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Cardiovascular Drugs Toprol (Lopressor) Zestril (lisinopril) Cozaar (losartan) Cardizem Digoxin Amiodorone Nitroglycerin Heparin, Coumadin Lasix

Aldosterone Coumadin antidote Heparin antidote Heparin blood labs Coumadin blood labs Contraindications for anticoagulants HDL norms LDL norms Rabdomylosis Beta-Blockers Beta-Blocker implications Beta-Blocker Prototype ACE-Inhibitor Prototype Angiotensin II Receptor Blockers (ARBs) Prototype Calcium Channel Blocker Prototype Cardiac Glycoside Prototype Antiarrythmic Prototype Nitrate Prototype Anticoagulants Prototypes Diuretic Prototype Potassium sparing diuretic Vitamin K Protamine Sulfate PTT PT/INR Hemophilia, liver disease, bone marrow disorders, ASA, Plavix, lovenox >40 <100 Muscle breakdown that can cause kidney failure; watch for with hyperlipidemic agents Blocks vasoconstriction; most drugs end in ol; causes decreased heart rate Contraindicated in COPD; may mask hypoglycemic reaction(lack of sweating); hold if HR<60; can cause fluid build-up, watch in CHF Blocks conversion of angiotensinI to II, therefore not moving to aldosterone thus releasing Na and water causing less volume but increasing potassium; most end in il Withhold from poor renal function, watch BUN creatinine; used for HTN,CHF and MI Renal insufficiency, cough, angina, cardiac arrhythmias due to potassium imbalances Bind angiotensin II receptors in bvs to prevent vasoconstriction; used for those intolerant to ACE to treat HTN usually with other meds; ex: Diovan Cozaar, Avapro, Atacand; many end in sartan Dizziness, headache,cough,muscle weakness (Na and K imbalances) alopecia Only PO; caution with liver and kidney disease; use with caution if on phenobarbital Slow movement of Ca into cardiac and smooth muscle thus causing vasodilation decreasing bp and cardiac workload; ex: Norvasc (BP), Cardizem(A-fib),Calan, Cardene

ACE Inhibitors

ACE Inhibitor implications ACE side effects ARBs

ARB side effects ARB implications Calcium Channel Blockers

Ca Channel Blocker side effects Ca Channel implications

Digoxin therapeutic range Dig toxicity Cardiac Glycoside implications Antiarrythmics

Antiarrythmic side effects Antiarrythmic implications

Nitrates side effects Nitrates Nitrate implications

Thrombolytics Thrombolytic contraindications

Bradycardia, heart blocks, dizziness, orthostatic hypotension. PO or IV;extended release form for HTN;interacts with grapefruit juice; blocks enzymes in small intestine 0.8-2.0 Yellow halo around objects, heacache, drowsiness <60hold; watch e-lytes: increase Ca, decreased K, decreased Mg;antidote to dig toxicity:digibind Class III block K channel which prolongs repolarization slowing down the rate and conduction of heart;ex: Amiodorone and betapace May produce vasodilation, hypotension and arrhythmias (bradycardia) First line treatment for ventricular fib and ventricular tachycardia; load patient with IV than PO; must be in glass container with filter; long half life>30days; no grapefruit juice Severe hypotension; headache, dizziness,skine redness with patch Reduces cardiac workload by vasodilation IV,sublingual,transdermal(gloves!); burns under tongue;take one every 5 minutes with a max of 3;rapid absorption; carried in dark bottle Clot busters; all IV Post-op; ulcers and GI bleeding; CVa within 2 months; trauma; uncontrolled HTN; liver disease; pregnancy

GI Drugs Antispasmodics Bentyl Antidiarrheals Lomotil Laxatives Metamucil Milk of Magnesia; Magnesium Citrate Dulcolax Colace Peptic ulcers PUD GERD Antacid Interactions Decrease muscle tone, reduce mobility of GI tract Antispasmodic Decrease GI mobility Antidiarrheal Bulk forming; chemical stimulant; lubricant Bulk forming Osmotic-pulls in water Stimulates peristalsis Stool softener-pulls in water and fats Dark tarry stools H. pylori infection Esophageal stricture; improper working of lower esophageal sphincter Alters drug absorption; do not give within 1-2 hours of other meds

Zollinger-Ellison Syndrome

Excessive acid production-H2 receptor antagonist used to treat Proton Pump Inhibitors Increased anticholinergic effects when used with antihistamines and antidepressants Stomach infection due to acid killing bacteria Narrow angle glaucoma; GI obstruction Stimulates hydrochloric acid Cause parietal cells to release more hydrochloric acid

Use when H2 blockers ineffective Antispasmodic interactions Long term use of Proton Pump Inihibitors Contraindications for antidiarrheals Gastrin H2 receptors

What is Glaucoma Disease of the major nerve of vision What is the cause of Glaucoma Usually related to elevated pressure in the eye (intraocular pressure) Also build up of the aqueous humor is the most common cause What is the goal in treatment Reduce IOP, Increase drainage of aqueous humor, decrease production of aqueous How do the anticholingeric work -Miosis, increase the rate of the fluid that leaves the eye, encourage the small muscles inside your eye to work harder. SE- Blurred vision, HA, bradycardia How is sympathomimetics work -Diviverfrin reduces the amount of fluid in the eye, which decreases the pressure. Stimulates the dilator muscle in results mydriasis, increase drainage decrease pressure SE- Ocular burning, lacrimation (tears) How do Beta blockers work?

-Decrease production of aqueous humor SE- Ocular burning, blurred vision, bronchospasms, arrhythmias What side effects are you worried about for each? See above How do you properly instill eye drops and ear drops? -wash hands -tilt head back slightly & pull down lower eyelid to create a small pocket -gently press on the intracanthus for 30 to 60 -Do not allow dropper tip to touch any surface, including the eyes or hands