Table 1. Diuretics. Drugs Mechanisms of Action Indications Adverse Drug Effects. Table 2. Electrolyte Modifiers.

Transcription

1 Table 1. Diuretics. hydrochlorothiazide 23 furosemide 23 triamterene 23 Inhibits sodium reabsorption at the distal convoluted tubule Inhibits sodium reabsorption at the loop of Henle Competitive inhibitor of the principle cell sodium channels Acute pulmonary edema (furosemide) Adjunct in chronic edema states (furosemide) Congestive heart failure Hepatic cirrhosis Renal dysfunction Corticosteroid and estrogen therapy Photosensitivity Hypokalemia (hydrochlorothiazide, furosemide) Hyperglycemia (hydrochlorothiazide, furosemide) Dry mouth (furosemide) Cardiac arrhythmias (hydrochlorothiazide, furosemide) Erythema multiforme Stevens-Johnson syndrome Toxic epidermal necrolysis Systemic lupus erythematosus (hydrochlorothiazide) Thrombocytopenia (furosemide) Nephrotoxicity (triamterene) Table 2. Electrolyte Modifiers. potassium chloride 23 Klor-Con M20 (potassium chloride) 23 Promote normal muscle contraction and nerve impulse generation Maintain normal renal function, acid-base balance, carbohydrate metabolism, and gastric acid secretion To prevent diuretic-induced hypokalemia GI discomfort Hyperkalemia (mild) Paresthesia of extremities Listlessness Weak or heavy limbs Hyperkalemia (severe) Arrhythmias Heart block Cardiac arrest

2 Table 3. β-adrenergic Blocking Agents. atenolol 23 metoprolol 23 Bystolic (nebivolol) 23 Selective β 1 -adrenergic receptor blocking agents carvedilol 23 Blocks α 1 -, β 1 -, and β 2 - adrenergic receptors Angina pectoris Cardiac arrhythmias Sedation, depression Mask symptoms of hypoglycemia Dyspnea, wheezing Dry mouth Lichenoid stomatitis Bradycardia Bronchospasm AV block Table 4. Angiotensin Converting Enzyme (ACE) Inhibitors. enalapril 23 lisinopril 23 lisinopril w/ hydrochlorothiazide 23 Inhibit conversion of angiotensin I to angiotensin II decrease arteriolar vasoconstriction aldosterone synthesis renal proximal tubule sodium chloride resorption ADH release Inhibit degradation of bradykinin vasodilation Diabetic nephropathy Cough Angioedema Hyperkalemia Angioedema Agranulocytosis Neutropenia Table 5. Angiotensin II-receptor Antagonists. losartan 23 Benicar (olmesartan) 23 Benicar HCT (olmesartan w/hydrochlorothiazide) 23 Diovan (vasartan) 23 Diovan HCT (vasartan w/ hydrochlorothiazide) 23 Antagonize the action of angiotensin II at AT1- receptors May indirectly increase vasorelaxant AT2-receptor activit Diabetic nephropathy Dizziness Rare thrombocytopenia Rhabdomyolysis Rare angioedema

3 Table 6. Calcium-channel Blocking Agents. amlopidine 23 Blocks voltage-gated L-type calcium channels and prevents the influx of calcium Relaxes vascular smooth muscle Reduces myocardial contraction Exertional angina Unstable angina Coronary spasm Hypertrophic cardiomyopathy Raynaud s phenomenon Pre-eclampsia Palpitations Peripheral edema Flushing Dizziness Gingival overgrowth Increased incidence of angina pectoris Rare myocardial infarction Table 7. Antihyperlipidemic Agents. pravastatin 23 lovastatin 23 simvastatin 23 Crestor (rosuvastatin sodium) 23 Lipitor (atorvastatin) 23 Niaspan (niacin) 23 Inhibit HMG-CoA reductase Reduce VLDL and LDL Promotes lipid metabolism Reduces total cholesterol, LDL, and triglycerides Hyperlipidemia Abdominal pain ( statins ) Constipation Diarrhea Dry mouth (fenofibrate) Myalgia Myopathy Rhabdomyolysis ( statins ) Hepatotoxicity Dermatomyocitis ( statins ) Tricor (fenofibrate) 23 Promotes the synthesis of lipoprotein lipase Increases the catabolism of triglycerides and VLDL Zetia (ezetimibe) 23 Vytorin (ezetimibe w/ simvastatin) 23 Inhibits the absorption of cholesterol from the small intestine Reduce LDL and triglycerides Lovaza (omega-3/fish) 23 Incompletely understood molecular mechanisms

4 Table 8. Cardiac Glycosides. Digoxin 23 Inhibits sodium/potassium ATPase Promotes intracellular sodiumcalcium exchange Inhibits sympathetic outflow in the autonomic nervous system and increases parasympathetic vagal tone Prolongs refractory period and decreases conduction velocity at the AV node Supraventricular arrhythmias Atrial flutter Paroxysmal atrial tachycardia Agitation Fatigue Muscle weakness Blurred vision Green-yellow halo around images Nausea Vomiting Arrhythmias AV block Table 9. Antithrombotic Agents. Plavix (clopidogrel) 23 Blocks ADP-dependent platelet aggregation Secondary prevention of thromboembolic events in patients with recent MI, stroke, or peripheral vascular disease Acute coronary syndromes Prevention of stent thrombosis (in combination with ASA) Chest pain Edema Hypertension Petechia, purpura, ecchymosis Abnormal liver function Heart failure Erythema multiforme Gastrointestinal hemorrhage in combination with ASA Rare intracranial hemorrhage

5 Table 10. Oral Anticoagulants. Warfarin 23 Interferes with the hepatic synthesis of vitamin K-dependent coagulation factors Factors II, VII, IX, and X Prophylaxis and treatment Deep vein thrombosis Pulmonary embolism Prevention and treatment of systemic embolism Myocardial infarction Prosthetic heart valve Purpura, ecchymosis, hematoma (Figures) Skin and other tissue necrosis Hemorrhage Hepatitis Hypersensitivity reaction 23. U.S. National Library of Medicine. DailyMed. Advanced Search. Accessed January 25, 2016.