CVS Drugs Flashcards
Ciprofibrate
Fibrate - PPAR agonist
Notes - Reduces serum LDL & TGs & increases serum HDL. CAUTION WITH STATINS (ESP. GEMFIBROZIL)
Femofibrate
Fibrate - PPAR agonist
Notes - Reduces serum LDL & TGs & increases serum HDL. CAUTION WITH STATINS (ESP. GEMFIBROZIL) Used for hypertriglyceridemia
Gemfibrozil
Fibrate - PPAR agonist
Notes - Reduces serum LDL & TGs & increases serum HDL. CAUTION WITH STATINS (ESP. GEMFIBROZIL)
Amiloride
K+ Sparring diuretic
Spironolactone
K+ Sparring diuretic & anti-androgen
Amiodarone
K+ channel blocker
Notes - Slows HR (by prolonging QT interval). Used for supraventricular & ventricular tachycardias. Has long half life in fat bc lipophilic
Dronedarone
K+ channel blocker
Notes - Slows HR (by prolonging QT interval). Analogue of amiodarone that is less effective. SE - paradoxical pro-arrhythmic effects “Torsades du pontes”
Sotalol
K+ channel blocker
Notes - Slows HR (by prolonging QT interval).
Disopyramide
Class Ia Na+ channel blocker
Notes - Slows HR by acting on non-nodal AP. Blocks Na+ channels during phase 0 block ++, Moderate A/D. Also blocks K+ channels during phase 3 and prevents outward flow so prolongs ERP, reducing the frequency of APs. Used for ventricular arrhythmias and AFib. SE - anti-cholinergic effects & constipation
Lidocaine
Na+ channel blocker
Notes - Slows HR by acting on non-nodal AP. Blocks Na+ channels during phase 0 block + (least), Fastest A/D.
Flecainide
Na+ channel blocker
Notes - Slows HR by acting on non-nodal AP. Blocks Na+ channels during phase 0 block +++ (most), Slowest A/D. used for ventricular arrhythmias. C/i in patients with structural heart disease
Statins
Competitive HMGCoA reductase inhibitors
Notes - reduce cholesterol synthesis, increase clearance of plasma cholesterol by increasing LDL receptors, decrease ox stress, increase stability of atherosclerotic lesions, decrease TG & increase HDL. SE - HMGCoA (hepatotoxicity/headache, myalgia/myopathy, GI effects, CPK increase, Avoid in pregnancy, liver impairment, elderly, hypothyroidism, hx of muscle disorders). CYP inhibitors. DDI with fibrates ESP gemfibrozil bc increases renal toxicity
Alirocumab, Evolocumab
mAb PCKS9 inhibitor
Notes - encourage LDL internalization/recycling. Reduce LDL 50-70%. Administer s/c every 2 weeks
Inclisiran
siRNA PCKS9 inhibitor
Glycerol trinitrate
Nitrate (vasodilator)
Notes - Causes spontaneous NO release. used with ACEi/ARB. used for pulmonary congestion & dyspnea. Taken sublingually. Tolerance with prolonged use. SE - postural hypotension & headache
Isosorbate mono/dinitrate
Nitrate (vasodilator)
Notes - Longer acting nitrate. Causes spontaneous NO release. used with ACEi/ARB. used for pulmonary congestion & dyspnea. Taken sublingually. Tolerance with prolonged use. SE - postural hypotension & headache
Hydralazine
Arteriodilator
Notes - direct acting vasodilator. Used for fatigue associated with CHF, preeclampsia, HT+HF in Africans
Nitropruside
Combined venodilator + arteriodilator
Notes - used for Acute HF IV only
Minoxidil
Direct acting vasodilator
Losartan, Valsartan
ARBs (inhibit RAAS)
Notes - SE same as ACEi but less severe. C/i in renal artery stenosis & breastfeeding. Can reduce fetal blood flow. NOT to be used with ACEi. especially effective against cerebrovascular events, TII diabetic nephropathy & bilateral renal artery stenosis (bc ACEi can’t be used).
