7/29/2019 Cardiovascular Drug Chart

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Cardiovascular DrugsBeta-Adrenergic Blockers Calcium Channel Blockers ACE Inhibitors Diuretics

Prototype Atenolol (Tenormin) Propranolol (Inderal)

Metoprolol (Lopressor)

Nifedipine (Procardia)

Verapamil (Calan)

Diltiazem (Cardizem)

Captopril (Capoten)

Enalapril (Vasotec)

Benazepril (Lotensin)

Action blocks beta receptors in heart; excitabilityof heart; reduces cardiac workload andoxygen consumption; release of renin;lowers BP by reducing CNS stimuli

blocks calcium access to cellscausing: contractility + conductivity of the heart

resulting in demand for O2. -> oxygenation of myocardialcells

blocks ACE in lungs fromconverting angiotensin I to

angiotensin II (powerful

vasoconstrictor); causes BP, aldosterone secretion, sodium

and fluid loss

Loop diuretics inhibit Na andCl reabsorption through direct

action primarily in the

ascending loop of Henle but

also in the proximal and distal

tubules. Thiazide diuretics act

primarily on the distal tubules,

habiting Na and Cl

reabsorption.

Indications HTN (used with diuretics), angina,

supraventricular tachycardia, prevent

recurrent MI, migraine headache, stage fright

(Propranolol) & heart failure

Angina, HTN, dysrhythmias,

interstitial cystitis, migraines

HTN, CHF Edema (heart, liver, or kidney),

HTN

Contraindications

breastfeeding, children, hypersensitivity,heart block, K-sparing diuretics, bilateral

renal artery stenosis, angioedema

heart block, Pregnancy, breastfeeding,severe adrenocortical

impairement, anuria, oliguria

Caution dialysis pts., hypovolemia, leukemia,

scleroderma, SLE, blood dyscrasias, CHF,

diabetes mellitus, thyroid/renal/hepatic

disease, COPD, asthma

Fluid & electrolyte depletion,

gout

SE/Adverse bradycardia, lethargy, GI disturbance, CHF, BP, depression, dizziness

BP, Bradycardia, mayprecipitate A-V block,

headache, abdominal

discomfort (constipation,

nausea), peripheral edema

dizziness, orthostatic

hypotension, GI distress,

nonproductive cough,

headache

Dehydration, hyponatremia,

hypochloremia, hypokalemia,

unusual tiredness, weakness,

dizziness, irregular heartbeat,

weak pulse, orthostatic

hypotension, tinnitus,

hyperglycemia, hearing lossDrug-Drug K-sparing diuretics, sympathomimetics, K+

supplements

Digitalis, lithium, NSAIDS, &

other antihypertensive meds

Interventions - Do not discontinue abruptly, taper

gradually over 2 wks, take with meals,

provide rest periods, for diabetic pts., block

normal signs of hypoglycemia (sweating,

tachycardia); monitor blood glucose,

medications have antianginal and

antiarrhythmic actions

- Monitor v/s, do not chew or

divide sustained-release

tablets, medications also have

antianginal actions, contact

HCP if BP < 90/60, instruct pt.

to avoid grapefruit juice

(verapamil), monitor for signs

of HF

- absorption if taken withfood- give 1 h ac or 2 h pc,

small, frequent meals, frequent

mouth care, change position

slowly, can be used with

thiazide diuretics

- monitor for adequate I&O and

K+ loss, monitor for weight and

v/s, monitor for S&S of hearing

loss, which may last 1-24 hrs,

teach pt. to take meds early in

the day, teach to report any

hearing loss or signs of gout