Drugs Quiz 2 Phcy 581

Atenolol brand name

Tenormin

Atenolol drug class

B-Adrenergic Blocker, Cardioselective

Atenolol indications

-Angina pectoris, chronic

-HTN (hypertension)

-AMI (Acute Myocardial Infarction)

Atenolol MOA

Cardioselective β-adrenergic that decreases AV nodal conduction in supraventricular tachycardias and blockade of catecholamine-induced dysrhythmias.

Atenolol BW

Avoid abrupt withdrawal

Atenolol contraindications

Hypersensitivity, sinus bradycardia, 2nd- or 3rd-degree AV block, overt heart failure or cardiogenic shock

Atenolol patient counseling

1. Take on an empty stomach.

2.Avoid abrupt discontinuation; exacerbations of angina may occur.

3.Report signs/symptoms of bradycardia, hypotension, heart failure, or exacerbation of angina with initial dosing and dose changes.

4.May cause dizziness or drowsiness.

5.Diabetic patients to carefully follow blood sugar levels as β-blockers may mask symptoms of hypoglycemia.

6.Drug may cause sexual side effects, fatigue, and depression

Atorvastatin brand name

Lipitor

Atorvastatin drug class

HMG-CoA Reductase Inhibitor

Atorvastatin indications

-Primary and secondary prevention of atherosclerotic cardiovascular disease

-Secondary prevention of cardiovascular events in patients with or at high risk for CAD (coronary artery disease)

-Familial hypercholesterolemia (homozygous or heterozygous)

Atorvastatin MOA

-HMG-CoA reductase inhibitors competitively inhibit conversion of HMG-CoA to mevalonate, an early rate-limiting step in cholesterol synthesis.

-A compensatory increase in LDL receptors, which bind and remove circulating LDL-cholesterol, results. Production of LDL-cholesterol also can decrease because of decreased production of VLDL-cholesterol or increased VLDL; removal by LDL receptors.

Atorvastatin BW

Non

Atorvastatin contraindications

Hypersensitivity, use in breastfeeding, active liver disease, unexplained persistent elevations of serum transaminases

Atorvastatin patient counseling

1. Avoid excessive alcohol, grapefruit, and grapefruit juice (>1 L/d) consumption while taking drug.

2. does not take the place of lifestyle changes (diet, exercise) to lower cholesterol levels.

3.Notify HCP if unexplained muscle tenderness or weakness occurs.

Benazepril brand name

Lotensin

Benazepril drug class

ACE-I, Antihypertensive

Benazepril indications

-hypertension

Benazepril MOA

a competitive ACE-I. It also reduces serum aldosterone, leading to decreased sodium retention, potentiates the vasodilator kallikrein-kinin system, and can alter prostanoid metabolism, inhibit the sympathetic nervous system, and inhibit the tissue renin-angiotensin system.

Benazepril BW

Pregnancy, fetal toxicity

Benazepril contraindications

Hypersensitivity; history of angioedema; anuria; concomitant use with aliskiren in patients with diabetes mellitus; concurrent sacubitril

Benazepril patient counseling

1.Avoid pregnancy.

2. Seek medical attention immediately if you experience any facial swelling.

3.Most common adverse effect is dry cough.

4.Use potassium supplements or salt substitutes only under medical supervision.

5. May cause dizziness that may worsen if dehydrated.

6.Take at the same time daily.

Bisoprolol brand name

Zebeta

Bisoprolol drug class

Cardioselective B-Adrenergic Blocker

Bisoprolol indications

-HTn

Bisoprolol MOA

-a cardioselective β-adrenergic blocker that decreases AV nodal conduction in supraventricular tachycardia and blockade of catecholamine-induced dysrhythmias.

-The antihypertensive mechanism is unknown, but contributing factors are renin blockade and decrease in myocardial contractility and cardiac output.

Bisoprolol BW

Noe

Bisoprolol contraindications

Hypersensitivity, severe sinus bradycardia, 2nd- or 3rd-degree AV block, overt heart failure, cardiogenic shock

Bisoprolol patient counseling

1.Instruct patient to report signs/symptoms of dyspnea, hypotension, or heart failure.

2.May cause dizziness, depression, or sexual dysfunction.

3.Drug may mask signs of low blood sugar.

4.Avoid activities that require alertness during initiation.

5.Rise slowly from a sitting/supine position, as drug may cause orthostatic hypotension.

6. Avoid abrupt discontinuation; may cause rebound hypertension.

Candesartan brand name

Atacand

Candesartan drug class

Angiotensin II Receptor Antagonist

Candesartan indications

-Heart failure

-HTN

Candesartan MOA

selective, reversible, competitive antagonist of the angiotensin II receptor type 1

Candesartan BW

Pregnancy

Candesartan contraindications

Hypersensitivity ARB, pregnancy

Candesartan patient counseling

1.Avoid pregnancy and notify physician immediately if become pregnant.