Enalapril, Captopril
ACEi (inhibit RAAS)
Notes - SE “TOPCARD” Teratogen, orthostatic hypotension, potassium increase, cough dry (bc buildup of bradykinin in lungs), angioedema, renal impairment, dizziness. C/i bilateral renal artery stenosis. Used for post MI, HT w HF, HT w LV dysfunction, secondary stroke prevention
Bisoprolol
BB (b1)
Notes - cardio depressive. Slow disease progression. c/i in variant angina
Carvedilol
BB (b and alpha1 blocker)
Notes - cardio depressive. Slow disease progression. Lowers TPR while preventing reflex tachycardia. Used for Asthma. c/i in variant angina
Labetolol
BB
Notes - cardio depressive. Slow disease progression. Used in pregnancy & for asthma. c/i in variant angina
Nebivolol
BB (b blocker and NO release from V-ECs)
Notes - cardio depressive. Slow disease progression. Racemic mixture of D/L isomers. c/i in variant angina
Metoprolol
BB
Notes - cardio depressive. Slow disease progression. Used for arrhythmias by elevated SNS activity (ex. after MI), AV node re-entry, supraventricular tachycardia, AFib & flutter. c/i in variant angina
Clonidine, Methyldopa
Centrally acting a2 agonists
Notes - Decreases TPR, HR & SNS activity. hypertensive crisis if withdrawn quickly. c/i depression
Doxazosin, Prazosin, Terazosin
a1 Antagonists “zosins”
Notes - relax SMC. SE - 1st dose orthostatic hypotension
Dobutamine
beta agonist
Notes - Used in acute HF only. Increases contractility, HR & CO.
Dopamine
beta agonist
Notes - Used in acute HF only. Increases contractility, HR & CO. used to increase renal perfusion & excretion of sodium. High doses bind b1 receptors
Digoxin
Cardiac glycoside
Notes - Positive inotropy. improves symptoms but NOT mortality. Inhibits NaK ATPase pump so sodium remains in cell. Low TI. Toxicity 2 ways 1) with diuretics can cause hypokalemia 2) slowed clearance in patients with renal failure can buildup in plasma. DDI verapamil (CCB) & amiodarone (anti-arrhythmic)
Verapamil
Non-DHP CCB
Notes -Inhibit VGLCC. Act on cardiac muscle. SE - constipation, heart block, worse HF. NOT TO BE USED WITH BB
Diltiazem
Non-DHP CCB
Notes -Inhibit VGLCC. Act on cardiac muscle and SMC
Nifedipine
DHP CCB
Notes -Inhibit VGLCC. Act on SMC. SE - “Cow”cium channel SHRED - slower heart rate, hypotension/headache, reflex tachycardia, edema, dizziness/flushing. Used for treatment of Raynauds. Can combine with BB to limit reflex tacchy so it is more effective for HT therapy
Nicardipine
DHP CCB
Notes -Inhibit VGLCC. Act on SMC. SE - “Cow”cium channel SHRED - slower heart rate, hypotension/headache, reflex tachycardia, edema, dizziness/flushing
Felodipine
DHP CCB
Notes -Inhibit VGLCC. Act on SMC. SE - “Cow”cium channel SHRED - slower heart rate, hypotension/headache, reflex tachycardia, edema, dizziness/flushing
Amlodipine
DHP CCB
Notes -Inhibit VGLCC. Act on SMC. SE - “Cow”cium channel SHRED - slower heart rate, hypotension/headache, reflex tachycardia, edema, dizziness/flushing. Long-acting so good for LT HT therapy
Colesevelam
Cholesterol absorption inhibitor
Notes - sequester bile acids. SE - bulky, unpalatable, diarrhea/constipation. DDI - impair absorption of anionic/neutral drugs ex warfarin, digoxin, thiazides
Colestipol
Cholesterol absorption inhibitor
Notes - sequester bile acids. SE - bulky, unpalatable, diarrhea/constipation. DDI - impair absorption of anionic/neutral drugs ex warfarin, digoxin, thiazides
Ezetimibe
Cholesterol absorption inhibitor
Notes - sequester bile acids. SE - bulky, unpalatable, diarrhea/constipation.
Nicorandil
K+ Channel agonist (NO donor)
Noters - hyperpolarizes the cell
Ranolazine
K+ Channel agonist (indirectly decreases calcium entry)
Notes - relaxes SMC & decreases contractility
Ivabradine
Bradycardic
Notes - inhibits If current in SA node to decrease HR. Used for chronic stable angina when BB contraindicated. Pro is that it has little effect on non-vascular SMC.
