Antihypertensive Medications

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Questions and Answers

What is an example of an ACE inhibitor?

lisinopril, captopril

What is the mechanism of action for ACE inhibitors?

Blocks conversion of angiotensin I → II, reducing BP

Common side effects of lisinopril and captopril include _____ cough.

Persistent

Common side effects of lisinopril and captopril include _____.

<p>Hyperkalemia</p> Signup and view all the answers

What is an example of an ARB?

<p>losartan</p> Signup and view all the answers

What is the mechanism of action for ARBs?

<p>Blocks angiotensin II receptors → vasodilation</p> Signup and view all the answers

ARBs have a higher chance of causing a persistent cough compared to ACE inhibitors.

<p>False (B)</p> Signup and view all the answers

What are some examples of beta-blockers?

<p>Metoprolol, Atenolol</p> Signup and view all the answers

What is the mechanism of action for BETA-Blockers?

<p>Reduce HR (negative chronotrope) Reduce contractility (negative inotrope)</p> Signup and view all the answers

What is a teaching point for BETA-Blockers?

<p>Slows down HR</p> Signup and view all the answers

Beta-blockers can worsen survival in heart failure if used carefully.

<p>False (B)</p> Signup and view all the answers

What should you monitor for when administering beta-blockers?

<p>bradycardia (A)</p> Signup and view all the answers

Give some examples of Dihydropyridine Calcium Channel Blockers

<p>nifedipine, amlodipine</p> Signup and view all the answers

What is the primary action of dihydropyridine calcium channel blockers?

<p>Primarily vasodilation</p> Signup and view all the answers

Dihydropyridines always cause reflex tachycardia.

<p>False (B)</p> Signup and view all the answers

Which is a rare side effect of Dihydropyridines?

<p>Wheezing or respiratory difficulties (C)</p> Signup and view all the answers

What is one distinction of Non-dihydropyridines?

<p>reduced HR</p> Signup and view all the answers

Adverse Effects of Non-dihydropyridines include _____.

<p>Bradycardia</p> Signup and view all the answers

What is the mechanism of action for nitrates?

<p>Relaxes smooth muscle in venous &amp; arterial vessels</p> Signup and view all the answers

To prevent tolerance build-up with Nitrates, _____.

<p>Remove patch for part of each day</p> Signup and view all the answers

How do Nitrates aid with chest pain?

<p>Helps with chest pain (angina) relief</p> Signup and view all the answers

Give another name for Nitrate?

<p>nitroglycerin</p> Signup and view all the answers

Indication for Ranolazine?

<p>Stable angina</p> Signup and view all the answers

How does Ranolazine work?

<p>Lowers cardiac O₂ demand without reducing HR or BP significantly</p> Signup and view all the answers

What is a key mechanism of Digoxin?

<p>Increases cardiac contractility</p> Signup and view all the answers

What are some uses for Digoxin?

<p>heart failure and atrial fibrillation</p> Signup and view all the answers

What is the action of Milrinone?

<p>Positive inotrope</p> Signup and view all the answers

What is the use case for Milrinone?

<p>acute exacerbation of HF</p> Signup and view all the answers

What is an indication for Antiarrhythmics (Amiodarone)?

<p>ventricular tachycardia or severe arrhythmias</p> Signup and view all the answers

What are some potential adverse effects of Antiarrhythmics (Amiodarone)?

<p>Hypotension, vision changes, blue skin hue (A)</p> Signup and view all the answers

What can Procainamide be used for?

<p>atrial fibrillation</p> Signup and view all the answers

What is the use case for Adenosine ATP?

<p>Supraventricular tachycardia</p> Signup and view all the answers

What should you teach patients about the administration of Adenosine ATP?

<p>Sense of impending doom or transient flushing/palpitations</p> Signup and view all the answers

What are some examples of HMG-CoA Reductase Inhibitors (Statins)?

