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GN pharm 2010 (2)
cardiac drugs: names, indication, mechanism of action, adv, contraindications
| Question | Answer |
|---|---|
| epinephrine class/ generic name | adrenergic agonists (catecholamine): epinephrine |
| epinephrine brand name | adrenaline |
| epinephrine mechanism of action | vasoconstriction, increase heart rate, increase myocardial contractility, increase rate , bronchodilator |
| epinephrine indication | hypotension, nasal congestion, treatment of AV block, asthma |
| epinephrine adverse effects | hypertensive crisis, dysrhythmias, increased workload of the heart and oxygen demand leads to the development of angina |
| epinephrine contraindications | tachydysrythmias and v.fib, MAOIs, tricyclic antidepressants, general anesthesia, beta-blockers |
| dopamine class/generic name | adrenergic agonists (catecholamine):dopamine |
| dopamine brand name | intropin |
| dopamine mechanism of action | renal blood vessel dilation, increase heart rate, increase myocardial contractility, increase rate (highdose- vasoconstriction) |
| dopamine indication | shock, heart failure |
| dopamine adverse effects | dysrhythmias, increased workload of the heart and oxygen demand leads to the development of angina, necrosis with high doses |
| dopamine contraindications | beta blockers, beneficial effects with diuretics |
| dobutamine class/generic name | adrenergic agonists: dobutamine |
| dobutamine brand name | dobutex |
| dobutamine mechanism of action | increase heart rate, increase myocardial contractility, increase rate |
| dobutamine indication | heart failure |
| dobutamine adverse effect | tachycardia |
| dobutamine contraindications | beta blockers |
| catecholamine/ adregenic agonists effectiveness | improved perfusion evidenced by urine output >30ml(normal renal function) mental status, and systolic bp >90 |
| prazosin class/generic name | alpha adrenergic blockers: prazosin (other doxazosin mesylate) |
| prazosin brand name | minipress, cardura |
| prazosin mechanism of action | venous and arterial dilation decreases peripheral vascular resistance slightly decreasing cardiac output, smooth muscle relaxation of prostatic capsule and bladder neck |
| prazosin indication | hypertension, (cardura used to decrease symptoms of BPH) |
| prazosin adverse effects | first dose orthostatic hypotension (low dose and give at night), tachycardia, vertigo, sexual dysfunction |
| prazosin containdications | antihypertensives increase hypotensive effect, hypersensitivity to drugs |
| clonidine class/generic name | centrally acting alpha agonists: clonidine, (others guanfacine HCL, methyldopa) |
| clonidine brand name | catapress (others tenex, aldomet) |
| clonidine mechanism of action | decrease sympathetic outflow to myocardium=bradycardia and decrease CO, decrease sympathetic outflow to peripheral vasculature= vasodilation and decrease BP |
| clonidine indication | hypertension, (migraine, menopause, withdrawal, severe cancer pain) |
| clonidine adverse effects | drowsiness, dry mouth, rebound hypertension |
| clonidine contraindications | antihypertensive meds- additive hypotensive effect, prazosin, MAOIs, tricyclic anidepressants-counteract effect, CNS depressants- additive CNS depressant |
| metroprolol class/generic name | beta adrenergic blockers: metropolol (others propranolol, atenolol, nadolol) |
| metropolol brand name | lopressor (others inderal, tenormin, toprol, corgard) |
| metropolol mechanism of action | decrease HR, decrease cardiac contractility, decrease rate of conduction |
| metropolol indication | angina pectoris, hypertension, cardiac dysrhythmias, myocardial infarction, heart failure |
| metropolol adverse effects | metropolol (beta1 affecting heart) bradycardia, decreased CO, AV block, orthostatic hypotension, drowsiness propanolol(inderal beta2 affecting lungs) bronchoconstriction, brochospasm, hypotension, glycogenolysis |
| metropolol contraindications | bradycardia, heart block, hypotension, heart failure, asthma, pulmonary problems metropolol- calcium channel blockers(intensifies effects), antihypertensives propanolol- insulin (prevents glycogenesis) |
| captopril class/generic name | ace-inhibitor: captopril (others enalapril, fosinopril, lisinopril, ramipril) |
| captropril brand name | captopen (others vasotec, monopril, prinivil, altace) |
