HTN, Osteoporosis, Arthritis, Gout Prototype drugs
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| Thiazide (Hydrochlorothiaizde) | -Diuretic
-Treats HTN
-Blocks reabsorption of sodium and chloride and prevents the reabsorption of water
-1st thing in morning
-Monitor k+
-Urinary potassium loss
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| Potassium-Sparing (spironolactone) | -Diuretic (modest)
-Treats HTN
-reduce blood volume by blocking aldosterone receptors
-promotes excretion of sodium and water
-Do not cause k+ depletion
-Possibility or retaining too much potassium
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| Loop (furosemide) | -Diuretic (extensive)--> greater decrease in BP
-Treats HTN
-Block reabsorption of sodium and chloride, and prevents reabsorption of water
-Emergent use not maintenance
-Ototoxic
-Hypokalemia and dehydration
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| Enalapril (vasotec) | -Drug for HTN and heart failure
-ACE inhibitor
-Prolonged half-life
-reduces angiotensin II and aldosterone levels
-1st dose phenomenon
-PRIL cough
-Angioedema, neutropenia, and agranulocytosis
-BLACK BOX WARNING
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| Lisinopril (prinivil, Zestril) | -Drug for HTN and heart failure
-ACE inhibitor
-acts by inhibiting ACE and decreasing aldosterone
-takes 2-3 weeks
-PRIL cough
-rash, hyperkalameia
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| Losartan | -Drug for HTN
-Angiotensin II receptor blockers
-Vasodilation and excretion of sodium + water
-Angioedema
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| Nifedipine (Adalat CC, Procardia XL) | -Drug for HTN and angina
-Calcium channel blocker
-less o2 utilization by heart
-admin alert for impending MI or within 2 weeks following MI
-reflex tachycardia
-TX of overdose: Vasopressors
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| Clonidine | -Drug for HTN
-Alpha2-adrenergic agonists
-Act within CNS
-rebound HTN if discontinued abruptly
-take at bedtime
-sedation, dry mouth
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| Doxazosin (cardura) | -Drug for HTN
-Alpha1-adrenergic blocker
-Dilates arteries and veins
-1st dose phenomenon
somnolence, headache, asthenia, dyspnea, dizziness
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| Metoprolol + Atenolol | -Drug for HTN
-Beta1- adrenergic blockers
-do not abruptly discontinue(rebound myocardial excitement)
-bradycardia
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| Metoprolol (lopressor, Toprol XL) | -Drug for HTN and heart failure
-Beta-adrenergic blocker
-reduces sympathetic stimulation of heart
-bradycardia, abnormal sexual function, insomnia
-interactions w/ Digoxin, alcohol, or antihypertensives
BLACK BOX WARNING-->abrupt withdrawal
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| Hydralazine (Apresoline) | -Drug for HTN and heart failure
-Direct-acting vasodilator
-TX of hypertensive emergency
-Abrupt withdrawal=rebound HTN and anxiety
-reflex tachycardia, palpitations, n/d, sodium+fluid retention
-Contraindicated in cardiac problems
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| Digoxin (lanoxin) | -Drug for heart failure
-Cardiac glycoside
-positive inotropic force action, inhibiting Na+-K+ ATPase
-Monitor digoxin levels(<1.8 ng/mL)
-Dysrhythmias, n/v, anorexia, visual problems
-older adults, renal impairment
-Interaction: diuretics andACE
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| Milrinone (Primacor) | -Drug for heart failure
-Phosphodiesterase inhibitor
-Short-term therapy of advanced HF
-IV
-Ventricular dysrhythmias, n/v
-contraindicated in pre-existing dysrhythmias
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| Methotrexate | -Antirheumatic drug
-DMARD
-bone marrow suppression, hepatic toxicity, GI ulcerations
-Notify provider if signs of infection of GI ulcerations
LABS
-W/ food or full glass of water
-can take 3-6 weeks
-Pregnancy X
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| Hydroxychloroquine (plaquenil) | -Antirheumatic drug
-DMARD
-relieves severe inflammation (often given w/salicylates or corticosteroids)
-same time everyday w/ milk
-GI disturbances, hair loss, Ocular effects
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| Allopurinol | -Antigout agent
-xanthine Oxidase inhibitor
-Inhibit uric acid production-->chronic gout
-2-3 L of fluids and monitor I&O
-W/ food
-Avoid food high in purine(red meat, scallops)
-Kidney injury, hepatitis, N/V
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| Colchicine | -Antigout drug
-Anti-inflammatory agent
-Pt who doesn't respond to safer agents
-acute attacks for people with chronic gout
-W/ food and antidiarrheal agent PRN
-GI toxicity, bone marrow suppression, muscle pain/tenderness
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| Raloxifene (evista) | -Drug for osteoporosis prevention
-SERM
-Act through estrogen receptor(pregnancyX)
-Consume vitamin D and calcium
-Perform weight bearing exercises
-hot flashes, leg cramps, weight gain
-BLACK BOX-risk for thromboembolism and stroke
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| Calcitonin- Salmon | -Drug for osteoporosis
-Calcitonin
-Inhibit activity of osteoClast
-Nasal spray(alternate nostrils)
-Monitor bone density scan
-Diet high in calcium and vitamin D
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| Alendronate (Fosamax) | -Drug for osteoporosis
-Bisphosphonate
-Lower ALP(enzyme associated w/ bone turnover)
-Empty stomach w/ full glass water 2hr before breakfast
-upright position 30 min after admin
-1-3 months
-GI--> n/v/d, flatulence, abdomen pain...
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| Calcitriol | -Vitamin D (active form)
-Bone resorption inhibitor
-hypercalcemia--> weakness, confusions, anorexia, n/v
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| Calcium Salts | -Calcium supplement
-Hypocalcemia agent
-oral w/ meals or within 1 hr following meals w/ full glass water
-hypercalcemia, lethargy, n/v, renal stones, extravasation
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