Pharmacology Flashcards
Atenolol (Tenormin)
Cardio
Beta blocker
* Indications: HTN, angina, post-MI, essential tremor, migraine, cluster headache (prevention), panic disorder
* MOA: ↓ HR, ↓ contractility, and ↓AVN conductivity
* Contraindications: Raynaud, asthma, sinus bradycardia, sinus node disfunction, heart block (other than 1st degree), edema, pregnancy (C)
* AE: Bradycardia, hypotension, glucose/lipid dysmetabolism, dizziness, fatigue, insomnia, constipation, alopecia, sexual dysfunction
* Interaction: Can increase the effect of drugs that slow down AV condition (digoxin, verapamil, diltiazem, alpha blockers), can mask tachycardia from hypoglycemia, decreased effects with aluminum salts/barbituates/NSAIDs/penicillin, depletes COQ10
* Caution: Abrupt withdrawral may cause rebound HTN
Carvedilol (Coreg)
Cardio
Beta-adrenergic blocking agent
* MOA: Alpha blocking: Vasodilation > dec. peipheral vascular resistance, dec. preload, dec. afterload, incr. renal blood flow, reduce portal HTN and pressure gradient in hepatic venous. Improve endothelial function and vascular remodeling.
* Indications: Mild to severe heart failure, left ventricular dysfunction.
* Containdications: Bronchial asthma, AV block, sick sinus syndrome, severe bradycardia, cardiogenic shock, severe hepatic impairment, pregnancy (C).
* AE: Hypotension, dizziness, fatigue, hyperglycemia, weight gain, diarrhea, weakness, bradycardia
* Interactions: Inhibited by delavirdine, fluconazole, ketoconazole, NSAIDs, sulfonamides, serum levels increased by chlonidine and cimetidine, depletes COQ10.
Metoprolol (Lopressor)
Cardio
Selective B1-receptor blocker
* MOA: ↓ HR, ↓ contractility, and ↓AVN conductivity
* Indications: CAD, compensated HF, arrhythmias (Afib), atrial flutter
* Contraindications: Bradycardia, hypotension, cardiogenic shock, decompensated HF, with CCB (diltiazem, verapamil) can precipitate AV block, sick sinus syndrome, pheochromocytoma (b-blocker before a-blocker → unopposed a-adrenoceptor mediated vasoconstriction → hypertensive crisis), heart block over 1 degrees, pregnancy C
* AE: Bradycardia, bradyarrhythmia
* Interactions: ↑ Effect of drugs that ↓ AV conductivity. ↓ Effects w/ aluminum salts, barbiturates, NSAIDS, penicillin. Can mask tachycardia from hypoglycemia. Depletes CoQ10.
* Caution: Abrupt withdrawral may cause rebound HTN
Propranolol (Inderal)
Cardio
Beta blocker
* * MOA: ↓ HR, ↓ contractility, and ↓AVN conductivity
* Indications: HTN, angina pectoris, post-MI, cluster headache prevention, panic disorder, essential tremor, migraine
* Contraindications: Raynaud’s syndrome, asthma, sinus bradycardia, sinus node dysfunction, heart block other than 1st degree, cardiogenic shock, edema, pregnancy C
* AE: Bradycardia, hypotension, glucose and lipid dysmetabolism, sexual dysfunction, dizziness, fatigue, insomnia, constipation, alopecia
* Interactions: Can ↑ effect of drugs that slow AV conditions (digoxin, verapamil, diltiazem, alpha blockers). Can mask tachycardia from hypoglycemia. ↓ Effects w/ aluminum salts, barbiturates, NSAIDS, penicillin. Depletes CoQ10.
* Caution: Abrupt withdrawal may cause rebound HTN
Rarely used today due to it’s non-selectivity with a tendency to cause bronchospasm
Lisinopril (Prinivil)
Cardio
ACE Inhibitor
* * MOA: Inhibition of ACE enzyme → ↓ angiotensin II (→ ↓ vasoconstriction → ↓ BP)
* Indications: HTN (esp w/ high renin activity), edema, hypervolemia, CHF, chronic renal failure, diabetic nephropathy
* Contraindications: Bone marrow suppression, renal artery stenosis, hyperkalemia, low renin HTN, pregnancy D
* AE: Dry cough, rash, fever, dizziness, neutropenia (higher risk w/ impaired renal fxn), proteinuria and nephrotic syndromes (in otherwise healthy pt), severe hypotension after first dose in CHF, renal artery stenosis, “scalded mouth” syndrome.
* Interactions: Antacids and NSAIDs interfere, capsaicin exacerbates cough, ↑ digoxin and lithium levels/toxicity, ↑ risk for hyperkalemia w K+sparing diuretics.
* Caution:
Amlodipine (Norvasc)
Cardio
CCB
* * MOA: Potent vasodilator (via relaxation of smooth muscle), minimal myocardial depressant activity
* Indications: HTN, angina
* Contraindications: Sick sinus syndrome, heart block, hypotension, acute MI, pulmonary congestion, chronic renal failure, unstable angina, pregnancy C
* AE: Edema, constipation, heartburn, fatigue, dizziness, palpitations, AV block, erectile dysfunction, nausea, headache, gynecomastia
* Interactions: Synergistic toxicity with B-blockers. ↑ Toxicity of carbamazepine, cyclosporine, digoxin, and theophylline. Calcium, vit D, barbiturates, rifampin, and phenytoin ↓ effects. H2-blocker antacids and quinidine ↑ effects/toxicity. Unpredictable interaction w/ lithium.
* Caution: Abrupt withdrawal > cause rebound HTN
Clonidine (Carapres)
Cardio
Central alpha agonist
* * MOA: Inhibit alpha-1 receptors (e.g., in smooth muscle): ↓ vasoconstriction → ↓ blood
pressure; relaxation of bladder neck muscles → ↓ bladder outlet obstruction and easier micturition
* Indications: Hypertensive urgency, HTN (alone or in combo w/ diuretics, cardiac glycosides, ACE-I, calcium agonist), BPH sx, symptomatic control of opioid withdrawal
* Contraindications: R/O prostate cancer before prescribing for BPH. Pregnancy C
* AE:
* Interactions: Hypotensive effects ↑ with B-blockers, diuretics, ACE-I, CCB, and other hypertensives. ↓ Effects w NSAIDs. Avoid dong quai, yohimbe, ginseng, garlic. Avoid saw palmetto w/ BPH (depletes COQ10)
* Caution: Syncope may happen within 90 mins of first dose.
Valsartan (Diovan)
Cardio
Spironolactone (Aldactone)
Cardio
Hydrochlorothiazide (HydroDiuril)
Cardio
Furosemide (Lasix)
Cardio
Nitroglycerin (Nitro-stat)
Cardio
Digoxin (Lanoxin)
Cardio
Amiodarone (Cordarone)
Cardio
Atropine (AtroPen)
Cardio
Atorvostatin (Lipitor)
Cardio
