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CV Drugs Flashcards

1
Q

Thiazides

A

Inhibits Na+ and H2O reabsorption in the distal tubule of kidney

Blocks Na+/Cl- transporter

ADR - hyperuricemia (gout), hyponatremia

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2
Q

Thalitone

A

Chlorthalidone

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3
Q

Zaroxolyn

A

Metolazone

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4
Q

Loop Diuretics

A

Inhibit Na+ and H2O reabsorption in the Loop of Henle of the kidney

Inhibit luminal Na+/K+/2Cl- transporter

Lose a lot of electrolytes

ADR - hypokalemia, hypomagnesemia, ototoxicity, overdiuresis

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5
Q

Lasix

A

Furosemide

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6
Q

Demadex

A

Torsemide

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7
Q

Bumex

A

Bumetanide

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8
Q

Potassium-Sparing

A

Enhance Na+ excretion and retain K+

Add-on to thiazide to maintain K+ levels

ADR - hyperkalemia

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9
Q

Dyazide/Maxide

A

Triamterene/HCTZ

K+ sparing drug

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10
Q

Renin

A

Converts angiotensinogen to angiotensin

Released from the juxtaglomerular cells in the kidney

Negative feedback mechanism

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11
Q

ACE Inhibitors (ACE-I)

A

Inhibits angiotensin converting enzyme thereby inhibiting production of angiotensin II

Used for hypertension, HF, Post MI, Kidney protection - opens up glomerulus

ADR - dry unproductive cough, angioedema, hyperkalemia

TERATOGENIC!!!

Monitor: BP, pulse, renal function, K+ levels

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12
Q

Zestril, Prinivil

A

Lisinopril

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13
Q

Altace

A

Ramipril

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14
Q

Vasotec

A

Enalapril

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15
Q

Lotensin

A

Benazapril

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16
Q

Accupril

A

Quinapril

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17
Q

Monopril

A

Fosinopril

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18
Q

Capoten

A

Captopril

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19
Q

Aceon

A

Perindopril

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20
Q

Univasc

A

Moexipril

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21
Q

Angiotensin Receptor Blockers (ARB)