<p>atorvastatin</p> Signup and view all the answers

A common side effect of HMG-CoA Reductase Inhibitors (Statins) is _____.

<p>Muscle aches</p> Signup and view all the answers

What should be monitored in patients taking HMG-CoA Reductase Inhibitors (Statins)?

<p>Monitor liver enzymes (LFTs)</p> Signup and view all the answers

What is an example of a Bile Acid Sequestrants?

<p>cholestyramine</p> Signup and view all the answers

Bile Acid Sequestrants may cause malabsorption of fat-soluble vitamins, causing potential deficiency of vitamin _____.

<p>Vitamin A</p> Signup and view all the answers

What is another use case for Bile Acid Sequestrants?

<p>pruritus in biliary obstruction (A)</p> Signup and view all the answers

What does Ezetimibe do?

<p>Inhibits cholesterol absorption</p> Signup and view all the answers

What effect does Fibrates (Gemfibrozil) have?

<p>Can cause myopathy</p> Signup and view all the answers

What is the function of Fibrates?

<p>reduce triglycerides</p> Signup and view all the answers

What is another name for Niacin?

<p>vitamin B3</p> Signup and view all the answers

What is a key side effect of Niacin (vitamin B3)?

<p>Flushing</p> Signup and view all the answers

What do Loop Diuretics (furosemide) do?

<p>Inhibit Na⁺ reabsorption</p> Signup and view all the answers

What should you watch out for when administering Loop Diuretics?

<p>Both B &amp; C (C)</p> Signup and view all the answers

What do Thiazide Diuretics (HCTZ) do?

<p>Inhibit reabsorption</p> Signup and view all the answers

When should you avoid Thiazide Diuretics (HCTZ)?

<p>sulfa allergy (A)</p> Signup and view all the answers

What is a concern for patients taking Thiazide Diuretics (HCTZ)?

<p>Risk for hypokalemia &amp; hyperglycemia</p> Signup and view all the answers

How Potassium-Sparing Diuretics work?

<p>Block aldosterone</p> Signup and view all the answers

What is the risk with Potassium-Sparing Diuretics?

<p>Risk for hyperkalemia</p> Signup and view all the answers

Potassium-Sparing Diuretics are recommended as a single therapy.

<p>False (B)</p> Signup and view all the answers

What is an Osmotic Diuretic?

<p>mannitol</p> Signup and view all the answers

What is the use case for Osmotic Diuretics (mannitol)?

<p>Reduces intracranial pressure</p> Signup and view all the answers

How can Osmotic Diuretics be administered?

<p>IV only</p> Signup and view all the answers

When educating a patient on Furosemide (Loop) , encourage _____.

<p>potassium-rich foods</p> Signup and view all the answers

What monitoring should be done when using Furosemide (Loop)?

<p>dizziness, orthostatic hypotension</p> Signup and view all the answers

What are some patient teaching points for Furosemide (Loop)?

<p>hearing loss if given IV too fast</p> Signup and view all the answers

What is a key priority for Spironolactone, Eplerenone?

<p>Check serum potassium regularly</p> Signup and view all the answers

What combination might prevent hypokalemia?

<p>Using a K⁺-sparing with furosemide</p> Signup and view all the answers

Select some examples Isotonic solutions:

<p>All of the above (D)</p> Signup and view all the answers

When should you use 0.9% NaCl?

<p>dehydration from vomiting/diarrhea</p> Signup and view all the answers

When is Lactated Ringer's used?

<p>burn patients</p> Signup and view all the answers

What is an example of Hypertonic solution?

<p>3% NaCl</p> Signup and view all the answers

When should you administer a Hypertonic solution?

<p>severe hyponatremia</p> Signup and view all the answers

What is an example of a Colloid solution?

<p>Dextran 40</p> Signup and view all the answers

When are colloid solutions used?

<p>Expand plasma volume</p> Signup and view all the answers

What special steps should you take when administeringPotassium Chloride (IV)?

