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Pharmacology: Medications for Cardiovascular Conditions - A Comprehensive Guide, Study notes of Infectious disease

A comprehensive overview of various medications used to treat cardiovascular conditions. It covers key aspects of each drug, including its mechanism of action, therapeutic uses, contraindications, interactions, complications, and administration guidelines. Particularly valuable for students and professionals in the field of pharmacology, nursing, and medicine.

Typology: Study notes

2024/2025

Uploaded on 03/31/2025

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bg1
Exam
1
hiazide
diuretics
Meds
affecting
urinary
output
·
hydrochlorothiazide
*
purpose
is
to
decrease
the
BP
,
·
Chlorothiazide
(can
be
given
Oral
31v)
excrete
edematous
fluid
seen
in
HF
.
Loop
diuretics
work
in
the
loop
of
·
Chlorthalidone
henle
of
the
kidney
.
These
are
furosemide/Lasics
The
purpose
is
to
block
reabsorption
of
sodium
&
Furosemide
Contraindications
Chloride
.
-
-
Blocks
the
reabsorption
-
anuria
of
sodium
and
chloride
.
It
It
promotes
diuresis
when
renal
function
isn't
impaired
prevents
the
reabsorption
of
water
.
-
use
caution
:
gout
,
CV
disease
,
liver
disease
,
works
In
the
early
distal
convuluted
tube
-
causes
extensive
diuresis
with
DM
,
dehydration
,
electrolute
Severe
Kidney
damage
disturbance
,
lithium
,
NSAIDs
#
I
chace
for
essential
HIN
unlabeled
use
is
hyperkalemia
.
can
be
given
Oral
,
IV
,
IM
Interactions
-
used
for
mild-moderate
HF
mu
Another
drug
is
bumentanide
-
Digoxin
will
increase
-
used
to
reduce
urine
production
·
lication
hypokalemic
effects
&
in
ppl
with
diabetes
cause
ventricular
-
promotes
reabsorption
of
calcium
*
Dehydration
:
monitor
for
oliguria
,
arrhythmias
dry
mouth
,
lethargy
.
&
can
reduce
risk
of
Osteoporosi
Monitor
electrolytes
-
Lithium
carbonate
blood
levels
can
increase
,
which
Complications
If
headache
,
Chest
pain
,
calf
or
pelvic
um
pain
occur
it
can
indicate
thrombosis
/
can
lead
to
toxicity
*
Dehydration
hyponatremia
embolism
-
NSAIDS
decrease
blood
*
Hypokalemia
&
hypochloremia
*
Hypotension
:
monitor
BP
flow
,
reducing
diuretic
effects
.
*
Hyperglycemia
*
Ototoxicity
:
avoid
use
of
other
ototoxic
drugs
like
aminoglycoside
Always
monitor
*
Hyperuricemia
, M
lipids
,
hypomagnesium
antibiotics
like
gentamicin
.
BP
,
US
,
ISO
,
and
(monitor
uric
acid
,
magnesium
,
HDL
,
LDL)
Tell
them
to
report
tinnitus
Thiazide
weight
indications
can
cause
*
Hypokalemia
:
monitor
for
S/S
like
-
can
cause
jaundice
in
baby
jaundice
in
muscle
cramps
,
weakness
-
Don't
use
If
there's
renal
impairement
babies
Foods
in
cause
no
risk
of
ototoxicity
Potassium
-
bananas-nuts
·
Alternate
day
dosing
-
potatoes
-
Spinach
·
weigh
them
the
same
time
-
dried
fruits
-
citrus
food
-
cantalopue
Other
adverse
effects
Diuretics
are
include
hyperglycemia
,
to
be
administered
hyperuricemia
,
hypocalcemia
,
first
thing
in
the
morning
hyponatremia
,
hypochloremia
&
before
2 pm
to
prevent
nocturia
pf3
pf4
pf5
pf8
pf9
pfa
pfd
pfe
pff
pf12
pf13
pf14
pf15
pf16
pf17
pf18
pf19
pf1a

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Exam 1

hiazide

diuretics

Meds

affecting

urinary output · hydrochlorothiazide

purpose is to decrease the BP , ·

Chlorothiazide

(can be

given Oral 31v) excrete edematous fluid seen in HF. Loop diuretics work in the loop of · Chlorthalidone henle of the kidney . These are furosemide/Lasics

The

purpose

is to

block reabsorption

of sodium &

Furosemide Contraindications

Chloride

.

