Therapeutic Goal
To reduce oxygen consumption on the hear, reduce heart rate and contractility
B Blockers
Loop Diuretics
Inhibit NKCC cotransporter in the thick ascending loop of henle resulting in selective inhibition of Na reabsorption and producing water loss
Angioedema, cough
ACE inhibitors
(should not use with Entresto, which also causes angioedema)
Nifedipine
Yes
Reduce renin-angiotensin-aldosterone activation due to heart damage
ACE Inhibitors/ARBs
Ivabradine
Inhibits If channel (funny current) at SA node
A patient taking this drug should adjust dosages of drugs like warfarin due to its inhibition of cytochrome P450.
It may also turn you blue.
Amiodarone
Warfarin
No - use heparin instead
Reduce the effect of platelet aggregation and activation to reduce the number and size of vascular clots
Anti-coagulation (aspirin, ADP receptor antagonists, Gly IIb/IIIa receptor antagonists)
Clopidogrel
ADP receptor antagonist. Irreversible inhibitor of P2Y12 receptors, blocks plaetlet activation.
Prasugrel comes with a black box warning that it is contraindicated in patients with what?
Active bleeding
Associated side effects are related to bleeding, hemorrhage, thrombocytopenia, anemia
ACE inhibitors
No
Sacubitril
Neprilysin inhibitor
SJS, thrombocytopenia, hepatotoxicity, renal failure, severe hyperkalemia, leukopenia
Statins
No
Ranolazine
Reduces calcium overload in the ischemic myocyte through inhibition of the late sodium current
For which class of drugs are we worried about reflexive tachycardia upon abrupt withdrawal?
B Blockers (atenolol, metropolol)