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Cardio Drugs
Use
37
Science
Graduate
06/23/2009

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Term
Bile Acid Binding Resins
Definition
Use: Adjuvant  w/statin b/c high LDL
Term
Statins
Definition
Use: Primary and secondary prevention of CAD, use in combo
Term
Cholesterol Absorption Blockers
Definition
Use: Adjuvant to statins
Term
Niacin (Nicotinic Acid)
Definition
Use: High triglycerides, high LDL, and low HDL-C levels
Term
Fibrates
Definition
Use: Severe high TGs and low HDLs like in metabolic syndromes (Type II Diabetes)
Term
Nitrates
Definition

Use: under tongue or IV to terminate angina episode OR oral, patch or ointment for prophylaxis (angina)

HF: IV or sublingual for acute decomp, limited w/hydralazine or in acute decomp (because decrease preload)

Term
B-adrenergic Blockers
Definition

Use: orally for chronic prophylaxis of stable, unpredictable in variant

HT: low and high dose works same, younger and middle-age HT's (non-blacks) respond best

Term
Ca Channel Blockers
Definition
Use: Chronic prophylaxis of stable or variant angina
Term
Ranolazine
Definition
Use: Alone as oral prophylaxis of chronic stable angina OR combo w/nitrates, b-blocks, or Ca channel blocks
Term
Aspirin
Definition
Use: oral, use low dose to minimize bleeding potential
Term
ADP Inhibitors
Definition
Use: Oral, slow onset (b/c pro-drug), long duration (4-8 days), combo w/aspirin
Term
GP IIb/IIIa Receptor Inhibitor
Definition
Use: IV, short duration of action (use in surg), oral doesn't work, combo w/aspirin and hep, Unstable angina
Term
Heparin
Definition
Use: IV (hep) SC (LMWH - more reliable absorption and plasma 1/2 life)
Term
Fondaparinux
Definition
Use: specific and selective, long 1/2 life, 100% bioavailable (sq) = once-daily x-coat w/out needing to monitor clotting time (unlike close monitor in heparin)
Term
Direct Thrombin Inhib
Definition
Use: IV, combo w/aspirin or other x-plates
Term
Fibrinolytic (TPA)
Definition
Use: IV w/in 2 hrs of MI symptoms
Term
Analgesics
Definition
Use: IV till pain relieved or toxic, some need LARGE cumulative doses but can tolerate them
Term
Renin Angiotensin Inhib
Definition

Use: post aspirin, b-blockers and reperfusion therapy (w/in 24 hrs of event)

HT: less effective in blacks and old, use w/diuretic, use ARBs (BEST SE PROFILE OR ALL HT DRUGS, but costs), excellent in protecting against nephropathy (esp diabetics), CAD and HF

Term
Oral X-Coags
Definition
Use: takes days for optimal onset, monitor dose via prothrombin time
Term
Loop Diuretics
Definition

Use: No survival, both chronic heart failure (oral) and acute decomp (IV). Most effective diuretic

HT: pts w/renal insufficiency or resistant HT

Term
Thiazide Diuretics
Definition
Use: No survival, only chronic stable heart failure (oral), combo w/loop diuretics, wide use as 1st line monotherapy for hypertension (esp blacks and old), low Na diet
Term
K+ Sparing Diuretics
Definition
Use: No survival.  Combo w/loop and/or thiazide diuretics to prevent K loss
Term
Aldosterone Antagonists
Definition

Use: Yes survival in combo w/standard tx for SEVERE chronic HF (independent of diuretic effects of drug)

HT: comb w/thiazide or loop diuretics to prevent hypokalemia, benefit in HF indicate potential use in HT + HF

Term
Renin Angiotensin Inhibitors (HF) 
Definition
Use: yes survival, important in current tx of systolic dysfunction, not as efficient as aldosterone inhib, decrease sx and hospitalizations
Term

Direct Arterial Vasodilators

Hydalazine

Definition
Use: Yes survival in combo w/isosorbide dinitrate in chronic HF, most vasodilators (unless also neurohormonal inhibs) NO to survival
Term
Digoxin
Definition
Use: low therapeutic index (esp in hypokalemia), restrict to severe HF or pts w/A fib, decrease sx and hospital, no survival, ventricular rate control in pts w/heart fail and A fib
Term
B agonists
Definition
Use: Restricted to acute decomp, decrease Sx, maintain circulatory stability, no survival
Term
Phosphodiesterase Inhibs
Definition
Use: Acute decomp HF only, decrease Sx, maintain circulatory stability, no survival
Term
Nesiritide
Definition
Use: restricted to acute decomp HF, decrease Sx, maintain circulatory stability, NO survival
Term
Class IA
Definition
Use: wide-spectrum for both supraventricular and ventricular arrhythmias due to re-entry or ectopic automaticity, term A fib or flutter, comb w/stuff to tx serious ventricular arrhythmia
Term
Class IB
Definition
Use: Ventricular aryth b/c re-entry or ectopic automaticity, use against digoxin-induced arryth and long Q-T syndrome (mexiletine and phenytoin), good at suppressing aryth caused by ischemia (MI)
Term
Class IC
Definition
Use: SERIOUS VENTRICULAR ARRYTHS b/c re-entry, A fib and flutter, AV nodal re-entry tachy
Term
Class II
Definition
Use: Arryth w/surg, anesthesia, exercise, coke or other xs SNS states, ventricular rate control (so vent can slow when atria going nuts) in A fib and flutter, long Q-T syndrome
Term
Class III
Definition
Use: broad supraventricular and ventricular aryths b/c of re-entry or ectopic automaticity, term A fib/flutter, combo w/devices for tx serious ventricular arryth, DRUG OF CHOICE for ventricular arryth in cardiac resuscitation, good @ tx arryth in pts w/heart fail (cause less arryths than other drugs)
Term
Class IV
Definition
Use: AV nodal re-entry tachy, VENTRICULAR RATE CONTROL in A fib/flutter
Term
Adenosine
Definition
Use: AV nodal re-entry tachy (can mistake for anxiety attack)
Term
Aliskiren
Definition
Use: less in blacks, STRONGLY better w/diuretic, additive w/ACEI or ARB but alone has same efficacy as either of the other two alone
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