ACE INHIBITORS (-pril)
What are the therapeutic actions of ACE INHIBITORS?
ACE inhibitors work in the lungs to block the angiotensin-converting enzyme (ACE), which normally changes angiotensin I into angiotensin II.
↓ Blood pressure ↓ Aldosterone production ↑ Potassium, ↓ sodium and water
What are the therapeutic actions of ARBS?
Block angiotensin II receptors
Prevent vasoconstriction
↓ Aldosterone release ↓ Blood pressure
What are the therapeutic actions of calcium channel blockers?
Block calcium entry into myocardial and smooth muscle cells
↓ Contractility
Vasodilation
What are the therapeutic actions of BETA BLOCKERS?
blocks the Sympathetic Nervous System. (Flight or fight system)
↓ HR and contractility
↓ Renin release
Block HMG-CoA reductase, an enzyme your body uses to make cholesterol.
Lower LDL (bad cholesterol) in the blood.
Slightly raise HDL (good cholesterol).
May protect blood vessels and slow progression of heart disease.
why are ACE INHIBITORS used?
Hypertension, Heart failure, Left ventricular dysfunction, Diabetic nephropathy
What are ARBS used for?
Hypertension
Heart failure
Post-MI
Slows progression of renal disease
what are calcium channel blockers used for?
hypertension
Angina
Tachyarrhythmias (non-DHP)
what are BETA BLOCKERS used for/
Hypertension
Angina
Post-MI
What are STATINS used for?
High cholesterol (LDL, triglycerides) that doesn’t get better with diet.
Preventing heart attacks (MI).
Preventing strokes.
Slowing the progression of coronary artery disease (CAD).
After certain procedures like revascularization in patients with multiple atherosclerotic cardiovascular disease (ASCVD) risk factors.
What are the DRUG–DRUG INTERACTIONS of ACE INHIBITORS?
NSAIDs
Diuretics
Potassium supplements
Potassium-sparing diuretics
Lithium
ARBs, renin inhibitors
what are the drug to drug interactions of ARBS?
Other antihypertensive medications → additive blood pressure lowering
Potassium supplements or potassium-sparing diuretics → risk of hyperkalemia
Lithium → may increase lithium levels
NSAIDs → may reduce effectiveness and affect kidney function
What are the drug to drug interactions of calcium channel blockers?
Grapefruit juice → can increase drug levels and risk of side effects
Other antihypertensive medications → additive blood pressure lowering effects
what are the drug to drug interactions of BETA BLOCKERS?
NSAIDs → may reduce the blood pressure–lowering effect of the beta blocker
Epinephrine → can have unpredictable heart effects if given with a beta blocker
Ergot alkaloids → can increase risk of vascular effects
Insulin or other antidiabetic agents → beta blockers can mask signs of low blood sugar
What are the drug to drug interactions of STATINS?
Other cholesterol-lowering drugs (like fibrates) → increases risk of muscle problems/myopathy
Certain antibiotics or antifungals (like erythromycin, azoles) → can increase statin levels → risk of liver damage or muscle problems
Grapefruit juice → can increase statin levels → risk of myopathy/rhabdomyolysis
Warfarin → may affect blood clotting
What are the adverse effects of ACE INHIBITORS?
Dry hacking cough
Hyperkalemia
Angioedema
Hypotension
Rash
Renal impairment
What are the adverse effects of ARBS?
hyperkalemia
Dizziness
Hypotension
Less cough than ACE inhibitors
Angioedema (rare)
What are the adverse effects of Calcium channel blockers?
Peripheral edema
Constipation
Bradycardia
Hypotension
Gingival hyperplasia
What are the adverse effects of BETA BLOCKERS?
bradycardia
Fatigue
Sexual dysfunction
Bronchospasm
What are the adverse effects of STATINS?
Common: headache, GI upset, myalgia(muscle aches) • Serious rhabdomyolysis and hepatoxicity
What is the prototype drug for ACE INHIBITORS?
Lisinopril
What is the prototype drug for ARBS?
Losartan
What is the prototype drug of calcium channel blockers?
PROTOTYPE- Amlodipine
CATEGORY OF THE DRUGS IS- Dihydropyridines
What is the prototype drug for BETA BLOCKERS ?
Generic name-Metoprolol
Brand name of it-lopressor
Another brand name- Toprol XL
What is the prototype drug of STATINS?
torvastatin