Pharmacology: Cardiovascular, Immune & GI Systems

• Study notes for MEN Pharmacology Exam #2 cover the cardiovascular system, immune system, and gastrointestinal system.

HTN (Hypertension)

• ACE inhibitors include lisinopril and captopril.
• ARBs include losartan.
• Aldosterone antagonists include spironolactone.
• Selective beta blockers include metoprolol or propranolol.
• Alpha blockers include prazosin.
• Alpha-2 agonists include clonidine.
• Non-dihydropyridines include verapamil.
• Dihydropyridines include nifedipine.
• Thiazides include HCTZ.
• Direct vasodilators include hydralazine.
• Nitroprusside is used for HTN crisis.
• Therapy goals involve preventing end-organ damage; also consider adverse effects (AEs), nursing implications (NIs), drug-drug interactions (DDIs), and monitoring.
• Drugs are used for reasons besides hypertension, like angina.

Angina

• Nitrates (short-acting and long-acting) are used to treat angina
• Other medications include non-dihydropyridines (verapamil), dihydropyridines (nifedipine), and selective beta-blockers (metoprolol)
• Therapy aims to decrease O2 demand and increase O2 supply.
• Consider types of drugs, AEs, NIs, and monitoring.

Antidysrhythmics

• Class 1B: lidocaine
• Class 2: propranolol
• Class 3: amiodarone
• Class 4: verapamil
• Other medications include adenosine and digoxin.
• Therapy aims to treat the cause, prevent dysrhythmia, and suppress dysrhythmia; also consider AEs and nursing implications.

Hyperlipidemia

• HMG-CoA Reductase Inhibitors (Statins) include atorvastatin.
• Other medications include niacin, bile acid sequestrants (colesevelam), cholesterol absorption inhibitors (ezetimibe), and fish oil.
• Lifestyle modifications should also be considered along with paying attention to adverse effects, drug-drug interactions, and nursing implications.

Heart Failure

• Loop diuretics include furosemide.
• Cardiac glycosides include digoxin and its reversal agent, Digibind.
• Other medications include beta blockers (metoprolol), ACE inhibitors (lisinopril), ARBs (losartan), aldosterone antagonists (spironolactone), and Alpha1/Beta1 agonists (dopamine/dobutamine).
• Consider treating electrolyte issues, AEs, and nursing implications.
• It is important to note if a drug can be used for both hypertension and heart failure and how the use for heart failure differs from the use for hypertension.

Thromboembolic Disorders

• Unfractionated Heparin (UFH) is heparin.
• Low Molecular Weight Heparin (LMWH) is enoxaparin (Lovenox).
• DTIs include dabigatran; argatroban is an IV form for HIT.
• Direct Factor Xa Inhibitors include rivaroxaban (Xarelto).
• Vitamin K antagonists include warfarin (Coumadin).
• Antiplatelet medications include aspirin and PY2 ADP receptor antagonists like clopidogrel (Plavix).
• Thrombolytics include alteplase (Activase) also known as tPA.
• Monitor aPTT and PT/INR, including use protocols and considerations for HITs.
• Reversal agents include vitamin K, protamine, idarucizumab, and adexanet alpha.
• Considerations include AEs, DDIs, and nursing implications (NIs).

PUD/GERD

• Treatment involves antibiotics plus acid suppression.
• H2 blockers include famotidine.
• PPIs include omeprazole.
• Antacids include calcium carbonate and Bismuth Subsalicylate.
• Mucosal protectants include sucralfate.
• Lifestyle modifications should be considered along with uses, AEs & DDIs, and individual variation.

GI: N/V

• 5HT3 antagonists include ondansetron.
• Dopamine antagonists include prochlorperazine & promethazine.
• Anticholinergics include scopolamine & dimenhydrinate for motion sickness.
• Considerations include uses, AEs, Nis, safety issues, and administration issues.

Urologic and Gynecologic Conditions; Gender-affirming hormone therapy

• Medications for non-contraceptive use include conjugated equine estrogen and medroxyprogesterone.
• Medications for contraceptive use include estrogen-progestin COCs, progestin-only "mini-pills", and emergency contraception (levonorgestrel).
• Other medications include testosterone, a PDE-5 inhibitor (sildenafil), a 5-alpha reductase inhibitor (finasteride), an Alpha1 adrenergic antagonist (tamsulosin), an anti-androgen (Spironolactone), and a GnRH Analog for puberty suppression (Leuprolide).
• Focus on gender affirming hormone therapy patient care, safety issues, and dosage forms.