FINAL EXAM DRUG LIST
CARDIAC DRUGS
-STATINS (atorvastatin, simvastatin)
o Diet and exercise must continue for drugs to work, give in evening (taper to prevent MI)
o Total (<200), LDL (<100), HDL (>45), triglycerides (<150)
o Monitor liver (ALT/AST)
Hepatotoxic, HMG- CoA reductase inhibitor (work in liver)
Avoid alcohol/grapefruit juice
o Monitor kidneys (CK/CRP)
Statins may break down muscle (rhabdomyolysis/myopathy)
o Not for pregnancy/breastfeeding (X), liver problems, may develop cataracts
ATENOLOL/METOPROLOL (Beta-blockers)
o Decrease HR/BP/contractility, mask signs of low BS (except sweating)
o Non-selective (propranolol, not for resp. issues due to bronchoconstriction)
o Don’t abruptly stop taking (rebound HTN, dysrhythmias, angina, MI)
Radial pulse must be > 60 to take med
o Sexual dysfunction is common, get BUN, CK, LFTs
CLONIDINE (alpha-agonist)
o Lowers HR/BP (tiny white pill), works in 30 minutes to drop BP (vasodilation)
o Watch for reflex tachy, rebound HTN, dry mouth/sedation/peripheral edema
o Watch for hypotension
DIGOXIN
o Oral/IV, for heart failure, check apical pulse daily* before (> 60)
Decrease workload (slow HR), increase contractility (beats harder)
Positive inotropic (increases contractility), negative chronotropic (decreases HR), negative
dromotropic (decreases electrical conduction)
Improves HF (more urine, less dyspnea, less sputum)
o Low K+/Mg+/high* Ca+ = high Digoxin (0.5-2 is normal)
Encourage high K+ foods to avoid toxicity
o Toxicity: green/yellow halos, anorexia, N/V, low HR (digoxin immune fab, place on monitor!)
DILTIAZEM/VERAPAMIL (calcium channel blockers)
o Cause vasodilation (affects smooth muscles)
Monitor for peripheral edema, flushing, constipation, BP/HR
o Good for African Americans! Avoid grapefruit
ENALAPRIL (ACE)
o Works in kidneys to treat HF/HTN (stops angi 1 from becoming angi 2)
Retains K+, avoid K+ sparing diuretics, salt subs (hyperkalemia)
Monitor kidney function in all ACEs!
o Lowers BP through vasodilation (less blood flow, not for kidney failure/pregnancy)
o Constant dry cough (high levels of bradykinin)
o Watch for: 1st dose hypotension, reflex tachy/rebound HTN, angioedema*
NITROGLYCERIN
o Decreases amount of O2 needed by the heart (light-resistant jars)
o SL (only PRN, for acute attacks, 1Q5 min x3, call 911) *sit, give water*
o Patch (apply daily, remove at bedtime to give 8 hour-free period at night)
o Additive effect with anything that lowers BP (alcohol, BP/ED meds, vasodilators)
o Side Effects: HA, dizzy, weak, syncope, flushed, edema, tolerance (vasodilation)
Watch for dyspnea, ortho hypo, reflex/rebound (high HR/BP/palpitations)
PRAZOSIN: (rise slowly, lowers BP)
, ANTI-PLATELETS
ASPIRIN
o Prevents clots in arteries* preg. D
o 81 mg (prophylactically against MI), 325 mg (anti-inflammatory)
Not for children (Reye’s syndrome), watch for salicism
Steroids (increases risk of ulcers)
Garlic, gingko, ginger (bleeding risk, also with warfarin/Tylenol)
Warfarin, ibuprofen, alcohol may increase risk of bleeding
Coffee ground emesis, nausea, stop 7 days before procedure!