<p>Infuse slowly</p> Signup and view all the answers

What is D50W (Dextrose 50% in Water)?

<p>severe hypoglycemia</p> Signup and view all the answers

When is D5W (5% in Water) useful?

<p>General fluid maintenance</p> Signup and view all the answers

D5W (5% in Water) is good for heavy resuscitation or shock.

<p>False (B)</p> Signup and view all the answers

What is Sodium Bicarbonate used for?

<p>metabolic acidosis</p> Signup and view all the answers

What is Ammonium Chloride used for?

<p>metabolic alkalosis</p> Signup and view all the answers

What is the antidote for Opioid?

<p>Naloxone (Narcan)</p> Signup and view all the answers

What is the antidote for Benzodiazepine?

<p>Flumazenil</p> Signup and view all the answers

What is the antidote for Beta-blocker?

<p>Glucagon</p> Signup and view all the answers

What is the antidote for Heavy metal poisoning?

<p>Dimercaprol</p> Signup and view all the answers

What is the antidote for lead poisoning?

<p>Disodium (EDTA</p> Signup and view all the answers

What is the antidote for TCA overdose?

<p>Sodium Bicarbonate</p> Signup and view all the answers

What is the antidote for Acetaminophen

<p>Acetylcysteine</p> Signup and view all the answers

Common side effects of lisinopril and captopril include persistent cough, hyperkalemia, and _____.

<p>angioedema</p> Signup and view all the answers

Give an example of an ARB.

<p>losartan</p> Signup and view all the answers

Compared to ACE inhibitors, what is a key point of ARBs?

<p>Reduced chance of persistent cough (B)</p> Signup and view all the answers

Give examples of BETA-Blockers.

<p>Metoprolol, Atenolol</p> Signup and view all the answers

Beta-blockers _____ down heart rate.

<p>slows</p> Signup and view all the answers

Give examples of Dihydropyridines.

<p>nifedipine, amlodipine</p> Signup and view all the answers

Dihydropyridines primarily induce what?

<p>Vasodilation (B)</p> Signup and view all the answers

Non-dihydropyridines increase heart rate.

<p>False (B)</p> Signup and view all the answers

Adverse effects of Non-dihydropyridines include _____, constipation, and hypotension.

<p>bradycardia</p> Signup and view all the answers

How do nitrates work?

<p>Relaxes smooth muscle in venous &amp; arterial vessels → ↓ preload &amp; afterload</p> Signup and view all the answers

Tolerance to nitrates can be prevented by removing the patch for part of each day, such as _____ hours on/12 hours off.

<p>12</p> Signup and view all the answers

What is nitroglycerin?

<p>Relaxes smooth muscle in venous &amp; arterial vessels → ↓ preload &amp; afterload</p> Signup and view all the answers

What is the indication for Ranolazine?

<p>Stable angina</p> Signup and view all the answers

Ranolazine significantly reduces heart rate and blood pressure.

<p>False (B)</p> Signup and view all the answers

How does Digoxin affect cardiac contractility?

<p>Increases cardiac conttractility</p> Signup and view all the answers

Digoxin is used to treat which conditions?

<p>Both A and B (D)</p> Signup and view all the answers

What is Milrinone used for?

<p>Acute exacerbation of HF</p> Signup and view all the answers

Milrinone is a long-term oral medication for heart failure.

<p>False (B)</p> Signup and view all the answers

What severe arrhythmias is Amiodarone used for?

<p>ventricular tachycardia</p> Signup and view all the answers

Adverse effects of Amiodarone include hypotension, vision changes, and _____.

<p>blue skin hue</p> Signup and view all the answers

What is Procainamide used for?

<p>atrial fibrillation</p> Signup and view all the answers

Procainamide decreases blood pressure.

<p>True (A)</p> Signup and view all the answers

What is Adenosine ATP used for?

<p>Supraventricular tachycardia</p> Signup and view all the answers

A teaching point with Adenosine ATP is to warn patients about a _____ upon administration.

