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NCTC Pharm Unit 3
| Question | Answer |
|---|---|
| Effects of Cardiac Glycosides | Positive Intropic Effect Positive Cardiac Output Negative Chronotropic effect Negative dromotropic effect |
| Class I antidysrhythmic drugs | Sodium Channel Blockers |
| Class II Antidysrhythmic drugs | Beta Blockers |
| Class III Antidysrhythmic drugs | Emergency rescue Drugs |
| Class IV Antidysrhythmic drugs | Calcium Channel Blockers |
| Positive inotropic agents | increase the force of myocardial contraction |
| Positive chronotropic agents: | increase the rate of the heart |
| Positive dromotropic agents: | accelerate conduction through the conduction system |
| Heart failure | Inability of the heart to pump blood to meet the body’s metabolic demands |
| Left ventricular failure | pulmonary edema, dyspnea, cough |
| Right ventricular failure: | pedal edema, jugular venous distention, ascites, hepatic congestion |
| Ejection fraction | (the amount of blood ejected with each contraction) is decreased when compared to the amount of blood in the ventricle before the contraction |
| Increased pressure in the left ventricle | pulmonary congestion |
| Increased pressure in the right ventricle leads to | peripheral congestion |
| Cardiac defect | Caused by myocardial deficiency such as results from MI or valve insufficiency |
| Systemic defect | Caused by CAD or diabetes Results in overload on an otherwise normal heart |
| Digoxin—dosing | Oral: 125 - 500 mcg (0.125 - 0.5 mg) tablets 50 - 200 mcg (0.05 - 0.2 mg) liquid-filled capsules Parenteral: 100- and 200 mcg (0.1 - 0.2 mg) IV injection |
| Digoxin - toxicity and antidote | Visual: colored vision (green, yellow, or purple), halos, flickering lights Anorexia is an early sign of toxicity Administer digibind (digoxin immune Fab) for severe overdose |
| hypokalemia | refers to the condition in which the concentration of potassium in the blood is low. s/s slight elevation of bp, muscular weakness and cramping, constipation. |
| Increased dig toxicity: | Adrenergics, furosemide, laxatives, steroids, thiazide diuretics |
| Reduced therapeutic effect:Digoxin | Antacids, antidiarrhetics, anticholinergics, barbiturates |
| CARDIAC GLYCOSIDES | Beneficial for improving strength of contractions and restoring cardiac rhythms Drugs that assist the failing heart perform its essential duties Originally obtained from plants (Digitalis purpurea, Digitalis lanata) in the foxglove family |
| CARDIAC GLYCOSIDES - indications | Used primarily in the treatment of CHF Used also in supraventricular arrhythmias - atrial fibrillation and atrial flutter |
| CARDIAC GLYCOSIDES - Drugs | Digoxin - Most commonly prescribed cardiac glycoside |
| Conditions predisposing patients to Digitalis toxicity | Cardiac pacemakers, hypokalemia, hypercalcemia, AV block, hypothyroidism, respiratory or renal disease, elderly age, acute MI, V-fib |
| Antidote for severe Digitalis toxicity | Digoxin immune Fab (Digibind) Hyperkalemia (K > 5 mEq / L) Life-threatening cardiac arrhythmias, bradycardia or heart block unresponsive to atropine or cardiac pacing Life-threatening digoxin or digitoxin overdose (> 10 mg in adults |
| Digitalis diet teaching | Take med 2 hours after eating milk products, cheese, yogurt, ice cream, or taking antacids Do not administer with meals high in fiber, because high fiber content binds to the dig and makes less available for absorption |
| PHOSPHODIESTERASE INHIBITORS (AKA PDIs or Inodilators) | Inamrinone - Only available IV |
| Nesiritide (Natrecor) | recombinant version of human-B-type natriuretic peptide (hBNP) Used in ICU as final effort to treat severe, life-threatening heart failure |
| Dysrhythmia | any deviation from the normal rhythm of the heart |
