Pharm 2 Flashcards by Hyuk Lee

3 A1 blocker Agents

Terazosin
Doxazosin
Prazosin — NOT approved for BPH // for PTSD

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(HTN)

A2 Agonists

Clonidine (PO/Patch)

Methyldopa — First line for HTN in Pregnancy

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(HTN)

B-Blockers Agents (ISA)

Acebutolol — B1 selective
Pindolol —Greater ISA than Acebutolol (Non-Selective)
Penbutolol

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(HTN)

Mixed a1 and Nonspecific B-blockers

Carvedilol — Both HF and HTN

Labetalol — 2nd line during Pregnancy

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Carvedilol

Pts w/ BOTH HF and HTN
Reduce Morbidity and Mortality w/ HF
Tablet ONLY —> Decrease Orthostatic HOTN

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Labetalol

A1 and Nonspecific B-blockers (HTN)

HTN(PO) — 2nd line during Pregnancy
Severe HTN (IV)

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Reserpine

MOA — Reduce Catecholamines
W/ other agents against MORE SEVERE forms of HTN

Adverse
Significant Mental Depression and Anxiety

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(HTN)

Main DHP-CCB

-Pine

Amlodipine
Clevidipine(IV)
Nicardipine(IV/PO)
Nifedipine
Felodipine

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(HTN)

Non-DHP

Verapamil

Diltiazem

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Digoxin w/ _____ or ______

Verapamil or Diltiazem

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Beta blockers w/ Verapamil or Diltiazem —> _______

Bradycardia

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CCB is more efficacious in ______ Population

African American

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Hydralazine

Atrial Vasodilators
SEVERE HTN (EMERGENCY)
Acceptable for HTN and Pregnancy
Combine w/ Nitrates (BiDil) —> Both HTN and HF in African-American pts

Lupus Erythematous like syndrome

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(HTN)

Minoxidil

Vasodilators
Pts w/ Renal Failure and Severe HTN who do NOT respond well to Hydralazine

Adverse — Hypertrichosis (Excessive hair growth)

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HTN Urgency

Agents

Clonidine
Captorpril - over clonidine if pt has HF
Labetalol — Pregnant or Cannot tolerate methyldopa

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HTN Emergency (Blurred Vision)

Vasodilators

Nitroglycerin (IV)
Sodium Nitroprusside (IV)
Fenoldopam (IV)
Hydralazine

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HTN Emergency

CCB

Nicardipine (PO/IV)

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HTN Emergency

ACEI

Enalaprilat — Rapid action, ONLY IV

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HTN Emergency

Adrenergic Inhibitors

Esmolol — Ultra-short actions cardioselective

Labetalol — Both Urgency (PO) and Emergency (IV)

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Labetalol

Selective a1 & Non-selective B blocker

Both HTN Urgency (PO) and Emergency (IV)

Preferred in coronary artery disease, End Stage Renal Disease

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Thiazides and Thiazides-like Diuretics

HCTZ
CHlorthalidone
Metolazone — CrCl <30
Chlorothaizide

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Loop Diuretics

Ethacrynic Acid — Alternative for pts w/ a Sulfa allergy
Furosemide
Bumetanide

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Osmotic Diuretics

Mannitol

(HF)

ARBs

Sacubitril/Valsartan

Angiotensin Receptor-Neprilysin Inhibitor ARNI

(HF) BB

Carvedilol — mixed a & b blockers (non-selective) Metoprolol - B1 Bisoprolol -B1

Metolazone

Thiazides & Thiazide-like Diuretics Effective at lower CrCl (<30)

(HF) Aldosterone Antagonist

Eplerenone | SPironolactone

(HF) Vasodilators

Hydralazine/Isosorbide Dinitrate (BiDil) Nitroglycerin Sodium Nitroprusside Nesirtide

Nitroglycerin (HF)

Ideal choice for HTN Emergency | Preferred agent for Preload Reduction w/ Pulmonary Congestion

DOC for HTN Emergency

Sodium Nitroprusside

(HF) Inotropic agents

Digoxin Dopamine Dobutamine Milrinone

Inotropic Agents that stimulate the Vagus Nerve

Digoxin

MOA Inhibits phosphodiesterase III (PDE3)

Milrinone

Treatment of CHF Agents that decrease Mortality

ACEI & ARBs BB Aldosterone Antagonist

Agent that reduce morbidity and mortality for African American w/ NYHA class III or IV HFrEF

BiDil

Vasodilator Free Radical NO —> Vasodilation ACS or HTN Emergency V dilation > A dilation

Nitroglycerin

Cinchonism

Quinidine (Class 1A)

Reversible lupus erythematous like syndrome

Procainamid (Class 1A)

Alternative agent in Pulseless VT/VF if amiodarone is NOT available

Lidocaine (IB)

DOC in Atrial Fibrillation and Flutter

B-Blocker

Contains Iodine >50% stop due to the side effect Pulmonary Fibrosis (Adverse) Blue Gray Skin

Amiodarone

DOC for Acute Conversion of Regular Rhythm Paroxysmal Supraventricular Tachycardia to Sinus Rhythm Only used in Emergency and Acute situation

Adenosine

Ventricular Rate Control ____________ Pts w/ Severe Asthma/Severe COPD — Preferred over B-blocker

Non-DHP CCBs

DOC for Symptomatic Bradyarrhythmia

Atropine (Anticholinergic)

DOC for Paroxysmal Supraventricular Tachycardia

Adenosine

DOC for Acute Ventricular Tachycardia/Pulseless Fibrillation

Epinephrine —> Amiodarone (1stline anti-arrhythmic) Lidocaine — 2nd Procainamide — 3rd (If pt is stable)

POC for Torsade’s de Pointes

Magnesium I

TX for Chronic Stable Angina

Rest or Nitroglycerin

First line for Stable Ischemic Heart Desease

B-Blockers

Nitrates | Stable Angina Maintenance Acute

Maintaines — w/ B-blockers or Non-DHP CCB Acute — Sublingual Tablet or Spray Nitrate

(Anti-Anginal) Two alternatives to beta blocker

CCB | Na+ Channel Blocker

(Anti-Anginal) Anti-platelet

Aspirin | Clopidogrel — Alternative to Aspirin

(Anti-anginal) For pts who have CV comorbidities (LVEF <40, HTN, DM, post MI, and or CKD)

ACEI or ARBs

Main drugs for African American

HF — Bidil HTN — Hydralazine w/ Nitrates HTN — CCBs work better w/ water pills Less responsive to ACEI and beta blocker as monotherapy

Safe for Pregnant Woman

Methyldopa — 1 Labetalol — 2 (if pt cannot tolerate methyldopa Nifedipine — DHP-CCB (HTN) Hydralazine — PO or IV (HTN)