Drugs to treat Endo-, Myo- and Pericarditis Flashcards
what drug classes are used to treat myocarditis?
ACE inhibitors Angiotensin II receptor blocker Aldosterone receptor blocker Beta blockers Diuretics
what is the common suffix for ACE inhibitors?
-pril
what is the common suffix for angiotensin II receptor blockers?
-sartan
what ACE inhibitors are used to treat myocarditis?
Baking Can Enable Fat Losers
Benazepril Captopril Enalapril Fosinopril Lisinopril
what are some adverse reactions of benazepril?
alopecia anaphylactic reactions angina angioedema anxiety
what are contraindications for giving benazepril?
ACE-inhibitor induced angioedema agranulocytosis ACE inhibitor hypersensitivity aoritc stenosis black patients (?) bone marrow suppression breast feeding cardiomyopathy CVD children
what must be monitored when giving benazepril?
BP
creatinine/BUN
potassium
sodium
what are some adverse reactions of captopril?
abdominal pain
agranulocytosis
alopecia
anaphylactic reaction
what are contraindications for giving captopril?
*Sulphur allergy* ACE inhibitor induced angioedema angioedema ACE inhibitor hypersensitivitiy aortic stenosis
what must be monitored when giving captopril?
BP
creatinine/BUN
potassium
sodium
what are some adverse reactions of enalapril?
abd pain alopecia anaphylacic reaction anemia angina angioedema anorexia anxiety arrhythmia exacerbation
what are contraindications to giving enalapril?
ACE inhibitor induced angioedema angioedema black patients breast feeding children geriatric heart failure hepatic disease hyperkalemia
what must be monitored when giving enalapril?
BP
LFTs
bilirubin
what is the black box warning of enalapril?
Fetal toxicity
what are some adverse reactions of fosinopril?
abd pain agranulocytosis anaphylactic reaction anemia angina angioedema arthralgia azotemia bradycardia bronchospasm
what are contraindications to giving fosinopril?
ACE inhibitor induced angioedema angioedema ACE inhibitor hypersensitivity aortic stenosis autoimmune disease black patients bone marrow suppression breast feeding cardiomyopathy CVD
what must be monitored when giving fosinopril?
BP
creatinine/BUN
potassium
sodium
what is the block box warning of fosinopril?
fetal toxicity
what are indications for giving benazepril?
HTN management
treatment for HF
what are indications for giving captopril?
HTN management
CHF
diabetic neuropathy
scleroderma
what are indications for giving enalapril?
*stroke prophylaxis* diabetic neuropathy HF HTN management proteinuria
what are indications for giving fosinopril?
HF
HTN management
proteinuria
what are indications for giving lisinopril?
HTN management
HF
acute MI
what drugs interaction with lisinopril?
diuretics
antidiabetics
NSAIDs
what are contraindications to giving lisinopril?
hypersensitivity
angioedema
what are some adverse reactions to lisinopril?
alopecia anaphylacic reaction anemia angioedema arthralgia asthenia azotemia blurred vision
what is the black box warning of lisinopril?
fetal toxicity
what angiotensin II receptor blockers are used to treat myocarditis?
Valsartan
Losartan
what are indications for giving valsartan?
HTN management
HF
Post MI
what are adverse reactions of valsartan?
allergic reaction asthenia palpitations pruritis/rash constipation dry mouth myalgia anxiety dyspnea vertigo impotence
what is the black box warning of valsartan?
fetal toxicity
what are indications for giving losartan?
HTN management
stroke prevention
diabetic nephropathy
what are some adverse reactions of losartan?
abd pain alopecia anaphylacic reaction anemia angina angioedema anorexia anxiety arrhythmia exacerbation
what are contraindications to giving losartan?
ACE inhibitor induced angioedema angioedema black patients breast feeding children geriatrics HF hepatic disease hyperkalemia hypotension hypovolemia
what must be monitored when giving losartan?
BP
LFTs
bilirubin
what is the black box warning of losartan?
fetal toxicity
what beta blockers are used to treat myocarditis?
