Mechanism of Action / Class Flashcards
Altoprev
Lovastatin
HMG-CoA Reductase inhibitor which prevents the conversion of HMG-CoA to mevalonate
Rate limiting step of cholesterol synthesis
decreases LDL by 20 - 55%
Pravachol
Pravastatin
HMG-CoA Reductase inhibitor which prevents the conversion of HMG-CoA to mevalonate
Rate limiting step of cholesterol synthesis
Zocor
Simvastatin
HMG-CoA Reductase inhibitor which prevents the conversion of HMG-CoA to mevalonate
rate limiting step of cholesterol synthesis
decreases LDL by 20-55%
Zetia
Ezetimibe
inhibits ABSORPTION of cholesterol in the small instestine
decreases LDL by 18-23%
Praluent
Alirocumab
PSK9 inhibitor that blocks the defradation of LDL receptor
decreases LDL by 60%
Repatha
Evolocumab
PSK9 inhibitor that blocks the degradation of LDL receptor
decreases LDL by 60%!!!
Welchol
Colesevelam
Bile Acid Sequestrant
prevent the reabsorption of bile acids
decreases LDL by 10-30%
INCREASES TG :(
Cholestyramine
Bile Acid Sequestrant
prevent the reabsorption of bile acids
decreases LDL by 10-30%
INCREASES TG :(
Antara
Fenofibrate
PPARalpha receptor activators which upregulate the expression of ApoC-II = increaes lipoprotein lipase = increase catabolism of VLDL = DECREASE TG
decrease TG by 20-50%
Lopid
Gemfibrozil
PPARalpha receptor activators which upregulate the expression of ApoC-II = increaes lipoprotein lipase = increase catabolism of VLDL = DECREASE TG
decrease TG by 20-50%
Tricor
Fenofibrate
PPARalpha receptor activators which upregulate the expression of ApoC-II = increaes lipoprotein lipase = increase catabolism of VLDL = DECREASE TG
decrease TG by 20-50%
Trilipix
Fenofibrate
PPARalpha receptor activators which upregulate the expression of ApoC-II = increaes lipoprotein lipase = increase catabolism of VLDL = DECREASE TG
decrease TG by 20-50%
Niacin
decreases hepatic synthesis of VLDL and LDL
*increases HDL by 15-35%
Lovaza
Omega-3 acid ethyl ester
fish oil that decreases TG
***can increase LDL :(
Vascepa
Icosapent ethyl
fish oil that decreases TG
**can increase LDL
Zestoretic
Lisinopril / HTCZ
-ACE inhibitor block conversion of angiotensin I to II to decrease vasoconstriction and aldosterone secretion
- Thiazide inhibit sodium reabsorption in the distal convoluted tubule
Exforge
Valsartan / Amlodipine
-ARB block angiotensin II from binding to its receptor and preventing vasoconstriction
- DHP CCB inhibit Ca ions from entering vascular smooth muscle to decrease peripheral arterial pressure
Benicar HCT
Olmesartan / HTCZ
-ARB block angiotensin II from binding to its receptor and preventing vasoconstriction
- Thiazide inhibit sodium reabsorption in the distal convoluted tubule causing increased secretion of water, Na, Cl, and K
Diovan HCT
Valsartan / HTCZ
-ARB block angiotensin II from binding to its receptor and preventing vasoconstriction
- Thiazide inhibit sodium reabsorption in the distal convoluted tubule causing increased secretion of water, Na, Cl, and K
Ziac
Bisoprolol / HCTZ
- Beta- 1 selective beta blockers causes decrease in HR
**preferred in HF patients
- Thiazide inhibit sodium reabsorption in the distal convoluted tubule causing increased secretion of water, Na, Cl, and K
Maxzide, Dyazide
Triamterene / HTCZ
- Potassium sparing diuretic
- Thiazide inhibit sodium reabsorption in the distal convoluted tubule causing increased secretion of water, Na, Cl, and K
Tenoretic
Atenolol / Chlorthalidone
- beta 1 selective beta blockers cause decrease HR
- Thiazide inhibit sodium reabsorption in the distal convoluted tubule causing increased secretion of water, Na, Cl, and K
Lotrel
Benazepril / Amlodipine
-ACE inhibitor block conversion of angiotensin I to II to decrease vasoconstriction and aldosterone secretion
- DHP CCB inhibit Ca ions from entering vascular smooth muscle to decrease peripheral arterial pressure
Norvasc
Amlodipine
DHP CCB inhibit Ca ions from entering vascular smooth muscle to decrease peripheral arterial pressure
Cardene IV
Nicardipine
DHP CCB inhibit Ca ions from entering vascular smooth muscle to decrease peripheral arterial pressure
Procardia XL
Nifedipine ER
DHP CCB inhibit Ca ions from entering vascular smooth muscle to decrease peripheral arterial pressure
Adalat CC
Nifedipine ER
DHP CCB inhibit Ca ions from entering vascular smooth muscle to decrease peripheral arterial pressure
Tiazac
Diltiazem
non DHP CCB control HR
**negative inotropic (contraction) effects too
moderate pgp and CYP3A4 inhibitors LOWER the doses of simvastatin and lovastatin!!!