CLOPIDOGREL
o Monitor for bleeding (petechia, bleeding gums, bruising), preg. B
o Avoid other blood thinners, and PPIs (decrease effectiveness)
HEPARIN
o SQ/IV prevents blood clots in veins* (preg. C)
May cause bleeding (avoid in stroke, ulcers, blood disorders, surgeries)
PTT (1.5-2 seconds); Antidote: protamine sulfate, half-life < 5 hours
Before stopping, must begin oral warfarin
WARFARIN
o PO, prevents clots in *veins & arteries*, highly protein bound
Vit. K is antidote (takes 24-48 hours to be effective, found in leafy greens)
Avoid large amounts to prevent drug inactivation
Monitor PT (1.5-2 seconds) and INR (2-3 seconds), half-life 3-4 days
Pregnancy X, avoid other blood thinners
DIURETICS
*Monitor for low BP, daily weights, 2.2 lbs = 1L, urine output should be 30 mL/hr.*
MANNITOL
o Osmotic (proximal tubule), very potent! (IV only)
For ICP, IOP, renal failure
Pulls fluid away from edematous tissues into blood, redistributes
o Watch for edema, HA, N/V, fluid/electrolyte imbalance (dehydration)
o Caution in heart disease (fluid may distribute around heart), get daily weights
FUROSEMIDE
o Loop diuretic (or heart failure/HTN/edema); IV (give slow or tinnitus, max 20 mg/min)
o Decreases all electrolytes (Na+, K+, Ca+, Mg+), and BP
Caution with Digoxin and BP meds (further decreases BP) *get BP before IV*
s/s of low Ca+ (Trousseaus, paresthesis), increase K+ foods
o Increases BS, uric acid, lipids, BUN/CK
o Phototoxic, ototoxic (avoid ototoxic drugs), contains SULFA
HCTZ (thiazides)
o Distal tubule, best for essential HTN* take before 2 pm
o Contraindicated in pregnancy & kidney failure (reduced blood to kidneys/uterus)
o Decreases electrolytes (except Ca+, that increases!), and BP
Toxicity risk with Digoxin, and BP meds (may further drop…)
Eat high K+ foods (monitor for muscle weakness)
o Increases BS, uric acid, lipids (hyperglycemia risk)
o Phototoxic (but not ototoxic ), contains SULFA
SPIRONOLACTONE (K+ sparing)
o For low K+, blocks aldosterone, least amount of fluid excreted
CARDIAC DRUGS
-STATINS (atorvastatin, simvastatin)
o Diet and exercise must continue for drugs to work, give in evening (taper to prevent MI)
o Total (<200), LDL (<100), HDL (>45), triglycerides (<150)
o Monitor liver (ALT/AST)
Hepatotoxic, HMG- CoA reductase inhibitor (work in liver)
Avoid alcohol/grapefruit juice
o Monitor kidneys (CK/CRP)
Statins may break down muscle (rhabdomyolysis/myopathy)
o Not for pregnancy/breastfeeding (X), liver problems, may develop cataracts
ATENOLOL/METOPROLOL (Beta-blockers)
o Decrease HR/BP/contractility, mask signs of low BS (except sweating)
o Non-selective (propranolol, not for resp. issues due to bronchoconstriction)
o Don’t abruptly stop taking (rebound HTN, dysrhythmias, angina, MI)
Radial pulse must be > 60 to take med
o Sexual dysfunction is common, get BUN, CK, LFTs
CLONIDINE (alpha-agonist)
o Lowers HR/BP (tiny white pill), works in 30 minutes to drop BP (vasodilation)
o Watch for reflex tachy, rebound HTN, dry mouth/sedation/peripheral edema
o Watch for hypotension
DIGOXIN
o Oral/IV, for heart failure, check apical pulse daily* before (> 60)
Decrease workload (slow HR), increase contractility (beats harder)
Positive inotropic (increases contractility), negative chronotropic (decreases HR), negative
dromotropic (decreases electrical conduction)
Improves HF (more urine, less dyspnea, less sputum)
o Low K+/Mg+/high* Ca+ = high Digoxin (0.5-2 is normal)
Encourage high K+ foods to avoid toxicity
o Toxicity: green/yellow halos, anorexia, N/V, low HR (digoxin immune fab, place on monitor!)
