Health Systems Lab Drug Quiz 2

Bumex - bumetanide

Loop diuretic

Dose Conversion: furosemide 40 mg = bumetanide 1 mg

Lasix - furosemide

Loop diuretic

IV:PO ratio 1:2

Diuril - chlorothiazide

Thiazide Diuretic

Only thiazide available IV

Carene - nicardipine

Dihydropyridine Calcium Channel Blocker

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

Cardizem - diltiazem

Nondihydropyridine Calcium Channel Blocker

Indications: Atrial fibrillation/other arrhythmias (rate control)

Warnings: May worsen symptoms of HF; bradycardia

Side effects: constipation (more with verapamil than diltiazem), gingival hyperplasia

verapamil

Nondihydropyridine Calcium Channel Blocker

Indications: Atrial fibrillation/other arrhythmias (rate control)

Warnings: May worsen symptoms of HF; bradycardia

Side effects: constipation (more with verapamil than diltiazem), gingival hyperplasia

Vasotec IV - enalaprilat

ACE Inhibitor

BBW: Fetal toxicity, avoid in pregnancy

Warning(s): Angioedema

Side effect(s): cough, hyperkalemia

Note(s): Do not use within 36 hours of sacubitril/valsartan (Entresto)

Brevibloc - esmolol

Beta Blocker, Beta-1 Selective

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.

Lopressor - metoprolol

Beta Blocker, Beta-1 Selective

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

Beta-Blocker, Nonselective and Alpha-1 Blocker

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): Commonly used IV agent for acute severe hypertension in pregnancy.

hydralazine

Vasodilator

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

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

nitroglycerin

Vasodilator

Contraindication(s): SBP <90 mmHg, DO NOT USE in combination with PDE5 inhibitors

Note(s): MOA: low doses: venous vasodilator, high doses: arterial vasodilator.

Requires non-PVC container (e.g. glass bottle).

Nipride - nitroprusside

Vasodilator

BBW: Metabolism produces cyanide (use the lowest dose for the shortest duration necessary)

Warning(s): Increased intracranial pressure

Note(s): Requires light protection during administration

milrinone

Vasodilator (PDE-3 Inhibitor; Inotrope

dobutamine

Beta-1 agonist; Inotrope

Note(s): may turn slightly pink due to oxidation but potency is not lost

Lanoxin - digoxin

Antiarrhythmic; Inotrope

Note(s): Narrow therapeutic index (monitor digoxin level);

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

Antidote: DigiFab

Nexterone - amiodarone

Antiarrhythmic

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

Antiarrhythmic, Class Ia

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

Xylocaine - lidocaine

Antiarrhythmic, Class Ib; Local Anesthetic

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

adenosine

Antiarrhythmic

Indication(s): Supraventricular re-entrant tachycardias.
Note(s): Half-life <10 seconds.

atropine

Anticholinergic; Antidote; GI Antispasmodic Agent

Indication(s): Bradycardia, inhibition of salivation and secretions, organophosphate poisoning