Top 200 Drugs Section 4: Cardiovascular Agents

Hypertension

High blood pressure

Systolic

First BP number, pressure created when heart beats

Diastolic

Second BP number, pressure inside blood vessels when heart rests

Desirable BP for healthy adult

< 120/80

Hypertension BP

140/90 (or more)

Pre-hypertension BP

120-139/80-89

How does a person qualify to be put into hypertension group

One of the 2 values of BP need to be within the hypertension category

Symptoms for hypertension

Dizziness, visual disturbances, headaches, nausea/vomiting

First choice of treatment for hypertension

lifestyle modifications

How do ACE-inhibitors work

Angiotensin-converting enzyme (ACE) decreases the production of angiotensin-II

What is angiotensin-II responsible for

Constricting blood vessels and releasing hormones that can raise BP

Zestril/Prinivil

lisinopril

Altace

ramipril

Accupril

quinapril

Lotrel

benazepril w/ amlodipine

Vasotec

enalapril

Suffix for ACE-inhibitors

-pril

ACE-inhibitors side effects

dry cough, rash, dizziness, swelling of body tissues, or hyperkalemia

How do Alpha-blockers work

Blocks alpha receptors and more muscles surrounding vessels to relax making blood flow easier

What are alpha receptors

Receptors that regulate hormones that constrict muscles around vessels

Cardura

doxazosin

Hytrin

terazosin

Alpha-blockers side effects

Headache, Nausea, Weakness, Weight gain, and first dose effect

What is first dose effect

Dizziness and possible fainting when patient rises suddenly caused by sudden drop in blood pressure

Alpha-adrenergic Agonists

Act as agonists at the receptors in the brain stem, results in decrease in heart rate and BP

Catapres

clonidine

Alpha-adrenergic Agonists side effects

dry mouth, drowsiness/dizziness, constipation, sedation, weight gain, loss of libido, weakness

Angiotensin-II Receptor Blockers (ARBs)

Similar to ACE inhibitors, these are used to decrease amount of angiotensin-II → they don’t inhibit production but block the receptors for angiotensin-II

Diovan

valsartan

Diovan HCT

Lavsartan w/ HCTZ

Cozaar

losartan

Benicar

olmesartan

Avapro

irbesartan

Avalide

Irbesartan w/ HCTZ

ARBs side effects

dizziness, diarrhea, back and leg pain, headache, localized swelling risk

Beta-blockers

Block beta receptors that are normally stimulated by epinephrine, results in slower beating heart and more relaxed blood vessels

Tenormin

atenolol

Toprol XL

metoprolol succinate

Lopressor

metoprolol tartrate

Coreg

carvedilol

Inderal

propranolol

Beta-blocker side effects

Fatigue, cold hands, dizziness/weakness, depression, trouble sleeping, loss of sexual desire, shortness of breath, and decreased exercise capacity

Calcium channel blockers

Prevents calcium from entering cells of our heart and blood vessel walls, which helps relax the vessels and widen the walls

Norvasc

amlodipine

Calan SR

verapamil

Adalat CC, Procardia XL

nifedipine ER

Cardizem

diltiazaem

Cardizem CD, Tiazac

diltiazem ER

Cartia XT

diltiazem SR

Calcium channel blocker side effects

constipation, headache, rapid heartbeat, drowsiness, nausea, flushing, swelling in lower extremities

Diuretics

Work by increasing amount of sodium and other elements our kidneys put in urine, this concentration draws more water out with it and leads to less fluid in our blood vessels → less pressure

Hydrodiuril

hydrochlorothiazide and HCTZ

Lasix

furosemide

Diuretics side effects

Low sodium, inc blood sugar and cholesterol, gout, impotence, menstrual irregularity, gynecomastia

Klor-con, K-dur, K-tab

potassium chloride

Potassium chloride

Supplement used to replace potassium levels in the body, used to treat or prevent hypokalemia

Lanoxin

digoxin

Digoxin

Use results in inc in sodium in cells which then causes inc in calcium in the cells → results in strong pump of heart and slowing rate of heart

Lanoxin side effects

dizziness/fainting, slow heartbeat, fast/pounding/irregular heartbeat, visual disturbances, unusual bleeding/bruising, black stools, pinpoint red rash

Isosorbide (nitrates family)

relaxes blood vessels and increases supply of blood and oxygen to the heart which reduces the workload on the heart

NOT used for an ACUTE ATTACK RELIEF

Isosorbide (mononitrate vs dinitrate)

Very similar w/ major difference being the recommended frequency of dosing

Both forms require a daily drug free period so that tolerance does not develop

Isosorbide side effects

cold sweats, clammy skin, visual disturbances, heartbeat changes, dark urine, blue-colored lips and extremities