Blocks the reabsorption -

anuria

of sodium and chloride. It It

promotes

diuresis when renal function

isn't

impaired

prevents the

reabsorption

of water.

use caution :

gout

, CV disease , liver disease

, worksIn

the early

distal

convuluted

tube

causes extensive diuresis with DM ,

dehydration

, electrolute Severe

Kidney

damage

disturbance , lithium , NSAIDs

# I

chace

for essential

HIN

unlabeled use is

hyperkalemia

. can be

given

Oral , IV , IM Interactions

used

for

mild-moderate HF mu Another

drug

is bumentanide

Digoxin

will increase

used to reduce urine

production

lication hypokalemic effects & in ppl with diabetes cause ventricular

promotes

reabsorption of calcium

Dehydration

: monitor for

oliguria,

arrhythmias

dry

mouth ,

lethargy

. & can reduce risk of Osteoporosi Monitor electrolytes

Lithium carbonate blood levels can increase , which

Complications

If headache , Chest pain , calf or pelvic um pain occur it can indicate thrombosis / can lead to toxicity

Dehydration hyponatremia

embolism

NSAIDS decrease blood

Hypokalemia

hypochloremia

Hypotension

: monitor BP

flow

,

reducing

diuretic effects. *

Hyperglycemia

Ototoxicity

: avoid use of other ototoxic

drugs

like

aminoglycoside

Always monitor

Hyperuricemia

, M lipids , hypomagnesium antibiotics like

gentamicin

.

BP

,

US , ISO,

and

(monitor

uric acid ,

magnesium

, HDL , LDL) Tell them to report tinnitus

Thiazide

weight

indications can cause

Hypokalemia : monitor for S/S like

can cause

jaundice

in baby

jaundice

in muscle cramps , weakness

Don't use If there's renal impairement

babies

Foods in cause no risk of

ototoxicity

Potassium

bananas-nuts · Alternate day dosing

potatoes

Spinach ·

weigh

them the same time

dried fruits - citrus food

cantalopue Other adverse effects Diuretics are include hyperglycemia , to be

administered

hyperuricemia, hypocalcemia

,

first

thing in the

morning

hyponatremia

hypochloremia

& before

2 pm

to

prevent

nocturia

Potassium-sparing Osmotic

diuretics

Spironolactone

mannitol

keeps

K

while

excreting

reduces increased

Intracranial

pressured

Intraocular

Sodium

& H

pressure

by

raising

Serum

Osmolality

drawing

back fluid

Blocks

action

of

aldosterone

into

the vascular & extravascular

space

USES L

They're

combined with

other

prevents Kidney

failure

diuretics

for lit

sparring

Administered for the

oliguria

phase

of Ak

effects to

treat

hypertension

Zedema

nations

Complications * HF s

pulmonary

edema

um

Hyperkalemia

(meds like ACE

inhibitors ,

Rebound increased intracranial pressure

ARBs

,

direct

renin inhibitors cause

hyperkalemial

Fluid &

electrolyte

imbalances

,

metabolic acidosis

Endocrine effects

·

Deep

voice

Contraindications

·

Hirstuism

um

·

impotence

·

gynecomastia

active

intracranial bleed

,

anuria

,

severe

·

Irregularities

of

menstrual cycle

Pulmonary

edema

,

Severe

dehydration , renal

failure

Drowsiness ,

metabolic acidosis

Interactions

um

Contraindications

um

Lithium

excretion

through

Kidney

is increased

Fetal harm

Don't take if

you

have

hyperkalemia

Increased risk

for

hypokalemia

w/ cardiac

glycosides

Severe

Kidney

failure Zanuria

Administration

we

use filter needle when

drawing

from the vial

a a filter

ARBs

Direct

Renin inhibitors

Losartan

Aliskiren

Valsartan -

Binds

with renin

to inhibit

production

of

· The

purpose

is to block the

anglotensin

I

,

decreasing

production

of

both

action of

angiotensin

2 in the body

.

angiotensin

aldosterone

·

vasodilation

·

Excretion

of

sodium

water

usest

uses

Relieves HTN

when used alone

or w/

another

hypertension

antihypertensive

med

Heart failure

Stroke

Preventolosartan

a

plicato

a

rash

,

cough

  • monitor

for rash

nephropathy

angioedema

.