| Arrhythmia | literally means "no rhythm" or in asystole (dead) |
| ANTIDYSRHYTHMIC DRUGS Vaughn Williams system of classification | Class I are considered membrane stabilizing Class II are beta-blockers Class III are drugs that are most commonly used to manage difficult dysrhythmias Class IV drugs are calcium channel blockers |
| Class Ia - Quinidine (Quinidex, Cardioquin, Quinaglut, Dura-Tab) | Has direct action on electrical activity and an indirect anticholinergic effect Procainamide (Pronestyl, Procan SR) |
| Class Ib - Lidocaine (Xylocaine) | -Is the prototype Ib drug and is one of the most effective treating ventricular dysrhythmias Is only available IV because it has extensive first-pass effect Acts by raising the ventricular fibrillation threshold |
| Class Ic - Flecainide (Tambocor) | -Used only for documented life-threatening ventricular dysrhythmias such as sustained v-tach |
| Class Ic - Propafenone (Rythmol) | Has mild beta-blocking effects and calcium channel blocking effects Use was limited to documented life-threatening ventricular dysrhythmias like sustained v-tach |
| Class II - Atenolol (Tenormin) | - Cardioselective beta-blocker Used to treat dysrhythmias, hypertension, and angina |
| Class II - Esmolol (Brevibloc) | -Cardioselective beta-blocker used in acute treatment of supraventricular tachy-arrhythmias or dysrhythmias that originate above the ventricles |
| Class II - Metoprolol (Lopressor) | Cardioselective beta-blocker used after an MI, hypertension, and angina |
| Class II - Propranolol (Inderal) | Nonspecific beta-blocker used for hypertension, angina, supraventricular dysrhythmias, v-tach, dig toxicity arrhythmias, hypertrophic subaortic stenosis, pheochromocytoma, thyrotoxicosis, migraines, post-MI, and tremor |
| Class II - Sotalol (Betapace) | Nonselective beta-blocker which has beta-blocking effects and class III effects |
| Class III - Amiodarone (Cordarone) | Acts as alpha- and beta-adrenergic blocker Most effective dysrhythmic for controlling supraventricular and ventricular dysrhythmias drug of last resort long half-life (2-3 months) Used to treat sustained v-tach, v-fib, and nonsustained v-tach |
| Class IV - Diltiazem (Cardizem) | Calcium channel blocker Primarily indicated for the temporary control of ventricular response in patients with atrial fib or flutter and PSVT |
| Class IV - Verapamil (Calan, Isoptin, Verelan) | Calcium channel blocker- Used to prevent recurrent PSVT and treat atrial flutter or fib, various dysrhythmias, angina, hypertension, and hypertrophic cardiomyopathy |
| Unclassified antidysrhythmics - Adenosine (Adenocard) | conversion of PSVT to sinus rhythm, particularly when the PSVT fails to respond to verapamil 10-second half-life so is only administered IV and will frequently cause asystole for a few seconds |
| ANTIDYSRHYTHMIC DRUGS - Teaching | Change positions slowly to avoid orthostatic hypotension - Avoid driving or hazardous activities until sedating effects are resolved Avoid activities that can cause vasodilation (hot tubs, saunas, etc.) Monitor blood pressure and pulse |
| Angina pectoris | the name for the pain of the heart, or chest pain |
| ischemia | Poor blood supply to an organ |
| ischemic heart disease | When the supply of blood to the heart is insufficient |
| 1 killer in the US population | Ischemic heart disease -the primary cause is CAD resulting from atherosclerotic plaques that occlude coronary arteries MI is the end result of CAD and ischemic heart disease |
| Things that influence the amount of oxygen required by the heart: | Heart rate Strength of the force of contraction Exercise Caffeine Stress Stimulation of the CNS |
