CARDIO Formulary (cad & hf) Flashcards
Non-DHP CCB
diltiazem, verapamil
Diltiazem brand name
Cardizem, Tiazac
Diltiazem doses
IR- 80-120 mg TID
XR- 180-360mg QD
Diltiazem AEs
Reduced myocardial contractility (V>D), AV/SA nodal conduction disturbances, bradycardia, AV block, Hypotension, HA, flushing, Constipation (V>D)
Diltiazem Monitoring
goal hr, constipation, av nodal disturbances
verapamil brand
Verelen, Calan, Isoptin
verapamil dosing
ir- 60-90mg TID or QID
sr- 240mg qd
verapamil AEs
Reduced myocardial contractility (V>D), AV/SA nodal conduction disturbances, bradycardia, AV block, Hypotension, HA, flushing, Constipation (V>D)
verapamil monitoring
goal hr, constipation, av nodal disturbances
DHP CCB
amlodipine, felodipine ER, nifedipine XL
nifedipine
Amlodipine brand
Norvasc
Amlodipine doses
5-10 mg qd
amlodipine AEs
Hypotension, flushing, HA, dizziness, PERIPHERAL
EDEMA (arteriole vasodilation), reduce myocardial
contractility, reflex adrenergic activation
amlodipine monitoring
blood pressure, HR, edema
felodipine ER brand
Plendil
felodipine ER doses
5-10mg qd
felodipine ER AEs
Hypotension, flushing, HA, dizziness, PERIPHERAL
EDEMA (arteriole vasodilation), reduce myocardial
contractility, reflex adrenergic activation
felodipine ER monitoring
blood pressure, HR, edema
nifedipine XL
nifedipine brand
Procardia-XL
nifedipine XL
nifedipine doses
30-60 mg qd
10-20mg tid
nifedipine XL
nifedipine AEs
Hypotension, flushing, HA, dizziness, PERIPHERAL
EDEMA (arteriole vasodilation), reduced myocardial
contractility, reflex adrenergic activation
nifedipine XL
nifedipine monitoring
blood pressure, HR, edema
Nitrates
isosorbide mononitrate
isosorbide dinitrate
nitroglycerin
(SL, patch, IV)
nitroglycerin
(SL, patch, IV) brands
Nitrostat (SL tab), Nitrolingual (spray),
Nitro-Dur (patch), Nitro-Bid (ung)
nitroglycerin
(SL, patch, IV) doses
300-600 mcg SL tab acutely
2.5-26 mg BID to QID chronic
0.4 mg/spray acutely
5-20 mcg/min IV acutely
0.2-0.8 mg/hr patch (on 12h, off 12h)
nitroglycerin
(SL, patch, IV) AEs
Headache (throbbing, pulsating), hypotension,
lightheadedness, dizziness, facial flushing,
reflex tachycardia
nitroglycerin
(SL, patch, IV) monitoring
Blood pressure (hypotension),
HR (tachycardia), diary that lists # of NG
doses used per week, how many episodes
of chest pain encountered, do not use with PDEI, use APAP for HA
isosorbide mononitrate brand
Imdur
isosorbide mononitrate doses
ir- 10-20mg bid
er- 30-240mg qd
isosorbide mononitrate AEs
Headache (throbbing, pulsating), hypotension,
lightheadedness, dizziness, facial flushing,
reflex tachycardia
isosorbide mononitrate monitoring
Blood pressure (hypotension),
HR (tachycardia), diary that lists # of NG
doses used per week, how many episodes
of chest pain encountered, do not use with PDEI, use APAP for HA
isosorbide dinitrate brand
isordil
isosorbide dinitrate doses
ir- 5-40mg bid to tid
er/sr- 40-80mg qd
isosorbide dinitrate AEs
Headache (throbbing, pulsating), hypotension,
lightheadedness, dizziness, facial flushing,
reflex tachycardia
isosorbide dinitrate monitoring
Blood pressure (hypotension),
HR (tachycardia), diary that lists # of NG
doses used per week, how many episodes
of chest pain encountered, do not use with PDEI, use APAP for HA
b1 selective beta blockers