Stop

the

med

,

call all

Reduces

mortality

following

an acute MI

swelling

of

pharynx,

Pelications

tongue ,

glottis

Angloedema

Hyperkalemia

Fetal

Injury

Hypotension

Diarrhea : close related

,

seen more in

girls

&

older

adult clients

Dizziness

,

lightheadedness

traindications

Hypotension

Pregnant/Lactation

contradications

ring

and 3rd trimes

a

*Bilateral

renal

stenosis

u

single

Kidney

hyperkalemia

Interactions

u

use

with

caution :

asthma

other

respiratory

·

Antihypertensives

problems ,

history

of

angioedema

,

DM

,

renal

·

Increased risk for lithium

toxicity

Stenosis ,

hypotension ,

Kidney/hepatic disease

Interactions

un

Decreases

blood

levels

of

furosemide

↑ effects

of other

antihypertensives

Atorvastatin

& Ketoconazole ↑

levels of aliskinen

High

fat-food

reduce

absorption

Calcium Channel Blockers

Amlodipine

Nifedipine-Verapmil-Diltiazem

Contraindications

Nifedipine

purpose ~

Blocks

calcium

channels

in the

blood -

Nifedipine

is contraindicated

vessel

leads to vasodilation

of vascular In

ppl

who're

in

cardiogenic

shock

Smooth

muscle

arteries of heart

use with Caution

in clients who have

Verapmil/

Diltiazem

acute Ml , unstable

Angina

,

Gortic

Stenosis ,

.

Has the

same purpose

.

It also

hypotension

,

sick Sinus

syndrome,

2nd/3rd

Av block

blocks Calcium

channels in the

myocardium,

SA node

,

AV node leads

to a decreased

Verapmil

is contraindicated

force

of contraction

,

HR

,

slowing

of

Hypotension

,

Digoxin

Toxicity ,

Severe HF ,

Heart block

,

lactation

use with caution if

they

have

kidney

/ liver disorders

,

mild-moderate

the rate

of conduction

through

Avnode

HF

,

Gerd

They

are used for Cardiac

dysrhythmias

like

Afib

,

atrial flutter

,

SVT)

Interactions

u

Nifedipine

complicin

is

Nifedipine

·

cimetidine

,

famotidine

grapefruit juice

can

lead to

toxicity

ladminister

metropolo

to counteract

Verapmil/Diltiazem

tachycardial

concurrent use

of

beta blockers can

lead to

HF

,

AV block

,

bradycardia

Acute

toxicity

.

No

grapefruit

juice

(due

to excessive

doses

. Monitor USEECG.

Provide

gastric

lavage

E Cathartic If needed . Nursing

administration

Administer

(norepinephrine,

calcium

,

isoprotereno,

lidocaine

,

IV

fluids

.

Have cardioversion

IV

verapmil

needs to be administered

Slowly

over 2- min

Cardiac pacer

available) -

Withhold med

if

HRA50 & SBP is

mmHg

Orthostatic hypotension

peripheral

edema.

Verapmil

& Diltiazem

complications

Constipation

(mostly verapmill

Suppression

ofCardiac

function

(Bradycardia ,

HF

. Observe

for slow pulse

activity

intolerance

Dysrhythmias

(QRS

complex

is widened &QTinterval

is

prolonged

Acute toxicity

(Resulting

in

hypotension

, brady.