| Chronic stable angina | (AKA classic and effort angina) is primarily caused by atherosclerosis Is triggered by exercise or stress (cold, fear, emotions) Pain is intense but usually subsides within 15 minutes with rest or drug therapy |
| Unstable angina | (preinfarction angina) is usually the early stage of progressive CAD Often culminates in MI in subsequent years Known as crescendo angina because pain increases in severity and frequency May occur at rest in later stages |
| Vasospastic angina | results from spasms of the layer of smooth muscle that surrounds the atherosclerotic coronary arteries Pain happens at rest without precipitating cause May follow a regular pattern, occurring at the same time of day |
| objectives to antianginal therapy | minimize the frequency, decrease the duration and intensity of the pain improve the patient's functional capacity with as few side effects as possible prevent or delay the worst outcome, MI |
| NITRATES / NITRITES | Relieves or prevents angina episodes May be administered q 5 minutes X 3 |
| Cardio-specific beta-blockers | slow the heart rate by decreasing the rate at which the SA fires and slow the rate of impulse through the AV as well |
| BETA-BLOCKERS - indicators | Angina, MI, hypertension, dysrhythmias, essential tremor, migraine headaches, tachycardia associated with “stage fright” |
| CALCIUM CHANNEL BLOCKERS | Very Nice Drugs=Verapamil, Nifedipine, Diltiazem plus Amlodipine, Nicardipine, and Bepridil) |
| decrease effectiveness of nitrates | cold temperatures and smoking |
| HYPERTENSION | The most common disease in the population of the Western Hemisphere Is a major risk factor for CAD, CVD, and death resulting from cardiovascular factors Is important risk factor for CHF, stroke, PVD, and renal failure |
| Primary hypertension | (AKA essential or idiopathic) cause is unknown Is found in 90% of patients |
| Secondary hypertension | is most commonly the result of another disease process such as: pheochromocytoma, eclampsia, or renal artery disease Also may result from use of certain medications When cause of problem is eliminated, the blood pressure returns to normal |
| Centrally-acting adrenergics | Act by stimulating the alpha2s in the brain, blocking norepinephrine to reduce blood pressure Side effects :CV: palpitations, orthostatic hypotension, first dose syncope, rebound hypertension |
| Clonidine (Catapres) | Prototype drug that has the best safety profile Used for hypertension and opioid withdrawal Available in topical and oral forms |
| Prazosin (Minipress) | Prototype alpha1-blocker Reduces peripheral vascular resistance and dilates arteries and veins Used to treat hypertension, BPH, and severe CHF |
| Dual-action alpha1- and beta- blockers labetalol (Normodyne) Carvedilol (Coreg) | Used for hypertension and mild to moderate heart failure |
| ANGIOTENSIN-CONVERTING ENZYME (ACE) INHIBITORS | Hypertension Adjunct treatment for CHF Stop the progression of left ventricular hypertrophy Cardioprotective after MI |
| Nephroprotective - (ACE) INHIBITOR | is a drug of choice to treat hypertension in diabetic patients Contraindications: allergy, hyperkalemia, lactation, children, bilateral renal artery stenosis SE -RESP: dry, nonproductive cough that is reversible upon discontinuation of therapy |
| prodrug | a drug that is inactive in its present form and must be biotransformed in the liver to its active form to be effective |
| Catopril (Capoten, Capozide) | Is not a prodrug Is an important advantage for patients with liver dysfunction Effective in preventing left ventricular dilation and dysfunction (ventricular remodeling) that arises in the acute period after an MI |
| Enalapril (Vasotec, Vaseretic) | Only ACE inhibitor available in oral and parenteral forms Is a prodrug and relies on the liver for biotransformation into usable form Shown to improve patient's chances of survival after an MI and reducing the incidence of CHF |