<p>sense of impending doom</p> Signup and view all the answers

What is a common side effect of HMG-CoA Reductase Inhibitors?

<p>Muscle aches</p> Signup and view all the answers

HMG-CoA Reductase Inhibitors do not affect the liver.

<p>False (B)</p> Signup and view all the answers

What is a possible deficiency to look for with Bile Acid Sequestrants?

<p>Vitamin A</p> Signup and view all the answers

Bile Acid Sequestrants are also used for what purpose?

<p>Pruritus in biliary obstruction (D)</p> Signup and view all the answers

Ezetimibe inhibits triglyceride absorption.

<p>False (B)</p> Signup and view all the answers

What is a side effect of Fibrates?

<p>Myopathy</p> Signup and view all the answers

Fibrates primarily reduce cholesterol.

<p>False (B)</p> Signup and view all the answers

A key side effect of Niacin is _____, and it is often premedicated with aspirin.

<p>flushing</p> Signup and view all the answers

Which vitamin is Niacin?

<p>vitamin B3 (B)</p> Signup and view all the answers

What do Loop Diuretics do?

<p>Inhibit Na⁺ reabsorption in loop of Henle</p> Signup and view all the answers

When using Loop Diuretics, watch for _____, hyponatremia, and ototoxicity.

<p>hypokalemia</p> Signup and view all the answers

What do Thiazide Diuretics do?

<p>inhibit reabsorption in distal convoluted tubules</p> Signup and view all the answers

Avoid using Thiazide Diuretics in _____.

<p>sulfa allergy</p> Signup and view all the answers

What do Potassium-Sparing medications do?

<p>Block aldosterone</p> Signup and view all the answers

Potassium-Sparing medications block _____ → retention of K⁺, excretion of Na⁺

<p>aldosterone</p> Signup and view all the answers

What does Osmotic (mannitol) do?

<p>Reduces intracranial pressure</p> Signup and view all the answers

Mannitol can be administered orally.

<p>False (B)</p> Signup and view all the answers

Encourage potassium-rich foods with _____ education.

<p>furosemide</p> Signup and view all the answers

What should you monitor for with Furosemide (Loop) Education?

<p>all of the above (D)</p> Signup and view all the answers

What priority is important with Spironolactone, Eplerenone?

<p>Check serum potassium regularly</p> Signup and view all the answers

Using a K⁺-sparing with furosemide _____ hypokalemia.

<p>Prevents</p> Signup and view all the answers

_____ helps with dehydration from vomiting/diarrhea

<p>0.9% NaCl</p> Signup and view all the answers

Lactated Ringer's is useful for what?

<p>burn patients (B)</p> Signup and view all the answers

What is hypertonic 3% NaCl used for?

<p>Severe hyponatremia</p> Signup and view all the answers

Hypertonic solutions are useful for hypernatremia.

<p>False (B)</p> Signup and view all the answers

What is hypotonic 0.45% NaCl used for?

<p>hypertonic dehydration or severe hypernatremia</p> Signup and view all the answers

Hypotonic solutions do not require careful monitoring.

<p>False (B)</p> Signup and view all the answers

What is an example of a colloid?

<p>Dextran 40</p> Signup and view all the answers

Colloids decrease plasma volume.

<p>False (B)</p> Signup and view all the answers

Infuse Potassium Chloride (IV) _____ (e.g., 10 mEq/hour) to avoid cardiac arrhythmias

<p>slowly</p> Signup and view all the answers

Why should Potassium Chloride (IV) be infused slowly?

<p>To avoid cardiac arrhythmias (A)</p> Signup and view all the answers

What is D50W used for?

<p>severe hypoglycemia</p> Signup and view all the answers

D50W is used for hyperglycemia.

<p>False (B)</p> Signup and view all the answers

D5W is used for heavy resuscitation and shock.

<p>False (B)</p> Signup and view all the answers

Sodium Bicarbonate is used for metabolic alkalosis.

