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17 Cards in this Set
- Front
- Back
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ACEI adverse effects?
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- non production cough (d/t increase in bradykinins)
- increase in K - angioedema - renal insufficiency - hypotension - neutropenia |
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ACEI contraindications and cautions?
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- K >5.5 mEq/dL
- hx of angioedema - pregnancy caution: - serum creatinine >3 - b/l renal arterial stenosis |
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angiotensin 2 receptor blocker method of action?
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blocks binding of angiotensin 2 to receptor in tissues -> decrease in production of aldosterone and vasopressin (preload), decreases vasoconstriction (afterload)
- doesn't inhibit metabolism of bradykinin = no cough |
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ARB adverse effects?
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- increase in K
- angioedema - renal insufficiency - hypotension - neutropenia |
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ARB indications?
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- patients who are intolerant to ACEI
- patients who are maxed out on other therapies |
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beta blocker method of action?
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ADDED to ACEI
- blocks effect of sympathetic neurotransmitters on heart -> decrease in ventricular arrhythmias, decrease in hypertrophy/ myocardial cell death, and decrease vasoconstriction/ heart rate - carvedilol (mixed BB)- additional alpha 1 block = decrease SVR, greater decrease in BP |
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beta blocker adverse effects?
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- hypotension: decrease vasodilator therapy -> no change -> decrease/ dc BB
- decrease HR: decrease BB -> no change -> dc BB - fluid retention: increase diuretic -> no change -> decrease/ dc BB - fatigue - weakness - depression - sexual dysfunction |
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aldosterone antagonist method of action?
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blocks effects of aldosterone on kidneys and vasculature
- decreased K/Mg loss -> decreased arrhythmias - decrease Na retention -> decreased fluid retention - decreased catecholamine potentiation -> decreased BP - blocks fibrotic actions on myocardium *added to existing diuretic therapy- no benefit alone* |
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aldosterone antagonist adverse effects?
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- increase in K
- gynecomastia - sexual dysfunction |
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aldosterone antagonist cautions?
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- serum creatinine > 2.5 in males and > 2 in females
- K > 5.0 |
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digoxin method of action?
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inhibits Na-K adenosine triphosphatase ->
- decreased central sympathetic outflow by sensitizing cardiac baroreceptors - decreased renal reabsorption of Na - increased cardiac contractility |
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digoxin adverse effects?
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toxicities
- heart: arrhythmias, block, bradycardia - GI disturbances - CNS: confusion, vision changes- green/orange halos |
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risk factors for digoxin toxicity?
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- decreased K/Mg
- hypothyroidism - interacting meds - renal insufficiency |
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digoxin contraindications and cautions?
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contraindication
- 2nd/3rd degree heart block caution - amiodarone - diuretics - spironolactone - verapramil |
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digoxin monitoring?
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- serum trough = 0.8-1.2 ng/mL
- BMP, HR, HF sxs increase monitoring if: - change in renal function or EKG - sxs of toxicity - change in interacting meds |
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nitrates/hydralazine method of action?
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always used together
- nitrates: decrease preload - hydralazine: vasodilator, increases effects of nitrates |
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nitrates/hydralazine adverse effects?
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both
- hypotension - dizziness - headache hydralazine - leukopenia - lupus-like syndrome nitrates - flushing - flu-like symptoms |
