Diuretics (-zide, -mide)
Thiazide diuretics |
LOOP diuretics |
K+ Sparing |
MOA |
i.e. Lasix (furosemide) |
i.e. spironolactone, triamterene |
Inhibits reabsorption of Na, K, Cl resulting is osmotic water loss |
MOA |
MOA |
Relaxes arterioles (decrease afterload) |
Loss of fluid by inhibition of Na and Cl reabsorption |
Blocks reabsorption of Na and water, potassium retained |
Indication |
Reduced BP |
Indications |
HTN (first line) |
Reduced SVR (afterload), reduced CVP (preload), reduced LVEDP |
HF |
Edematous state d/t HF, liver cirrhosis |
Indications |
Contraindications |
Contraindications |
Edema (rt sided HF) |
Allergy, kyperkalemia, kidney failure, anuria |
Drug allergy, hepatic coma, anuria, kidney failure |
Fluid accumulation d/t liver/kidney disease |
Adverse Effects |
Adverse Effects |
HTN |
Spironolactone- gynecomastia, amenorrhea, irregular menses, etc. |
Electrolyte disturbances (decrease K, elevated Ca, lipids, glucose, uric acid) |
Pulmonary edema (lt sided HF) |
Triamterene- kidney stone d/t reduced folic acid |
Dizziness |
Crackles/low O2 sats |
GI disturbance |
Contraindications |
Thrombocytopenia |
allergy, hepatic coma, severe electrolyte loss (Na & K), pregnancy/BF, gout |
Pancreatitis |
Adverse Effects |
Cholecystitis |
Electrolye loss/dehydration |
Headache |
Furosemide- ototoxicity/photosensitivity |
Impotence |
Orthostatis hypotension |
|
Hyperglycemia, hyperuricemia |
*Thiazide diuretics work on distal tubule
*Loop diuretics work on ascending loop of Henle
*K sparing works on collecting duct
|
|
Beta Blockers (-olol)
i.e. atenolol, metoprolol, bisoprolol, timolol (eye drops), labetalol (IV)
MOA
- blocks SNS stimulation of Beta 1
- Reduced renin and aldosterone release and fluid balance
- Vasodilation of aterioles= Decreased PVR and BP
- Decreased myocardial stimulation
- Decreased HR
- Decreased conduction through AV node
- Prolonged SA node recovery
- Decreases myocardial O2 demand and contractility
*reduces the work of the heart
Indications
- HTN, angina, dysrhythmias
Contraindications
- Allergy
- Uncompensated HF
- Cardiogenic shock
- Heart block
- Bradycardia
- Pregnancy
- Severe pulmonary disease (B2)
- Raynaud's disease
Adverse Effects
- Can worsen angina or cause MI if stopped quickly
- Symptoms of HF (coughing, SOB, Edema, fatigue)
- Can mask signs of hypoglycemia
- CV: AV block, bradycardia, HF, PV insufficiency, hypotension
- Resp: bronchospasm, bronchoconstriction
- CNS: dizziness, depression, lethargy
- GI: nausea, dry mouth, vomiting, constipation, diarrhea
- Hema: thrombocytopenia |
** Watch for diabetic pts
** Monitor closely if given with calcium channel blocker
ARBs (-sartan)
i.e. losartan, eprosartan, valsartan, irbesartan, telmisartan
MOA
- blocks binding of angiotensin II to receptors
- Affects smooth muscle and adrenal gland
- Blocks vasoconstriction and secretion of aldosterone
Indications
- HTN, HF (decrease preload/afterload), decreased mortality after MI
Contraindications
- allergy, pregnancy/BF, kidney dysfunction (caution), older adults
Adverse Effects
- URI, headache, hypotension, tachycardia, S/S of toxicity
Interactions
- Cimetidine, phenobarbital, rifampin, K+ supplements |
|
|
Calcium Channel Blockers (-pine, -amil)
i.e. Amlodipine (dihydropyridines), Diltiazem (benzothiazepines), Verapamil (phenylakylamines)
MOA
- Blocks Ca access to cells causing:
- decreased contractility
- decreased conductivity of the heart
- decreased demand for O2
- dilation of coronary arteries (decreased afterload, increased oxygen supply)
**decreases work of the heart
Indications
- Angina
- HTN
- SVT
- Atrial fib/flutter
- Migraines
- Intracranial aneurysm rupture
Contraindications
- allergy, acute MI, 2 or 3* heart block, hypotension
Adverse Effects
- Hypotension
- Palpitations
- Tachycardia or bradycardia
- HF
- Constipation
- Nausea
- Dermatitis
- Dyspnea
- Rash/flushing
- Peripheral edema
Interactions
- beta blocker, digoxin, h2 blockers, cyclosporin
- grapefruit |
**avoid grapefruit
**do not take diltiazem with cyclosporin
** check liver and renal fx
** Weight- check for peripheral edema
Nitrates (nitroglycerin)
MOA
- dilation of blood vessels (relaxation of smooth muscle) esp coronary vessels
- decreased afterload and preload
Indications
- Angina (stable, unstable, vasospastic)
Contraindications
- allergy, anemia, closed-angle glaucoma, hypotension, head injury
Adverse Effects
- headache, tachycardia, postural hypotension, reflex tachycardia, tolerance
Interactions
- alcohol, beta blockers, CCB, antipsychotics, erectile dysfunction medications |
**light sensitive
**check expiration date
**comes in many forms- sublingual, chewable, oral tabs, capsules, ointments, patches, translingual spray, IV
**ensure pt is not on erectile dysfunction medication
**always date and time nitro patches upon application
** administer while seated, take BP measure pain, then wait 5 mins and repeat up to 3x
|
|
ACE inhibitors (-pril)
i.e. ramipril, fosinopril sodium, lisinopril, enalapril, perindopril, captopril
MOA
- Suppresses formation of angiotensin II from the RAAS system
- Reduces PVR
- Increases CO
Indications
- HTN (decreased afterload, prevents formation of ACE II)
- HF (prevents Na and water resorption, causes diuresis, decreases preload)
- Protective effects on kidney (decreases GFR)
Contraindications
- History of angioedema, renal artery stenosis, K+ >5mmol/L
Adverse Effects
- Hyperkalemia
- Fatigue, mood changes, dizziness, headache
- Dry, non-productive cough**
- Hypotension
- Angioedema
- Rash, thrombocytosis, loss of taste, proteinuria, pruritis, anemia, neutropenia
Interactions
- NSAIDS
- Potassium sparing diuretics
- Lithium and ACE inhibitors |
**Do not use during pregnancy/BF
|
Created By
Metadata
Favourited By
Comments
No comments yet. Add yours below!
Add a Comment
Related Cheat Sheets