Calan SR
Verapamil
non DHP CCB control HR
**negative inotropic (contraction)
moderate pgp and CYP3A4 inhibitors LOWER the doses of simvastatin and lovastatin!!!
Altace
Ramipril
ACE inhibitor block Angio I to II conversion to decrease vasoconstriction and aldosterone release
Vasotec
Enalapril
ACE inhibitor block Angio I to II conversion to decrease vasoconstriction and aldosterone release
Lotensin
Benazepril
ACE inhibitor block Angio I to II conversion to decrease vasoconstriction and aldosterone release
Prinivil
Lisinopril
ACE inhibitor block Angio I to II conversion to decrease vasoconstriction and aldosterone release
Accupril
Quinipril
ACE inhibitor block Angio I to II conversion to decrease vasoconstriction and aldosterone release
Avapro
Irbesartan
ARB block angio II from receptor to prevent vasoconstriction
Benicar
Olmesartan
ARB block angio II from receptor to prevent vasoconstriction
Cozaar
Losartan
ARB block angio II from receptor to prevent vasoconstriction
Diovan
Valsartan
ARB block angio II from receptor to prevent vasoconstriction
Aliskiren
Direct renin inhibitor
Aldactone
Spironolactone
Aldosterone antagonist (non-selective) will also block androgen
Eplerenone
Selective aldosterone antagtonist
(no endocrine side effects)
Triamterene
Potassium sparing diuretic
Lopressor
Metoprolol
Beta 1 selective blocker
Bystolic
Nebivolol
Beta 1 selective blocker with Nitric Oxide (NO) vasodilation
Inderal
Propanolol
Beta 1 and 2 blocker
***HIGHLY lipid solubility that passes BBB
Corgard
Nadolol
Beta 1 and 2 blocker
***HIGHLY lipid soluble that passes BBB
Coreg
Carvediol
Beta 1, 2 and Alpha 1 blocker
Labetalol
Beta 1,3, and alpha 1 blocker
Catapres
Clonidine
central acting alpha 2 agonist that stimulating sympathetic outflow of NE to decrease SVR and HR
***patch formulation for patients who cannot swallow!!!
remember it is Kapvay for ADHD
Methyldopa
centrally acting alpha 2 agonist that stimulates NE to decrease SVR and HR
***DILE drug
Guanfacine
Centrally acting alpha 2 agonist
** Intuniv brand name for ADHD
Hydralazine
direct vasodilator of arteries
***DILE drug
Sacubitril
Neprilysin inhibitor that increases Natriuretic Peptide that are VASODILATORY
***1st line in HFrEF
What are the first line agents for Heart Failure patients?
Beta blockers
ACE inhibitors (Entresto)
Loop diuretics
What HF medications decrease mortality?
Aldosterone Antagonists
SGLT2 inhibitors
Beta blockers
ACE/ARBs
Hydralazine/Nitrate
What benefit does Lanoxin provide in heart failure patients?
increase cardiac output and decreases cardiac hospitalizations
MOA: inhibits Na-K-ATPase causing a positive inotropic effect (increasing cardiac output) and negative chronotropic effect (decrease HR)
SE: bradycardia, hypokalemia, hypomagnesium, hypercalcemia, mental disturbances
PGP and CYP substrate (lower dose by 50% with amiodarone)
What are the requirements for starting ivabradine in a heart failure candidate?
- must be at target dose on all mortality decreasing HF medications
- be in sinus rhythm with HR >/= 70 bpm
SE: bradycardia, QTc prolongation, afib
**do not use with strong CYP3A4 inhibitors
Vericiguat can be used to treat what?
Heart failure
soluble cGC stimulator
BW: pregnancy - need contraception during use!
What supplementation might be needed for HF patients?
Potassium (Klor-Con, Micro-K, K-Tab)
Oral solution 10% (20mEq/15mL) mix with 6 oz of water
Capsules: Klor-Con Sprinkle, Micro-K can be opened
ER tablets: K-Tab, Klor-Con 10 swallow whole
Klor Con M - can be split it half
SE; abdominal pain/cramping, DIARRHEA, nausea, flatuence
