Cardiovascular Drugs

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Cardiovascular Drugs

Pump (heart contraction)

Antiarrhythmics

Class IV

Tx for HTN, angina

Phase 2: block calcium channels, delay phase 1&2

diltiazem, verapamil (CCB)

Class III

Tx for V-fib, pulseless v-tach, cardiac arrest

Phase 3: block K+ channels

amiodarone, sotolol

Class II

Tx for SVT, PVC

Phase 4: prolongs rest phase decrease BP, workload

Beta blockers -lol

Class I

Tx for V-tach

Phase 0: block Na+ channels

Lidocaine, flecainide

CHF

Cardiac Glycosides

dig toxicity

check heart rate

make heart beat slower & harder

Digoxin

PDE inhibitors

Don't give with Lasix

AE: ventricle arrhythmias

increase contraction & increase SNS stim.

Milrinone. IV only

HCN blockers

caution w/ A-fib & heart block

AE: bradycardia, HTN, a-fib

slows SA node improves cardiac output

Ivabradine

AntiHTN

SNS blockers

check HR before administering

lower BP, lower HR

Block SNS response

Beta-blockers -lol

Diuretics

Pt. ed. reasons for med & compliance

1st line med for HTN

increase Na+ & water excretion frim kidneys

hydrochlorothiazide, spironolactone

vasodilators

monitor pt. w/ CAD, CHF, tachycardia

lower BP, causes tachycardia

used in severe HTN emergencies

hydralazine, minoxidil, nitroprusside

AE: low BP S&S

slows contractility & impulses dilates arteries

inhibit movement of Ca+ in action potential Phase 2

-dipine

ARBs

AE: low BP S&S renal damage

lowers BP

block angiotensin II receptors

-sartan

ACE inhibitors

take on empty stomach

treats HTN

decrease BP decrease aldosterone

block angiotensin-converting enzyme=no Angiotensin II

-pril

AntihypoTN

Long term: midodrine (PO)

Short term: Norepi, epi, phenylephrine (all IV)

Stimulate SNS response

Increase BP, blood volume, & heart contraction

Plasma (blood)

Anemia Tx.

Epo stimulation

Monitor: HTN, seizures, Hgb level

IV or subq only

CKD, dialysis, cancer

epoetin alfa

Other anemias

Monitor GI & bone marrow

sickle cell: hydroxyurea, ABX

Megaloblastic: Folic acid, Vit. B12

iron deficiency

Diarrhea, dark stools

Z-track or PO

elevate serum iron

ferrous-

Anticoagulants

Antidotes: warfarin=Vit. K heparin=protamine sulfate Eliquis & Xarelto=Andexxa

PE, DVT, A-fib

Interferes w/ clotting cascade

Antiplatelets

Aspirin, Plavix, Brillinta

Good pt. teaching

Know pt. hx.

CVD, CAD, PAD

Slippery platelets

Antianginals

CCB

coronary artery spasms HTN, angina

decrease workload decrease HR decrease O2 needs

vasodilation

diltiazem, verapamil, -pine

Beta blockers

Subtopic

decrease HR decrease contractility decrease BP

Tx. for HTN, angina

-lol, metoprolol

Nitros

Monitor HR & BP

Dizziness, headache, SOB

decrease preload decrease workload

Dilates blood vessels

Nitroglycerin, Nitro paste

Pipes (blood vessels)

cholesterol absorp. inhibitors

bloating, cramping

Take alone. 2-4 hrs.

lower cholesterol absorption

Ezetimibe

bile acid sequesterase

Limits fat sol. Vitamin absorption

Pt. compliance issues

4-6x/day

Binds with bile

Cholestyramine

HMG-CoA

Rhabdo & cataracts

Monitor liver

Blocks cholesterol synthesis

Statins