Carvedilol - nonselective alpha and beta blocker
Bisoprolol - beta 1 blocker
Metoprolol - beta 1 blocker
what are indications for giving carvedilol?
CHF
post MI left ventricular dysfunction
HTN management
what are contraindications to giving cavedilol?
bronchial asthma or bronchospamsic conditions second or third degree AV block severe bradycardia hepatic impairement hypersensitivity
what are adverse reactions of carvedilol?
dizziness fatigue hypotension diarrhea hyperglycemia asthenia bradycardia weight gain
what must be monitored when giving carvedilol?
BP
HR
what can happen if you abruptly stop beta blockers?
acute exacerbation of coronary artery disease
what are indications for giving bisoprolol?
angina
afib
CHF
HTN management
what are contraindications for giving bisoprolol?
acute bronchospasm
acute HF
asthma
what are adverse reactions of bisoprolol?
acne alopecia angina angioedema arthralgia asthenia AV block back pain bradycardia bronchospasm cough depression
what must be monitored when giving bisoprolol?
BP
HR
creatitine/BUN
what are indications for giving metoprolol?
acute MI angina afib/aflutter cardiomyopathy HF HTN management migraine prophylaxis tremor CV mortality prevention
what are contraindications for giving metoprolol?
acute bronchospasm acute HF asthma AV block hypersensitivity bradycardia breast feeding bronchitis cardiogenic shock CV disease
what are some adverse reactions of metoprolol?
abd pain agranulocytosis alopecia amnesia anxiety arthralgia AV block blurred vision
what must be monitored when giving metoprolol?
BP
HR
what diuretic is used to treat myocarditis?
furosemide
what are indications for giving furosemide?
edema associated with:
CHF
pulmonary edema
impaired GI absorption
what are contraindications to giving furosemide?
anuria
hx of hypersensitivity
what are adverse reactions of furosemide?
water/electrolyte depletion dry mouth thirst weakness lethargy myalgia hypotension oliguria tachycardia arrhythmia N/V
what drugs should not be used with furosemide?
aminoglycoside antibiotics
ethacrynic acid - ototoxicity
what aldosterone receptor blocker is used to treat myocarditis?
spironolactone
what are indications to giving spironolactone?
CHF edema management HTN management hepatic/nephrotic syndrome primary hyperaldosteronism
what are contraindications to giving spironolactone?
hypokalemia
addison’s disease
concomitant use of Eplerenone
what are some adverse reactions of spironolactone?
hyperkalemia hypotension impaired renal function electrolyte dysfunction gynecomastia
what drugs interact with spironolactone?
agents that increase potassium
Lithium
NSAIDs
what drugs are used to treat pericarditis?
glucocorticoids
NSAIDs
what is the first line treatment for pericarditis?
NSAIDs
when should glucocorticoids be used to treat pericarditis?
only in patients with NSAID contraindications:
history of peptic ulcer
> 65 y/o
concurrent use of ASA, corticsosteroids or anticoagulants
what two drugs are the preferred NSAIDs for treating pericarditis?
ibuprofen
colchicine
what are contraindications to giving ibuprofen?
acute gastric or duodenal ulcer
significant hepatic impairment or active liver disease
impaired renal function
what are some adverse reactions of ibuprofen?
decreased appetite
edema/fluid retention
what are some indications for giving colchicine?
gout
pericarditis
what are contraindications to giving colchicine?
patients with renal and/or hepatic impairment
drugs that inhibit CYP3A4
what are some adverse reactions of colchicine?
GI symptoms:
N/V
diarrhea
abd pain
what drugs are used to treat endocarditis?
antibacterials: #1 choice is vancomycin because it covers staph, strep and enterococci
what is a contraindication to giving vancomycin?
hypersensitivity
what are adverse reactions to vacomycin?
anaphylaxis "red man syndrome" (that sounds racist) AKI hearing loss neutropenia C. diff
what drugs interact with vancomycin?
anesthetic agents:
may cause erythema and histamine-like flushing
