THERAPEUTIC AGENTS- CARDIOVASCULAR SYSTEM

includes meds and disorders

Hypertension

• known as the silent killer, high BP

• heart has to work harder to pump blood through the vascular system to provide oxygen and nutrients to the body

• essential has unknown cause, most cases

• secondary has known cause, infrequent cases

• can be easily determined with a BP screening

Hypotension

• not a common chronic condition, low BP

• can be secondary to some acute injury like shock of certain meds

• hypotension can be orthostatic, happens when standing up or lying down and can make you feel dizzy or lightheaded or faint

Hyperlipidemia

• increase in cholesterol in the bloodstream that can lead to atherosclerosis

• increases the incidence of angina, heart attack, and stroke

• Diets high in fat and cholesterol can lead to increases in low-density lipoproteins (LDLs) and triglycerides (TGs) in the blood

• LDLs and TGs can deposit in the walls of blood vessels and

  create plaques

Coronary Artery Disease

• where the arteries of the heart do not receive proper oxygenation

• Due to atherosclerosis and occlusion of coronary arteries

• Can cause several symptoms or conditions including angina pectoris (i.e., chest pain or a sense of pressure)

Thrombotic Events

• result of unwanted clotting in the body

• The formation of a clot in a vessel which blocks blood flow is known as thrombosis

• An embolus is a blood clot that has traveled through the body to another area where it can become lodged and create a blockage

• Thrombi and emboli can precipitate myocardial infarction,

  stroke, or deep vein thrombosis (DVT)

Myocardial Infarctions

• MIs are heart attacks

• If coronary blood flow to an area of the heart becomes entirely blocked because of thrombus or embolism, that area of heart muscle cannot receive necessary oxygen

• leads to death of the heart muscle and a myocardial infarction

Arrhythmias

• irregular heartbeats, can be serious or non-serious

• can destroy the rhythm of the heart

• If the ventricles are not beating in a rhythmic manner, the

  heart will not pump blood efficiently

Heart Failure

• progressive disease in which the heart cannot pump enough blood to meet the needs of the body

• Hypertension, MI, and CAD can contribute to the

  development of heart failure

• Edema (retention of fluid) is a common characteristic of heart failure

• Eventually, the heart can no longer pump adequately

What are Beta Blockers?

• Treat high blood pressure or arrhythmias (rapid heart rate)

• Usually end in an -ol

What are Calcium Channel Blockers?

• treat high BP and chest pain

What are Diuretics?

• treat high BP and edema

What are ACE Inhibitors?

• treat high BP

• ends in -pril

What are Angiotensin Receptor Blockers (ARBs)?

• treat high BP

• ends in -sartans

What are Antihyperlipidemics?

• usually used to treat high bad cholesterol

• can decrease the uptake of cholesterol from the intestines or decrease production in the body

• common ending for HMG-coA reductase inhibitors is -statins

What are Anticoagulants?

• used to prevent an emboli and the possibility for a heart attack or a stroke

Amlodipine (calcium channel blockers)

Brand Name: Norvasc

SE(s): Flushing, heartburn, GI upset, edema

CI/Notes: BBW Fetal toxicity

Atenolol (beta blocker)

Brand Name: Tenormin

SE(s): Dizziness, tiredness, weakness

CI/Notes: Bradycardia (C/I)

Benazepril (ACE inhibitors)

Brand Name: Lotensin

SE(s): Dry cough, dizziness

C/I: Pregnancy

Carvedilol (beta blockers)

Brand Name: Coreg

SE(s): Dizziness, weakness, hypotension bradycardia

C/I: Bronchial asthma, cardiogenic shock

Clonidine HCl

Brand Name: Catapres

SE(s):

Diltiazem (calcium channel blockers)

Brand Name: Cardizem CD

SE(s): Dizziness, weakness, headache

C/I: Hypotension

Diltiazem XT (calcium channel blockers)

Brand Name: Cartia XT

SE(s): Dizziness, weakness, headache

C/I: Hypotension

Enalapril (ACE inhibitors)

Brand Name: Vasotec

SE(s): Dry cough, dizziness

C/I: Pregnancy

Furosemide (diuretic)

Brand Name: Lasix

SE(s): Excessive urine, stomach cramps, light sensitivity, dizziness, hypokalemia

Hydrochlorothiazide (HCTZ) (diuretic)

Brand Name: Microzide

SE(s): Excessive urine, stomach cramps, light sensitivity, dizziness, hypokalemia

Irbesartan (ARB)

Brand Name: Avapro

SE(s): Dizziness, tiredness, weakness

C/I: Pregnancy

Lisinopril (ACE inhibitors)

Brand Name: Prinivil, Zestril

SE(s): Dry cough, dizziness

C/I: Pregnancy

Metoprolol succinate XL (beta blockers)

Brand Name: Toprol XL

SE(s): Dizziness, tiredness, weakness

Metoprolol tartrate (beta blockers)

