Cardiology Drugs Flashcards
Calcium Channel Blockers
interferes with Ca++ uptake in smooth muscle: dilate arteries, reduce resistance
- Amiodipine 2.5mg initial, 10mg target
- Diltiazem ER 120-180mg initial, 360mg target
- Nitrendipine 10mg initial, 20mg target
Beta Blockers
block B-1 receptors on myocardium: decrease contraction and heart rate
- Atenolol 25-50mg initial, 100mg target
- Metropolol 50mg initial, 100-200mg target
Angiotensin Converting Enzyme (ACE) Inhibitor
blocks ACE from lungs: inhibits Angiotensin I to II conversion, bradykinin increase
- Benazepril 10-40mg (max 80)
- Enalapril 10-40mg
- Lisinopril 10-40mg
- Quinapril 10-40mg
S/E: cough, hyperkalemia (labs to monitor), angioedema
Angiotensin Receptor Blockers (ARB)
block binding of angiotensin II to AT1 receptor
- Eprosartan 400mg initial, 600-800mg target
- Candesartan 4mg initial, 12-32mg target
- Losartan 50mg initial, 100mg target
- Valsartan 40-80mg initial, 160-320mg target
- Irbesartan 75mg initial, 300mg target
Thiazide Diuretics
incr. Na+ and H2O excretion: lower volume, lower Na+ in smooth mm. decr. contraction
- Bendroflumethiazide 5mg initial, 10mg target
- Chlorthalidone 12.5mg initial, 12.5-25mg target
- Hydrochlorothiazide 12.5-25mg initial, 25-100mg target
- Indapamide 1.25mg initial, 1.25-2.5mg target
S/E: hypokalemia, hypercalcemia, hyperuricemia, hyperglycemia, hypomagnesemia, metabolic alkalosis
Angiotensin II Receptor Agonist
stimulates angiotensin II binding side at AT2 receptor (vasodilaiton, inhib. cell growth)
- Azilsartan 80mg
- Candesartan 8-32mg
- Eprosartan 600-800mg
- Irbesartan 150-300mg
- Losartan 50-100mg
- Valsartan 80-320mg
Combination Therapy
CCB + ACE Inhibitor + Thiazide Diuretic
- Amolodopine 2.5mg + Benzapril 5mg + Chlorthalidone 12.5mg
Enzyme inhibited by Statins
HMG-Coase Reductase (HMGCR)
precursor to cholesterol
- Lovastatin
- Simvastatin
- Atorvastatin
- Pravastatin
S/E: elevated liver enzymes
Blood Lipid Values
Normal - Borderline - High - Very High
- cholesterol: <200 200-239 _>_240
- triglycerides: <150 150-199 200-499
- LDL <100 130-159 160-189 190-500
- HDL good >60 bad <40
very high LDL
normal triglycerides
xanthalasmas, xanthomas
Familial Hypercholesterolemia (FH)
high LDL (d/t high VLDL)
high triglycerides
high LDL and high triglycerides
xanthalasmas but NOT xanthomas
Familial Combined Hyperlipidemia
LDL 130-250
triglycerides usually normal
NO xanthomas
Polygenic Hypercholesterolemia
high triglycerides only
200-500 fasting
can be 1000+ with high fat meal (can cause acute pancreatitis)
eruptive xanthomas (rash), whitening of retinal arteries
Familial HyperTriglyceridemia
Statin Dosing Guidelines
- High dose
- atherosclerotic cardiovascular disease
- LDL _>_190
- Moderate to High
- 10-year risk >7.5%
- LDL 70-189
- Moderate
- Age 40-75
- Diabetes
- LDL 70-189
Cholesterol Absorption Inhibitors
Ezetimibe
- good in combination
- S/E: abd pain, fatigue, cough, diarrhea, back pain, arthralgia