<p>False (B)</p> Signup and view all the answers

Ammonium Chloride is used for metabolic acidosis.

<p>False (B)</p> Signup and view all the answers

Naloxone reverses benzodiazepine overdoses.

<p>False (B)</p> Signup and view all the answers

What is Flumazenil used for?

<p>Benzodiazepine antidote</p> Signup and view all the answers

Flumazenil reverses opioid overdoses.

<p>False (B)</p> Signup and view all the answers

What is Glucagon used for?

<p>Beta-blocker overdose</p> Signup and view all the answers

Glucagon reverses severe hypertension.

<p>False (B)</p> Signup and view all the answers

What is Dimercaprol used for?

<p>Heavy metal poisoning</p> Signup and view all the answers

Dimercaprol is used for acetaminophen overdose.

<p>False (B)</p> Signup and view all the answers

What is Edetate Calcium Disodium used for?

<p>lead poisoning</p> Signup and view all the answers

Edetate Calcium Disodium is used for mercury poisoning.

<p>False (B)</p> Signup and view all the answers

Sodium Bicarbonate reverses opioid overdoses.

<p>False (B)</p> Signup and view all the answers

What is Acetylcysteine used for?

<p>Acetaminophen overdose</p> Signup and view all the answers

Acetylcysteine is used for lead poisoning.

<p>False (B)</p> Signup and view all the answers

Common side effects of lisinopril/captopril include Persistent cough, Hyperkalemia, and _________

<p>Angioedema</p> Signup and view all the answers

Common side effects of lisinopril and captopril include Persistent cough, Hyperkalemia (due to reduced aldosterone), and _____ (e.g., swollen lips).

<p>Angioedema</p> Signup and view all the answers

Name two examples of BETA-Blockers

<p>Metoprolol, Atenolol</p> Signup and view all the answers

Give an example of a Dihydropyridine Calcium Channel Blocker

<p>nifedipine, amlodipine</p> Signup and view all the answers

Give an example of a Non-dihydropyridine

<p>verapamil, diltiazem</p> Signup and view all the answers

What are some adverse effects of Non-dihydropyridines?

<p>Bradycardia, Constipation, Hypotension</p> Signup and view all the answers

How to Nitrates help with chest pain

<p>Relaxes smooth muscle in venous &amp; arterial vessels_ → ↓ preload &amp; afterload Tolerance Prevention</p> Signup and view all the answers

_______ can help with chest pain (angina) relief

<p>nitroglycerin</p> Signup and view all the answers

What are the indications of Digoxin?

<p>heart failure and atrial fibrillation</p> Signup and view all the answers

What are Antiarrhythmics (Amiodarone), used for?

<p>ventricular tachycardia or severe arrhythmias</p> Signup and view all the answers

What does Ezetimibe inhibit?

<p>cholesterol absorption</p> Signup and view all the answers

What are Fibrates (Gemfibrozil) used for?

<p>reduce triglycerides</p> Signup and view all the answers

What Key side effect does Niacin (vitamin B3) have?

<p>Flushing</p> Signup and view all the answers

What side effects do Loop Diuretics (furosemide) have?

<p>hypokalemia, hyponatremia, ototoxicity</p> Signup and view all the answers

Thiazide Diuretics (HCTZ) should be safe for a patient with sulfa allergy

<p>False (B)</p> Signup and view all the answers

What electrolyte abnormality should one look out for when administering Potassium-Sparing (spironolactone, eplerenone)?

<p>Risk for hyperkalemia</p> Signup and view all the answers

What is Furosemide (Loop) Education used for?

<p>potassium-rich foods</p> Signup and view all the answers

What is Spironolactone, Eplerenone used for?

<p>Combination Therapy</p> Signup and view all the answers

What is Isotonic (0.9% NaCl, Lactated Ringer's, 5W) used for?

<p>burn patients</p> Signup and view all the answers

What is Colloids: Dextran 40 used for?

