergy to sulfa, Nephritis, Gout)

Question 3

CNS SYMPATHETIC OUTFLOW BLOCKER: Clonidine

• MOA?
• Use?
• SE?

Answer 3

MOA: activates alpha-2 adrenergic receptors -> decrease sympathetic outflow

Use:
• HTN
• Cancer pain, Opioid withdrawal

SE:
• Rebound HTN (Antidote: Phentolamine)
• Sedation, Dry mouth

Question 4

CNS SYMPATHETIC OUTFLOW BLOCKER: Methyldopa

• MOA?
• Use?
• SE?

Answer 4

MOA: activates alpha-2 adrenergic receptors -> decrease sympathetic outflow

Use: Preecalmpsia

SE:
• Hemolytic anemia* ((+) Coomb’s test)
• Sedation

Question 5

GANGLION BLOCKERS: Hexamethonium
Trimethaphan, Mecamylamine

• MOA?
• Use?
• SE?

Answer 5

MOA: competitively blocks Nn nicotinic Ach receptors

Use: HTN (obsolete), HTN emergencies

SE:
• Postural hypotension
• Sympa and Parasympa blockade (dry mouth, blurred vision, constipation, sexual dysfunction)

Question 6

NERVE TERMINAL BLOCKERS:

1. Reserpine
2. Guanethidine, Guanadrel

• MOA?
• Use?
• SE?

Answer 6

MOA:

1. Irreversibly block the vesicular monoamine transporter (VMAT)
2. Inhibits vesicular release of NE from presynaptic neuron

Use: HTN (obsolete)

SE: Suicide, Severe depression, Sedation

Question 7

ADRENERGIC BLOCKERS: Prazosin
Tamasulosin
Doxazosin, Terazosin (longer duration of action than Prazosin)
Silodosin, Alfuzosu

• MOA?
• Use?
• SE?

Answer 7

MOA: Adrenergic antagonist (alpha 1 selective)

Use:
• BPH (Tamsulosin: most selective)
• HTN

SE:
• Orthostatic hypotension (give at bedtime)
• Reflex tachycardia
• Dizziness, Drowsiness, Headache, Weakness
• Asthenia, Nausea, Edema

Question 8

ADRENERGIC BLOCKERS:
Propanolol
Pindilol, Timolol, Labetalol
Carvedilol, Nadolol, Levobunolol, Metipranolol
Betaxolol, Bisoprolol, Nebivolol

• MOA?
• Use?
• SE?

Answer 8

MOA:
• blocks beta 1 & 2 receptors
• reduce renin release
• blocks sympathetic efferents on heart and BP

Use:
• HTN, Angina prophylaxis, Arrythmia
• Migraine, Performance anxiety
• Hyperthyroidism, Glaucoma (Metipranolol)
• Pheochromocytoma (Labetalol, Carvedilol)

SE: 
• Bronchospasm
• AV block, HF
• CNS sedation, Erectile dysfunction
• Masks hypoglycemia in diabetics: Carvedilol, Labetalol