Cardiovascular Drugs

HMG-CoA

Statins

Blocks cholesterol synthesis

Monitor liver

Rhabdo & cataracts

bile acid sequesterase

Cholestyramine

Binds with bile

4-6x/day

Pt. compliance issues

Limits fat sol. Vitamin absorption

cholesterol absorp. inhibitors

Ezetimibe

lower cholesterol absorption

Take alone. 2-4 hrs.

bloating, cramping

Nitros

Nitroglycerin, Nitro paste

Dilates blood vessels

decrease preload
decrease workload

Dizziness, headache, SOB

Monitor HR & BP

Beta blockers

-lol, metoprolol

Tx. for HTN, angina

decrease HR
decrease contractility
decrease BP

Subtopic

CCB

diltiazem, verapamil, -pine

vasodilation

decrease workload
decrease HR
decrease O2 needs

coronary artery spasms
HTN, angina

Antiplatelets

Slippery platelets

CVD, CAD, PAD

Know pt. hx.

Good pt. teaching

Aspirin, Plavix, Brillinta

Anticoagulants

Interferes w/ clotting cascade

PE, DVT, A-fib

Know pt. hx.

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

Anemia Tx.

iron deficiency

ferrous-

elevate serum iron

Z-track or PO

Diarrhea, dark stools

Other anemias

Megaloblastic: Folic acid, Vit. B12

sickle cell: hydroxyurea, ABX

Monitor GI & bone marrow

Epo stimulation

epoetin alfa

CKD, dialysis, cancer

IV or subq only

Monitor: HTN, seizures, Hgb level

AntihypoTN

Increase BP, blood volume,
& heart contraction

Stimulate SNS response

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

Long term: midodrine (PO)

AntiHTN

ACE inhibitors

-pril

block angiotensin-converting
enzyme=no Angiotensin II

decrease BP
decrease aldosterone

treats HTN

take on empty stomach

ARBs

-sartan

block angiotensin II
receptors

lowers BP

AE: low BP S&S
renal damage

CCB

-dipine

inhibit movement of Ca+
in action potential Phase 2

slows contractility & impulses
dilates arteries

AE: low BP S&S

vasodilators

hydralazine, minoxidil, nitroprusside

used in severe HTN emergencies

lower BP, causes tachycardia

monitor pt. w/ CAD, CHF, tachycardia

Diuretics

hydrochlorothiazide, spironolactone

increase Na+ & water excretion
frim kidneys

1st line med for HTN

Pt. ed. reasons for med
& compliance

SNS blockers

Beta-blockers -lol

Block SNS response

lower BP, lower HR

check HR before administering

CHF

HCN blockers

Ivabradine

slows SA node
improves cardiac output

AE: bradycardia, HTN, a-fib

caution w/ A-fib
& heart block

PDE inhibitors

Milrinone. IV only

increase contraction &
increase SNS stim.

AE: ventricle arrhythmias

Don't give with Lasix

Cardiac Glycosides

Digoxin

make heart beat
slower & harder

check heart rate

dig toxicity

Antiarrhythmics

Class I

Lidocaine, flecainide

Phase 0: block Na+
channels

Tx for V-tach

Class II

Beta blockers -lol

Phase 4: prolongs rest phase
decrease BP, workload

Tx for SVT, PVC

Class III

amiodarone, sotolol

Phase 3: block
K+ channels

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

Class IV

diltiazem, verapamil (CCB)

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

Tx for HTN, angina