<p>Expand plasma volume in hypovolemic shock</p> Signup and view all the answers

What is Potassium Chloride (IV) used for?

<p>cardiac arrhythmias</p> Signup and view all the answers

What is D50W (Dextrose 50% in Water) used for?

<p>severe hypoglycemia or insulin overdose</p> Signup and view all the answers

What is D5W (5% in Water) used for?

<p>General fluid maintenance</p> Signup and view all the answers

What is Naloxone (Narcan) used for?

<p>Opioid antidote</p> Signup and view all the answers

What is Edetate Calcium Disodium (EDTA) used for?

<p>Lead poisoning</p> Signup and view all the answers

Flashcards

ACE Inhibitors

Block conversion of angiotensin I to angiotensin II, which reduces blood pressure.

Common ACE Inhibitor Side Effects

Persistent cough, hyperkalemia, and angioedema.

ARBs

Block angiotensin II receptors, causing vasodilation.

Beta-Blockers

Reduce heart rate and contractility, decreasing cardiac workload.

Signup and view all the flashcards

Calcium Channel Blockers (Dihydropyridines)

Primarily cause vasodilation, which can lead to reflex tachycardia.

Signup and view all the flashcards

Calcium Channel Blockers (Non-dihydropyridines)

Cause vasodilation and reduce heart rate.

Signup and view all the flashcards

Nitrates

Relaxes smooth muscle in venous and arterial vessels, reducing preload and afterload.

Signup and view all the flashcards

Ranolazine

Lowers cardiac oxygen demand without significantly reducing HR or BP.

Signup and view all the flashcards

Digoxin

Increases cardiac contractility by inhibiting Na+/K+-ATPase.

Signup and view all the flashcards

Milrinone

Positive inotrope, used for acute exacerbation of heart failure. Short-term IV therapy.

Signup and view all the flashcards

Antiarrhythmics (Amiodarone)

Used for ventricular tachycardia or severe arrhythmias.

Signup and view all the flashcards

Procainamide

Can convert atrial fibrillation to normal sinus rhythm.

Signup and view all the flashcards

Adenosine ATP

Can 'reset' conduction in supraventricular tachycardia.

Signup and view all the flashcards

HMG-CoA Reductase Inhibitors (Statins)

Muscle aches (myalgia). Monitor liver enzymes.

Signup and view all the flashcards

Bile Acid Sequestrants (cholestyramine)

May cause malabsorption of fat-soluble vitamins, like Vitamin A.

Signup and view all the flashcards

Ezetimibe

Inhibits cholesterol absorption in the GI tract.

Signup and view all the flashcards

Fibrates (Gemfibrozil)

Can cause myopathy (muscle aches). Primarily reduce triglycerides.

Signup and view all the flashcards

Niacin (vitamin B3)

Key side effect is flushing, often pre-medicate with aspirin.

Signup and view all the flashcards

Loop Diuretics (furosemide)

Inhibit Na+ reabsorption in loop of Henle. Watch for hypokalemia, hyponatremia, ototoxicity.

Signup and view all the flashcards

Thiazide Diuretics (HCTZ)

Inhibit reabsorption in distal convoluted tubules. Avoid in sulfa allergy. Risk for hypokalemia & hyperglycemia.

Signup and view all the flashcards

Potassium-Sparing Diuretics

Block aldosterone, retaining K+ and excreting Na+. Risk for hyperkalemia.

Signup and view all the flashcards

Osmotic Diuretics (mannitol)

Reduces intracranial pressure (ICP), helps in acute renal failure.

Signup and view all the flashcards

K+ sparing with furosemide

Hypokalemia prevention.

Signup and view all the flashcards

0.9% NaCl

Helps with dehydration from vomiting/diarrhea.

Signup and view all the flashcards

Hypertonic: 3% NaCl

Used for severe hyponatremia.

