Cardio Pharm Indications Flashcards
Nifedipine
Anti-HTN. Used in conjunction with beta blocker to prevent reflex tachy. Contraindicated post-MI./CHF.
Amlodipine
Anti-HTN. Used in conjunction with beta blocker to prevent reflex tachy. Contraindicated post-MI./CHF
Diltiazem
Paroxysmal supraventricular dysrhythmias. Not as strong as Verapamil, low side effects. Not effective against HTN.
Verapamil
Paroxysmal supraventricular dysrhythmias, angina (decreases demand for O2 and increases coronary blood flow, HTN (reduces SVR).
Furosemide
Anti-HTN, CHF.
HCTZ (hydrochorthiazide)
First line for uncomplicated Anti-HTN. SEs: sulfa allergy, hypokalemia, insulin resistance, increased TG + LDL.
Losartan
Anti-HTN, can be used to treat aortic dilation.
Enlalapril
Anti-HTN.
Direct Renin Inhibitors
Anti-HTN. Not really used.
Phenoxybenzamine
3rd line Anti-HTN. Also used in treatment of BPH.
Prazosin
3rd line Anti-HTN. Also used in treatment of BPH.
Doxazosin/Terazosin
3rd line Anti-HTN. Also used in treatment of BPH.
Clonidine
Anti-HTN, (Watch out for brady), rebound HTN after discontinuation is a big problem.
Spironolactone
Anti-HTN.
Hydralazine
Used for HTN during preg, pre-ecclampsia, usually in combo w/ beta blockers to prevent reflex SNS. Tox: excessive dilation – flushing, sweating, hypotension, angina, palps, Lupus-like.
Sodium nitroprusside
Drug of choice for HTN emergency! Rapid onset, IV. Use beta blockers before withdrawing infusion.
Nitrates
Anti-HTN. Anti-angina.
Propranolol
Severe HTN
Metoprolol
Severe HTN
Carvedilol
Systolic dysfunction heart failure.
Epinephrine
Commonly used after cardiopulmonary bypass or in resuscitations to restart cardiac contractions (rarely used in CHF)
Norepinephrine
Hypotension, Distributive Shock
Dopamine
CHF, Hypotension, Bradycardia (med doses), Shock (med and high doses). Side effects: tachy, HTN, vomiting.
Dobutamine
Can diagnose CAD, simulate exercise.
Isoproterenol
Post-transplant to drive heart rate and decrease PVR. Can also be used to increase SA node rate if bradycardia is present.
Phenylephrine
Hypotension, Distributive Shock
Milrinone
CHF, CAD. Risk of hypotension and shock.
Digoxin
Atrial arrhythmias (fib), CHF classes II-IV, not great for acute MI (increases cardiac metabolic demand). Drug interactions common - low dose very important. Contra - premature vent contractions, v-tach, AV block, bradycardia, SA node disease w/out pacemaker, uncontrolled hypokalemia, right sided heart failure, hypertrophic myopathy, WPW.
Atropine
Stops vagal reaction, restores AV conduction in disorders with prolonged AV nodal refractoriness (such as inferior MI or dig toxicity).
Acetylcholine
Not used clinically.
Edrophonium
IV bolus, lasts for 30 seconds, used to treat break SVTs due to AV nodal reentry or AV bypass tract. Used to diagnose SVTs.
Physostigmine
No active clinical use.
Neostigmine
No active clinical use.
Anything-astatin
Hypercholesterolemia. 1st line therapy for LDL reduction, very effective. Can cause rhabdomyolysis, myalgia, myopathy.
Fibrates
HyperTGemia to prevent pancreatitis. Adjunct to statins.
Niacin
Hyperlipidemia.
Cholesterol absorption inhibitor
Used with statins or with statin-intolerant patients.
Bile acid sequestrant
Add to statin therapy, or with statin-intolerant patients.
Aspirin
NSTEMI, STEMI
Clopidogrel
NSTEMI, STEMI (bleeding risk)
Glycoprotein Iib/IIIa inhibitor
NSTEMI, STEMI (bleeding risk)
t-PA, streptokinase, urokinase
STEMI (bleeding risk)
Heparin
NSTEMI, STEMI (bleeding risk)
Procainamide/Quinidine
V-tach, A-fib, AV Reentry. May cause Torsade in pts with long QT (if so treat with isoproterenol to increase HR, decrease QT)
Lidocaine
V-tach, A-fib, AV Reentry. May cause Torsade in pts with long QT (if so treat with isoproterenol to increase HR, decrease QT)
Flecainide
V-tach, A-fib, AV Reentry. May cause Torsade in pts with long QT (if so treat with isoproterenol to increase HR, decrease QT)
Amiodarone
V-tach, A-fib, AV Reentry. May cause Torsade in pts with long QT (if so treat with isoproterenol to increase HR, decrease QT)
Sotalol
V-tach, A-fib, AV Reentry. May cause Torsade in pts with long QT (if so treat with isoproterenol to increase HR, decrease QT)
Adenosine
Reentry arrhythmias that require AV node: AVNRT, AVRT, WPW. Contra: 2nd, 3rd degree heart block, sick sinus, long QT, severe hypotension
