cardiology meds 3 Flashcards
memorize
adenosine
antiarrhythmias
a1 receptor agonist (opens K+ channels hyperpolarizing AV node)
for: acute arrhythmias
short half life: 10 seconds
must be given as large dose, rapidly, IV bolus
must warn pts they’ll feel their heart stop for a few sec
quinidine
antiarrhythmias
class IA
For: atrial/ventricular arrhythmia
side effects: pro-arrhythmic
cinchonism: tinnitus, hearing loss, blurred vission, HA, delirium, rash
contra: mortality in pts w/afib or flutter, don’t use w/fluoroquinolones/ritonavir
procainamide
antiarrhythmias
class IA
metabolized by N-acetyltransferase into metabolite N-acetyl procainamide: slow acetylators ^
for: atrial/ventricular arrhythmia
side effect: proarrhythmic, rash hypotension
contra: black box warning: fatal blood dyscrasias (agranulocytosis), drug induced lupus
disopyramide
antiarrythmic
for: atrial/ventricular arrhythmia
lidocaine
antiarrhythmic
Class IB
For: only for ventricular arrhythmias and when HR is high
side effect: crosses BBB (hallucinations/confusion), lightheadedness, hepatic insufficiency
extensive “first pass” given only by IV
propafenone
antiarrhythmics Class IC negative inotropic properties little to no affect on refractory period sodium channel block that decreases conduction/automaticity for: arrhythmia side effect: metallic taste, dizziness, visual disturbances contra: AV disorders, sinus brady, shock
flecainide
antiarrhythmic
class IC
negative inotropic property
little to no affect on refractory period
sodium channel block that decreases conduction/automaticity
for: arrhythmia
side effect: pro-arrythmic, visual disturbances, dizziness
sotalol
antiarrhythmic potassium channel blocker B blocker class 3 for: afib/flutter, vfib, vtach side effect: brady, heart block, pulmonary fibrosis, thryoid dysfunction, blue skin, hepatotoxicity "everything but the kidneys contra: 2nd and 3rd degree heart block
dofetilide
antiarrhythmic potassium channel blocker B blocker class 3 for: afib/flutter, vfib, vtach contra: 2nd and 3rd degree heart block
amiodarone
antiarrhythmic potassium channel blocker B blocker class 3 for: afib/flutter, vfib, vtach: acute/chronic arrhythmias side effect: brady, heart block, pulmonary fibrosis, thryoid dysfunction, blue skin, hepatotoxicity "everything but the kidneys contra: 2nd and 3rd degree heart block DDI w/digoxin: lower digoxin dose by 50% extremely long half life: 25-60 days given by IV and PO
ibutilide
antiarrhythmic potassium channel blocker B blocker class 3 for: afib/flutter, vfib, vtach contra: 2nd and 3rd degree heart block
dronedarone
antiarrhythmic potassium channel blocker B blocker class 3 for: afib/flutter, vfib, vtach contra: 2nd and 3rd degree heart block fewer side effects than amiodarone
nitroprusside
vasodilators
for: hypertensive crisis
side effects: lactic acidosis, AMS, death, methemoglobinemia,
available in IV
NO diffuses from complex into SM of vessels=vasodilation “balanced vasodilator” bc it targets venous/arterioles
hydralazine
vasodilators
decreases Ca2+ in SM cells
only affects arteriole side
side effects: dizziness, orthostatic hypotension, HA, periipheral edema (bc renin release)
slow acetylators as hydralazine levels ^ can lead to lupus like syndrome
nesiritide
vasodilators recombinant BNP for: acute congestive HF administered by IV increased mortality when used chronically
nitroglycerin
organic nitrates
for: chronic tx of angina
side effects: flushing, HA, rash, methemoglobinemia
quick tolerance, nitrate free period to reduce
transdermal (chronic) sublingual/buccal spray (acute)
have life 1.5 minutes
isosorbide dinitrate
organic nitrates
for: chronic tx of angina
side effects: flushing, HA, rash, methemoglobinemia
quick tolerance, nitrate free period to reduce
TID d/t short half life
isosorbide mononitrate
organic nitrates
for: chronic tx of angina
side effects: flushing, HA, rash, methemoglobinemia
quick tolerance, nitrate free period to reduce
longest half life»_space; qd
pravastatin
-statin suffix
HMG-CoA reductase inhibitor
tx of dyslipidemia
for: risk of CAD by decreasing LDL & ^ HDL
side effect: muscle pain, rhabdo, when given w/fibrates ^ risk myopathy
short half life
moderate/low intensity
simvastatin
-statin suffix
tx of dyslipidemia
for: risk of CAD by decreasing LDL & ^ HDL
side effect: muscle pain, rhabdo, when given w/fibrates ^ risk myopathy
short half life
moderate/low intensity
fluvastatin
-statin suffix
tx of dyslipidemia
for: risk of CAD by decreasing LDL & ^ HDL
side effect: muscle pain, rhabdo, when given w/fibrates ^ risk myopathy
short half life
moderate/low intensity
lovastatin
-statin suffix
tx of dyslipidemia
for: risk of CAD by decreasing LDL & ^ HDL
side effect: muscle pain, rhabdo, when given w/fibrates ^ risk myopathy
short half life
moderate/low intensity
atorvastatin
-statin suffix
tx of dyslipidemia
for: risk of CAD by decreasing LDL & ^ HDL
side effect: muscle pain, rhabdo, when given w/fibrates ^ risk myopathy
longer half life
high/moderate intensity
pitavastatin
-statin suffix
tx of dyslipidemia
for: risk of CAD by decreasing LDL & ^ HDL
side effect: muscle pain, rhabdo, when given w/fibrates ^ risk myopathy
longer half life
moderate/low intensity
rosuvastatin
-statin suffix
tx of dyslipidemia
for: risk of CAD by decreasing LDL & ^ HDL
side effect: muscle pain, rhabdo, when given w/fibrates ^ risk myopathy
longer half life
high/moderate intensity
cholestyramine
tx of dyslipidemia bile acid sequestrants typically administered w/statins for: decrease of LDL side effect: GI discomfort, constipation, bloating, ^ ALT/AST, increased TG, hyperchloremic acidosis (rare), can bind to warfarin: separate admin. by 2 hrs
colestipol
tx of dyslipidemia bile acid sequestrants typically administered w/statins for: decrease of LDL side effect: GI discomfort, constipation, bloating, ^ ALT/AST, increased TG, hyperchloremic acidosis (rare), can bind to warfarin: separate admin. by 2 hrs
colesevelam
tx of dyslipidemia bile acid sequestrants typically administered w/statins for: decrease of LDL side effect: GI discomfort, constipation, bloating, ^ ALT/AST, increased TG, hyperchloremic acidosis (rare), can bind to warfarin: separate admin. by 2 hrs
gemfibrozil
tx of dyslipidemia
a fibrate
for: lower TG, may reduce LDL & ^ HDL
side effects: can increase effects of warfarin, gallstones, pancreatitis, rash, rhabdo, myopathy
contra: renal/hepatic failure (eliminated by kidney/liver)h
don’t give w/statins: can ^ myopathy/rhabdo
fenofibrate
tx of dyslipidemia
a fibrate
for: lower TG, may reduce LDL & ^ HDL
side effects: can increase effects of warfarin, gallstones, pancreatitis, rash, rhabdo, myopathy
contra: renal/hepatic failure (eliminated by kidney/liver)
takes 3-6 weeks to work
niacin
lowers TG ^ HDL side effects: flushing (bc peripheral vasodilation) can take baby aspirin to reduce flushing so: start low/slow or: ER formula insulin resistance: be aware w/DM pts
