Cardiac Medications Review 2011

Cardiac Medications: What’s With the Mixing & Matching? Michele B. Collins MSN RN CCRN September 2009

Sodium-Potassium Pump ,[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object]

Cardiac Repolarization ,[object Object],[object Object]

Cardiac Repolarization ,[object Object]

[object Object],Wayne K. Anderson, Dean, State University of New York School of Pharmacy

Medications Discussed ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Why so Many? ,[object Object],[object Object]

Automaticity ,[object Object],[object Object],[object Object],[object Object]

Re-entry ,[object Object],[object Object]

[object Object],[object Object],[object Object]

Positive Inotropes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

ANTIARRHYTMICS (Vaughan Williams classification) ,[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object]

Class I Antidysrhythmics: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Class 1c ,[object Object],[object Object],[object Object]

Class I: Sodium channel blockers ,[object Object]

Beta blockers ,[object Object],[object Object],[object Object],[object Object],[object Object]

Class II Agents: Beta Blockers ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Side Effects ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Cardioselectivity ,[object Object],[object Object],[object Object],[object Object]

Non Cardioselectivity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Beta Blockers ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Carvedilol Timolol Nadolol Betaxolol Pindolol Labetolol

Calcium Channel Blockers ,[object Object],[object Object],[object Object],[object Object],[object Object]

Uses ,[object Object],[object Object],[object Object],[object Object]

Side Effects ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Diltiazem (Cardizem) ,[object Object],[object Object],[object Object],[object Object]

Calcium Channel Blockers ,[object Object],[object Object],[object Object],[object Object],[object Object],Felodipine Isradapine Nicardipene Nimodipine Bepridil

ACE Inhibitors (“pril”) ,[object Object],[object Object]

ACE Inhibitors ,[object Object],[object Object],[object Object],[object Object]

Indications ,[object Object],[object Object],[object Object],[object Object]

Side Effects ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object]

Ace Inhibitors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

ARBs ,[object Object],[object Object],[object Object],[object Object],[object Object]

Angiotensin II Receptor Blockers (ARBs) ,[object Object],[object Object],[object Object],[object Object]

Digitalis ,[object Object],[object Object],[object Object]

Actions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Digitalis Toxicity ,[object Object],[object Object],[object Object],[object Object],[object Object]

Drug Interactions ,[object Object],[object Object],[object Object]

Digoxin Fab (Digibind) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Nitrates ,[object Object],[object Object],[object Object],[object Object]

Short-acting: Nitroglycerin ,[object Object],[object Object]

Long-acting Nitrates: Isordil, nitroglycerin ointment, nitroglycerin transdermal patch ,[object Object],[object Object],[object Object],Nitrate-free periods (6 – 10 hrs/ 24 hr period) to prevent tolerance Remove patch before defibrillating as patch may explode

Side Effects ,[object Object],[object Object],[object Object]

Drug Interactions ,[object Object],[object Object]

Nitrates ,[object Object],[object Object],[object Object]

Amiodarone ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Side Effects ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Class III — Potassium Channel Blockers ,[object Object],[object Object],[object Object]

So How Does This Relate to My Patients? HTN ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Pharmacologic Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Goals for Mgt of Heart Disease ,[object Object],[object Object],[object Object]

What Drugs Help to Meet these Goals? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

What Drugs Help to Meet these Goals (cont’d)? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Treatment Goals for HF ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

ACE Inhibitors ,[object Object],[object Object]

Beta-Blockers ,[object Object],[object Object]

Antidysrhythmic Drugs ,[object Object]

Antihypertensives ,[object Object],[object Object],[object Object],[object Object],[object Object]

Managing the Cost ,[object Object],[object Object],[object Object],[object Object],[object Object]

Refill Red Tape ,[object Object],[object Object],[object Object],[object Object]

Simple Steps: Lifestyle Changes ,[object Object],[object Object]

Preload or Afterload? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Cardiac Medications Review 2011

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Cardiac Medications Review 2011