Formulary Quiz 1

Class: diltiazem (Cardizem, Tiazac)

Non-DHP CCB

Generic: Cardizem, Tiazac

Diltiazem

Brand: diltiazem

Cardizem, Tiazac

Common doses: diltiazem (Cardizaem, Tiazac)

IR: 80-120 mg TID
XR: 180-360 mg QD

Adverse effects: diltiazem (Cardizem, Tiazac)

Reduced myocardial contractility, AV/SA nodal conduction disturbances, bradycardia, AV block, hypotension, flushing, headache, dizziness, constipation

Monitoring parameters: diltiazem (Cardizem, Tiazac)

Goal HR, constipation, watch for AV/SA nodal disturbances

Class: verapamil (Verelen, Calan, Isoptin)

Non-DHP CCB

Generic: Verelen, Calan, Isoptin

Verapamil

Brand: verapamil

Verelen, Calan, Isoptin

Common doses: verapamil (Verelen, Calan, Isoptin)

IR: 60-90 mg TID to QID
SR: 240 mg QD

Adverse effects: verapamil (Verelen, Calan, Isoptin)

Reduced myocardial contractility, AV/SA nodal conduction disturbances, bradycardia, AV block, hypotension, flushing, headache, dizziness, constipation

Monitoring parameters: verapamil (Verelen, Calan, Isoptin)

Goal HR, constipation, watch for AV/SA nodal disturbances

Class: amlodipine (Norvasc)

DHP CCB

Generic: Norvasc

Amlodipine

Brand: amlodipine

Norvasc

Common doses: amlodipine (Norvasc)

5-10 mg QD

Adverse effects: amlodipine (Norvasc)

Hypotension, flushing, headache, dizziness, peripheral edema (arteriole vasodilation), reduced myocardial contractility, reflex adrenergic activation

Monitoring parameters: amlodipine (Norvasc)

Blood pressure, HR, edema

Class: isosorbide mononitrate (Imdur)

Nitrate

Generic: Imdur

Isosorbide mononitrate

Brand: isosorbide mononitrate

Imdur

Common doses: isosorbide mononitrate (Imdur)

IR: 10-20 mg BID
ER: 30-240 mg QD

Adverse effects: isosorbide mononitrate (Imdur)

Headache (throbbing, pulsating), hypotension, lightheadedness, dizziness, facial flushing, reflex tachycardia

Monitoring paramaeters: isosorbide mononitrate (Imdur)

Blood pressure (hypotension), HR (tachycardia), diary that lists number of NTG doses used per week, how many episodes of chest pain were encountered, do not use with PDEI, use acetaminophen for headache

Class: isosorbide dinitrate (Isordil)

Nitrate

Generic: Isordil

Isosorbide dinitrate

Brand: isosorbide dinitrate

Isordil

Common doses: isosorbide dinitrate (Isordil)

IR: 5-40 mg BID to TID
ER/SR: 40-80 mg QD
20 mg TID

Adverse effects: isosorbide dinitrate (Isordil)

Headache (throbbing, pulsating), hypotension, lightheadedness, dizziness, facial flushing, reflex tachycardia

Monitoring parameters: isosorbide dinitrate (Isordil)

Blood pressure (hypotension), HR (tachycardia), do not use with PDEI, use acetaminophen for headache

Class: nitroglycerin (Nitrostat, Nitrolingual, Nitro-Dur, Nitro-Bid)

Nitrate

Generic: Nitrostat (SL tab), Nitrolingual (spray), Nitro-Dur (patch), Nitro-Bid (ointment)

Nitroglycerin

Brand: nitroglycerin

Nitrostat (SL tab), Nitrolingual (spray), Nitro-Dur (patch), Nitro-Bid (ointment)

Common doses: nitroglycerin (Nitrostat)

300-600 mcg SL tab acutely
2.5-26 mg BID to QID chronic

Common doses: nitroglycerin (Nitrolingual)

0.4 mg/spray acutely

Common doses: nitroglycerin

5 mcg/min initially, increasing by 5 mcg/min every 5 to 10 minutes (max 200)

Common doses: nitroglycerin (Nitro-Dur)

0.2-0.8 mg/hr patch (on 12h, off 12h)

Adverse effects: nitroglycerin (Nitrostat, Nitrolingual, Nitro-Dur, Nitro-Bid)

Headache (throbbing, pulsating), hypotension, lightheadedness, dizziness, facial flushing, reflex tachycardia

Monitoring parameters: nitroglycerin (Nitrostat, Nitrolingual, Nitro-Dur, Nitro-Bid)

Blood pressure (hypotension), HR (tachycardia), do not use PDEI, use acetaminophen for headache

Class: atenolol (Tenormin)

B1 selective B-blocker

Generic: Tenormin

Atenolol

Brand: atenolol

Tenormin

Common doses: atenolol (Tenormin)

50-100 mg QD

Adverse effects: atenolol (Tenormin)

Bradycardia, sinus arrest, AV block, reduced LVEF (b/c decreased contractility), fatigue, depression, nightmares, sexual dysfunction, intensified insulin-induced hypoglycemia, peripheral vascular complication, B-blocker withdrawal syndrome (causes angina)

Monitoring parameters: atenolol (Tenormin)

Goal HR (rest: 50-60 bpm, exercise:

Class: bisoprolol (Zebeta)

B1 selective B-blocker

Generic: Zebeta

Bisoprolol

Brand: bisoprolol

Zebeta

Common doses: bisoprolol (Zebeta)

Initial dose: 1.25 mg daily
Target dose: 10 mg daily

Adverse effects: bisoprolol (Zebeta)

