Drugs and Classes Flashcards
captopril
RAAS - ACE inhibitor
hyperkalemia, orthostatic hypoTN, angioedema, persistent cough, neutropenia
cardioprotection
norepinephrine
adrenergic agonist
necrosis, tachycardia, HTN
monitor urine output, extremity perfusion
short half life
lovastatin
dislipidemia halt formation of VLDL, LDL
hepatotoxic, myopathic
rhabdomyolysis
avoid: grapefruit juice
atenolol
β1 blocker slows HR, lowers BP bradycardia, hypoTN, masked hypoglycemia d/t blocked adrenaline HOLD if HR<50 do not abruptly discontinue cardioprotection
losartan
RAAS - angiotensin II antagonist (ARB)
hyperkalemia, orthostatic hypoTN, angioedema
propranolol
β1, β2 blocker slows HR, lowers BP, bronchoconstricts
bradycardia, hypoTN, masked hypoglycemia d/t blocked adrenaline, bronchoconstriction!
HOLD if HR<50; contraindicated for pts w/resp dz
do not abruptly discontinue
cardioprotection
epinephrine
adrenergic agonist, combined w/local anesthetic
increases HR, BP, contractile force, bronchodilates, vasoconstricts
effects last 10-20mins
monitor urine output, extremity perfusion
nitroglycerin
anti-angina - widespread vasodilation at onset
headache (common), orthostatic hypoTN, reflex tachycardia, tolerance–>rest period needed
3 pill max, 5min b/w each
avoid: erectile dysfunction meds
digoxin
afib, heart failure - lower HR, increased contractile force
bradycardia, disrhythmias
toxicity: (early) N/V/anorexia, (late) yellow/halo vision, bradydysrhythmias, altered mental status, syncope
avoid: diuretics, ACE inhibitors, ARBs, antacids
must maintain nml K levels
hold if apical HR<60
lisinopril
RAAS - ACE inhibitor
hyperkalemia, orthostatic hypoTN, angioedema, persistent cough
cardioprotection
labetalol
β1, β2, and α1 blocker slows HR, lowers BP, bronchoconstricts, vasodilates
bradycardia, hypoTN, masked hypoglycemia d/t blocked adrenaline, bronchoconstriction
HOLD if HR<50; contraindicated for pts w/resp dz
do not abruptly discontinue
cardioprotection
mannitol
emergency diuretic reduces intracranial pressure/cerebral edema
may cause: heart failure, rebound intracranial pressure, metabolic acidosis, crackles
must be kept warm, used with filter d/t crystallization
carvedilol
β1, β2, and α1 blocker slows HR, lowers BP, bronchoconstricts, vasodilates
bradycardia, hypoTN, masked hypoglycemia d/t blocked adrenaline, bronchoconstriction
HOLD if HR<50; contraindicated for pts w/resp dz
do not abruptly discontinue
cardioprotection
enalapril
RAAS - ACE inhibitor
hyperkalemia, orthostatic hypoTN, angioedema, persistent cough
cardioprotection
dobutamine
adrenergic agonist
necrosis, tachycardia, HTN
increased cardiac workload
monitor urine output, extremity perfusion
furosemide
diuretic for edema or heart failure (too strong for HTN)
hypokalemia: fatigue, cramps, palpitations, N/V
tinnitus!!, hyperglycemia
atorvastatin
dislipidemia halt formation of VLDL, LDL
hepatotoxic, myopathic
rhabdomyolysis
avoid: grapefruit juice
diltiazem
calcium channel blocker - decrease BP, HR
HTN, angina pectoris, CCBS: peripheral edema, bradycardia, syncope
avoid: grapefruit juice
nifedipine
calcium channel blocker - decrease BP
HTN, angina pectoris, peripheral edema, syncope
avoid: grapefruit juice
niacin/nicotinic acid
vitamin B3 (meat) - increases HDL, decreases LDL intense flushing of the face, GI issues may take aspirin 30min prior to admin
nitroprusside
HTN crisis - drastic drop in BP
must be protected from light
may cause cyanide poisoning
hydrochlorothiazide
diuretic, 1st drug of choice for HTN
hypokalemia: fatigue, cramps, palpitations, N/V
hyperglycemia
clonidine
anti-HTN
drowsiness, dry mouth
avoid: other CNS depressants
metaprolol
β1 blocker slows HR, lowers BP bradycardia, hypoTN, masked hypoglycemia d/t blocked adrenaline HOLD if HR<50 do not abruptly discontinue cardioprotection
dopamine
adrenergic agonist
necrosis, tachycardia, HTN
monitor urine output, extremity perfusion
simvastatin
dislipidemia halt formation of VLDL, LDL
hepatotoxic, myopathic
rhabdomyolysis
avoid: grapefruit juice
rosuvastatin
dislipidemia halt formation of VLDL, LDL
hepatotoxic, myopathic
rhabdomyolysis
avoid: grapefruit juice
amiodarone
cardiac dysrhythmias
baseline testing needed
dysrhythmias, hepatotoxicity, pulmonary toxicity, thyroid dysfunction, photosensitivity, visual disturbances
adenosine
