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12 Cards in this Set
- Front
- Back
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Organic nitrates
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Amyl Nitrite (Isoamil Nitrite) - inhalation
Nitroglycerin (Glyceril trinitrate, Nitro-Bid, Nitro-Stat, Nitro-Dur, Nitrol) Isosorbide dinitrate (ISDN, Isochron, Isordil, Sorbirate, Dilatrate) Isosorbide-5-mononitate (Imdur, Ismo) Erythrityl tetranitrate (Cardilate) Pentaerythritol (Peritrate) |
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Organic nitrates
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Fast, short acting, converted to NO
Low concentration (decrease venous return --> decrease preload) High concentrations (reduce coronary vascular tone by dilation of systemic arterioles) Relaxes smooth muscle |
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Organic nitrates adverse effects?
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Throbbing headache
Orthostatic hypotension Syncope Flushing Tachycardia |
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Amyl Nitrite
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Inhaled, useful in cyanide poisoning, rarely used for angina due to headache, tachycardia, and orthostatic hypotention
Poppers |
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Isosorbide dinitrate
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Moderate-to-long acting for angina prophylaxis, used as adjunct in treatment of CHF (e.g. with hydralazine)
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Beta-Adrenergic blocking agents
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Propranolol (Inderal) - nonselective
Timolol (Betimol, Blocadren) - nonselective Nadolol (Corgard) - nonselective Bisoprolol (Zebeta) - B1 Atenolol (Tenormin) - B1 Metoprolol (Lopressor) - B-1 |
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Pindolol (Visken)
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Nonselective beta receptor antagonist
"vasodilatory beta blocker" |
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Beta-Adrenergic blocking agents uses?
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Decrease heart rate, cardiac output, blood pressure (reduce myocardial oxygen demand). Nonselective more side effects.
Tachyarrhythmia, MI, migraine, heart failure Several weeks to develop effects |
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Beta-Adrenergic blocking agents side effects?
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Contraindicated for patients with Diabetes and Peripheral Vascular Disease.
Can prolong/enhance hypoglycemia, mask s/s of hypoglycemia, may occasionally cause hyperglycemia CNS side effects, hypotension, reduced HDL, rebound hypertension/arrythmias on withdrawal. Avoid in patients with asthma and COPD |
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Calcium Channel Blockers
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Verapamil (Calan, Verelan, Covera-HS, Isoptin)
Diltiazem (Cardizem, Dilacor) Dihydropyridines: Nifedipine (Procardia, Adalat) Amlodipine (Nosvasc) Felodipine (Plendil) Isradipine (Dynacirc) Nisoldipine (Sular) Nicardipine (Cardene) Nimodipine (Nimotop, selective for cerebral arterioles) Lercanidipine (final approval pending, 24 hour duration) |
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Calcium Channel Blockers
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Inhibition of Ca++ influx across plasma membrane
Useful in ischemic patients with Diabetes of Peripheral Vascular Disease, those with asthma and COPD, those with adverse reactions to B-blockers, Prinzmetal angina SE: conduction abnormalities, edema, dizziness |
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Verapamil (Calan, Verelan, Covera-HS, Isoptin)
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Angina, HTN, supraventricular tachyarrhythmias
Least selective of all Ca++ channel blockers, slows conduction decreasing HR and oxygen demand Adverse effects: sinus brady., transient asystole, AV block, constipation |
