Drug Cards Flashcards
Amlodipine
Brand Name: Norvasc
Class: Calcium Channel Blocker
MOA: Inhibits Ca2+ influx into vascular smooth muscle and myocardium. Ca2+ influx is required for muscles to move. This makes the heart beat with less force and blood vessels relax -> decreased BP
Indication: HTN, Stable/Variant Angina
Pregnancy Category: N/A
Contraindication: Hypersensitivity to Amlodipine
Black Box Warnings: N/A
Key Counseling Pts:
-Report s/s of hypotension or exacerbation of angina with initial dosing and dose changes.
-Avoid Alcohol
-Report s/s of peripheral edema, fatigue, hypotension or hepatic dysfunction.
-May cause dizziness which may if too much water is lost from the body.
Nifedipine
Brand Name:
-Adalat CC
-Procardia
-Procardia XL
-Nifedical XL
Class: Calcium Channel Blocker
MOA: Inhibits Ca2+ influx into vascular smooth muscle and myocardium. Ca2+ influx is required for muscles to move. This makes the heart beat with less force and blood vessels relax -> decreased BP
Indication: HTN, Stable/Variant Angina
Pregnancy Category: N/A
Contradictions: Hypersensitivity, Cardiogenic Shock, STEMI, Concomitant use of CYP3A4/5
Black Box Warnings: N/A
Key Pt. Counseling Points:
-Take on an empty stomach
-Report s/s of hypotension, exacerbation of angina, peripheral edema, fatigue
-Avoid sudden discontinuation of drug causing rebound HTN
-May cause dizziness
-Avoid grapefruit
-May see tablet/shell in stool
Chlorthalidone
Brand Name: Hygroton
Class: Thiazide Diuretic
MOA:
-Inhibits loop of Henle and proximal convoluted tubule Na+ and Cl-
-Help kidneys get rid of excess water, Na+ or salt
-Reduces blood volume to lower blood pressure
Indications: HTN, Edema, Systolic heart failure
Pregnancy Category: N/A
Contraindications:
-Hypersensitivity to chlorthalidone or sulfonamides
-Anuria (failure to produce urine)
Black Box Warnings: N/A
Key Counsel Pts:
-Take in morning with food
-Report s/s of dyspnea, hypotension, gout or heart failure
-Avoid Alcohol (hypotension) and NSAIDS (decrease effectiveness)
-May cause dizziness or blurred vision
-Avoid driving/heavy machinery
Furosemide
Brand Name: Lasix
Class: Loop Diuretic
MOA:
-Inhibits loop of Henle/ proximal convoluted tubule Na+ and Cl- resorption
-Actively secreted via nonspecific organic acid transport system into lumen of thick ascending limb of Henle’s loop,
-Decreases sodium reabsorption by completing for chloride site on Na+/K+/2Cl- Cotransporter
Indications:
-Edema related to heart
-Renal Failure
-HTN
Pregnancy Category: Low Risk
Contraindications:
-Hypersensitivity to furosemide
-Anuria (no urine)
Black Box Warnings: Fluid and electrolyte loss
Key Counseling Pts:
-Avoid alcohol, NSAIDS, activities that require coordination till drug effects are realized.
-Increased risk of sun sensitivity
-May cause dizziness, vertigo or blurred vision
-Report s/s of hypotension, decreased urine output, ototoxicity, severe skin reactions
-Eat High-K+ foods as directed.
Hydrochlorothiazide
Brand Name: Microzide, HydroDiuril
Class: Antihypertensive Thiazide diuretic
MOA:
-Inhibits distal convoluted tubule Na+ and Cl- resorption and increases excretion.
-Interferes with their reabsorption in cortical diluting segment of nephron.
Indication: Edema and HTN
Pregnancy Category: N/A
Contraindications:
-Hypersensitivity to HCTZ or Sulfonamide
-Don’t use with dofetilide (Class 3 antiarrhythmic) drugs
-Anuria
Black Box Warnings: N/A
Key Counseling Pts:
-May be taken w/wo food
-Take early to avoid nocturia (peeing @ night) even taking BID (8am&2pm)
-May cause dizziness
-Report s/s of hypotension.
-Eat high-K+ foods during therapy
-Avoid alcohol and using NSAIDS
Spironolactone
Other Name: Aldactone
Class: K+ Sparing Diuretic, Selective Aldosterone Blocker
MOA:
-Competes with Aldosterone receptor in distal renal tubules which increases Na+, Cl- and H2O excretion while sparring K+, Mg2+, H+.
-Produces delayed & mild diuresis (kidneys filter too much bodily fluid to increases your urine production)
-Acts from interstitial side of distal and collecting tubular epithelium to block Na-K exchange.
