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Cardio Drugs Other

Other Information about Cardio Drugs

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 membraneā€¦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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