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TOP 300 > Miscellaneous Cardiovascular Meds (8) > Flashcards

Miscellaneous Cardiovascular Meds (8) Flashcards

1
Q

class and brand name

generic name: metoprolol

A

class: beta blocker
brand name: lopressor, toprol XL

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2
Q

indication

metoprolol

A
  • heart failure
  • angina
  • myocardial infarction
  • arrhythmias
  • hypertension
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3
Q

MOA

metoprolol

A

beta-adrenergic blocker

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4
Q

black box warnings

metoprolol

A

abrupt withdrawl in patients with coronary artery disease

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5
Q

common ADRs

metoprolol

A
  • dizziness
  • fatigue
  • hypotension
  • bradycardia
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6
Q

rare but serious ADRs

metoprolol

A

heart failure (in patients that are fluid overloaded)

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7
Q

key counseling points

metoprolol

A
  • may cause dizziness.
  • when starting beta-blockers patients may feel fatigued, though this generally goes away with time.
  • Please avoid abruptly stopping this medication because it can cause rebound symptoms
  • If you have diabetes, this can mask the feeling of low blood glucose.
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8
Q

class and brand name

clonidine

A

class: alpha-2 adrenergic agonists
brand name: catapres, kapvay

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9
Q

indication

clonidine

A

hypertension

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10
Q

MOA

clonidine

A

Stimulates alpha-2 adrenoceptors in the brain stem, thus activating an inhibitory neuron, resulting in reduced sympathetic outflow from the CNS, producing a decrease in peripheral resistance, renal vascular resistance, heart rate, and blood pressure

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11
Q

common ADRs

clonidine

A
  • dizziness
  • drowsiness
  • fatigue
  • dry mouth
  • constipation
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12
Q

rare but serious ADRs

clonidine

A

heart block and syncope

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13
Q

key counseling points

clonidine

A
  • This drug is for your high blood pressure.
  • Side effects of this medication include drowsiness, fatigue, dry mouth, and constipation.
  • If you experience severe dizziness or passing out, please call your doctor right way.
  • Please avoid abruptly stopping this medication because it can cause rebound symptoms.
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14
Q

class and brand name

hydralazine

A

class: vasodilator
brand name: apresoline

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15
Q

indication

hydralazine

A

hypertension and heart failure with reduced ejection fraction

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16
Q

MOA

hydralazine

A

Direct vasodilation of arterioles (with little effect on veins). Although exact mechanism unknown, arterial vasodilation may occur via inhibition of calcium release from the sarcoplasmic reticulum and inhibition of myosin phosphorylation in arterial smooth muscle cells

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17
Q

major contraindications

hydralazine

A

coronary artery disease

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18
Q

common ADRs

hydralazine

A

dizziness and reflex tachycardia

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19
Q

rare but serious ADRs

hydralazine

A

drug induced lupus erythematosus (DILE)

especially at high doses

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20
Q

key counseling points

hydralazine

A
  • This drug is for your high blood pressure.
  • Side effects of this medication include dizziness.
  • If you develop a skin rash while on this medication please contact your doctor.
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21
Q

class and brand name

nitroglycerin

A

class: venodilator
brand name: minitran, nitrostat, nitro-dur

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22
Q

indication

nitroglycerin

A
  • chest pain (angina)
  • heart failure with reduced ejection fraction
  • hypertension
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23
Q

MOA

nitroglycerin

A

Forms the free radical nitric oxide which in smooth muscle activates guanylate cyclase which increases guanosine 3’5’ monophosphate (cGMP) leading to smooth muscle relaxation.
Produces a vasodilator effect on the peripheral veins and arteries with more prominent effects on the veins

24
Q

major contraindication

nitroglycerin

A

use with phosphodiesterase 5 inhibitors (sildenafil, tadalafil)

25
Q

common ADRs

nitroglycerin

A

headaches and dizziness

26
Q

rare but serious ADR

nitroglycerin

A

syncope

27
Q

key counseling points

nitroglycerin

A
  • Sublingual/Spray: This medication is to be used when you feel severe chest pain. Sit before taking this medication. Dissolve one table under your tongue or use spray every 5 minutes for up to 3 doses. Call 911. You may feel dizziness or a burning/tingling in your mouth.
  • Tablet: This medication is for your heart failure, chest pain, or hypertension. It may cause dizziness or a headache.
28
Q

class and brand name

ranolazine

A

class: antianginal
brand name: ranexa

29
Q

indication

ranolazine

A

angina

30
Q

MOA

ranolazine

A

Ranolazine inhibits the late phase of the inward sodium channel during cardiac repolarization reducing intracellular sodium concentrations, thereby reducing calcium influx via Na+-Ca2+ exchange that in turn reduces ventricular tension and myocardial oxygen consumption