2.Use potassium supplements or salt substitutes only under medical supervision.

3.May cause dizziness that may worsen if dehydrated.

4. Seek care if angioedema, excessive fluid loss, hyperkalemia, reduction in urination, or jaundice occurs.

Carvedilol brand name

Coreg, Coreg CR

Carvedilol drug class

α/β-Adrenergic Blocker

Carvedilol indications

-Heart failure with reduced ejection fraction

-HTN

Carvedilol MOA

a selective α1- and nonselective β-adrenergic blocker that decreases AV nodal conduction in supraventricular tachycardias and blockade of catecholamine-induced dysrhythmia.

Carvedilol BW

No

Carvedilol contraindications

Hypersensitivity, bronchial asthma, severe sinus bradycardia, 2nd- or 3rd-degree AV block, sick sinus syndrome, overt heart failure, cardiogenic shock, severe hepatic impairment

Carvedilol patient counseling

1. Take with food or milk.

2.Report signs/symptoms of heart failure, bradyarrhythmias, bronchospasm, hypotension, syncope, or exacerbation of angina with initial dosing and dose changes.

3.Avoid abrupt discontinuation, may cause rebound HTN.

4. Avoid driving, using machinery, or doing anything else that could be dangerous if not alert.

5. Diabetic patients should carefully follow blood sugar levels as beta-blockers may mask symptoms of hypoglycemia.

Chlorthalidone brand name

Hygroton, Thalitone

Chlorthalidone drug class

Thiazide Diuretic

Chlorthalidone indications

-HTN

-Edema

Chlorthalidone MOA

increases sodium and chloride excretion by interfering with their reabsorption in the cortical-diluting segment of the nephron.

Chlorthalidone BW

nah

Chlorthalidone contraindications

Hypersensitivity to sulfonamides; anuria

Chlorthalidone patient counseling

1.Take in the morning with food.

2.Instruct patient to report signs/symptoms of dyspnea, hypotension, gout, or heart failure.

3.Avoid alcohol (may cause hypotension) and NSAIDs (may decrease effectiveness).

4.This medicine may cause dizziness or blurred vision.

5.Avoid driving, using machinery, or doing anything else that could be dangerous if not alert.

Digoxin brand name

Digitek, Digox, Lanoxin

Digoxin drug class

Digitalis Glycoside

Digoxin indications

-Atrial fibrillation

-Heart failure

-Supraventricular tachyarrhythmia

Digoxin MOA

Digitalis glycosides exert positive inotropic effects through improved availability of calcium to myocardial contractile elements, thereby increasing cardiac output in heart failure. Antiarrhythmic actions are caused primarily by an increase in AV nodal refractory period via increased vagal tone, sympathetic withdrawal, and direct mechanisms.

Digoxin BW

No

Digoxin contraindications

Hypersensitivity, ventricular fibrillation

Digoxin patient counseling

1.Take after morning meals (and after evening meals if giving in divided doses).

2. Report signs/symptoms of bradycardia.

3. Do not discontinue drug suddenly.

Diltiazem brand name

Cardizem, Cartia XT, Dilacor XR, Dilt-XR, Taztia XT, Tiazac

Diltiazem drug class

Calcium channel blocker

Diltiazem indications

-hypertension

-Stable, chronic angina

-Atrial arrhythmia and paroxysmal supraventricular tachycardia

Diltiazem MOA

calcium-channel-blocking drug that decreases HR, prolongs AV nodal conduction, and decreases arteriolar and coronary vascular tone. It also has negative inotropic properties.

Diltiazem BW

none

Diltiazem contraindications

Hypersensitivity; hypotension; 2nd- or 3rd-degree AV block, sick sinus syndrome

Diltiazem patient counseling

1. Report symptomatic hypotension, bradyarrhythmia, peripheral edema, or syncope.

2.This drug is available in multiple brand names with varying properties by brand.

3.Instruct patient to follow administration instructions specific to the prescribed brand with regard to meals and timing.

4.Do not drink alcohol while taking this drug.

5. Some products may be opened and sprinkled on a spoonful of applesauce (applesauce should not be hot, and should be swallowed without chewing, followed by a glass of water).

6. Administer at same time of day, either morning or evening.

Dipyridamole brand name

Aggrenox, Persantine

Dipyridamole drug class

Platelet Aggregation Inhibitor

Dipyridamole indications

-Thromboprophylaxis after heart valve replacement

Dipyridamole MOA

Inhibits the uptake of adenosine into platelets, endothelial cells, and erythrocytes resulting in an increase in local concentrations of adenosine, which is a coronary vasodilator and a platelet aggregation inhibitor.