Al block,

Eventricular

dysrhythmias)

Centrally

acting

alpha

agonists

Clonidine

Methyldopa

Acts

within the CNS

to decrease

sympathetic

outflow

resulting

in decreased

stimulation

of

the

adrenergic

receptors

of heart

&

peripheral

vascular

system

usest

Interactions

primary

hypertension

concurrent

use of

prozosin

,

severe cancer

pain

MAOls

, tricyclic

antidepressants

can

counteract the effect

Management

of

ADHD

Additive

CNS

depressants

can occur with

Investigational

use

concurrent

use

of

other

CNS

depressants

Calcohol

migraine

flushing

from

menopause

manage

Tourette

Administration

manage

of

withdrawl

from

alcohol

,

tobacco

w

oploids

.

give

med

by

Gral

, epidural

,

Complications

transdermal

routes (clonidine

only

Take

larger

duse at

bedtime

Drowsiness

& Sedation

Dry

mouth

Rebound

hypertension

If

abruptly

discontinued

Contradications

Avoid

use

of

transdermal

patch

on

affected skin In Scleroderma

&

SLE

·

contraindicated

in

clients

who

have

a

bleeding

disorder or

are on

anticoagulants

·

use with

caution

: Asthma

,

Stroke

,

COPD

,

recent

M

, DM

, depressive

disorder

Beta

adrenergic

blockers

(sympatholytics

Cardioselective

metoprolo ,

atendol ,

esmolal

Nonselective

:

Proprandol

,

Nadolol

Alpha

E beta

blockers

Carvedilol

,

Labetalo

Contraindica

-tons

Negative

chronotropic , inotropic, dromotropic

  • use

metoprolol

, propranolol

,

labetolo

Alpha

blockade adds vasodilation

with caution

  • crosses

placenta

Reduces release

of renin -

Proprano

:

appears

in

breast milk

Therapeutic

uses↓

Don't

give

to

ppl

/

#V block & Sinus

Primary hypertension

bradycardia

Angina

,

tachy

Dysrhythmias ,

Hf ,

MI

-use with caution : myasthenia

gravis

,

hypotension,

suppresses

reflex tachy .

Hyperthyroidism,

peripheral

vasculardisease ,

DM

,

depression,

Migraine

, pheochromocytoma

,

glaucoma

Interactions

Complications

of

Beta

,

Metroprolo

E

Propranolol

Beta

Bradycardia

·

CB blockers

Verapmil

Ediltiazen intensify

effects

of

beta blockers

Hold if below

bpm

use

wi caution in DM be

it

masks tachycardia,

Betaz

early

manifestation of low

blood

glucose

can

mask

hypoglycemic

effect

of

insulin

Decreased

CO

prevent

the breakdown

of

fat in response

to

AV

block

(get

baseline ECG Monitor

hypoglycemia

Orthostatic

hypotension

Rebound

myocardium

excitation

Administration

~

(myocardium

becomes sensitized

to catecholamines

give

orally

once

or

twice a

day

with

long

term use of

beta blockers)

  • atenool ,

metoprolol ,

labetalo , Dropranool

can be

Elications

of

Betaz

given

IV

Take w food

toabsorption

Bronchoconstriction

Glycogenolysis

is

inhibited

(N

risk for harm from hypoglycemia

because

the

process

of

glycogen- glucose

Never

stop

is impaired.

taking

them

abruptly

Cardiac

Glycosides

Quinidine↑ risk of

toxicity

because it

reduces Kidney

excretion

Digoxin

Verapmil

Digoxin

=

toxicity

positive

inotropic

(* force of

contraction)

Administration

Negative

Chronotropic

(GHR)

IV

given

over

5 min. 10-15 if

pulmonary

edema

Usest -

Never double dose

If 1

is

missed

Treats

HF

but

shortens life

Span

in Females

Dysrhythmias

like

AFIB

How to manage

toxicity

stop digoxin

potassium

wasting

  • Monitor
  • levels

implication

a

cardiotoxicity

lidocaine

Treat

dysrhythmias

with

phenytoin

or

caused

by

hypokalemia

blood

digoxin

Bradycardia

Give

atropine

levels

, heart disease

Activated

charcoal

, Cholestyramine

,

or

Optimal

therapeutic

level :

  1. 5-0. 8

ng/mL

digoxine

immune

fab

can bind

digoxins

Report

manifestations

of

hypokalemia

prevent absorption

GI

effects

like anorexia , nausea ,

vomiting

anorexia is first

sign

of

toxicity

CNS effects

·

headache

·

fatigue

/ weak

vision

changes (blurred vision

,

yellow-green

Or

white halos around

objects)

