week 6

ACE inib approved just for HTN

ACE inib approved just for HTN

• Benazepril [Lotensin]

• Enalaprilat

• Moexipril

ACE inhib approved for HF 🫀

• Captopril

• Enalapril

• Fosinopril

• Lisinopril

• Quinapril

ACE inhib that prevents MI, stroke, & death for people at risk for CVD

ramipril [altace]

ACE inhib approved for LVD after MI

Trandolapril & captopril

ACE approved for diabetic nephropathy🚽

Captopril [Capoten]

ARB approved just for HTN

• Azilsartan

• Eprosartan

• Olmesartan

ARB approved for HF 🫀

• Candesartan

• Valsartan

ARB approved for diabetic nephropathy🚽

irbesartan & losartan

ARB that prevents MI, stroke, & death for people at risk for CVD (cannot take ACE)

telmisartan [micardis]

CCB indicated for angina

• Nifedipine

• Amlodipine

• Nicardipine

• Verapamil

• Diltiazem

CCB for HTN, angina, dysrhythmias

verapamil & diltiazem

vasodilator commonly used in an emergency 🚑

nitroglycerin

which vasodilator is selective for arterioles

• hydralazine

• minoxidil

• diltiazem

• nifedipine

• verapamil

nitroglycerin & isosorbide dinitrate

• selective vasodilator for veins

• emergency use when needing to reduce blood pressure

• decrease the heart’s workload

• increase the return of oxygenated blood into the heart

best antihypertensive for African Americans

CCB

HTN in children & adolescents

ACE & ARBS avoided in girls sexually active or pregnant

MANAGES pre-eclampsia 🤰

labetalol

treats SEVERE pre-eclampsia

labetalol w/ magnesium sulfate (seizure prophylaxis)

treatment of choice for hypertensive emergency

sodium nitroprusside [nitropress]: a direct-acting vasodilator that relaxes smooth muscle of arterioles & veins

how does digoxin work?

• Exerts a positive inotropic action on the heart 🫀

• Increases the force of ventricular contraction and can thereby increase cardiac output

class I sodium channel blocker antidysrhythmic

• quinidine

• procainamide

• disopyramide

• lidocaine

• phenytoin

• mexiletine

• flecainide

• propafenone

class II beta blocker antidysrhythmic

• propranolol

• acebutolol

• esmolol

class III potassium channel blocker antidysrhythmic

• amiodarone

• dronedarone

• sotalol

• dofetilide

• ibutilide

class IV CCB antidysrhythmic

• verapamil

• diltiazem

how to prevent strokes

warfarin 🩸

DOC used long term to slow ventricular rate in a patient w/ AFib (AMDV)

• BB: atenolol or metoprolol

• CCB: diltiazem or verapamil

DOC for atrial flutter

cardioversion or IV ibutilide [covert]

how to prevent recurrences of atrial flutter

• long term therapy w/:

  • class 1C Na channel blockers: flecainide, propafenone

  • class 3 K channel blockers: amiodarone

• stroke prevention w/ anticoagulants

DOC to suppress VFib <<life threatening

• amiodarone

• defibrillation req. to stabilize

sign of digoxin toxicity 🪦

halo 😇 effect & dysrhythmias (VFib & VFlutter)

DOC to treat digoxin-induced toxicity 🪦

lidocaine

patients meds that can cause Torsades (QT prolongation)

• Class 1A: Na channel blockers (flencainide, propafenone)

• Class 3: K channel blockers (amiodarone, ibutilide)

DOC used for acute management of Torsades de Pointes (QT prolongation)

IV magnesium + cardioversion

which class of lipoprotein can contribute to atherosclerosis?

LDL

which class of lipoprotein can contribute to pancreatitis?

VLDL

which class of lipoprotein can protect against atherosclerosis?

HDL

statin used as a starter dose or for low-intensity therapy for ASCVD prophylaxis

• simvastatin

• pravastatin

• lovastatin

statin used as a starter dose or for high-intensity therapy for ASCVD Prophylaxis

• atorvastatin

• rosuvastatin

which drug decreases LDL for ASCVD prophylaxis?

PCSK9 inhibitors

which drug increases HDL for ASCVD prophylaxis?

HMG-CoA reductase inhibitors (statins)

which drug decreases TG for ASCVD prophylaxis?

fibrates

statin recommended for patients w/ liver impairment/disease

• Lovastatin [Altoprev]

• Pitavastatin [Livalo]

statin recommended for patient with renal impairment/disease

• Atorvastatin (lipitor)

• Fluvastatin (Lescol, Lescol XL)

used as maintenance treatment for chronic stable angina (MPNV)

• BB: metoprolol & propranolol

• CCB: nifedipine & verapamil

• non-drug: avoid overexertion, heavy meals, emotional stress, exposure to cold

used as maintenance treatment for variant Angina (Prinzmetal’s or Vasospastic) Angina

• CCB: nifedipine & verapamil

Which drug in MONA-B will improve hemodynamics?

• MORPHINE!!

• used for the management of STEMI to improve hemodynamics thus lowering cardiac oxygen demand, helping preserve the ischemic myocardium

which drug is used for management of STEMI to reduce cardiac pain, infarc size, short term mortality, & increase long term survival?

BB: atenolol or metoprolol

What MUST you look up to make sure atenolol or metoprolol is given appropriately?

DOSAGE 💊