Bradycardia, sinus arrest, AV block, reduced LVEF (b/c decreased contractility), fatigue, depression, nightmares, sexual dysfunction, intensified insulin-induced hypoglycemia, peripheral vascular complication, B-blocker withdrawal syndrome (causes angina)

Monitoring parameters: bisoprolol (Zebeta)

HR and caution asthmatics

Class: metoprolol succinate (Toprol XL)

B1 selective B-blocker

Generic: Toprol XL

Metoprolol succinate

Brand: metoprolol succinate

Toprol XL

Common doses: metoprolol succinate (Toprol XL)

Initial dose: 12.5-25 mg daily
Target dose: 200 mg daily

Adverse effects: metoprolol succinate (Toprol XL)

Bradycardia, sinus arrest, AV block, reduced LVEF (b/c decreased contractility), fatigue, depression, nightmares, sexual dysfunction, intensified insulin-induced hypoglycemia, peripheral vascular complication, B-blocker withdrawal syndrome (causes angina)

Monitoring parameters: metoprolol succinate (Toprol XL)

HR and caution asthmatics

Class: metoprolol tartrate (Lopressor)

B1 selective B-blocker

Generic: Lopressor

Metoprolol tartrate

Brand: metoprolol tartrate

Lopressor

Common doses: metoprolol tartrate (Lopressor)

50-100 mg BID

Adverse effects: metoprolol tartrate (Lopressor)

Bradycardia, sinus arrest, AV block, reduced LVEF (b/c decreased contractility), fatigue, depression, nightmares, sexual dysfunction, intensified insulin-induced hypoglycemia, peripheral vascular complication, B-blocker withdrawal syndrome (causes angina)

Monitoring parameters: metoprolol tartrate (Lopressor)

Goal HR (rest: 50-60 bpm, exercise:

Class: nebivolol (Bystolic)

B1 selective B-blocker

Generic: Bystolic

Nebivolol

Brand: nebivolol

Bystolic

Common doses: nebivolol (Bystolic)

5-40 mg QD

Adverse effects: nebivolol (Bystolic)

Bradycardia, sinus arrest, AV block, reduced LVEF (b/c decreased contractility), fatigue, depression, nightmares, sexual dysfunction, intensified insulin-induced hypoglycemia, peripheral vascular complication, B-blocker withdrawal syndrome (causes angina)

Monitoring parameters: nebivolol (Bystolic)

Goal HR (rest: 50-60 bpm, exercise:

Class: propranolol (Hemangeol, Inderal)

Non-selective B-blocker

Generic: Hemangeol, Inderal

Propranolol

Brand: propranolol

Hemangeol, Inderal

Common doses: propranolol (Hemangeol, Inderal)

IR: 80-160 mg, divided doses
ER: 80-320 mg QD

Adverse effects: propranolol (Hemangeol, Inderal)

Bradycardia, sinus arrest, AV block, reduced LVEF (b/c decreased contractility), fatigue, depression, nightmares, sexual dysfunction, intensified insulin-induced hypoglycemia, peripheral vascular complication, B-blocker withdrawal syndrome (causes angina), bronchoconstriction

Monitoring parameters: propranolol (Hemangeol, Inderal)

Goal HR (rest: 50-60 bpm, exercise:

Class: benazepril (Lotensin)

ACE inhibitor

Generic: Lotensin

Benazepril

Brand: benazepril

Lotensin

Common doses: benazepril (Lotensin)

10-40 mg QD

Adverse effects: benazepril (Lotensin)

Cough, angioedema, hyperkalemia, neutropenia, agranulocytosis, proteinuria, glomerulonephrintis, acute renal failure, loss of taste

Monitoring parameters: benazepril (Lotensin)

Caution angioedema, SCr, K+, dizziness, cough

Class: enalapril (Vasotec)

ACE inhibitor

Generic: Vasotec

Enalapril

Brand: enalapril

Vasotec

Common doses: enalapril (Vasotec)

Initial dose: 2.5-5 mg BID
Target dose: 10 mg BID

Common doses: enalaprilat

1.25-2.5 mg Q6-8h

Adverse effects: enalapril (Vasotec)

Cough, angioedema, hyperkalemia, neutropenia, agranulocytosis, proteinuria, glomerulonephritis, acute renal failure, loss of taste

Monitoring parameters: enalapril (Vasotec)

Caution angioedema, SCr, K+, dizziness, cough

Class: fosinopril (Monopril)

ACE inhibitor

Generic: Monopril

Fosinopril

Brand: fosinopril

Monopril

Common doses: fosinopril (Monopril)

Initial dose: 5-10 mg QD
Target dose: 40 mg QD

Adverse effects: fosinopril (Monopril)

Cough, angioedema, hyperkalemia, neutropenia, agranulocytosis, proteinuria, glomerulonephritis, acute renal failure, loss of taste

Monitoring parameters: fosinopril (Monopril)

Caution angioedema, SCr, K+, dizziness, cough

Class: lisinopril (Zestril)

ACE inhibitor

Generic: Zestril

Lisinopril

Brand: lisinopril

Zestril

Common doses: lisinopril (Zestril)

Initial dose: 2.5-5 mg QD
Target dose: 20-40 mg QD

Adverse effects: lisinopril (Zestril)

Cough, angioedema, hyperkalemia, neutropenia, agranulocytosis, proteinuria, glomerulonephritis, acute renal failure, loss of taste

Monitoring parameters: lisinopril (Zestril)

Caution angioedema, SCr, K+, dizziness, cough