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43 Cards in this Set
- Front
- Back
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olol |
Beta blockers |
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sartan |
ARB's |
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pine |
CCB's |
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pril |
Ace Inhibitors |
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Vasodilators |
Hydralazine- emegernt situations to lower BP, They cause edema and tachycardia |
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Beta Blockers |
decrease cardiac output by decreasing the rate, contactility and conduction velocity of the heart. |
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use in extreme caution in heart failure |
beta blockers, CCB's
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Use metrprolol and carvedilol for 2-3 after a MI |
beta blockers use |
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beta 1 |
Selective for cardio tissue
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beta 2 |
receptors are predomininantly in the smooth muscle of bronchial's and vascular system |
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decrease cardicac contractility, slow the rate of ventricular contractions, dilate arteries and reduce peripheral resistance |
Calcium channel blockers |
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block calcium from moving into the cell membranes of cardiac and smooth muscle |
CCB's |
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DHP (dihydropyridines) CCB's |
DHP's do not affect the cardiac conduction system and are not used for arrythmia's. examples- nifedipine, amlodipine |
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Non DHP, CCB's |
Are used for both HTN and arrythmias. |
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CCB's who to use in |
Work well for African American's |
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Thiazides |
Inhibits Na reabsorption in distal tubule Depletes Na and K Conserves Ca- good in osteoperosis ex. hctz |
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Loop Diuretics |
Depletes Na, K, Mg, Ca in distal tubule Most efficent but used for severe HTN ex. Lasix |
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K Sparing diuretics |
inhibits Na reabsorption in the collecting duct. Serious adverse effect his hyperkalemia and is dangerous in patients using ACE inhibitors or diabetecs or renal impariment ex. Spironalactone |
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Prevent the conversion of angiotensin 1 to angiotensin 2 Potentiate water and NA loss but spare K. |
ACE inhibitors |
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Ace inhibitors in combination |
good to combine with a thiazide diuretic do not combine with K sparing diuretic |
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Good for diabetics |
Ace inhibitors potentiate bradykinin which enhnances insulin sensitivity. |
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ACE side effects |
non productive cough, angioedema |
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Avoid NSAID's |
When taking ACE and ARBS it can reduce thier efficacy. |
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Prevent angiotensin from attaching to the receptor sites leading to limited vasoconstriciton and secretion of aldosterone |
ARB's |
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Anti hypertensive's at bedtime |
Taking 1 HTN med at bedtime has been shown to improve BP control and reduce cardiovascular events. |
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JNC 8 guidelines |
60 > 150/90 18 > with CKD or diabetes 140/90 |
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Do not take with HTN |
devil’s claw, ginseng, goldenseal, black licorice, ma huang, squill or yohimbe.
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Drugs that elevate BP |
a.) Sympathomimetic agents such as pseudoephedrine and methylphenidate
b.) NSAIDs & COX-2 inhibitors 3.) Corticosteroids 4.) CNS stimulants such as caffeine 5.) Estrogens and progestins 6.) SNRIs such as venlafaxine & sibutramine 7.) Immunosuppressants such as cyclosporine and tacrolimus |
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Migraines,A-fib, Tachycardia, Hyperthyroid, |
Use a BB or a CCB |
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Dyslipidemia |
use a Alpha blocker |
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Diabetes, Heart failure, renal diseasee |
Use ACE inhibitor |
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BB containidicated |
asthma, depression, diabetes, high cholesterol, heart block, PVD, and pregnancy |
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Containdicated in pregnancy |
ARB's, ACE and direct renin inhibitors are teratrogenic |
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Use in Pregnancy |
Methyldopa- alpha 2 adrenergic agonist Labetaolol Nifedipine |
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High Cholesterol treatment |
Patients with cardio disease- high intensity statin Over age 75- use moderate intensity statin if LDL > 190 use high intensity statin Diabetics over age 40 start on statin |
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Lipid monitor |
Monitor lipids 4-12 weeks after starting a statin then yearly after. |
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Statins |
Block an enzyme in the cholesterol synthesis pathway. Mainstay of treatment |
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Statins Contraindicated |
In pregnancy, with azole antifungals |
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Statin Adverse effects |
Myopathy- muscle pain or weakness and could lead to rhabdo Check LFT at the start of therapy |
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bile acid resins |
irreversibly bind to bile acids in the gut and prevent thier reabsorption, so the liver has to remove cholsterol from the blood to make more bile ex. whelchol |
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Fibric acid derivatives |
Lower triglycerides ex. gemfibrozil |
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Zetia |
Selective intestinal cholesterol inhibitor, inhibits absoprtion of cholesterol at small intestine. |
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Statin side effect managemet |
Lower the dose
Change the statin to fluvastatin, pravastatin or low-dose rosuvastatin Check to make sure there are no drugs the patient is taking that might interact with the statin Suggest alternate day dosing Correct a low Vit D level and assess for hypothyroidism |
