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CV Exam 1 Drugs and Treatments
Drugs and Treatments for CV Exam 1
57
Medical
Professional
09/22/2011

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Term
Corticosteroids/cyclphosphamide
Definition
immunsuppression, for Polyarteritis Nodosa
Term
Phenylephrine
Definition
increases BP via vasoconstriction
Term
Ischemic Heart Disease
Definition
BB first/CCB alternate (stable angina), BB+ACEI (unstable angina), ACEI+BB+aldosterone antagonist (history of MI), goal <130/85
Term
Heart failure
Definition
ACEI/BB (asymptomatic), ACEI/BB/ARB/aldosterone blocker/loop diuretic (symptomatic), goal <130/85
Term
Chronic kidney disease
Definition
ACEI/ARB, thiazides not good if GFR<30 or creatinine>2.5 (switch to loop diuretic), goal <130/85
Term
Thiazide-like diuretics (hydorchlorothiazide, chlorthialidone)
Definition
inhibit Na+/Cl- symporter (ENCC1) mainly at Distal Convoluted Tubule, increased renal excretion of Na+/K+/Cl-/Mg2+, increase resorption of Ca2+, 1x daily oral therapy, for mild HTN/edema/hypercalciuria/nephrogenic diabetes, side effects of HYPONATREMIA/ARRHTYMIA/hyperuricemia/hypercalcemia/glucose intolerance/hyperlipidemia/erectile dysfunction/rash/fever/malaise
Term
Loop Diuretics (ethacrynic acid, torsemide, bumetanide, furosemide)
Definition
MOST EFFECTIVE "HIGH CEILING" DIURETICS, increase excretion of Na+/K+/Ca2+/Mg2+, rapid onset oral (30min) or IV (5min), for EDEMA/HTN/hypercalcemia, low half-life (not as good as thiazides for moderate HTN), side-effects of dehydration/circulatory collapse/hypokalemia/hyponatermia/hypomagnesemia/hyperglycemia/dyslipidemia/hyperuricemia/metabolic acidosis/OTOTOXICITY (worse IV)
Term
hydrochlorothiazide, chlorthalidomide
Definition
thiazide-like diuretics
Term
Ethacrynic acid
Definition
loop diuretic, non-sulfonamide (no allergies), increased ototoxicity
Term
Torsemide
Definition
loop diuretic, longer half-life
Term
bumetanide, furosemide
Definition
loop diuretics
Term
K+ Sparing Diuretics (amiloridine, traimterene)
Definition
block Na+ channels (ENaC) in collecting duct, reduced K+ excretion, for preventing/correcting hypokalemia, side-effects of hyperkalemia/nausea/vomiting/diarrhea and headache (amiloridine)/leg cramps and megaloblastic anemia (triamterene)
Term
amiloridine
Definition
K+ sparing diuretic, diarrhea/headache
Term
traimterene
Definition
K+ sparing diuretic, leg cramps/megaloblastic anemia
Term
Mineralocorticoid receptor antagonists (spironolactone, eplerenone)
Definition
block mineralocorticoid receptor (aldosterone), decreased ENaC and Na+K+, decreased resorption of Na+ and decreased excretion of K+/H+, ATPase activity, for hypokalemia/CHF, side-effects of hyperkalemia/hyponatremia/gynecomastia and menstrual abnormalities and GI upset and rash (spironolactone)
Term
Spironolactone
Definition
Mineralocorticoide receptor antagonist, gynecomastia/menstrual abnormalities/GI upset/rash
Term
eplerenone
Definition
mineralocorticoid receptor antagonist
Term
ACE Inhibitors (-pril drugs)
Definition
inhibit ACE conversion of AI to AII and bradykinin metabolism, cause vasodilation and decrease GFR, no changes to sympathetic reflex, 1-2x daily therapy, rapid BP fall if high renin, progressive BP fall independent of renin, for CHF/HTN/diabetes/kidney disease, decrease preload/afterload in CHF, decrease proteinuria in diabetes/kidney disease, side-effects of cough/angiodema/hypotension/hyperkalemia/LOSS OF TASTE, DO NOT USE IN PREGNANT PATIENTS
Term
-pril drugs
Definition
ACE inhibitors
Term
Captopril
Definition
ACE inhibitor, non-prodrug (active form)
Term
Angiotensin Recepter Blockers (-sartan drugs)
Definition
antagonize AT1 (AII) receptor, more selective/less side-effects than ACE inhibitors, 1x daily therapy, takes 4wks for effect, less coughing/angioedema due to no inhibition of bradykinin metabolism, DO NOT USE IN PREGNANT PATIENTS (risk to fetus)
Term
-sartan drugs
Definition
Angiotensin Receptor Blockers
Term
Direct Renin Inhibitors (aliskiren)
Definition
block renin, no conversion of angiotensin to AI
Term
Aliskiren
Definition
direct renin inhibitor
Term
Calcium Channel Blockers (-dipine drugs, diltiazem, verapamil)
Definition
inhibit L-type (slow) Ca2+ channels, cause vasodilation
Term
