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27 Cards in this Set
- Front
- Back
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Sympatholytics: anti-adrenergics/adrenergic antagonists.
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Alpha 1 blockers,
Alpha 2 agonists Beta 1 & beta 2 blockers Beta 1 only blocker COMBO: Alpha 1 & Beta1 blockers |
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Alpha 1 blocker prototype
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Prazolin (minipress)
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Prazolin (minipress)
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Alpha 1 blocker.
Dilates arteries and veins-treats HTN/BPH. SE: orthostatic HTN, reflex tachycardia, inhibs. ejaculation, nasal congestion, move slowly in beginning, dose at HS to decrease hypotensive effects |
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Clonidine (Catapress)
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Acts in CNS: ALPHA 2 receptor-decreases sympathetic outflow to blood vessels
Rare rebound HTN w/drug withdrawal. Drowsiness dry mouth generally free of serious side effects, w/d over 2-4 days.... avoid hazardous equipment at that time... |
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Beta blockers
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Propanolol(Inderal): beta 1 & 2
Metoprolol(Lopressor): Beta 1 only Carvedilol(coreg): Alpha 1 & Beta 1 |
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Propanolol(Inderal)
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Beta 1 & 2 blocker (heart & lungs)
Causes BRONCHOconstriction: not good to use wiht asthmatics or COPDers. decreases HR, lowers CO, Decreases Renin release. Used for HTN, Angina pain, migraines, stage fright, also lowers AV node conduction. SE: Bradycardia, decreases glycogenesis, but masks hypoglycemic: risk for hypoglycemia higher in DM, Interaccts with CCBs: excess heart suppression. Crosses CNS:caution in depression, hallucinations. Don't use with people who have anaphylactic reactions. Also can cause Heart block, Heart failure. rebound tachycardia and arrhythmia with rapid withdrawal. Hold if HR <60 or sbp <100. |
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Metropolol(lopressor)
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Results: decrease in HR, ventricular contractility, AV node conduction, renin secretion.
Preferred for Pr. with asthma or DM, used for HTN, angina, heart failure and MI. SE: bradycardia: hold if HR <60 or SBP <100, decreased CO, AV block rebound tachycardia (W/D Drug slowly!) heart failure. |
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Carvedilol(coreg) *Think coregulation..takes two to co-regulate!
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Blocks Alpha 1 & Beta 1
Used for HTN, MI investigational for angina. SE: same as Alpha 1 and Beta 1... |
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Diuretics
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Start with these.
Decrease BP Reduces GFR that causes retention of Na+, Cl-, and H2O-lowers fluid volume. high ceiling loops, potassium sparing, osmotic diuretics, thiazide. |
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Diuretic names
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Furosemide (Lasix)
Thiazide (HTDZ) Mannitol Spirolactone |
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High ceiling loop diuretic
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Furosimide(Lasix)
sheds a lot of K+ |
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Thiazide Diuretic
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THDZ- sheds K+
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Osmotic- pulls water from 3rd spacing
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Mannitol - like sugar syrup
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K+ sparing
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spirolactone
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Calcium Channel BLockers
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Blocks Angiotenin 2 once made,
Blocks Ca++ in heart:decreases myocardial contractility lowers BP Increases Coronary perfusion decreases AV node conduction(only diltiazem) used for: angina, HTN, atrial fib, PSVT CONTRAINDICATED with pregnancy Renal Artery Stenosis. If cough or angioedema occurs STOP STAT! |
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Calcium channel blockers
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Diltiazem (Cardizem)
nifedipine (Procardia) |
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Diltiazem(Cardizem)
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CCB in heart and blood vessels
Dilates arterioles to decr. BP & increase coronary perfusion AV NODE blockade decr. HR and AV node conduction (Most imp. effect) Decr. myocardial conduction Used for Angina, HTN atrial flutter, atrial fib, psvt SE: Dizzy, flushing, HA, ankle & Foot edema, exzematous rash Cautions: heart block, bradycardia, heart failure Interactions: Increases blood plasma Digoxin levels 60%! |
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nifedipine (Procardia)
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ccb
vasodilation causes decr BP, increased coronary perfusion, activates baroreceptor reflex to incr. HR. DOES NOT SUPPRESS HR, AV CONDUCTION OR CONTRACTILITY! used for HTN, angina of effort, vasopspastic angina, investigational for migrane & preterm labor SE: Reflex tachycardia, dizzyflushing, rash, peripheral edema, HA, gingival hyperplasia. Interacts with Beta blockers prevent reflex tachycardia. |
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Direct acting vasodilator
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apresoline(hydralazine)
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Apresoline(Hydralazine)
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Selective dilation of arterioles to decrease SVR(AFTERLOAD)
decr. BP, Incr. HR & myocardial contractility by reflex actions. Used for HTN, Hypertensive crisis, angina, short term use in HF, pheochromocytoma, pulmonary artery hypertension, PVD. SE: HA, dizzy, weakness, fatigue, postural hypotension, reflex tachycardia, SLE, increased blood volume. Interactions: Beta blockers protect against reflex tachycardia, yet can worsen heart failure and increase blood volume: give diuretic maybe. Med. + other HTN med = additive effects...doubles effects.. Direct acting vasodilator |
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RENIN-ANGIOTENSIN System agents (RAAS)
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Ace inhibitor: Lisinopril (Prinivil, zestril)
ARB(Angiotensin 2 blocker): Losartan(Cozaar) Aldosterone blocker: eplerenone(Inspra) |
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ACE inhibitor
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lisinopril (Prinivil, Zestril)
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ARB
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angiotensin 2 blocker
Losartan(Cozaar) |
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aldosterone blocker
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eplerenon(Inspra)
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eplerenone(Inspra)
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causes K+ retention, NA+ & H2O excretion, decr. BP & Blood volume.
USED: HTN, Heart Failure SE: Hyperkalemia (Hold for K+ >5.0) Max effects take 4 weeks to develop Caution with ACE I or ARB or decreased renal function. Contraindications: K+ supplement, salt subst., K+ sparing diuretics Intereactions: increased med levels (2X) if given with erythromycin, verapamil, flucoazole; 5X if given with ketoconazole; med + Lithium = increased lithium levels. |
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losartan (Cozaar)
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ARB-blocks action of angiotensin 2.
Used for: HTN, MI, diab.neuropathy-type2 esp., MI, CBA, prevention in pts. wiht HTN & LV hypertrophy SE: Angioedema: NEVER give again if this develops. Additive effects with other HTN meds Contraindications: pregnancy (Teratogenic), renal artery stenosis |
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Lisinopril(Prinivil, Zestril)
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ACE inhib: decr. levels of Angiotensin 2, increases bradykinins, causes artero vasodilatoin, decreased blood volume.
Uses: HTN, HF, MI, Dec GRF, prvent MI, Stroke, death in high risk CV pts, slows diab. nephropathy. SE: Cough (5-10%) Stop med stat. angioedema, 1st dose can cause hypotension in pts. with severe htn, Na + or volume depletion, pts. on diuretics) Hyperkalemia (Hold if K+ >5.0) contraindicated in pregnancy, pts wiht renal artery stenosis. Interactions: Med + diuretic = hypotension Med + other HTN med = additive affect Med + lithium= toxic lithium levels NSAIDS or ASA may decrease antihypertensive effects of med . decrease dosage in renal disease. |
