Cardiovascular Drugs Flashcards
It is a class of drug that acts as a diuretic that inhibits reabsorption of HCO3. It also decreases intraocular pressure, therby used for patients with glaucoma. Moreover, it is the DOC for acute mountain sickness. S/E: metabolic acidosis
One of the drugs under this classification can also decrease intracranial pressure
Proximal convoluted tubule diuretics
Carbonic anhydrase inhibitors
Acetazolamide, Brinzolamide
Mannitol (osmotic diuretic)
It is a class of drug that acts as a diuretic that inhibits the Na/K/2 Cl cotransport or NKCC receptor. They are also known as high-ceiling diuretics due to their potency. It is used for acute pulmonary congestion or edema
S/E: hyponatremia, hypocalcemia, hypokalemia, hyper-GUL, ototoxicity
Loop of Henle or loop diuretics
Bumetamide, Furosemide, Torsemide, Ethacrynic acid (most ototoxic)
It is a class of drug that acts as a diuretic that inhibits the reabsorption of Na and Cl or inhibits the Na/Cl co-transporter or NCC channel. This is the first-line drug for hypertension, since they cause vasodilation aside from diuresis. They are the DOC for patients with kidney stones or nephrolithiasis
S/E: hyponatremia, hypokalemia, hypercalcemia, hyper-GUL
Distal convoluted tubule diuretics
Thiazide diuretics
Hydrochlorothiazide, Chlorothiazide, Indapamide
It is a class of drug that acts as a diuretic that inhibits the aldosterone mediated reabsorption of Na and secretion of K. They prevent cardiac remodeling
S/E: hyperkalemia
Collecting tubule duct diuretic: potassium sparing diuretic
Aldosterone antagonists
Spironolactone, Eplerenone
It is a centrally acting alpha agonist that stimulate the alpha-2 receptors in the brainstem, reducing sympathetic outflow. It specifically is used for hypertensive urgency, administered sublingually
Clonidine
It is a class of drug that acts as a diuretic that inhibits Na channels
S/E: hyperkalemia
Collecting tubule duct diuretic: epithelial sodium channel inhibitors (ENAC)
Amiloride, triamterene
It is a centrally acting alpha agonist that stimulate the alpha-2 receptors in the brainstem, reducing sympathetic outflow. It is used by pregnant women and gives a positive result for Coombs test
Methyldopa
It is a centrally acting alpha agonist that stimulate the alpha-2 receptors in the brainstem, reducing sympathetic outflow. They are the old drugs of this classification
Guanfacine
Guanabenz
They are drugs that block beta-1 adrenergic receptors, reducing heart rate and cardiac contractility. These are not first-line drugs; they are only given if the patient has a compelling indication
These drugs have a side effect of hypotension, so these specific group of beta blockers are used to counteract hypotension
Beta blockers
Beta blockers with intrinsic sympathomimetic action
These drugs block the conversion of angiotensin I to angiotensin II. Their S/E is dry cough, due to the non-degradation of bradykinin. Just like spironolactone, they prevent cardiac remodeling.
C/I: AKI. DOC: CKD
All of these drugs are prodrugs, except two
Angiotensin converting enzyme (ACE) blockers
Lisinopril and captopril
These drugs competitively block angiotensin II receptors. They do not have the S/E of dry cough, making them preferrable for patient comfort. Just like spironolactone, they prevent cardiac remodeling.
C/I: AKI. DOC: CKD
Angiotensin II receptor blockers (ARBs)
These drugs bind to alpha-1 subunit of L-type calcium channel in muscle cell membrane reducing vascular smooth muscle contractility. It is vessel selective.
ADR: peripheral edema
Dihydropyridine CCB
These drugs bind to alpha-1 subunit of L-type calcium channel in muscle cell membrane reducing vascular smooth muscle contractility. It is cardioselective.
ADR: bradycardia
Non-dihydropyridine CCB
Diltiazem and verapamil (more selective)
This drug is a direct vasodilator that reduces intracellular calcium in vascular smooth muscle cells. It causes arteriolar dilation
Hydralazine
This drug is a direct vasodilator that causes potassium efflux with smooth muscle relaxation. It causes arteriolar dilation. It is now used for hirsutism
Minoxidil
This drug is used for heart failure as a positive inotropic drug. It activates beta-1 receptors predominantly found in the heart. It is the DOC for cardiogenic shock
Dobutamine
This drug is used for heart failure as a positive inotropic drug. It inhibits the Na/K ATPase pump. It is an alkaloid from Digitalis lanata and can have an S/E of arrythmia. The DOC for the arrythmia is lidocaine IV
Digoxin
This drug is used for heart failure as a positive inotropic drug that is a PDE inhibitor (phosphodiesterase) which prevents the degradation of cAMP
Milrinone
These drugs are vasodilators used for heart failure that increases the nitric oxide concentration to relax the smooth muscles. Management of its adverse effects are having free days to prevent its build up
Nitrates and nitroprusside
It is a vasodilator for heart failure used to block calcium influx
Hydralazine
It is a miscellaneous drug for HF used to decrease the preload, which then decreases the workload of the heart. It is used by patients with normal blood pressure but has heart failure
Loop diuretics
These two are miscellaneous drugs for HF used to prevent cardiac remodeling
Spironolactone
ACE inhibitors
It is a miscellaneous drug for HF that mimics the brain natriuretic peptide and increases cGMP
Nesiritide
It is a miscellaneous drug for HF that decreases inotropy, thereby heart rate as well
Beta-blockers
Ways to decrease the demand in stable angina
Rest
Cardiac depressants (negative inotropy) like non-DHP and beta-blockers
A vasodilator used to increase the supply in stable angina that has a short duration and are fast acting. They are given SL
ISDN
A vasodilator used to increase the supply in stable angina that are intermediate acting. They are given orally as maintenance medications when angina becomes more frequent
ISMN
A vasodilator used to increase the supply in stable angina that has a long duration
Transdermal patches
A miscellaneous drug for stable angina that is a metabolism modifier used to decrease fatty acid synthesis, resulting to lesser cholesterol plaque
Trimetazidine
This is used for the management of NSTEMI and UA to dilate the coronary blood vessels and to relieve the angina
Nitrates
This is used for the management of NSTEMI and UA to dissolve the clot
Dual antiplatelet (aspirin 80 and clopidogrel 75)
Anti-coagulant (heparin and enoxaparin)
This is used for the management of NSTEMI and UA once it was stabilized
ACEIs/ ARBs
Beta-blockers
Spironolactone
High dose statin (Atorvastatin 40)
Management for STEMI starting with either the jugular vein or femoral artery. This should be done within 90 minutes
Percutaneous coronary intervention
Angioplasty
Stenting
If PCI is still not available, these drugs can be given
Fibrinolytic agents (Streptokinase, Alteplase)
Management for STEMI if there are too many occlusions in different blood vessels or if there is total occlusion of a blood vessel. It makes use of the mammary artery or saphenous vein in the thigh
Coronary artery bypass graft
