Hospital Drug Quiz #2

Bumetanide (loop diuretic)

Bumex

Furosemide (loop diuretic)

Lasix

Chlorothiazide (thiazide diuretic)

Diuril

Nicardipine (dihydropyridine calcium channel blocker)

Cardene

diltiazem (nondihydropyridine calcium channel blocker)

Cardizem

Verapamil - no brand; answer is therapeautic class

Nondihydropyridine calcium channel blocker

enalaprilat (ACE inhibitor)

Vasotec IV

esmolol (beta blocker, beta-1 selective)

Brevibloc

metoprolol (beta blocker, beta-1 selective)

lopressor

propranolol (beta blocker; nonselective)

Inderal

Labetalol (N/A - TC)

beta blocker, non selective and alpha-1 blocker

hydralazine

vasodilator

nitroglycerin

vasodilator

Nitroprusside (vasodilator)

Nipride

milrinone

vasodilator (PDE-3 inhibitor); inotrope

Dobutamine

beta-1 agonist; inotrope

digoxin (antiarrhythmic; inotrope)

lanoxin

amiodarone (antiarrhythmic)

Nexterone

Procainamide

antiarrhythmic class Ia

lidocaine (antiarrhythmic class Ib; local anesthetic)

Xylocaine

adenosine

antiarrhythmic

atropine

anticholinergic; antidote; GI antispasmodic agent

bumetanide

Dose Conversion: furosemide 40 mg = bumetanide 1 mg

furosemide

Furosemide IV:PO ratio 1:2 (furosemide 20mg IV = furosemide 40mg PO

chlorothiazide

Only thiazide available IV

nicardipine

Hypotension (especially with severe aortic stenosis), should not be used in advanced aortic stenosis

diltiazem

Indication(s): Atrial fibrillation/other arrhythmias (rate control)

Warning(s): May worsen symptoms of HF; bradycardia; increased LFTs

Side effect(s): Edema, constipation (more with verapamil than diltiazem), gingival hyperplasia

verapamil CP

Indication(s): Atrial fibrillation/other arrhythmias (rate control)

Warning(s): May worsen symptoms of HF; bradycardia; increased LFTs

Side effect(s): Edema, constipation (more with verapamil than diltiazem), gingival hyperplasia

enalapril

BBW: Fetal toxicity; avoid in pregnancy

Warnings: Angioedema

Side effects: cough, hyperkalemia

Notes: do not use within 36 hours of sacubitril/valsartan

esmolol

Warning(s): Caution in pts with diabetes; can worsen hyperglycemia or hypoglycemia and mask hypoglycemic
conditions. Caution in bronchospastic diseases (asthma and COPD) and Raynaud’s

Note(s): Ultra-short-acting IV beta-1 selective blocker. Effects usually resolve within 10–20 minutes after stopping
the infusion; commonly used for rapid heart rate control and perioperative hypertension/tachycardia

metoprolol

BBW: Do not discontinue abruptly;

Warning(s): Caution in pts with diabetes; can worsen hyperglycemia or hypoglycemia and mask hypoglycemic
conditions. Caution in bronchospastic diseases (asthma and COPD) and Raynaud’s

Note(s): Metoprolol tartrate IV is not equivalent to PO (IV:PO ratio is 1:2.5)

propranolol

BBW: Do not discontinue abruptly

Contraindication(s): Asthma

Warning(s): Caution in pts with diabetes; can worsen hyperglycemia or hypoglycemia and mask hypoglycemic
conditions. Caution in Raynaud’s.

Note(s): High lipid solubility, crosses BBB, associated with more CNS side effects, but makes it useful for other
conditions (migraine prophylaxis). Non-selective BBs are used in portal HTN

labetalol

BBW: Do not discontinue abruptly

Contraindication(s): Asthma

Warning(s): Caution in pts with diabetes; can worsen hyperglycemia or hypoglycemia and mask hypoglycemic
conditions. Caution in Raynaud’s.

Commonly used IV agent for severe hypertension in pregnancy

hydralazine CP

Indication(s): Chronic hypertension, hypertensive emergency (off-label), HFrEF (off-label)

Warning(s): Drug-induced lupus erythematosus (DILE - dose and duration related)

Nitroglycerin

BBW: metabolism produces cyanide

Warnings: Increased intracranial pressure

Notes: Requires light protection during administration

Dobutamine - CP

may turn slightly pink due to oxidation but potency is not lost

Digoxin

Notes: Narrow therapeutic index (monitor digoxin level);

Toxicity: s/sx blurred/double vision, greenish-yellow halos signs of toxicity

Antidote: DigiFab

Amiodarone

BBW: Pulmonary toxicity, hepatotoxicity; proarrhythmic effects. Amiodarone is used for life-threatening
arrhythmias only.

Note(s): Infusions >2 hours require a non-PVC container. Use 0.22 micron filter. Antiarrhythmic drug of choice in
heart failure. Very long half-life; numerous drug interactions

procainamide - CP

BBW: Potentially fatal blood dyscrasias (agranulocytosis). Long term use leads to positive antinuclear antibody
(ANA) in 50% of patients, which can result in drug-induced lupus erythematosus (DILE) in 20-30% of patients

lidocaine

Indication(s): Ventricular arrhythmias (refractory VT/ cardiac arrest)

adenosine - CP

Indications: Supraventricular re-entrant tachycardias

Notes: Half-life < 10 seconds

atropine - CP

Indications: bradycardia, inhibition of salivation and secretions, organophosphate poisoning