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23 Cards in this Set
- Front
- Back
- 3rd side (hint)
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CCB
block voltage-gated calcium channels in arterial smooth muscle and myocardium causing relaxation and vasodilation (dec. afterload) verapamil and diltiazem have –ve ionotropic effects |
MONITOR:
weight gain (oedema) BP |
- look out for signs of swollen ankles or trouble putting shoes on
NO ORTHOSTATIC HYPO. |
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Dihyfropyridine
- vascular selective - INDICATIONS? -SE? Counselling? |
I: HT
Angina (amlodipine and nifedipine) AN for angina SE: peripheral oedema ankle swelling dizziness headache flushing hypotension tachycardia (especially with dihydropyridines) as vasodilation $ sympathetic tone |
9, 12+,
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Nifedipine (Adalat, Adefin)
10, 20 mg (60) 20, 30, 60 mg CR Oris |
tab, 10 – 40 mg twice daily.
CR, 30 – 120 mg daily. +angina |
9, 12, 18
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Lercanidipine (Zanidip)
10, 20 mg |
10 – 20 mg daily
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9, 12, 18, C
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Amlodipine (Norvasc)
5, 10 mg |
2.5 – 10 mg daily
+angina |
9, 12
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Felodipine (Felodur, Plendil)
2.5, 5, 10 mg CR |
2.5-10mg daily
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5, 9, 12, 18
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Benzothiazepine
- intermediate selectivity for vascular smooth muscle and myocardium ! doesn’t cause tachycardia |
HT
Angina |
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Diltiazem (Cardizem, Vasocardol)
60 mg 180, 240, 360 mg CR |
180–240 mg daily.
CR, initially 180 mg – 360 mg daily. SE: bradycardia |
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Phenylalkylamine
- DEC. rate and contractility of the heart by depressing the sinua node |
HT, angina, Tachyarrhthmias, AF or atrial flutter
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Verapamil (Isoptin, Anpec)
40, 80, 120, 160 mg (100) 160, 180, 240 mg CR |
40 – 160 mg 2-3 times daily.
CR, 120 – 240 mg daily SE: constipation INC. LFTs |
! verapamil commonly causes
constipation – increase fibre in diet etc |
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B- Blockers
block beta receptors in heart and peripheral vasculature |
HT, angina
SE: SOB, bronchospasm cold extremities n/d nightmares (more with 5, 8) insomnia Dec. BP & HR fatigue, dizzy, dec. concentration impotence |
9, 12+
13, 16 (3,4) A ! If experience cough, SOB, fatigue, cold feet or toes seek medical advice. ! This medicine may cause dizziness/fatigue; do not drive or operate machinery if affected. ! Asthma? COPD? Caution: DM (mask symptoms of hypoglycaemia e.g. tachy, tremor) – hyperlipidaemia, PVD, hyperthyroidism, uncontrolled HF |
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B1 blockers
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ß 1 selective blockers (atenolol,
metoprolol) cause less vasoconstrictn (cold feet and hands) and do not reduce response to exercise induced hypoglycaemia (stim. of glucoseneogenesis in the liver is mediated my ß cells) atenolol metoprolol bisoprolol |
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non-selective b-blockers
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labetolol (some alpha action)
Oxprenolol Pindolol Propanolol |
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Indications of the 8 b-blockers
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HT [1,3,4,5,6,7,8]
Angina [1,5,6,7,8] Tachyarrhythmia [1,5,6,7,8] MI [1,5,8] P’vent migraine [1,5,8] Ess tremor & ctrl tremor in anxiety/hyperthyrd [8] HF [2,3,5], Portal HT [8] |
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1. Atenolol (Noten, Tenormin, Tensig)
50 |
25-100mg d
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9, 12
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2. Bisoprolol (Bicor)
1.25, 2.5, 5, 10 |
start 1.25 d, $ slow (M=10 d)
ONLY HF |
9, 12
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3. Carvediolol (Dilatrend)
3.125, 6.25, 12.5, 25 |
3.125 bd, $ slow (25-50 bd)
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9, 12, 13, 16
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4. Labetolol (Presolol, Trandate)
100, 200 |
start 100 bd, main 200-400 bd
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9, 12, 13, 16
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5. Metoprolol (Betaloc, Minax, Toprol-
XL) 50, 100, 23.75, 47.5, 95, 190 CR |
50-100 1-2 times d
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9, 12
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6. Oxprenolol (Corbeton)
20, 40 |
20 - 80mg bd (M=320 d)
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9, 12
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7. Pindolol (Barbloc, Visken)
5, 15 |
10 - 30mg d in 2-3 divd dose
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9, 12
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8. Propranolol (Deralin, Inderal)
10, 40, 160 |
20 - 320mg d in divd doses
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9, 12
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Monitoring for B-blockers
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Glucose & Lipid Levels
BP LFT ECG |
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