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Cardio Drugs Other
Other Information about Cardio Drugs
| Question | Answer |
|---|---|
| Bile Acid Binding Resins | Other: Good offset by increase in chol synth, use statin, can also interfere w/absorption of other oral drugs |
| Statins | Other: More than just effects on decrease cholesterol (CAD): improve endothelial cell function, enhance plaque stability, reduce inflamm |
| Cholesterol Absorption Blockers | Other: Bile acid binding resins inhib absorption of ezetimibe (use other or other w/a statin) |
| Niacin (Nicotinic Acid) | Other: Using niacin + statin = increase in statin-induced myopathy. Uses sustaines-release niacin (Niaspan) |
| Fibrates | Other: Fibrates + Statin = increased statin-induced myopathy (heart disease), LDL increase in some, use is combo but has same SE for myopathy as the niacin/statin combo, good @ decreasing TGs |
| Nitrates | Other: Tolerance = major problem thus use intermittently. Sildenafil and other ED drugs last longer b/c blockage of cGMP metabolismIn Stable angina = veins relaxIn Variant angina = reverses spasms |
| B-adrenergic Blockers | Other: use w/caution in people w/conduction disorders or obstructive lung disease, abrupt withdrawals can cause attacks or other ischemic symptoms (very dangerous rebound effect) |
| Ca Channel Blockers | Other: careful in conduction issues and in combo w/B-blockers b/c can cause heart failure (VD, but can use dihydro + b-blockers), lots of drug interactionsStable: decrease workVariant: coronary A spasm |
| Ranolazine | Other: efficacy and tolerability NOT change elderly and comorbid (preexisting) conditions (diabetes, heart fail)ALMOST ALL PTS CAN TAKE SAFELY!!! (b-block have issues in diabetes and heart fail) |
| Aspirin | Other: 5-8% show resistance to x-plate effects (have increase risk of SE's) |
| ADP Inhibitors | Other: Clopidogrel = rapidly replacing ticlopidine b/c quicker onset and less neutropenia. Some people resistant to clopidogrel. |
| GP IIb/IIIa Receptor Inhibitor | Other: best used prior to percutaneous coronary interventions than in unstable angina |
| Heparin | Other: Resistance forms b/c of differences in concentrations of heparin-binding proteins in plasma or b/c accelerate clearanceAnti-coags have increased risk of bleeding than x-plates, don't use in pts w/bleeding disorders |
| Fondaparinux | Other: overall more favorable long-term outcomes than heparin, limited data on cost effectiveness (enoxaparin: heparin may still cost less) |
| Direct Thrombin Inhib | Other: trials underway to determine efficacy in unstable angina and other ischemic syndromes |
| Fibrinolytic (TPA) | Other: less benefit in old or high BP post MI, more benefits in diabetes post MILife saving in acute MI, serious issues if not careful |
| Analgesics | Other: Also in Unstable angina, pain relief is a primary goal in the setting of acute chest pain due to MI |
| Renin Angiotensin Inhib | Other: benefits clear in old, prior MI, congestive heart failure or other reduced ventricular function ptsHT: no benefic to combining ARB and ACEI in HT but happens alot |
| Oral X-Coags | Other: lots vit K = less effective, liver disease increase effectHeparin is too risky in the long term, and this doesn't x-coag in test tube like heparin does. |
| Loop Diuretics | resist to diuretic effects (HF pts), overcome w/inc dose or add thiazide, combo w/K-spare diur (K loss), inc by RASI (ACEI or ARB), low Na, high K diets, ONLY diuretic for acute decomp, less effective than thiazide in HT, chronic renal fail w/high BP |
| Thiazide Diuretics | Other: combo w/K-sparing diuretic (prevent xs K loss), actions potentiated (increased) w/angiotensin inhib (ACEI or ARB), choice in hypertense w/out comorbid dx, not strong enough in hypertense w/chronic renal fail, second in heart fail to loop diuretics |
| K+ Sparing Diuretics | Other: Aldosterone antagonists (also K sparing) block insertion of channel into membrane…the two are not the same Use in heart fail w/high BP |
| Aldosterone Antagonists | Other: why it's help still being worked out, use in people that don't response to other BP drugs (main use in hypertension, more SE's than other K sparing) |
| Renin Angiotensin Inhibitors (HF) | Other: no benefit to combo ACEI w/ARB, combo w/diuretic |
| Direct Arterial Vasodilators | Other: use w/inability to tolerate ACEI/AR or blacks |
| Digoxin | Other: lots interactions, K+ or digoxin x-ab's to tx OD (hard to use), clinical use decrease b/c cause arryth (b/c increase Ca inside myocardial cells) |
| B agonists | Other: Dobutamine continuous IV several days in severe clinical decomp, pharm tolerance limit efficacy in long term |
| Phosphodiesterase Inhibs | Other: DRUG OF CHOICE in pts w/b-blockers that need inotropic support (like in decomp), chronic consistent therapy decrease survival |
| Nesiritide | Other: may be associated w/ risk of xs mortality and worsening of renal insufficiency |
| Class IA | Other: decrease ventricular contractility, musc ant, decrease clinical use b/c causes aryths |
| Class IB | Other: lidocaine MUST be parenterally (not oral), little effect on EKG |
| Class IC | Other: prone to cause arryth, decrease ventricular contractility |
| Class II | Other: decrease sudden cardiac death post MI |
| Class III | Other: Amiodarone blocks alpha and beta receptors, Ca and Na channels. Ibutilide, dofetilide and azimilide for term A fib/flut |
| Class IV | Other: on EKG look like B-blocker |
| Adenosine | Other: SHORT DURATION (acute), IV only |
| Aliskiren | Other: Expensive and new/unproven |
Created by:
chavezc3
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