| captropril mechanism of action | block production of angiotensin= decreasing peripheral vascular resisitance, vasodilation, excretion of sdium and water, and retention of potassium |
| captropril indication | heart failure, hypertension, myocardial infraction, diabetic and nondiabetic nephropathy, high rick of MI, stoke, death |
| captropril adverse effects | first dose orthostatic hypotension, cough, hyperkalemia, angioedema, altered taste |
| captopril contraindications | diuretics, antihypertensives, potassium supplements or potassium sparing diuretics, lithium, NSAIDs, angioedema, renal artery stenosis |
| nifedipine class/ generic name | calcium channel blockers: nifedipine (others amiodipine, felodipine, nicardipine) |
| nifedipine brand name | adalat, procardia (others norvasc, plendil, cardene) |
| nifedipine mechanism of action | blocking calcium channel in blood vessels leads to vasodilation of peripheal and heart arterioles |
| nifedipine indication | angina pectoris, hypertension |
| nifedipine adverse effects | reflex tachycardia, peripheal edema, acute toxicity |
| nifedipine contraindications | beta blockers and grapefruit juice |
| verapamil,dilitiazem class/generic name | calcium channel blockers: verapamil,dilitiazem |
| verapamil, diltiazem brand names | calan, cardizem |
| verapamil, diltiazem mechanism of action | blocking calcium channel in blood vessels leads to vasodilation of peripheal and heart arterioles blocking calcium channels in myocardium, SA node, AV node leads to decrease force of contraction, decrease HR, and slowing of conduction through AV node |
| verapamil, diltiazem indication | angina pectoris, hypertension, cardiac dysrhythmias A.FIB A.FLUT SVT |
| verapamil, diltiazem adverse effects | orthostatic hypotension and edema, constipation, suppression of cardiac function, dysrhythmias, acute toxicity |
| verapamil, diltiazem contraindications | digoxin, beta-blockers, grapefruit juice |
| sodium nitroprusside generic name | sodium nitroprusside (others labetalol, diazoxide, fenoldopam, trimethapan |
| sodium nitroprusside brand name | others trandate, hyperstat, corlopam, arfonad |
| sodium nitroprusside mechanism of action | direct vasodilation of arteries and veins resulting in rapid reduction of blood pressure (decreased preload and afterload) |
| sodium nitroprusside indication | hypertensive crisis, decrease bleeding during surgery |
| sodium nitroprusside adverse effects | excessive hypotension, cyanide poisoning, thiocynate poisoning |
| sodium nitroprusside contraindications | liver and kidney disease |
| sodium nitroprusside administration notes | protect from light- color should be slightly brown |
| nitroglycerine generic name | nitroglycerine (other isosorbide dinitrate |
| nitroglycerine brand name | nitrol, nitostat (other imdur) |
| nitroglycerine mechanism of action | stable angina- decrease oxygen demand by dilating vessels unstable angina- relaxes or prevents spasm increasing oxygen demand |
| nitroglycerine indication | angina, heart failure from acute MI |
| nitroglycerine adverse effect | headache, orthostatic hypotension, reflex tachycardia, tolerance |
| nitroglycerine contraindication | hypersentivity, head injury (can increase intracranial pressure), antihypertensive medications: beta-blockers, calcium channel blockers, diuretics- hypotensive additive, viagra |
| digoxin class/generic name | cardiac glycoside: digoxin |
| digoxin brand name | lanoxin, lanoxicaps, digitek |
| digoxin mechanism of action | increases force and efficacy of myocardial contraction improving heart pump with imporved SV and CO decreases rate SA node depolarization giving ventricles more time to fill leading to improved SV and CO |
| digoxin indication | heart failure, dysrhythmias- A.fib |
| digoxin adverse reactions | dysrhythmias, cardiotoxicity leading to bradycardia, GI effects, CNS effects- fatigue, weakness, vision changes |
| digoxin contraindications | thiazide diuretics, ACE inhibitors, ARBs, dopamine, qiunidine, verapamil |
| digoxin notes | check pulse rate and rhythm, therapeutic level 0.5 to 2.0, monitor potassium |
| ARBs | losarTAN similar to ace inhibitors major difference cough and hyperkalemia are not side effects |
| procainamide class/generic name | antidysrhythmic-sodium channel blocker a: procainamide (other quinidine) |
| procainamide brand name | pronestyl, procanid, quinidex |