| ANGIOTENSIN II RECEPTOR BLOCKERS | Act by blocking the binding of AII to the AII receptor sites Blocking of vasoconstriction action and secretion of aldosterone Have similar efficacy to ACE Inhibitors but do not cause cough |
| Losartan (Cozaar) | Seem to be better tolerated than ACE inhibitors CALCIUM CHANNEL BLOCKERS Used primarily for the treatment of hypertension and angina |
| DIURETICS | Primary effects are decreasing plasma and extracellular fluid volumes Leads to decreased cardiac output and total peripheral resistance |
| VASODILATORS | Mechanism of action and drug effects Act directly to relax arteriolar smooth muscle Directly elicits peripheral vasodilation and reduction in peripheral vascular resistance Hypotensive effects is the notable effect Also restores hair growth |
| Hydralazine hydrochloride (Alazine, Apresoline) - vasodilator | Contraindication in hypersensitivity, CAD, mitral valvular or rheumatic heart |
| Minoxidil (Loniten, Rogaine) -vasodilator | Side/adverse effects: EKG changes, pericardial effusion and tamponade, angina, breast tenderness, rash, and thrombocytopenia |
| HYPERTENSION - Teaching | Teach importance of compliance and report signs of impotence and sexual dysfunction Physicians will examine fundus of the eye as a more reliable indicator of long-term effectiveness of treatment than blood pressure readings |
| KIDNEY FUNCTION | Normal filtering is 180 liters per day |
| CARBONIC ANHYDRASE INHIBITORS | Mainly used in treatment of open-angle glaucoma and CHF Metabolic acidosis occurs and is beneficial for prevention of seizures |
| LOOP DIURETICS | Very potent diuretics that result in dilation of blood vessels of the kidneys, lungs, and rest of body |
| Loop Diuretics side effects | CNS: dizziness, headache, tinnitus, blurred vision GI: nausea, vomiting, diarrhea hEMA: agranulocytosis, thrombocytopenia, neutropenia |
| Furosemide (Lasix) | Prototype and most used drug of the loop diuretics Primarily used in the management pulmonary edema and edema associated with CHF, liver disease, nephrotic syndrome, and ascites watch for ORTHOSTATIC HYPERTENSION |
| OSMOTIC DIURETICS -Mannitol (Resectial, Osmitrol) | drug of choice used in the early oliguric phase of acute renal failure (ARF) Adverse effects - Most common: headaches, chest pains, tachycardia, blurred vision, chills, and fever Convulsions, thrombophlebitis, and pulmonary congestion |
| POTASSIUM-SPARING DIURETICS - Spironolactone (Aldactone) | Prevents potassium from being pumped into the tubule so is therefore preserved Interactions - Hyperkalemia with ACE inhibitors and potassium supplements |
| THIAZIDE AND THIAZIDE-LIKE DIURETICS - Hydrochlorothiazide (Hydrodiuril) | One of the most prescribed therapies for hypertension Also edematous conditions, idiopathic hypercalciuria, and diabetes insipidus Increases DIG TOXICITY |
| NURSING PROCESS Diuretic drugs | Assessment of patient's baseline VS, fluid volume status, intake and output, serum electrolytes, weight, serum creatinine, ABGs, pH, and uric acid levels Decreased cardiac output Electrolyte imbalances Fluid volume deficit pain |
| Intravascular fluid | is inside the blood vessels |
| Extravascular fluid | is outside the blood vessels |
| Plasma | fluid that is intravascular |
| Interstitial fluid | is in the spaces between cells, tissues, and organs |
| Extracellular fluid | plasma and interstitial fluid |
| colloids | Plasma proteins - Substances that increase the COP and move fluid from the interstitial spaces to the plasma Albumin (Albuminar, Albutein, Buminate, Plasbumin) |
| isotonic -dehydration | Caused by a loss of sodium and water from the body Results in decreased extracellular fluid Examples: diarrhea and vomiting |
