Cardiac

Thiazides

• Hydrochlorothiazide

• k-wasting

Loop diuretics

• Furosemide

• k-wasting

Potassium Sparing

• spironolactone

Beta blockers

watch osmosis videos

s/e: lethargy, GI disturbance, CHF, lower BP, depression

Action - blocks beta receptors in the heart causing:

lower HR, lower force of contraction, lower rate of A-V conduction

Alpha-adrenergic antagonists s/e:

• orthostatic hypotension

• tachycardia

• vertigo

• sexual dysfunction

• examples: doxazosin (cardura), prazosin (minipress)

Calcium channel blockers

actions: blocks calcium access to cells

causing: lowers contractility and lowers conductivity of the heart and lowers demand for oxygen

s/e: lower BP, bradycardia, may precipitate AV block, headache, abdominal discomfort (constipation, nausea)

**see angioedema = stop med!!*

ACE inhibitors

actions: lowers peripheral vascular resistance without:

increasing cardiac output, increasing cardiac rate, increasing cardiac contractility

s/e: dizziness, orthostatic hypotension, GI distress, cough, headache

Valsartan (diovan)

Losartan (cozaar)

ACE and ARBs are not pregnancy-safe

Direct-acting vasodilators

• direct-acting vasodilators: relax vascular smooth muscles directly, bypassing nerve receptors

• common medications: hydralazine, minoxidil, sodium nitroprusside

Heart failure: heart muscles weaken and enlarge, loses ability to pump blood adequately, compensatory mechanisms fail, lungs and periphery become congested

BNP = brain natriuretic peptide

cardiac glycosides: digoxin

• increases myocardial contractility

• increases stroke volume

• decreases preload

• decreases heart rate

• s/e: bradycardia

• dig toxicity: blurred or yellow vision, n/v

• antidote: digoxin immune fab (brand names DigiFab or Digibind)

• Digoxin and potassium**

• monitor potassium, digoxin levels and heart rate (do not give below 60), check kidney function

• for heart failure, keep (water) pressure down

• patient education: diet, exercise, daily weight monitoring

Other meds to treat angina

• vasodilators

• angiotensin-converting enzymes

• diuretics

antianginal drugs: nitrates

• promote vasodilation

• relieve angina symptoms (pain)

• side effects and adverse reactions (headache, hypotension, flushing, dizziness, weakness, syncope)

• routes of administration (sublingual, translingual, topical, aerosol spray (inhalation), IV, buccal and oral extended-release capsule and tablet)

• stored in dark, dry, cool, place, no child-proof cap to easy access

• contraindicator: Viagra (both lower BP)