Brand Name: Lopressor

SE(s): Dizziness, tiredness, weakness

Nifedipine ER (calcium channel blockers)

Brand Name: Adalat CC, Nifedical

SE(s): Flushing, heartburn, GI upset

Olmesartan (ARBs)

Brand Name: Benicar

SE(s): Dizziness, tiredness, weakness

C/I: Pregnancy

Propranolol HCl (beta blockers)

Brand Name: Inderal

SE(s): Dizziness, tiredness, weakness

C/I: Bronchial asthma, cardiogenic shock

Quinapril (ACE inhibitors)

Brand Name: Accupril

SE(s): Dry cough, dizziness

C/I: Pregnancy

Ramipril (ACE inhibitors)

Brand Name: Altace

SE(s): Dry cough, dizziness

C/I: Pregnancy

Spironolactone (diuretic)

Brand Name: Aldactaone

SE(s): Hyperkalemia, excessive urine, gynecomastia

C/I: Hyperkalemia

Triamterene and hydrochlorothiazide (diuretic)

Brand Name: Dyazide, Maxzide

SEs: Hyperkalemia

BBW: Hyperkalemia

Valsartan (ARBs)

Brand Name: Diovan

SE(s): Dizziness, tiredness, weakness

C/I: Pregnancy

Verapamil SR (calcium channel blockers)

Brand Name: Calan SR, Verelan P

SE(s): Dizziness, constipation

C/I: Hypotension

Clopidogrel (anticoagulant)

Brand Name: Plavix

SE(s): Bleeding, easy bruising

C/I: Active bleeding

BBW: Diminished effects in poor metabolizers

Warfarin sodium (anticoagulant)

Brand Name: Coumadin, Jantoven

SE(s): Bleeding, easy bruising

C/I: Active bleeding, major recent surgery, pregnancy

Atorvastatin (antihyperlipidemic)

Brand Name: Lipitor

SE(s): Muscle pain, liver damage, headache

C/I: Pregnancy, breast feeding

Ezetimibe (antihyperlipidemic)

Brand Name: Zetia

SE(s): Tiredness, diarrhea, joint pain

C/I: Hepatic or renal disease

Fenofibrate (antihyperlipidemic)

Brand Name: Tricor

SE(s): Headache, back/stomach pain

C/I: Dialysis, breast feeding

Gemfibrozil (antihyperlipidemic)

Brand Name: Lopid

SE(s): Diarrhea, stomach pain

C/I: Hepatic or renal disease

Lovastatin (antihyperlipidemic)

Brand Name: Mevacor

SE(s): Muscle pain, liver damage, headache

C/I: Pregnancy, breast feeding

Niacin (antihyperlipidemic)

Brand Name: Niaspan

SE(s): Flushing, itchiness

C/I: Active peptic ulcer

Pravastatin (antihyperlipidemic)

Brand Name: Pravachol

SE(s): Muscle pain, liver damage, headache

C/I: Pregnancy, breast feeding

Rosuvastatin (antihyperlipidemic)

Brand Name: Crestor

SE(s): Muscle pain, liver damage, headache

C/I: Pregnancy, breast feeding

Simvastatin (antihyperlipidemic)

Brand Name: Zocor

SE(s): Muscle pain, liver damage, headache

C/I: Pregnancy, breast feeding

Simvastatin and ezetimibe (antihyperlipidemic)

Brand Name: Vytorin

SE(s): Muscle pain, headache

C/I: Pregnancy, breast feeding

Clonidine (Misc)

Brand Name: Catapress

SE(s):

CI/Notes:

Digoxin (Misc)

Brand Name: Lanoxin

SE(s):

CI/Notes:

Amlodipine and valsartan (combo)

Brand Name: Exforge

SE(s): Dizziness, throat irritation

C/I: Pregnancy

Benazepril and amlodipine (combo)

Brand Name: Lotrel

SE(s): Dry cough, weakness

Bisoprolol and HCTZ (combo)

Brand Name: Ziac

SE(s): Dizziness, tiredness, weakness

C/I: Bronchial asthma, cardiogenic shock

Irbesartan and HCTZ (combo)

Brand Name: Avalide

SE(s): Dizziness, tiredness, weakness, excessive urination

C/I: Pregnancy

Lisinopril and HCTZ (combo)

Brand Name: Prinzide, Zestoretic

SE(s): Flushing, heart burn, GI upset

C/I: Pregnancy

Losartan and HCTZ (combo)

Brand Name: Hyzaar

SE(s): Dizziness, tiredness, weakness, excessive urination

Olmesartan and HCTZ (combo)

Brand Name: Benicar HCT

SE(s): Dizziness, tiredness, excessive urination

C/I: Pregnancy

Valsartan and HCTZ (combo)

Brand Name: Diovan HCT

SE(s): Dizziness, tiredness, weakness, excessive

urination, headache

CI/Notes: Pregnancy (C/I)