IV push anti-dysrhythmic stops the heart
short half life
resuscitation equipment on hand
avoid: caffeine
isosorbide mononitrate
anti-angina - prophylactic widespread vasodilation
headache (common), orthostatic hypoTN, reflex tachycardia, tolerance–>rest period needed
avoid: crushing med, erectile dysfunction meds
spironolactone
diuretic
increases potassium levels–>hyperkalemia: arrhythmias, fatigue, cramps, palpitations, N/V
may cause endocrine issues
avoid: K rich foods, salt substitutes
verapamil
calcium channel blocker - decrease BP, HR
HTN, angina pectoris, CCBS: peripheral edema, constipation, bradycardia, syncope
avoid: grapefruit juice
amlodipine
calcium channel blocker - decrease BP
HTN, angina pectoris, peripheral edema, syncope
avoid: grapefruit juice
aspirin
antiplatelet aggregation
GI, renal impairment, tinnitus, diaphoresis, headache, acidic blood–>Kussmal resp
sx of bleeding: increased HR, decreased BP, ecchymosis, coffee-ground emesis, melena
avoid: herbals “g”
clopidogrel
antiplatelet aggregation
GI
sx of bleeding: increased HR, decreased BP, ecchymosis, coffee-ground emesis, melena
avoid: herbals “g”
heparin
rapid acting, short half-life anticoagulant
requires close monitoring of PTT:
nml = 40sec, therapeutic = 60-80sec
sx of bleeding: increased HR, decreased BP, ecchymosis, coffee-ground emesis, melena
antidote: protamine
avoid: herbals “g”
enoxaparin
rapid acting, longer half-life anticoagulant
less monitoring needed
must inject in subcutaneous “love handles”, don’t twist cap/aspirate, leave air bubble in syringe
must take at same time daily
sx of bleeding: increased HR, decreased BP, ecchymosis, coffee-ground emesis, melena
avoid: herbals “g”
antidote: protamine
warfarin
5 day delayed onset
must monitor PT/INR:
nml = 1, therapeutic = 2-3, mechanical heart valves = 3-4.5
must maintain vitamin K levels (leafy greens, mayo)
avoid: herbals “g”
antidote: vitamin K
protamine sulfate
antidote for heparin, enoxaparin anticoagulants
epoeitin alpha
anti-anemia - synthetic erythropoeitin
HTN, risk CV events, tumor progression
darbepoetin alpha
long acting anti-anemia - synthetic erythropoeitin
HTN, risk CV events, tumor progression
ferrous sulfate
iron deficient anemia take b/w meals w/OJ to increase absorption nausea, constipation, dark green/melena liquid form stains teeth avoid: antacid, dairy, caffeine
iron dextran
iron deficient anemia
avoid: antacid, dairy, caffeine
cyanocobalamin
deficient anemia - vitamin B12
hypokalemia
blood
acute hemolytic rxn d/t ABO incompatability
sx occu w/in 20mins:
chills, fever, tachycardia, lower back pain, hematuria
stop transfusion STAT
metformin
biguanide type II diabetes anorexia, N/V/D, flatulence, vitamin B12/folic acid deficiency lactic acidosis - rare need CBC q3months, monitor kidneys avoid: excess ETOH d/t lactic acidosis
glipizide
sulfonylurea type II diabetic
hypoglycemia, weight gain
take w/breakfast
avoid: ETOH d/t disulfiram-like rxn
glyburide
sulfonylurea type II diabetic
hypoglycemia, weight gain
take w/breakfast
avoid: ETOH d/t disulfiram-like rxn
glimepiride
sulfonylurea type II diabetic
hypoglycemia, weight gain
take w/breakfast
avoid: ETOH d/t disulfiram-like rxn
insulin
diabetes
hypoglycemia
increased affect w/sulfonylreas, beta blockers, ETOH
counteracted w/thiazide diuretics, glucocorticoids
may tx hyperkalemia
omeprazole
proton pump inhibitor slow onset, short half-life rebound sx: reflux, heartburn, gas pneumonia, osteoporosis, hypomagnesemia don't crush/chew; take before breakfast
esomeprazole
proton pump inhibitor slow onset, short half-life rebound sx: reflux, heartburn, gas pneumonia, osteoporosis, hypomagnesemia don't crush/chew; take before breakfast
pantoprazole
proton pump inhibitor slow onset, short half-life rebound sx: reflux, heartburn, gas pneumonia, osteoporosis, hypomagnesemia don't crush/chew; take before breakfast
lansoprazole
proton pump inhibitor slow onset, short half-life rebound sx: reflux, heartburn, gas pneumonia, osteoporosis, hypomagnesemia don't crush/chew; take before breakfast
ranitidine
H2 blocker - stomach diminished effect over time rebound sx if abruptly stopped confusion w/poor renal function avoid: antacid w/in 1h
cimetidine
H2 blocker - stomach diminished effect over time rebound sx if abruptly stopped confusion w/poor renal function avoid: antacid w/in 1h