31
Q

major contraindications

ranolazine

A
  • hepatic cirrhosis
  • concurrent use of strong CYP3A4 inhibitors or inducers
32
Q

common ADRs

ranolazine

A

Constipation and nausea

33
Q

rare but serious ADRs

ranolazine

A

QT prolongation

34
Q

key counseling points

ranolazine

A
  • This medication is for your chest pain.
  • Swallow the tablet whole, do not crush or chew.
  • The medication may cause some constipation and nausea. Many drug interactions exist so please inform your doctor if you have any medication changes.
35
Q

class and brand name

sacubitril/valsartan

A

class: ARB/Neprilysin inhibitor
brand name: entresto

36
Q

indication

sacubitril/valsartan

A

Heart failure with reduced ejection fraction

37
Q

MOA

sacubitril/valsartan

A
  • ARB: Selective, reversible competitive antagonist of angiotensin II receptor. The angiotensin II receptor is responsible for vasoconstriction, aldosterone secretion, sympathetic outflow, and simulation of renal sodium reabsorption
  • Neprilysin inhibitor: inhibits neprilysin leading to decrease breakdown of natriuretic peptides; inducing vasodilation and natriuresis
38
Q

major contraindications

sacubitril/valsartan

A

pregnancy and use of an ACEI within 36 hours

39
Q

black box warnings

sacubitril/valsartan

A

pregnancy

40
Q

common ADRs

sacubitril/valsartan

A
  • hyperkalemia
  • hypotension
  • acute kidney injury
41
Q

rare but serious ADRs

sacubitril/valsartan

A

angioedema

42
Q

key counseling points

sacubitril/valsartan

A
  • This medication is for your heart failure.
  • May cause dizziness (worsens when dehydrated).
  • It should be avoided in pregnancy.
  • Use potassium supplements/salt substitutes only under medical supervision.
  • Stop taking the medication and call your doctor right away if you experience any swelling of the mouth or lips.
43
Q

class and brand name

digoxin

A

class: cardiac glycoside
brand name: digitek, lanoxin

44
Q

indication

digoxin

A

atrial fibrillation and heart failure with reduced ejection fraction

45
Q

MOA

digoxin

A
  • Atrial fibrillation: Direct suppression of the AV node conduction to increase effective refractory period and decrease conduction velocity
  • Heart Failure: Inhibition of the sodium/potassium ATPase pump in myocardial cells results in a transient increase of intracellular sodium, which in turn promotes calcium influx via the sodium-calcium exchange pump leading to increased contractility
46
Q

common ADRs

digoxin

A

anorexia and diarrhea

47
Q

rare but serious ADRs

digoxin

A

arrhythmias and heart block

48
Q

key counseling points

digoxin

A
  • This drug is for your atrial fibrillation or heart failure.
  • You may require blood draws to confirm you are receiving a safe an effective dose.
  • This drug has many drug interactions so check with your doctor before starting or changing any medications.
49
Q

class and brand name

amiodarone

A

class: class III antiarrhythmic
brand name: codarone, pacerone

50
Q

indication

amiodarone

A

atrial or ventricular arrythmia

51
Q

MOA

amiodarone

A

Class III antiarrhythmic agent which inhibits adrenergic stimulation (alpha- and beta-blocking properties), affects sodium, potassium, and calcium channels, prolongs the action potential
and refractory period in myocardial tissue; decreases AV conduction and sinus node function

52
Q

black box warnings

amiodarone

A
  • arrhythmias
  • hepatotoxicity
  • proarryhthmic effects
  • pulmonary toxicity
53
Q

common ADRs

amiodarone

A
  • bradycardia/hypotension
  • nausea/vomiting
  • photosensitivity
54
Q

rare but serious ADRs

amiodarone

A
  • hepatotoxicity
  • proarrhythmic effects
  • pulmonary toxicity
  • thyroid disease
55
Q

key counseling points

amiodarone

A
  • This medication is to treat your heart rhythm.
  • There are many side effects and drug interactions associated with this medications so it requires close monitoring with your doctor.
  • Always wear sunscreen or cover your skin when in direct sunlight, a blue-greying of your skin can appear.

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