A

Block angiotensin II directly at site of action via AT1 receptor

ADR - same as ACE-I but no cough

TERATOGENIC

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22
Q

Cozaar

A

Losartan

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23
Q

Avopro

A

Irbesartan

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24
Q

Atacand

A

Candesartan

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25
Diovan
Valsartan
26
Benicar
Olmesartan
27
Micardis
Telmisartan
28
Teveten
Eprosartan
29
Edarbi
Azilsartan
30
Aldosterone Antagonists
Inhibits aldosterone effects on the Na+/K+ exchange site in the distal tubule Used to decrease fibrosis, resistant hypertension, heart/liver failure ADR - hyperkalemia, breast tenderness (gynecomastia), renal dysfunction
31
Aldactone
Spironolactone Can cause gynecomastia (breast tenderness)
32
Inspra
Eplerenone Aldosterone antagonist
33
Beta Blockers
Blocks SNS (B1, B2, Alpha receptors) Suppress the release of renin Negative inotrope (force of contraction), negative chronotrope (heart rate) Used for: Post MI, angina, HF, headaches tremors CAD ADR - bradycardia, bronchospasm (caution in asthma with non-selective agents), fatigue
34
Lopressor/Toprol XL
Metoprolol Lopressor: tartrate salt BID dosing Toprol: succinate salt QD dosing Selective for B1
35
Tenormin
Atenolol Selective for B1
36
Bystolic
Nebivolol Selective for B1 Vasodilation through NO to lower BP
37
Inderal
Propranolol Non-selective B1/B2
38
Coreg
Carvedilol Non-selective used for HF Peripheral vasodilation through alpha blockade
39
Trandate
Labetalol Non-selective Vasodilation like Coreg
40
Calcium Channel Blockers
Specific for L-type receptors Blocks channels, decreases Ca2+ current, relaxation of smooth muscle Negative inotrope and chronotrope Uses: hypertension, angina
41
Norvasc
Amlodipine Dihydropyridine (DHP) ADR - Orthostatic hypotension, GERD, reflex tachycardia, edema MOA - arterial vasodilation, decrease afterload
42
Plendil
Felodipine Dihydropyridine (DHP) ADR - Orthostatic hypotension, GERD MOA - arterial vasodilation, decrease afterload
43
Sular
Nisoldipine Dihydropyridine (DHP) ADR - Orthostatic hypotension, GERD MOA - arterial vasodilation, decrease afterload
44
Procardia XL/Adalat CC
Nifedipine Dihydropyridine (DHP) ADR - Orthostatic hypotension, GERD MOA - arterial vasodilation, decrease afterload
45
Cardene
Nicardipine Dihydropyridine (DHP) ADR - Orthostatic hypotension, GERD MOA - arterial vasodilation, decrease afterload
46
Calan/Isoptin/Verelan
Verapamil Non-DHP, used for atrial tachycardias MOA - decrease myocardial contractility, decrease rate of contraction, some peripheral vasodilation ADR - constipation, AV Block, bradycardia, GERD
47
Cardizem/Dilacor XR
Diltiazem Non-DHP MOA - decrease myocardial contractility, decrease rate of contraction, some peripheral vasodilation ADR - constipation, AV Block, bradycardia, GERD
48
Alpha 2-agonists
Stimulation of the receptors inhibits the sympathetic output from the brain (vasomotor center) Inhibits release of NE from nerve terminals Cause peripheral vasodilation
49
Catapress
Clonidine Lowers BP by decreasing HR and reducing peripheral vascular resistance ADR - dry mouth, must be tapered (can't quit cold turkey)
50
Alpha 1-receptor antagonists
Block alpha receptors in the vasculature Vasodilation decreases peripheral vascular resistance Primarily used for BPH
51
Flomax
Tamsulosin Specific for alpha 1A & 1D receptors ADR - orthostatic hypotension so give at night to start; start low/slow, reflex tachycardia, nasal stufffiness, edema
52
Hytrin
Terazosin non-specific, used for BPH & BP ADR - orthostatic hypotension
53
Cardura
Doxazosin non-specific, used for BPH & BP ADR - orthostatic hypotension
54
Minipress
Prazosin non-specific, used for BPH & BP ADR - orthostatic hypotension
55
Nitrates/Nitrites
Used for angina & HF (in combo w/Hydralazine)
56
Nitroglycerin
ADR - Orthostasis, throbbing headache, tachycardia Tolerance - need nitrate-free period of 10-12 hours daily Contraindicated with PDE Inhibitors - Viagra, Cialis, Levitra, hypotensive medications Monitor: HR<100, SBP>90-100
57
ISMOR/Imdur
Isosorbide mononitrate Once daily dosing, nitrate free period built into release mechanism
58
Hydralazine
Arterial vasodilator used in hypertension (esp during pregnancy), HF MOA - not known ADR - headache, nausea, flushing, tachycardia, dizziness Monitor: BP, pulse, HF symptoms, compliance