atenolol, bisprolol, metroprolol succinate, nebivolol
b1 selective and non-selective beta blockers AEs
Bradycardia, sinus arrest, AV block, reduced LVEF
(b/c decreased contractility), fatigue, depression,
nightmares, sexual dysfunction, intensify insulin-
induced hypoglycemia, peripheral vascular
complication, B-blocker withdrawal syndrome
(causes angina), bronchoconstriction (non-
selective only)
atenolol brand
tenormin
atenolol doses
50-100mg qd
b1 selective and non-selective beta blockers monitoring
Goal HR (rest: 50-60 bpm, exercise: <100 or
75% of anginal HR), painful episode journal
and NTG use, caution asthmatics
bisoprolol brand
zebeta
bisprolol doses
initial: 1.25mg qd
target: 10mg qd
metropolol succinate brand
troprol xl
metoprolol succinate doses
initial: 12.5mg- 25mg qd
target: 200mg qd
nebivolol brand
bystolic
nebivolol doses
5-40mg qd
non-selective beta blocker
propranolol
propranolol brand
hemangeol, inderal
propranolol dose
80-160mg qd
tPA mimic
alteplase, reteplase, tenecteplaase
tPA mimics AEs
bleeding
tPA mimics monitoring
Bleeding, angioedema, hx of stroke, peptic
ulcer, severe HTN, or trauma
alteplase brand
activase
altplase doses
15mg bolus, 0.75mg/kg over 30 min, 0.5mg/kg over 60 min
reteplase brand
retevase
reteplase dose
10u bolus, 10u boluse after 30 min
tenecteplase brand
TNKase
tenecteplase doses
30mg if <60kg, 35mg if 60-70kg, 40mg if 70-80kg, 45mg if 80-90, 50mg if >90kg
LMWH
enoxaparin
enoxaparin brand
lovenox
enoxaparin dose
prophylaxis -30mg sc q12h or 40mg sc qd
treatment- 1mg/kg q12h or 1.5mg/kg qd
0.5mg/kg iv bolus
enoxaparin AEs
bleeding, injection site rash, fever
enoxaparin monitoring
CBC with platelet, SCr, fecal occult blood,
anti Xa levels
Factor Xa inhibitor
fondaparinux
fondaparinux brand
arixtra
fondaparinux dose
2.5mg sc qdaily
fondaparinux AEs
bleeding
fondaparinux Monitoring
anti Xa levels, scr
direct thrombin inhibitor
bivalirudin
bivalirudin brand
angiomax
bivalirudin dose
0.7mg/kg, then 1.75mg/kg/hr
bivalirudin AEs
hypotension, nausea, bleeding, muscle ache, HA
bivalirudin monitoring
activated clotting time, signs of bleeding
thiazides
hydrochlorothiazide
hydrochlorothiazide brand
microzide, esidrix, hydrodiuril
hydrochlorothiazide dose
initial: 25mg/day
max: 50mg/day
hydrochlorothiazide AEs
Hypokalemia, hypomagnesemia, hypercalcemia,
hyperuricemia, hyperglycemia, hyperlipidemia,
sexual dysfunction, Li toxicity
hydrochlorothiazide monitoring
CI with sulfa allergy or anuria, K+, Mg2+,
Ca2+, uric acid, blood glucose, lipids
Class V antiarrhythmic
digoxin
digoxin brand
lanoxin, digitalis, digox
digoxin dose
0.125mg-0.25mg daily
digoxin AEs
nausea, vomiting, dizziness, HA, thrombocytopenia
digoxin monitoring
Serum digoxin, K+, Ca2+, Mg2+, SCr, signs of
digoxin toxicity
ARN/ARB
sacubitril/valstartan
sacubitril/valsartan brand
entresto
sacubitril/valsartan AEs
Hypotension, hyperkalemia, dizziness, angioedema
sacubitril/valsartan monitoring
scr, K+, angioedema
anticoagulant
heparin
heparin brand
hemochron, hep-lock
heparin dose
80u/kg iv bolus, then 18u/kg/hr infusion
heparin AEs
bleeding, thrombocytopenia, osteoporosis, hypersensitivity
heparin monitoring
aPTT, signs of bleeding
late iNa blocker
ranolazide
ranolazide brand
ranexa
ranolazide dose
500-1000mg bid
ranolazide AEs