Signup and view all the flashcards

Hypotonic: 0.45% NaCl

For hypertonic dehydration or severe hypernatremia.

Signup and view all the flashcards

Colloids: Dextran 40

Expand plasma volume in hypovolemic shock.

Signup and view all the flashcards

Potassium Chloride (IV)

Infuse slowly (e.g., 10 mEq/hour) to avoid cardiac arrhythmias.

Signup and view all the flashcards

D50W

Severe hypoglycemia or insulin overdose.

Signup and view all the flashcards

D5W (5% in Water)

General fluid maintenance.

Signup and view all the flashcards

Sodium Bicarbonate

Used for metabolic acidosis

Signup and view all the flashcards

Ammonium Chloride

Used for metabolic alkalosis

Signup and view all the flashcards

Naloxone

Opioid antidote

Signup and view all the flashcards

Flumazenil

Benzodiazepine antidote

Signup and view all the flashcards

Overdose

Glucagon

Signup and view all the flashcards

Dimercaprol

Heavy metal poisoning

Signup and view all the flashcards

Edetate Calcium Disodium

Lead poisoning

Signup and view all the flashcards

Sodium Bicarbonate

TCA overdose

Signup and view all the flashcards

Acetylcysteine

Acetaminophen overdose

Signup and view all the flashcards

Study Notes

ACE Inhibitors

  • Block the conversion of angiotensin I to angiotensin II, which lowers blood pressure.
  • Lisinopril and captopril are examples of ACE inhibitors.

Common Side Effects of ACE Inhibitors

  • Include a persistent cough, hyperkalemia (due to reduced aldosterone), and angioedema (e.g., swollen lips).
  • If the cough is intolerable, switching to an ARB is recommended.

ARBs

  • Losartan is an example.
  • Block angiotensin II receptors, leading to vasodilation.
  • Compared to ACE inhibitors, ARBs have a reduced chance of causing a persistent cough.

Beta-Blockers

  • Metoprolol and atenolol are examples.
  • Reduce heart rate (negative chronotrope) and contractility (negative inotrope), which helps in heart failure and angina by decreasing cardiac workload.
  • Slowing down heart rate is beneficial in conditions like atrial fibrillation.
  • Can improve survival in heart failure if used carefully.
  • Monitor for bradycardia and hypotension.

Calcium Channel Blockers - Dihydropyridines

  • Nifedipine and amlodipine are examples.
  • Primarily cause vasodilation, which can lead to reflex tachycardia.
  • In rare cases, wheezing or respiratory difficulties can occur.

Non-dihydropyridines

  • Verapamil and diltiazem are examples.
  • Cause vasodilation and reduce heart rate (negative chronotropy).
  • Used for hypertension, angina, and atrial fibrillation rate control.
  • Adverse effects include bradycardia, constipation (especially with verapamil), and hypotension.

Nitrates

  • Relax smooth muscle in venous and arterial vessels, decreasing preload and afterload.
  • Used to help with chest pain (angina) relief.
  • Tolerance prevention involves removing the patch for part of each day (e.g., 12 hours on/12 hours off).
  • Nitroglycerin is an example.

Ranolazine

  • Indicated for stable angina not responding to other medications.
  • Lowers cardiac oxygen demand without significantly reducing heart rate or blood pressure.

Digoxin

  • Increases cardiac contractility (positive inotrope) by inhibiting Na⁺/K⁺-ATPase.
  • Used for heart failure and atrial fibrillation (to slow ventricular rate).

Milrinone

  • Positive inotrope used for acute exacerbation of heart failure.
  • It is a short-term IV therapy for patients not responding to standard drugs.

Antiarrhythmics (Amiodarone)

  • Used for ventricular tachycardia or severe arrhythmias.
  • Adverse effects include hypotension, vision changes, and blue skin hue.
  • Has a long half-life; monitor for organ toxicities (liver, lungs, thyroid).

Procainamide

  • Can convert atrial fibrillation to normal sinus rhythm.
  • Watch for hypotension and QRS widening.

