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Cardiac I

Pharmocology Cardiac Meds

Risk Factors of Hypertension Family history of hypertension Advanced age African-American race Obesity Inactivity Cigarette smoking Excessive salt intake Excessive alcohol intake
Beta-1 receptor sites are located primarily in the HEART
Beta-2 receptor sites are located primarily in the LUNGS
Thiazide diuretics Usually the first choice to treat hypertension Lose fluid—decrease preload—BP falls Think about electrolytes! Cross-sensitivity to sulphonamides
Selective Aldosterone Blockers Spironolactone Eplerenone Pharmacotherapeutics Treatment of hypertension alone or with other antihypertensives
Aldosterone Blockers Pharmacodynamics Selective binding to mineralocorticoid receptors preventing aldosterone from binding to its receptor sites Inhibition of sodium and water retention (pt loses Na and H2O) These drugs are also potassium-sparing diuretics
Selective Aldosterone Blockers Hyperkalemia, hyponatremia Dizziness Drug Interactions Most ACE inhibitors, ARBs, or CYP3A4 potent inhibitors St. John’s wort Grapefruit juice
ACE Inhibitors Examples: Captopril (prototype) Lisinopril Enalapril (can also be IV) Accupril Ramipril Pharmacotherapeutics Treatment of hypertension Preload reduction heart failure Cardioprotective following MI
Adverse Effects of ACEI Inhibitors Chronic dry cough (sometimes disappears after a few months) First-dose hypotension Angioedema GI distress Reflex tachycardia Hyperkalemia
ACEI N.B. African-American patients have less therapeutic response than Caucasians to ACEI and are more likely to have adverse effects.
Minimizing Adverse Effects Monitoring for at least 2 hours after initial dose-make sure the patient is sitting or reclining. Monitoring serum electrolyte levels (can increase K+). No K+ supplements NORMAL K+: 3.5-5.0
ACE Inhibitors All ACEI carry a Black Box warning for the second and third trimesters of pregnancy—can cause injury or even death to a developing fetus.
Created by: kai.f0201