| hypotonic dehydration | Caused when sodium loss is greater than water loss Results in higher concentration of solutes inside the cell to pull extracellular fluid into the cells Examples: renal insufficiency and inadequate aldosterone secretion |
| hypertonic dehydration | Caused when water loss is greater than sodium loss higher concentration of solutes outside the cell to pull intracellular fluid outside of the cells causing dehydration of the cells themselves Examples: elevated temperature resulting in perspiration |
| CRYSTALLOIDS | Normal saline Hypertonic saline Lactated Ringer's solution D5W Plasmalyte 20%or less blood loss (slow loss) |
| Dextran (Gentran) Hetastarch (Hespan)- Obtained from cornstarch | Is a solution of glucose Expands the plasma volume by drawing fluid into the vessels from the tissues |
| BLOOD PRODUCTS | Can carry oxygen because of the hemoglobin that they contain Can carry oxygen and increase the plasma volume Most expensive and least available of the fluids Require human donors |
| Packed RBCs (PRBCs) | Obtained from centrifuging of whole blood and separation of RBCs from plasma and other cellular components Advantage: O2 carrying capacity is better than other blood products and less likely to cause cardiac fluid watch for reactions though |
| Fresh frozen plasma (FFP) | May be used as adjunct to massive blood transfusion in the treatment of patients with underlying coagulation disorders ex hemophilia can be given with the clotting factors |
| POTASSIUM | Serum K+ levels range from 3.5 to 5 mEq/L Appropriate levels are critical to normal body functioning NEVER GIVE IV PUSH -TOO MUCH KILLS Sources: fruit, juices, fish, vegetables, poultry, meats, and dairy products |
| Hyperkalemia | results when the plasma level exceeds 5 mEq / L Causes: renal failure, burns, trauma, infections, metabolic acidosis, excessive K+ loss from cells, potassium supplements, potassium-sparing diuretics, ACE inhibitors |
| Hypokalemia | results when the serum level is less than 3.5 mEq / L Usually occurs from excessive loss of K+ than from inadequate intake Causes: malabsorption, diarrhea, burns, thiazide and t-like diuretics, corticosteroids, alkalosis, vomiting, loop diuretics, |
| Hypokalemia - Signs and symptoms | Early: anorexia, lethargy, mental confusion, nausea, muscle weakness, and hypotension Late: neuropathy, paralytic ileus, secondary alkalosis, cardiac dysrhythmias |
| Hyperkalemia signs and symptoms: | muscle weakness, paresthesia, paralysis, cardiac rhythm irregularities, ventricular fibrillation, and cardiac arrest Treatment depends on severity and ranges from dietary restriction to administration of sodium bicarb, calcium gluconate, and dextrose |
| SODIUM | Normal serum Na+ level is 135 - 145 mEq / L Dietary sources are table salt, fish, meats, and seasoned foods |
| Hyponatremia | occurs when Na+ level is below 135 mEq Signs and symptoms: lethargy, hypotension, stomach cramps, vomiting, diarrhea, and seizures |
| Hypernatremia | occurs when serum levels exceed 145 mEq / L Signs and symptoms: red, flushed skin; dry, sticky mucous membranes; increased thirst; temperature elevations; and oliguria or anuria |
| Blood products must be administered with normal saline only | VS should be checked and documented q 15 min Report any apprehension, restlessness, flushed skin, increased pulse and respirations, dyspnea, rash, swelling, fever and chills, nausea, weakness, and jaundice hemolytic reaction: fever, chills, and back pai |
| Signs of hemolytic reaction: | fever, chills, and back pain |
| Signs of fluid overload: | distended neck veins, SOB, expiratory rales, anxiety, and frothy-blood-tinged sputum |