HR

under

Contraindications does

not

get

enters

breast milk

digoxin

contraindicated in ppl

w/

VFIB

,

VTACH

,

2nd

gard

degree

heart

block

Interactions

· ACE inhibitors

EARBs

↑ risk of

hyperkalemia

which can

lead to decreased

therapeutic

levels of

digoxin

·

Dopamine

Digoxin-heart

squeezes

to fight

·

Never take

wi Antacids

Organic

Nitrates

Nitroglycerin

In chronic

Stable

angina

it dilates the veins

decreases venous return whichI cardiac

oxygen

demand

In Prinzmetal

Angina

it prevents

Coronary

artery spasm ,

Increasing oxygen

supply

Complications

Headache (use

aspirin)

Orthostatic

hypotension

  • Reflex tachu

Tolerance

Contraindications

can effect maternal fetal circulation

contraindicated in Severe anemia ,

close-

angle

glaucoma,

traumatic head

Injury

be it

can * Intracranial

pressure

use caution in

ppl

taking

antihypertensive

meds , clients who have hyperthyroidism or

Kidney ,

liver

dysfunction

Do not take

phosphodiesterase type

5 with

Nitro. Severe

hypotension

Interactions

~

alcohol

contributes to

hypotensive

effect

Treatment of

anginal

attack

stop

activity

.

Sit or lie down

No relief after first tablet? Call all

Don't take

more than 3

Cholesterol

absorption

inhibitor

Ezetimibe

Inhibits reabsorption

of

cholesterol Secreted in

bile

absorption

ofCholesterol from food

can be used in combo w/ statins

complications

u

Hepatitis

Lobserve

for liver

dysfunction

like anorexia

,

jaundice

,

I

important

to obtain

Myopathy

baseline cholesterol

HDL

,

LDL

triglycerides

Contraindications

levels

,

liver a

kidney

Pregnant/Lactating

function tests

contraindicated

if

they

have active

Follow low-fat

,

low

moderate-severe

liver disorders

Cholesterol

diet

Interactions

mu

Bile acid

Sequestrants (cholestyramine)

interfere with

absorption. Take

ezetimibe Ihr before

or thr after

Stating

Can t risk of liver

dysfunction

myopathy

Concurrent

use with

fibrates

(gemfibrozil)

increases

risk of Cholelthiasis

Emyopathy

Levels

can be increased with

concurrent use

of

Cyclosporine

Bile Acid

Sequestrants

Prototype

:

Cholestyramine

Colesevelam ,

Colestipol

Nursing

Administration

Purpose

:

Decrease LDL

colesevalem should be taken we food

not

taken

with

other meds

can be taken with statins

Colestipol

shouldn't be

crushed

. Give 30

min before a meal

complicatio

a

Colestipol

is also in

powder

form

Contraindications

Don't use with

oral

contraceptives

Colesevelam is

contraindicated

in

clients who have bowel obstruction or

pancreatitis caused

by

high

triglycerides

use cautiously

If they

have

dysphagia

or 61

disorders

Interactions

They

interfere

with absorption

of

many

meds

levothyroxine

second-gen sulfonylureas

phenytoin (seizure med)

ADEK

vitamines

Oral

contraceptives

take

these

meds Ihr

before or

4hr after

Monoclonal Antibodies

Alirocumab-Evolocumab

Decreases

LDL

by

binding

to

receptors

used as

adjunct

to

dietary

modifications in

people

with

elevated

LDL

Complications

um

Hypersensitivity

Creport

rash

, Urticaria

,

vasculitis)

Local

injection

site reaction

(rotate

sites

,

avoid areas of inflammation

,

rashl

,

Contraindicated

Pregnancy

,

use

w/ caution

. Crosses

placenta

.

History

of

hypersensitivity

to

med

Administered

via

subcutaneous

route

.

~ huthmicMedicators

a

sopyramide

Class I

meds are sodium

channel

blockers

that

slow

cardiac

conduction

velocity

Purpose

is to slow

impulse conductions

in the Atria

,

ventricles

,

Divided

Into 1 A

,

IB

,

I

and

His-Purkinje

system

.