Dihydropyridine Class CCBs (-dipine drugs)
Definition
greter affinity for smooth m, cause tachycardia/peripheral edema
Term
-dipine drugs
Definition
CCBs, dihydropyridine class
Term
Non-Dihydropyridine Class CCBs (verapamil, diltiazem)
Definition
greater affinity for SA/AV nodes, cause AV block/bradycardia/heart failure/constipation
Term
verapamil, diltiazem
Definition
non-dihydropyridine class CCBs
Term
Nonselective B-Antagonists (nadolol, propranaolol, timolol)
Definition
block both B1 and B2, more adverse effects
Term
nadolol, propranolol, timolol
Definition
non-selective beta blockers
Term
Cardioselective B-antagonists (atenolol, bisoprolol, metoprolol)
Definition
greater affinity for B1 than B2, limited to low doses
Term
atenolol, bisoprolol, metoprolol
Definition
cardioselective beta blockers
Term
B-blockers
Definition
for mild-severe HTN, upregulation of B-receptors can cause rebound HTN (taper dose 10-14 days), PREFERRED FOR MI/ISCHEMIA/CHF, avoid in AV block/bradycardia/COPD/diabetes, side-effects of fatigue/depression/insomnia/bradycardia/dyslipidemia/glucose dysfunction
Term
Beta blockers with Intrinsic Sympathomimetic Activity (acebutolol, pindolol, penbutolol)
Definition
less decrease in HR/CO, for HTN prone to bradyarrhythmia/vascular disease, side-effects like other BBs with less bradycardia/dyslipidemia
Term
acebutolol, penbutolol, pindolol
Definition
B-blockers with ISA
Term
B-blockers with a-blocking (carvedilol, labetolol)
Definition
a-blockade causes decreased TPR, B-blockade reduces baroflex-mediated increase in HR/renin
Term
carvedilol, labetolol
Definition
B-blockers with a-blocking
Term
a-antagonists (-zosins)
Definition
acute decrease in arterial and venous resistance/reflex increase in HR/renin, chronic vasodilation and normal HR/CO/renin, lowers triglycerides/increases HDL, EXTREME POSTURAL HYPOTENSION AFTER FIRST DOSE (TAKE AT BEDTIME), a1-selective, for mild HTN/men with BPH, side-effects of dizziness/vertigo/sedation/headache/palpitations/fluid retention
Term
terazosin, doxazosin
Definition
a-antagonists, 1x per day
Term
prazosin
Definition
a-antagonist, 2-3x per day
Term
a2 agonists (clonidine, guanabenz, guanfacine, methyldopa)
Definition
stimulate a2 in NTS, decrease sympathetic vasomotor function/renin release, side-effects of sedation/xerostoma/bradycardia/heart block/withdrawal
Term
clonidine, guanabenz, guanfacine
Definition
a2 agonists
Term
methyldopa
Definition
a2 agonist, converted to methyline, causes coombs+ anemia/hepatitis
Term
Sympatholytics (reserpine)
Definition
deplete neurotransmitters by blocking VMAT, severe depression/GI cramps/ulcers
Term
reserpine
Definition
sympatholytic
Term
Direct vasodilators (minoxidil, hydralazine, nitroprusside)
Definition
side-effects of tachycardia/fluid retention/flushing/headache/aggravated angina, ALWAYS USE WITH DIURETIC FOR EDEMA AND BB FOR TACHYCARDIA
Term
Minoxidil
Definition
direct vasodilator, opens K+ channels in smooth m., closes Ca2+ channel (less contraction), causes pericardial effusion/hypertrichosis/angina, works when other drugs fail, SAVE FOR SEVERE HTN
Term
Hydralazine
Definition
direct vasodilator, opens K+ channels, inhibits IP3 mediated Ca2+ release, stimulates NO production from ECs, for chronic HTN/HTN crisis/HTN from preeclampsia, cuases angina/LUPUS-LIKE SYNDROMA (ANA, less at <200mg/day)
Term
Nitroprusside
Definition
direct vasodilator, produces NO, for HTN crisis/CHF, continuous IV, uptaken in RBCS and converted to CN, treat with sodium thiosulfate, causes metabolic acidosis (CN) and anorexia/nausea/fatigue/spasms/psychosis (thiocyanate toxicity)
Term
Dopamine Agonists (fenoldopam)
Definition
activate D1 receptors, arteriolar dilation (especially kidneys), decreases TPR, stimulates Na+ excretion, rapidly metabolised, continuous IV, for HTN emergencies
Term
fenoldopam
Definition
dopamine agonist
Term
methyldopa, labetolol
Definition
for HTN during pregnancy
Term
atenolol
Definition
causes low birth weight
Term
diuretics
Definition
alter electrolyte imbalance, avoid in pregnancy
Term
Nitroprusside, fenoldopam, labetolol, hydralazine, phentolamine
Definition
drugs for hypertensive emergency
Term
phentolamine
Definition
a-blocker, for pheochromocytoma
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