| Hemostasis | process that halts bleeding after an injury to a blood vessel |
| Anticoagulants | inhibit the action or formation of clotting factors to prevent clots from forming Are given prophylactically only to prevent intravascular thrombosis May be used to prevent clot formation or the extension of an existing clot |
| Antiplatelet drugs | prevent platelet plugs from forming by inhibiting platelet aggregation Can be beneficial for preventing heart attacks and strokes |
| Hemorrheologic drugs | alter platelet function without preventing them from working Thrombolytic drugs breakdown preformed clots |
| Hemostatic agents | promote blood coagulation for treating bleeding disorders |
| antidote to heparin | protamine sulfate Can act as fast as 5 minutes to reverse the anticoagulant properties of heparin Rule of thumb is 1 mg of protamine sulfate can reverse 100 units of heparin |
| antidote to warfarin | vitamin K Dose depends on clinical situation and how acute it is High doses of vitamin K (10-15 mg) given IV can reverse bleeding effects within 6 hours Vitamin K will maintain the reversal effect for up to 1 week |
| Warfarin | (Coumadin-most commonly prescribed oral anticoagulant) Must monitor PT/INR (2-3.5 is therapeutic range) |
| Enoxaparin (Lovenox) | Low Molecular Weight Heparin (LMWH) does not require lab monitoring as does heparin |
| Heparin | Activated partial thromboplastin time (APTT) is the lab value used to determine heparin dosages Therapeutic levels are reached when the clotting time is 2 1/2 - 3 times the control time May be done as often as q 4 hours |
| Aspirin | affects the platelet for its lifespan (7 days) Decreased urine output, tinnitus, swelling of the feet/ankles/legs, dark urine, clay-colored stools, abdominal pain, rash, blurred vision, halos around objects LFT, |
| Dipyridamole | adjunct to warfarin in prevention of postop thromboembolic complications, and prevent platelet aggregation |
| ANTIFIBRINOLYTIC DRUGS Aminocaproic acid (Amicar) Desmopressin (DDAVP) | prevent the lysis of fibrin to promote clot formation Have an opposite effect than the anticoagulants and antiplatelets Used to stop bleeding SE - thrombotic events in stroke and MI rapid infusion can cause bradycardia or hypotension |
| THROMBOLYTICS | Drugs used to breakdown existing clots Used to reestablish blood flow to blood-starved heart muscle to preserve left ventricular function |
| Streptokinase (Streptase) | Oldest thrombolytic agent used Is not clot-specific Is made from nonhuman source so may induce antigen-antibody allergic response Causes antibodies to form within 5 days SK nor APSAC can not be readministered within 1 year due to allergic response |
| Alteplase (Activase) | Is clot-specific Does not induce antigen-antibody allergic reaction Can be readministered in case of a reinfarct Has very short half-life of 5 minutes Is given concomitantly with heparin to prevent reocclusion of the infracted blood vessel |
| Triglycerides | Function as an energy source Stored in adipose tissue water-insoluble that must be bound to specialized lipid-transporting proteins called apoproteins |
| Cholesterol | Used primarily in the body to form steroid hormones, cell membranes, and bile acids Are also water-insoluble |
| Lipoproteins | Are a combination of triglycerides, cholesterol, and an apoprotein Transport lipids via the blood Types of lipoproteins classified by density and proportion of lipid and protein content |
| HDL | is believed to be cardioprotective and referred to as "good" cholesterol |
| HMG-CoA REDUCTASE INHIBITORS (Statins) | Most potent drugs available for lowering serum LDL Most effective drugs for lowering LDL and cholesterol GI: constipation, cramps, diarrhea, nausea, changes in bowel habits liver dysfunctions, myalgias |