Delays repolarization

usest

SVT
VTACH

Atrial

flutter

Afib

Applications

Diarrhea

·

resolves after

stopping

med. Give wi food to reduce

gastric upset

Cinchonism

·

tinnitus

,

headache , nausea

, vertigo, disturbed

vision ·

can

develop

after I dose

cardiotoxicity

·

widening

of QRS

by

over 50 %,

increasing

the QT

Interval

,

Prolonging

of the PRInterval

are

indications of procainamide

cardiotoxicity

·

Therapeutic

quinidine

level is 2-

magimL

·

Monitor

for

confusion , drowsiness

,

vomit

·

Monitor vs &ECG

·

If

dysrhythmias continue

,

hold the med

Hypotension

Contradication

n,

a

harm

hypersensitivity

to

procaine , complete

heart block ,

atypical

ventricular tachy

. SLE

use with caution in ppl

with

partial

AV block ,

myasthenia Gravis , Iver/Kidney

disorder

,

Hf ,

digoxin

toxicity

Interactions

Antidysrhythms

have additive effects

E can increase

toxicity

Beta blockers & Cimetidine can t

quinidine

effects

Antihypertensives

have additive

hypotensive

effect

Class

2

Propranolol ,

Esmolo,

Acebutolo

usesd

AFIB

Atrial flutter

Paroxysmal

Sur

HTN

Angina

PVC

Severe recurrent

ventricular

tachydusrhutmias

Exercise

induced tachydysrhythmias

Paraxysmal

atrial

tachy

~

Complicatioef

,

Av block

,

Sinus arrest

,

bronchospasm ,

Hypotension

Contraindications

Propranolol

crosses

the

placenta

can cause

neonatal

bradycardia

,

hypotension

, hypoglycemia

.

can

decrease blood

supply to

placent

a

can

increase risk

for

premature

birth

or

Infant

death

can

cause

intrauterine

growth

retardation

,risk

ofCardiac

complications

use caution in DM

,

liver

,

thyroid

or

respiratory dysfunction

Wolft

Parkinson-white

syndrome

Administer

Give no faster

than

mg/min

Class 3

Amiodarone

Dotetilide

Potassium Channel blockers

prolong

the

action

potential

&

refractory

period

of

the cardiac

cycle

Action

Delays

repolarization

Amiodarone slows

Prolongs

action

potential the

ventricular

Reduced

automaticity

in the

SA node

HR

.

causes blue-gray

Reduced

contractility

conduction

In the

AV

,

ventricles

, Purkinje

Slin

color

.

Dilates

coronary blood vessels

uses

um

  • Conversion

of

AFIB

: Oral route

Recurrent

VFIB EVACH

Atrial flutter

using

dronedarone

, sotalo which

is

also a

beta

blocker)

,

dofetilide ,

butilide

implicato

e

toxicity

(observe

for

Cough

,

dyspnea

,

e +c

Sinus Brady

and AV block (monitor

BP , ECG ,

Indications of HFl

Visual

disturbance

(photophobia

, blurred

Vision ,

  • blindness. Do shellen

Others

: liver Ethyroid dysfunction

,

Gl disturbance ,

CNS effects , photosensitivity ,

blue-gray

discolored skin

Phlebitis :

use of

central venous Catheter

Hypotension

: Brady

, Al

block

Contraindications

crosses

placenta

can harm fetus. Don't breastfeed

Newborns

,

Infants ,

clients with

AV block Ebradycardia

use

Cautiously

with liver

,

thyroid,

or

respiratory

dysfunction

,

HF

, Efluid

Selectrolyte Imbalances

Interactions

Digoxin

levels

concurrent use of beta blockers

, verapmil ,

Diuretics ,

antibiotics Can

" risk of

dysrhuthmias

diltiazem can lead

to

bradycardia

Cholestyramne,

St John's Wort

,

rifamping levels of amiodarone

can *

plasma levels of

quinidine

,

procainamide ,

digoxin

,

diltiazem , warfarin

Administration

Highly

toxic

Obtain baseline

eg

, eye

exam

,

Chest

X-ray.

Along

W/ K

  • Adverse effects

can

continue

weeks or months after meds discontinue