CCD and ACS/HF Drug Formulary 2024 Flashcards
Top 300 Drugs from Sowinski
Amlodipine (Norvasc) Dosing:
5-10mg daily
Starting dose: 2.5mg daily
Amlodipine (Norvasc) AE:
-Hypotension, flushing, headache, peripheral edema, dizziness, reflex tachycardia
Amlodipine (Norvasc) Monitoring Parameters:
- BP (bc hypotension risk)
- DI: grapefruit juice, CYP3A inducers/inhibitors
Aspirin (Ecotrin, Valazore) Dosing:
for CCD: 81mg daily
for ACS: 325mg chewable ASA loading dose
Aspirin (Ecotrin, Valazore) AE:
- GI/Brain bleed
- Hypersensitivity
Aspirin (Ecotrin, Valazore) Monitoring Parameters:
- Bleeding
- Drug interactions: take 12h apart from ticagrelor
Atenolol (Tenormin) Dosing:
50-100mg daily
Starting dose: 25-20mg daily
Atenolol (Tenormin) AE:
- Sinus bradycardia, sinus arrest, AV block, reduced LVEF
- bronchoconstriction
- fatigue, depression, exercise intolerance, sexual dysfunction
Atenolol (Tenormin) Monitoring Parameters:
- HR
- CI in bradycardia (HR<50); high deg AV block or sick sinus syndrome
Atorvastatin (Lipitor) Dosing:
40-80mg daily (high)
Atorvastatin (Lipitor) AE:
- Muscle pain, darkened urine
Atorvastatin (Lipitor) Monitoring Parameter:
- Get lipid panel
- Muscle pain, darkened urine
- Liver function tests
- Grapefruit juice (1 quart)
- CI: pregnancy
Benazepril (Lotensin) Dosing:
40mg daily/20mg BID
Starting dose: 10mg daily/BID
N/A for HF
Benazepril (Lotensin) AE:
- Dry cough, angioedema, hyperkalemia
- DI: NSAIDs
Benazepril (Lotensin) Monitoring Parameters:
- Do not use in hypotension/shock, bilateral renal artery stenosis or Hx of worsening of renal function w/ ACE inhibitor/ARB exposure, acute renal failure, or drug allergy/angioedema
- Check Scr, K, BP, and angioedema
Bisoprolol (Monocor, Zebeta) Dosing:
5-10mg daily
For HF:
10mg daily
Initial: 1.25mg daily
Bisoprolol (Monocor, Zebeta) AE:
- Sinus bradycardia, sinus arrest, AV block, reduced LVEF
- bronchoconstriction
- fatigue, depression, exercise intolerance, sexual dysfunction
Bisoprolol (Monocor, Zebeta) Monitoring Parameters:
-HR
- CI in bradycardia (HR<50); high deg AV block or sick sinus syndrome
Bumetanide (Bumex) Dosing:
2mg daily
Starting dose: 0.5mg daily/BID
Bumetanide (Bumex) AE:
- Hypokalemia
- Hypomagnesemia
- Hypocalcemia
- Hyperuricemia
- Ototoxicity
Bumetanide (Bumex) Monitoring Parameters:
- CI: Sulfa allergy
- Better in pts w/ CrCl<30ml/min
- Check K, Mg, Ca levels
Candesartan (Atacand) Dosing:
32mg daily
Starting dose: 8mg daily
Candesartan (Atacand) AE:
- Hypotension
- Hyperkalemia
- Angioedema
- GFR reduction
- fetal pathologies
Candesartan (Atacand) Monitoring Parameters:
- BUN/Scr, K, renal function
- CI: Hx of angioedema on an ARB, concomitant use of aliskiren in pts w/ DM, pregnancy/breastfeeding
Carvedilol (Coreg) Dosing:
25-50mg BID
Starting dose: 6.25mg BID
For HF:
Coreg - 25-50mg BID
Initial - 3.125 BID
Coreg CR 80mg daily
Initial - 10mg daily
Carvedilol (Coreg) AE:
- Sinus bradycardia, sinus arrest, AV block, reduced LVEF
- bronchoconstriction
- fatigue, depression, exercise intolerance, sexual dysfunction
Carvedilol (Coreg) Monitoring Parameters:
- CI in bradycardia (HR<50); high deg AV block or sick sinus syndrome
Chlorthalidone (Thalitone, Hygroton) Dosing:
100mg daily
Starting dose: 12.5mg daily
Chlorthalidone (Thalitone, Hygroton) AE:
- Hypokalemia
- Metabolic acidosis
- Hyperuricemia
- Hypercalcemia
- Hyperglycemia
- Hyperlipidemia
- Sexual dysfunction
Chlorthalidone (Thalitone, Hygroton) Monitoring Parameters
- K levels, electrolyte levels, glucose levels, lipid/TG/cholesterol levels
- DI: lithium toxicity with concurrent use
- CI: sulfa allergy, anuria (can’t pee)
Clopidogrel (Plavix) Dosing:
75mg daily
Loading dose: 300-600mg (none if they took a fibrinolytic + they’re above 75 yo)
Clopidogrel (Plavix) AE:
- Bleeding (increased when added to ASA)
- Diarrhea
- Rash
Clopidogrel (Plavix) Monitoring Parameters:
- Hold 5 days prior to CABG
- Bleed risk
Dapagliflozin (Farxiga) Dosing:
10mg daily
Starting dose: 5mg daily
Dapagliflozin (Farxiga) AE:
- UTIs
- Genital fungal infections (gangrene)