Indications:
-Heart Failure
-Edema associated with heart failure
-Nephrotic syndrome
-HTN
-Hypokalemia (low K+)
Pregnancy Category: N/A
Contradictions:
-Anuria
-Hypersensitivity to spironolactone.
-Acute renal insufficiency
-Hyperkalemia
Black Box Warnings: May increase tumor risk
Key Counseling Pts:
-May cause dizziness
-Avoid driving/machinery
-Report s/s of hyperkalemia and hypoatremia
-Avoid high K+ sources
-Avoid alcohol and NSAIDs
Triamterene-HCTZ
Brand Name: Dyazide
Class: K+ Sparring/Thiazide diuretic combination
MOA: Inhibits distal convoluted tubule Na+/Cl- resorption
- Refer to Triamterene & HCTZ
Indications: Edema, HTN
Pregnancy Category: N/A
Contraindications:
-Anuria
-Hypersensitivity to HCTZ, sulfonamides or triamterene
-Avoid K+ sources and concomitant uses of other K+ sparring diuretics
-Acute/chronic Renal Insufficiency
-Hyperkalemia
Black Box Warnings: Beware of Hyperkalemia!
Key Counseling Pts:
-May cause dizziness. Rise slowly from sitting or lying to avoid dizziness.
-Avoid K+ sources, alcohol, NSAIDs
-May cause photosensitivity (use sun screen)
-Sulfonamide allergy patients must caution
Hydralazine
Brand Name: Apresoline
Class: Peripheral Vasodilator
MOA:
-Dilates peripheral blood vessels directly
-Greater effect on arterioles than on veins
Indications: HTN
Pregnancy Category: N/A
Contraindications:
-Hypersensitivity to Hydralazine
-Dissecting Aortic Aneurysm
-Coronary Artery Disease
-Mitral Valve Rheumatic Heart Disease
Black Box Warnings: N/A
Key Counseling Pts:
-Avoid alcohol or sudden discontinuation of the drug (rebound HTN)
-May cause dizziness
-Report s/s chest pain, palpitations, tachyarrhythmia, hypotension, agranulocytosis, systemic lupus erythematosus or hepatoxicity
Clonidine
Brand Name: Catapres, Kapvay
Class: Alpha2-Adrenergic Agonist, “Alpha Blocker”
MOA:
-Clonidine simulates presynaptic alpha2-adrenergic receptors and blocks postsynaptic alpha2-adrenergic receptors in the CNS by activating inhibitory neurons to decrease sympathetic outflow.
-Clonidine is not a complete agonist, so some of its effects might result from antagonist actions at presynaptic alpha-receptors.
-These actions reduce peripheral vascular resistance, renal vascular resistance, HR, and BP.
Indication: ADHD, HTN
Pregnancy Category: N/A
Contraindication: Hypersensitivity to Clonidine
Black Box Warnings: Epidural Use
Key Patient Counseling Pts:
-Avoid Alcohol and CNS depressants.
-Use caution with driving and other tasks requiring alertness.
-May cause nausea, vomiting, insomnia, constipation, fatigue, or dry mouth.
-Swallow extended-release tablet whole.
-Apply patch to hairless area of intact skin on upper outer arm or chest; rotate patch location. If patch loosens during the 7 day wearing, secure adhesive cover.
-Report s/s of hypotension, exacerbation of angina peripheral edema, fatigue, hypotension, or hepatic dysfunction with initial dosing and dose changes. Avoid abrupt discontinuation to avoid rebound HTN.
Prazosin
Brand Names: Minipress, Prazin, Prazo,
Class: Alpha Blocker
MOA:
-Prazosin inhibits the postsynaptic alpha1-adrenoceptors.
-This inhibition blocks the vasoconstricting effect of catecholamines on the vessels, leading to peripheral blood vessel dilation through blood vessel constriction by adrenergic receptor activation, epinephrine and norepinephrine normally try to increase blood pressure.
Indication: HTN
Pregnancy Category: N/A
Contraindications: Sensitivity to quinazolines, prazosin or its ingredients
Black Box Warning: N/A
Key Patient Counseling Points:
-Do not take more or less of it or take it more often than prescribed by your doctor.
-Your doctor will probably start you on a low dose of prazosin and gradually increase your dose.
-Prazosin controls high blood pressure but does not cure it. Continue to take prazosin even if you feel well.
-Do not stop taking prazosin without talking to your doctor.
-Take this medication by mouth with or without food, usually two or three times daily or as directed by your doctor. If stomach upset occurs, take with food or milk. The dosage is based on your age, medical condition and response to therapy.