Dipyridamole BW

None

Dipyridamole contraindications

Hypersensitivity

Dipyridamole patient counseling

1.Rise slowly from a sitting/supine position.

2. Patient should take oral formulation on empty stomach 1 h before or 2 h after meal.

Doxazosin brand name

Cardura, Cardura XL

Doxazosin drug class

α1-Adrenergic Blocker

Doxazosin indications

-Benign prostatic hyperplasia

-HTN

Doxazosin MOA

-selectively blocks postsynaptic α1-adrenergic receptors, reducing peripheral resistance through arterial and venous dilations.

-Reflex tachycardia that occurs with other vasodilators is infrequent because there is no presynaptic α2-receptor blockade.

-Increase urine flow by relaxing smooth muscle tone in the bladder neck and prostate.

Doxazosin BW

None

Doxazosin contraindications

Hypersensitivity to other quinazolines

Doxazosin patient counseling

1. Initial dose should be taken with breakfast, particularly with sustained-release products.

2.Avoid activities requiring coordination until drug effects are realized, as drug may cause vertigo or dizziness.

3.Rise slowly from a sitting/lying position, as this drug may cause orthostatic hypotension.

4.Syncope or loss of consciousness is possible with first dose or dose increases, especially if patient is in an upright position.

5. Report priapism to HCP immediately.

Edoxaban brand name

Savaysa

Edoxaban drug class

Factor Xa Inhibitor

Edoxaban indications

-Nonvalvular atrial fibrillation (prophylaxis, to reduce the risk of stroke)

-Venous thromboembolism (treatment, following 5-10 d of parenteral anticoagulant)

Edoxaban MOA

selective inhibitor of FXa. By inhibiting FXa, edoxaban decreases thrombin generation and thrombus development.

Edoxaban BW

Premature discontinuation increases risk of thrombotic events; increased risk of spinal hematoma with spinal puncture or neuraxial anesthesia; reduced efficacy in nonvalvular atrial fibrillation patients with CrCl >95 mL/min

Edoxaban contraindications

Hypersensitivity, active bleeding

Edoxaban patient counseling

1.Seek medical attention if any unexpected bleeding or trouble breathing.

2.Take with or without food.

3.Do not stop taking edoxaban without talking with your HCP; stopping early may increase the risk of stroke, especially in patients with atrial fibrillation.

4.may be discontinued 24-48 h prior to dental and surgical procedures and restarted after hemostasis, following consultation with a prescriber.

5.Avoid OTC NSAIDs and high-dose aspirin, as they increase the risk of bleeding.

Enalapril brand name

Vasotec

Enalapril drug class

ACEI, Antihypertensive

Enalapril indications

-Heart failure

-HTN

-Kidney disease, nondiabetic

Enalapril MOA

-a prodrug that is rapidly converted to its active metabolite, enalaprilat, a competitive ACEI.

-It reduces serum aldosterone, leading to decreased sodium retention, potentiates the vasodilator kallikrein-kinin system, and inhibits the sympathetic nervous system and tissue renin-angiotensin system.

-The net effect is reduction in total peripheral resistance and BP in hypertensive patients and reduction in elevated afterload in patients with heart failure.

Enalapril BW

Pregnancy

Enalapril contraindications

Hypersensitivity, history of angioedema, pregnancy, concurrent sacubitril

Enalapril patient counseling

1.Use potassium supplements or salt substitutes only under medical supervision.

2.Report signs/symptoms of angioedema.

3.May cause dizziness that may worsen if dehydrated.

4. Use caution rising from sitting or lying position, especially when initiating treatment

Enoxaparin brand name

Lovenox

Enoxaparin drug class

Anticoagulant, Low-Molecular-Weight Heparin

Enoxaparin indications

-DVT prophylaxis, abdominal surgery

-DVT prophylaxis, hip or knee replacement surgery

-DVT prophylaxis, acute medical illness

-DVT treatment

-Acute ST-segment elevation AMI

-Unstable angina and non-Q-wave AMI

Enoxaparin MOA

low-molecular-weight heparin which has anti-factor Xa and IIa properties.

Enoxaparin BW

Neuraxial anesthesia may cause hematomas

Enoxaparin contraindications

Hypersensitivity to heparin or pork products; active major bleeding; concurrent neuraxial analgesia

Enoxaparin patient counseling

1.If self-administered (outside health-care facility), instruct patient on appropriate administration technique.

2.Do not mix with other injectable medications.

3.Monitor for signs of thrombosis and bleeding complications.

4. In order to minimize bruising, do not rub injection site after administration.

Epinephrine autoinjector brand name

Adrenaclick, Auvi-Q, EpiPen, EpiPen Jr.

Epinephrine autoinjector drug class

Alpha/Beta Agonist, Anaphylaxis Agent