- Hypotension
- Hyperkalemia
- Increased cholesterol
Dapagliflozin (Farxiga) Monitoring Parameters:
- Do not use in pts with eGFR of <25, unless already on it, then monitor
- Do not use if pt is on end-stage renal dysfunction on hemodialysis
Digoxin (Lanoxin) Dosing:
0.25mg daily
Starting dose: 0.125mg daily
Digoxin (Lanoxin) AE:
- Seeing halos (hallucinations)
- Dizziness
- Headache
- Stomach pain
Digoxin (Lanoxin) Monitoring Parameters:
- HR, ECGs, BUN/SCr, K, Mg, Ca, serum digoxin levels to watch for toxicity
Diltiazem (Cardizem) Dosing:
80-120mg TID
Dilt ER:
Starting dose: 120-180mg daily
Max dose: 360-540mg daily
Diltiazem (Cardizem) AE:
- Red. myocardial contractility, bradycardia, hypotension, flushing, headache, dizziness, constipation
Diltiazem (Cardizem) Monitoring Parameters:
- CI in HFrEF, bradycardia (HR<50); high deg AV block or sick sinus syndrome (no pacemaker)
- Do not use in pts w/ LV dysfunction, increased risk for cardiogenic shock, PR interval >0.24s
Empagliflozin (Jardiance) Dosing:
25mg daily
Starting dose: 10mg daily
Empagliflozin (Jardiance) AE:
- UTIs
- Genital fungal infections (gangrene)
- Hypotension
- Hyperkalemia
- Increased cholesterol
Empagliflozin (Jardiance) Monitoring Parameters:
- Do not use in pts with eGFR of <30ml/min, unless already on it, then monitor
- Do not use if pt is on end-stage renal dysfunction on hemodialysis
Enalapril (Vasotec) Dosing:
40mg daily
Starting dose: 5mg BID/TID
HF:
10mg BID
Initial: 2.5-5mg BID
20mg enalapril = 20mg lisinopril = 150mg captopril
Enalapril (Vasotec) AE:
- Dry cough, angioedema, hyperkalemia
- DI: NSAIDs
Enalapril (Vasotec) Monitoring Parameters:
- Do not use in hypotension/shock, bilateral renal artery stenosis or Hx of worsening of renal function w/ ACE inhibitor/ARB exposure, acute renal failure, or drug allergy/angioedema
- Check Scr, K, BP, and angioedema
Felodipine (Plendil) Dosing:
5-10mg daily
Max dose: 20mg daily
Felodipine (Plendil) AE:
-Hypotension, flushing, headache, peripheral edema, dizziness, reflex tachycardia
Felodipine (Plendil) Monitoring Parameters:
- DI: grapefruit juice, CYP3A inducers/inhibitors
Fosinopril (Monopril) Dosing:
40mg daily
Starting dose: 10mg daily
For HF:
40mg daily
Initial: 5-10mg daily
Fosinopril (Monopril) AE:
- Dry cough, angioedema, hyperkalemia
- DI: NSAIDs
Fosinopril (Monopril) Monitoring Parameters
- Do not use in hypotension/shock, bilateral renal artery stenosis or Hx of worsening of renal function w/ ACE inhibitor/ARB exposure, acute renal failure, or drug allergy/angioedema
- Check Scr, K, BP, and angioedema
Furosemide (Lasix) Dosing:
80mg daily
Starting dose: 20mg/dose
Furosemide (Lasix) AE:
- Hypokalemia
- Hypomagnesemia
- Hypocalcemia
- Hyperuricemia
- Ototoxicity
Furosemide (Lasix) Monitoring Parameters:
- CI: Sulfa allergy
- Better in pts w/ CrCl<30ml/min
Hydrochlorothiazide (Microzide) Dosing:
50mg daily
Starting dose: 12.5mg daily
Hydrochlorothiazide (Microzide) AE:
- Hypokalemia
- Metabolic acidosis
- Hyperuricemia
- Hypercalcemia
- Hyperglycemia
- Hyperlipidemia
- Sexual dysfunction
Hydrochlorothiazide (Microzide) Monitoring Parameters
- K levels, electrolyte levels, glucose levels, lipid/TG/cholesterol levels
- DI: lithium toxicity with concurrent use
- CI: sulfa allergy, anuria (can’t pee)
Hydralazine (Apresoline) Dosing:
40-300mg 2-4 times daily
Hydralazine (Apresoline) AE:
- Palpitations
- Tachycardia
- Chest pain
- GI SE
- Lupus-like rash
Hydralazine (Apresoline) Monitoring Parameters:
- Caution with CVA, renal impairment, CAD, liver disease, SLE
Irbesartan (Avapro) Dosing:
300mg daily
Starting dose: 150mg daily
Irbesartan (Avapro) AE:
- Hypotension
- Hyperkalemia
- Angioedema
- GFR reduction
- fetal pathologies
Irbesartan (Avapro) Monitoring Parameters:
- BUN/Scr, K, renal function
- CI: Hx of angioedema on an ARB, concomitant use of aliskiren in pts w/ DM, pregnancy/breastfeeding
Isosorbide dinitrate (Isordil, ISDN) Dosing:
Chewable tab: 5-10mg once daily
SL tab: 2.5-10mg once daily
Isosorbide dinitrate (Isordil, ISDN) AE:
- Headaches
- Hypotension
- Bradycardia