DILTIAZEM/VERAPAMIL (calcium channel blockers)
o Cause vasodilation (affects smooth muscles)
Monitor for peripheral edema, flushing, constipation, BP/HR
o Good for African Americans! Avoid grapefruit
ENALAPRIL (ACE)
o Works in kidneys to treat HF/HTN (stops angi 1 from becoming angi 2)
Retains K+, avoid K+ sparing diuretics, salt subs (hyperkalemia)
Monitor kidney function in all ACEs!
o Lowers BP through vasodilation (less blood flow, not for kidney failure/pregnancy)
o Constant dry cough (high levels of bradykinin)
o Watch for: 1st dose hypotension, reflex tachy/rebound HTN, angioedema*
NITROGLYCERIN
o Decreases amount of O2 needed by the heart (light-resistant jars)
o SL (only PRN, for acute attacks, 1Q5 min x3, call 911) *sit, give water*
o Patch (apply daily, remove at bedtime to give 8 hour-free period at night)
o Additive effect with anything that lowers BP (alcohol, BP/ED meds, vasodilators)
o Side Effects: HA, dizzy, weak, syncope, flushed, edema, tolerance (vasodilation)
Watch for dyspnea, ortho hypo, reflex/rebound (high HR/BP/palpitations)
PRAZOSIN: (rise slowly, lowers BP)
, ANTI-PLATELETS
ASPIRIN
o Prevents clots in arteries* preg. D
o 81 mg (prophylactically against MI), 325 mg (anti-inflammatory)
Not for children (Reye’s syndrome), watch for salicism
Steroids (increases risk of ulcers)
Garlic, gingko, ginger (bleeding risk, also with warfarin/Tylenol)
Warfarin, ibuprofen, alcohol may increase risk of bleeding
Coffee ground emesis, nausea, stop 7 days before procedure!
CLOPIDOGREL
o Monitor for bleeding (petechia, bleeding gums, bruising), preg. B
o Avoid other blood thinners, and PPIs (decrease effectiveness)
HEPARIN
o SQ/IV prevents blood clots in veins* (preg. C)
May cause bleeding (avoid in stroke, ulcers, blood disorders, surgeries)
PTT (1.5-2 seconds); Antidote: protamine sulfate, half-life < 5 hours
Before stopping, must begin oral warfarin
WARFARIN
o PO, prevents clots in *veins & arteries*, highly protein bound
Vit. K is antidote (takes 24-48 hours to be effective, found in leafy greens)
Avoid large amounts to prevent drug inactivation
Monitor PT (1.5-2 seconds) and INR (2-3 seconds), half-life 3-4 days
Pregnancy X, avoid other blood thinners
DIURETICS
*Monitor for low BP, daily weights, 2.2 lbs = 1L, urine output should be 30 mL/hr.*
MANNITOL
o Osmotic (proximal tubule), very potent! (IV only)
For ICP, IOP, renal failure
Pulls fluid away from edematous tissues into blood, redistributes
o Watch for edema, HA, N/V, fluid/electrolyte imbalance (dehydration)
o Caution in heart disease (fluid may distribute around heart), get daily weights
FUROSEMIDE
o Loop diuretic (or heart failure/HTN/edema); IV (give slow or tinnitus, max 20 mg/min)
o Decreases all electrolytes (Na+, K+, Ca+, Mg+), and BP
Caution with Digoxin and BP meds (further decreases BP) *get BP before IV*
s/s of low Ca+ (Trousseaus, paresthesis), increase K+ foods
o Increases BS, uric acid, lipids, BUN/CK
o Phototoxic, ototoxic (avoid ototoxic drugs), contains SULFA
HCTZ (thiazides)
o Distal tubule, best for essential HTN* take before 2 pm
o Contraindicated in pregnancy & kidney failure (reduced blood to kidneys/uterus)
o Decreases electrolytes (except Ca+, that increases!), and BP
Toxicity risk with Digoxin, and BP meds (may further drop…)
Eat high K+ foods (monitor for muscle weakness)
o Increases BS, uric acid, lipids (hyperglycemia risk)
o Phototoxic (but not ototoxic ), contains SULFA
SPIRONOLACTONE (K+ sparing)
o For low K+, blocks aldosterone, least amount of fluid excreted