Adenosine (ATP)

  • Used for supraventricular tachycardia to "reset" conduction.
  • Teaching point: Patients may experience a sense of impending doom or transient flushing/palpitations upon administration.

HMG-CoA Reductase Inhibitors (Statins)

  • Atorvastatin is an example.
  • A common side effect is muscle aches (myalgia).
  • Monitor liver enzymes (LFTs) because they can injure the liver.

Bile Acid Sequestrants

  • Cholestyramine is an example.
  • May cause malabsorption of fat-soluble vitamins, potentially leading to vitamin A deficiency.
  • Also used for pruritus in biliary obstruction.

Ezetimibe

  • Inhibits cholesterol absorption in the GI tract.

Fibrates

  • Gemfibrozil is an example.
  • Can cause myopathy (muscle aches).
  • Primarily reduce triglycerides.

Niacin (Vitamin B3)

  • Reduces triglycerides.
  • A key side effect is flushing, which can often be prevented by premedicating with aspirin.

Loop Diuretics

  • Furosemide is an example.
  • Inhibit Na⁺ reabsorption in the loop of Henle.
  • Watch for hypokalemia, hyponatremia, and ototoxicity.
  • Encourage potassium-rich foods
  • Monitor for dizziness, orthostatic hypotension, and tinnitus/hearing loss if given IV too fast

Thiazide Diuretics

  • HCTZ is an example.
  • Inhibit reabsorption in distal convoluted tubules.
  • Should be avoided in cases of sulfa allergy.
  • There is a risk for hypokalemia and hyperglycemia.

Potassium-Sparing Diuretics

  • Spironolactone and eplerenone are examples.
  • Block aldosterone, leading to retention of K⁺ and excretion of Na⁺.
  • Risk for hyperkalemia.
  • Often combined with loops to prevent K⁺ loss.
  • Priority: Check serum potassium regularly
  • Using a K⁺-sparing with furosemide prevents hypokalemia

Osmotic Diuretics

  • Mannitol is an example.
  • Reduces intracranial pressure (ICP) and helps in acute renal failure.
  • Administered IV only.

Isotonic Solutions

  • 0.9% NaCl, Lactated Ringer's, and D5W (initially) are examples.
  • 0.9% NaCl helps with dehydration from vomiting/diarrhea.
  • Lactated Ringer's is used for burn patients and fluid resuscitation.

Hypertonic Solutions

  • 3% NaCl is an example.
  • Used for severe hyponatremia.

Hypotonic Solutions

  • 0.45% NaCl is an example.
  • Used for hypertonic dehydration or severe hypernatremia, requiring careful monitoring.

Colloids

  • Dextran 40 is an example.
  • Expand plasma volume in hypovolemic shock.
  • Watch for fluid overload/pulmonary edema.

Potassium Chloride (IV)

  • Infuse slowly (e.g., 10 mEq/hour) to avoid cardiac arrhythmias.

D50W (Dextrose 50% in Water)

  • Used for severe hypoglycemia or insulin overdose.

D5W (5% in Water)

  • Used for general fluid maintenance (e.g., in children).
  • Not for heavy resuscitation or shock.

Sodium Bicarbonate

  • Used for metabolic acidosis (e.g., certain renal failure cases)
  • Used for TCA overdose (e.g., amitriptyline)

Ammonium Chloride

  • Used for metabolic alkalosis (e.g., severe vomiting).

Naloxone (Narcan)

  • Opioid antidote (e.g., morphine overdose).

Flumazenil

  • Benzodiazepine antidote (e.g., lorazepam overdose).

Glucagon

  • Used for beta-blocker overdose and severe bradycardia/hypotension.

Dimercaprol

  • Used for heavy metal poisoning (e.g., mercury).

Edetate Calcium Disodium (EDTA)

  • Used for lead poisoning.

Acetylcysteine

  • Used for acetaminophen overdose.

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