EPCC Pharmacology PDF

2 Calcium Channel Blockers (CCB) 512 Mechanism Prevents calcium from entering cells, especially at of Action heart & blood vessels, so will decrease HR & myocardial contraction Category C Therapeutic Hypertension Angina pectoris Uses Dysrhythmias Maybe migraines Adverse Effects Specific Drugs CARDIO...

2 Calcium Channel Blockers (CCB) 512 Mechanism Prevents calcium from entering cells, especially at of Action heart & blood vessels, so will decrease HR & myocardial contraction Category C Therapeutic Hypertension Angina pectoris Uses Dysrhythmias Maybe migraines Adverse Effects Specific Drugs CARDIOVASCULAR SYSTEM MEDS: Other Vasodilators 519 Cardiac Glycosides 582 (wide variety) (also called digitalis drugs) RAAS Inotropic—increases force of Organic nitrates contraction, slows conduction CCBs & increases refractory period; Beta blockers so increases cardiac output Others Absorption variable; Excretion slow so accumulates Hypertension HF is major use Dysrhythmias Reduces symptoms & increase exercise tolerance Anti-dysrhythmias 528 Several categories. Both tachy and brady mechanisms. Changes in the EKG Dysrhythmias Headaches, drowsiness, flushing, fatigue, dizziness, edema. 1 & 2—reflex tachycardia 3 & 4-constipation/dysrhythmia 1.amlodipine not heart 2.nifedipine Postural hypotension and reflex tachycardia Dysrhythmias Anorexia* n/v Diplopia Dysrhythmias hydralazine—use for high 3.verapamil affects heart 4.diltiazem nitroprusside—acts fast, so used in ER for hypertensive emergency minoxidil—used in severe hypertension, but potential serious side effects. digoxin—used less frequently now because not proven to prolong life. Considered second line 5 Classes I—Sodium channel blockers II—Beta adrenergic blockers II—Potassium channel block IV—Calcium channel block V—Others Used less frequently now. I—quinidine adverse effects include CNS, and GI Many drug interactions No grapefruit juice Many drug interactions. Drug Interactions Grapefruit juice inhibits metabolism so increases Comments toxicity. First line for AfricanAmerican population BP, HF & hypertensive crisis Unique—lupus like syndrome Effective dose is close to the toxic dose. Anorexia*--an early sign of toxicity (watch for it) Many drug interactions. Organic Nitrates 548 Used for 100s of years. Works directly on smooth muscle to promote dilation of veins, so decrease in O2 demand Angina pectoris (sudden severe pain due to decreased oxygen supply, usually when demand is up) Headache Orthostatic hypotension and reflex tachycardia nitroglycerin Lots of different routes and durations. All hypotensive drugs especially beta blockers. Degrades easily (no light, heat, or moisture). Chemically it is the same as the nitro in explosives