constipation, nasuea, dizziness, ha, dose-related increase in QT-interval
ranolazide monitoring
Don’t use with strong 3A4 inhibitors or
inducers or drugs that also prolong QT interval,
watch renal function
alpha 1 antagonist + nonselective beta blockers
labetalol, carvedilol
alpha 1 anatagonist + non selective beta blockers AEs
Orthostatic hypotension, tingling of skin, nausea,
dizziness, fatigue, see B-blockers
alpha 1 antagonist + non selective beta blockers monitoring
bp, hr
labetalol brand
normodyne, trandate
labetalol dose
200-400mg bid
carvedilol brand
coreg
carvedilol dose
initial: 3.125mg bid or 10mg qd
target: 25mg bid or 80mg qd
Decrease TG
omega-3 fatty acid
omega-3 fatty acid brand
lovaza
omega-3 fatty acid dose
4g qd
omega-3 fatty acid AEs
burping, indigestion, bad taste in mouth, smelly breath
omega-3 fatty acid monitoring
TG, LDL-C, liver function tests
HCN inhibitor
ivabradine
ivabradine brand
corlanor, procoralan
ivabradine dose
2.5-5mg bid, adjust q2w based on hr
max- 7.5bid
ivabradine AEs
afib, bradyarrhythmia
vassopressor
dobutamine, dopamine
ivabradine monitoring
HR, bradyarrhythmia
dobutamine brand
dobutrex
dobutamine AEs
angina, tachyarrhythmia, HA, dyspena
Dobutamine monitoring
ECG, HR, BO, pulmonary wedge pressure, CO, K+
dopamine brand
inotropin, dopastat
dopamine dose
2-50mcg/kg/min
dopamine AEs
chest pain, HTN, palpitations, tachycardia, HA, Anxiety, dyspnea
dopamine monitoring
ECG, BP, HR, SCr, CVP, caution extravasation
COX-1 inhibitor
aspirin
aspirin dose
75-162mg qd
aspirin AEs
gi bleeding, intercrannial bleeds, hypersensitivity, major bleeding
aspirin monitoring
bleeding, gi ulcers
furosemide dosing HF
initial- 20-40mg QD or BID
usual- 20-60mg QD or BID
torsemide dosing HF
initial- 10-20mg QD
usual- 10-80mg QD
spironolactone dosing HF
crcl> 50
- initial: 12.5 - 25mg QD
-maintenance: 25mg QD
crcl<50
-initial: 12.5 QD or every other day
-maintenance: 12.5-25 mg QD
eplerenone dosing HF
crcl>50
- initial: 25mg QD
-target: 50mg QD
crcl< 50
-initial: 25mg every other day
-maintenance: 25mg QD
sacubitril/valsartan dosing HF
high dose- 49/51mg BID; max - 97/103 mg BID
low dose- 24/26mg BID
hydrochlorothiazide brands HF
esidrix, hydrodiuril
hydrochlorothiazide dosing HF
initial- 25mg QD
max- 100m QD
enalapril dosing HF
initial- 2.5-5mg
target- 10mg bid
captopril dosing HF
initial- 6.25-12.5mg TID
target- 50mg TID
lisinopril dosing HF
initial- 2.5-5mg QD
target- 20-40mg QD
quinapril dosing HF
initial- 5-10mg BID
target- 20-40md BID
ramipril dosing HF
initial- 1.25-2.5mg QD
target- 5mg BID or 10mg QD
fosinopril dosing HF
initial- 5-10mg QD
target- 40mg QD
losartan dosing HF
initial- 25-50mg
target- 150mg
valsartan dosing HF
initial- 20-40mg BID
target- 160mg BID
candesartan dosing HF
initial- 4mg QD
target- 32mg QD
bisoprolol dosing HF
initial- 1.25mg QD
target - 10mg QD
carvedilol dosing HF
initial- 3.125mg BID
target- 25-50mg BID
CR
- initial: 10mg QD
-target: 80mg QD
metoprolol tartrate dosing HF
initial-12.5-25mg QD
target- 200mg QD
SGLT2 inhibitors HF
dapagliflozin and empagliflozin 10mg QD
hydralazine dosing HF
initial- 25mg TID/QD
target-75mg TID
max- 100mg TID
isdn dosing HF
initial- 20mg TID/QD
target- 40mg TID
max- 80mg TID
ivabradine dosing HF
2.5mg BID, adjust q2 weeks based on HR
digoxin dosing HF
0.125-0.25mg QD