59
BiDil
Hydralazine/Isosorbide dinitrate used in HF to decrease pre/after load Tachyphylaxis - tolerance ADR - nausea, flushing, tachycardia, drug induced lupus
60
Ranexa
Ranolazine Add on therapy for angina blockade of late Na+ current that facilitates Ca2+ entry through the Na+/Ca2+ exchanger which allows heart to function w/ decreased oxygen supply Does not lower BP and HR like other options ADR - dizziness, headache, constipation, edema
61
Digitalis
Digoxin MOA - positive inotropic effects, negative chronotropic, Low TI, used in HFrEF & A Fib ADR - toxicity can cause arrhythmias, hypokalemia, hypomagnesemia, hypercalcemia
62
Angiotensin II + neprilysin inhibitor (ARNI)
Used in HFrEF, replaces ACE-I & ARB
63
Entresto
Sacubitril/Valsartan ARB must be used in combo w/neprilysin inhibitor to block increased RAAS levels ADR - hypotension, hyperkalemia, cough, dizziness, renal failure, angioedema
64
I(funny) Channel Inhibitor
Used in HFrEF selectively binds to the I(funny) channels in the SA node (funny current because it is unusual in behavior)
65
Corlanor
Ivabradine slows depolarization which slows SA activity which reduces HR ADR - Phosphenes (visual brightness) = little dots, bradycardia, A-Fib
66
Class I Antiarrhythmic Agents
Na+ channel blockade 1A - PDQ (Procainamide, Quinidine, Disopyramide) 1B - MLT (Mexiletine, Lidocaine, Tocainide) 1C - Flecainide, Propafenone
67
Class II Antiarrhythmic Agents
Sympatholytic (Beta blockers)
68
Class III Antiarrhythmic Agents
K+ channel blockers
69
Class IV Antiarrhythmic Agents
Ca2+ channel blockade
70
Cordarone
Amiodarone Class III, used for atrial/ventricular arrhythmias
71
Chylomicrons
triglyceride rich Function: is to transport dietary cholesterol & triglycerides to cells for energy use & storage
72
VLDL (very low density lipoprotein)
triglyceride rich Function: transport triglycerides from the liver to peripheral tissues for energy
73
LDL (low density lipoprotein/bad cholesterol)
Primary therapeutic target in most patients Produced by removal of triglycerides from VLDL in circulation
74
HDL (high density lipoprotein/good cholesterol)
Function: transports excess cholesterol from the cells back to the liver or transfers it to other lipoproteins High levels are antiatherogenic & therefore beneficial
75
HMG-CoA reductase Inhibitors
Decreased cholesterol synthesis results in decreased cholesterol levels in the liver, increase in the number of LDL receptors on the surface of the liver beneficial for primary/secondary prevention ADR - myopathy, increased hepatic enzyme levels (AST/ALT) Avoid grapefruit juice, TERATOGENIC Onset of action: 4-6 weeks (6-8 weeks)
76
Mevacor
Lovastatin
77
Zocor
Simvastatin
78
Lescol
Fluvastatin
79
Pravachol
Pravastatin
80
Lipitor
Atorvastatin
81
Crestor
Rosuvastatin
82
Livalo
Pitavastatin
83
Bile Acid Sequestrants (BAS)
MOA - act by binding bile acids in the intestine, preventing their reabsorption & leading to their excretion in the feces, up-regulation of LDL receptors, increased removal of cholesterol from the blood stream, up-regulation of HMG-CoA reductase
84
Questran
Cholestyramine Bile Acid exchange resin - cation that exchange a Cl- anion for a negatively charged bile acid
85
Colestid
Colestipol Bile Acid exchange resin - cation that exchange a Cl- anion for a negatively charged bile acid
86
Welchol
Colesevelam NOT ABSORBED FROM THE GI TRACT Bile Acid sequestrant - binds to a bile acid w/o leaving a Cl- ion behind GI side effects = constipation, nausea, flatulence
87
Zetia
Ezetimibe Selective cholesterol absorption inhibitor, blocks NPC1L1 transporter absorbed systemically
88
Fibric Acid Derivatives (Fibrates)
stimulate the nuclear agonist transcription receptor (PPAR-alpha) PPAR = peroxisome proliferator activated receptor, increases lipoprotein lipase synthesis used to lower triglyceride levels
89
Lopid
Gemfibrozil Contraindicated w/Simvastatin
90
Tricor/Lofibra
Fenofibrate
91
Trilipix
Choline Fenofibrate
92
Niacin
Reduces triglycerides synthesis in the liver, inhibits lipolysis in adipose tissue resulting in decreased VLDL synthesis by the liver leading to decreased LDL production ADR - cutaneous vasodilation (flushing) = prostaglandin mediated & can be decreased by giving aspirin 30 min prior, TWF
93
Zebeta
Bisoprolol Used in HF

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