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Cardio Drug Uses

Uses of Cardio Drugs

QuestionAnswer
Bile Acid Binding Resins Adjuvant with statin because of high LDL
Statins Primary and secondary prevention of CAD, combo
Cholesterol Absorption Blockers Adjuvant to statins
Niacin (Nicotinic Acid) High triglycerides, high LDL, and low HDL-C levels
Fibrates Severe high triglycerides and low HDLs, metabolic syndromes (Type II Diabetes)
Nitrates Sublingual or IV to terminate angina episode OR oral, patch or ointment for prophylaxis for angina. HF: IV or sublingual for acute decomp, limited with hydralazine or in acute decomp (because of decreased preload)
B Blockers Orally for chronic prophylaxis of stable angina, unpredictable in variant angina. HT: low and high doses have same efficacy, non-black and non-elderly respond best.
Ca Blockers Chronic prophylaxis of stable or variant angina
Ranolazine Alone as oral prophylaxis of chronic stable angina OR combo with nitrates, b blockers, or Ca blockers
Aspirin Oral, low dose : minimize bleeding potential
ADP Inhibitors Oral, slow onset (pro-drug), long duration (4-8 days), combo with aspirin.
GP IIb/IIIa Receptor Inhibitors IV (oral won't work), short duration, (surgery), combo with aspirin and heparin. Unstable angina.
Heparin IV for normal, subcutaenous for low : has more reliable absoprion and longer plasma half life.
Fondaparinux Specific and selective, long half life, 100% bioavailablility : sq = once-daily anticoagulant without need for monitoring clotting time (unlike heparin).
Direct Thrombin Inhibitors IV, combo with aspirin or other antiplatelets.
Fibrinolytic (TPA) IV within 2 hrs of MI symptom onset.
Analgesics IV untill pain is relieved or toxic SEs become apparent. Some patients need LARGE cumulative doses, but can tolerate them.
Renin Angiotensin Inhibitors Post: aspirin + b blockers + reperf therapy (within 24 hrs). HT: less in old blacks, use with diuretic or ARBs (BEST SE PROFILE OF ALL HT, $), protect against nephrop (diab), and CAD in HF. Inc survival, syst dys, aldo inhib better, dec symptoms and hosp.
Direct Arterial Vasodilators (Hydalazine) Increases survival in combo with isosorbide dinitrate in chronic HF, most vasodilators (unless also cause neurohormonal inhibition) NO survival
Digoxin Low therapeutic index (especially in hypokalemia), restrict to severe HF or patients with A fib, decrease symptoms and hospitalizations, NO survival, ventricular rate control in patients with HF + A fib.
B Agonists Restricted to acute decompensated, decrease symptoms, maintains circulatory stability, NO survival.
Phosphodiesterase Inhibitors Circulatory stability, NO survival
Nesiritide Restricted to acute decompensated HF, decrease symptoms, maintains circulatory stability, NO survival.
Class IA Wide-spectrum for both supraventricular and ventricular arrhythmias due to re-entry or ectopic automaticity, terminates A fib or flutter, comb to treat serious ventricular arrhythmias.
Class IB Ventricular aryth due to re-entry or ectopic automaticity, use against digoxin-induced arrhythmias and long Q-T syndrome (mexiletine and phenytoin), good at suppressing arrhythmias caused by ischemia (MI).
Class IC SERIOUS VENTRICULAR ARRHYTHMIAS due to re-entry, A fib and flutter, or AV nodal re-entry tachycardia.
Class II Arrhythmia with surgergy, anesthesia, exercise, cocaine or other excessive SNS states, ventricular rate control in A fib and flutter, or long Q-T syndrome.
Class III Broad for supravent or vent arrhyth (re-entry or ectopic), terminates A fib or flutter, combo with devices in serious ventricular arrhyth : DRUG OF CHOICE in cardiac resuscitation, great in patients with heart fail (less SEs).
Class IV AV nodal re-entry tachycardia, VENTRICULAR RATE CONTROL in A fib or flutter.
Adenosine AV nodal re-entry tachycardia (can mistake for anxiety attack).
Aliskiren Use: less in blacks, STRONGLY better w/diuretic, additive w/ACEI or ARB but alone has same efficacy as either of the other two alone
Created by: chavezc3
 

 



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