| procainamide mechanism of action | decreases electrical conduction, decreases rate of repolarization, increases automaticity |
| procainamide indication | supraventricular tachycardia, ventricular tachycardia, atrial flutter atrial fibrillation |
| procainamide adverse effects | systemic lupus syndrome- painful inflammed joints, blood dyscrasias (neutropenia), cardiotoxicity- widened QRS and QT |
| procainamide contraindications | heart blocks, systemic lupus, anticholinergic meds increase drymouth, urinary retention, constipation and tachyardia. antihypertensive increase hypotension |
| lidocaine class/generic name | antidysrhythmic- sodium channel blocker b: lidocaine |
| lidocaine brand name | xylocaine |
| lidocaine mechanism of action | decrease electrical conduction, decrease automaticity, increase rate of repolarization |
| lidocaine indication | short term use for ventricular dysrhythmias |
| lidocaine adverse effects | CNS effects- drowsiness, altered LOC, parethesias, seizures, resp arrest |
| lidocaine contraindications | stokes adams syndrome, wolff parkinson white syndrome, and severe heart block. cimetidime, beta blockers and phenytoin increase effects of lidociane |
| amiodarone class/ generic name | antidysrhythmic- potassium channel blocker: amiodarone |
| amiodarone brand name | cordarone, pacerone |
| amiodarone mechanism of action | decrease rate of repolarization, decrease electrical conduction, decrease contractility, decrease automaticity |
| amiodarone indication | conversion of A.FIB, recurrent V.FIB, recurrent V.TACH |
| amiodarone adverse effects | pulmonary toxicity, sinus bradycardia and AV heart block, may cause heart failure to develop, hypotension, visual disturbances, liver and thyroid dysfunction, GI disturbances, highly toxic |
| amidarone contraindications | AV heart block, bradycardia, doses should be lowered qiunidine, procainamide, digoxin, warfarin. cholestyramine decreases levels of amiodarone, diuretics antidysrhythmics and antibiotics increase risk of dysrhythmias, grapefruit juice |
| atorvastatin class/generic name | antilipemics-HMG CoA Reductase Inhibitors (statins): atorvastatin (other simvastatin, lovastatin, pravastatin) |
| atorvastatin brand name | lipitor (other zocor, mevacor, pravachol) |
| atorvastatin mechanism of action | supress liver cholesterol synthesis: liver increases number of LDL receptors increasing removal of LDL from blood. increasing HDL promoting vasodilation, decrease plaque formation, decrease rick of thromboembolism |
| atorvastatin indication | hypercholesterolemia, prevention of coronary events, MI, stroke raise HDL |
| atorvastatin adverse effects | hepatotoxicity, myopathy- muscle aches, pain and tenderness. peripheral neuropathy- numbeness tingling pain in hands |
| atorvastatin contraindications | fibrates, erthromycin, grapefruit juice |
| gemfibrozil class/generic name | antilipemics/fibrates: gemfibrozil (other fenofibrate) |
| gemfibrozil brand name | lopid (tricor, lofibra) |
| gemfibrozil mechanism of action | decrease in triglyceride levels promotes more LDL excretion and HDL increase |
| gemfibrozil indication | reduction of plasma triglycerides, increase levels of HDL |
| gemfibrozil adverse effects | gall bladder stones, myopathy, hepatotoxcity |
| gemfibrozil contraindications | liver diasease, warfarin, statins, cholestyramine |
| ezetimibe class/ generic name | antilipemics- cholesterol absorption inhibitor: ezetimibe |
| ezetimibe brand name | zetia |
| ezetimibe mechanism of action | inhibit cholesterol secreted in bile and from food |
| ezetimibe indication | lower LDL clients with modified diets, with statins or alone |
| ezetimibe adverse effect | none |
| ezetimibe contraindications | cholestyramine interferes with absorption, statins- risk of liver dysfnction, fibrates, cyclosporine |
| cholestyramine class/generic name | antilipemics bile sequestrants: cholestyramine |
| cholestyramine brand name | questran |
| cholestyramine mechanism of action | increase in LDL receptors increasing removal from blood. lowering LDL levels |
| cholestyramine indication | adjunct to statins and diet to lower cholesterol levels |
| cholestyramine adverse effects | constipation |
| cholestyramine contraindications | biliary disease, digoxin, warfarin, thiazides, and tatracyciles interfere with absorption |
Created by:
lilmunst3r
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