click below
click below
Normal Size Small Size show me how
Cardiac I
Pharmocology Cardiac Meds
Term | Definition |
---|---|
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. |