| Atorvastatin (Lipitor) | Primarily used to lower LDL and total cholesterol Also used for raising HDL |
| BILE ACID SEQUESTRANTS | AKA: Bile acid-binding resins and ion-exchange resins Will lower LDL 15-30%; increase HDL 3-8%; increase triglycerides 10-50% |
| Cholestyramine (Questran) | Contraindicated in those with hypersensitivity and biliary obstruction Available in powder form to be mixed with liquid |
| NIACIN - Nicotinic acid (niacin, Nicor, Nicolar) | Adverse effects - Skin: cutaneous flushing, pruritis, hyperpigmentation, alopecia |
| FIBRIC ACID DERIVATIVES | Adverse effects GI: nausea, vomiting, diarrhea, gallstones, acute appendicitis GU: impotence, decreased urinary output, hematuria, increased risk of UTIs Other: drowsiness, dizziness, rash, pruritis, alopecia, eczema, vertigo, headache |
| NURSING PROCESS - Lowering Cholesterol | Diet therapy, nutrition, and exercise cannot be underemphasized and is integral part of antilipemic therapy |
| Positive Inotropic Drugs | Digoxin Inamrinone Nesiritide (Natrecor) |
| Digitalizing: | Administration of loading dose to rapidly bring digoxin levels up to a desirable therapeutic level Due to digoxin's fairly long duration of action and half-life Maintenance dose after digitalizing is 0.125 - 0.5 mg / d |
| Antidysrhythmic Drugs - Class 1 | Quinidine (Quinidex, Cardioquin, Quinaglut, Dura-Tab) Procainamide (Pronestyl, Procan SR) Lidocaine (Xylocaine) Flecainide (Tambocor) Propafenone (Rythmol) Atenolol (Tenormin) Esmolol (Brevibloc) Metoprolol (Lopressor) Propranolol (Inderal) |
| Antidysrhythmic Drugs Class II | Atenolol (Tenormin) Esmolol (Brevibloc) Metoprolol (Lopressor) Propranolol (Inderal) Sotalol (Betapace) |
| Antidysrhythmic Drugs Class III | Amiodarone (Cordarone) |
| Antidysrhythmic Drugs Class IV | Diltiazem (Cardizem) Verapamil (Calan, Isoptin, Verelan) |
| Antidysrhythmic Drugs- unclassified | Adenosine (Adenocard) |
| Antianginal Drugs | Nitroglycerine (Nitro-bid, Notrostat, Nitrong) Isorbide dinitrate (Isordil, Sorbitrate, Dilatrate) Atenolol (Tenormin) Metoprolol (Lopressor) |
| Antihypertensive Drugs - Centrally-acting adrenergics | Clonidine (Catapres) Prazosin (Minipress) labetalol (Normodyne) Carvedilol (Coreg) |
| Antihypertensive Drugs - ANGIOTENSIN-CONVERTING ENZYME (ACE) INHIBITORS - dry, nonproductive cough that is reversible upon discontinuation of therapy | Catopril (Capoten, Capozide) - nonprodrug Enalapril (Vasotec, Vaseretic) - prodrug |
| Antihypertensive Drugs - ANGIOTENSIN II RECEPTOR BLOCKERS - Have similar efficacy to ACE Inhibitors but do not cause cough | Losartan (Cozaar) |
| Antihypertensive Drugs -CALCIUM CHANNEL BLOCKERS | Hydralazine hydrochloride (Alazine, Apresoline) Minoxidil (Loniten, Rogaine) |
| Diuretic Drugs - CARBONIC ANHYDRASE INHIBITORS | Acetazolamide (Diamox) |
| Diuretic Drugs -LOOP DIURETICS | Furosemide (Lasix) |
| Diuretic Drugs -OSMOTIC DIURETICS | Mannitol (Resectial, Osmitrol) |
| Diuretic Drugs - POTASSIUM-SPARING DIURETICS | Spironolactone (Aldactone) |
| Diuretic Drugs -THIAZIDE AND THIAZIDE-LIKE DIURETICS | Hydrochlorothiazide (Hydrodiuril) |
| Coagulation Modifier Drugs -ANTICOAGULANTS | Warfarin (Coumadin-most commonly prescribed oral anticoagulant) Enoxaparin (Lovenox) Heparin |
| Coagulation Modifier Drugs -ANTIPLATELET AGENTS | Aspirin |
| Coagulation Modifier Drugs -ANTIFIBRINOLYTIC DRUGS | Aminocaproic acid (Amicar) Desmopressin (DDAVP) |
| Coagulation Modifier Drugs -THROMBOLYTICS | Streptokinase (Streptase) Alteplase (Activase) |
| Antilipemic Drugs | HMG-CoA REDUCTASE INHIBITORS (Statins) Atorvastatin (Lipitor) BILE ACID SEQUESTRANTS - Cholestyramine (Questran) NIACIN - Nicotinic acid (niacin, Nicor, Nicolar) |
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