Pharmacology

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Author:
amgomez
ID:
107060
Filename:
Pharmacology
Updated:
2011-10-07 01:37:27
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Cardiovascular System Drugs
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Description:
Common Side Effects
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  1. What are some of the side and/or adverse effects of the centrally acting alpha2 agonist, clonidine (Catapres)?
    • Central nervous system effects: drowsiness, dizziness
    • Dry mouth
    • Rebound hypertensive crisis
  2. What are some of the side and/or adverse effects of the cardiac glycoside digoxin (Lanoxin)?
    • Nausea, vomiting, anorexia (may be adverse effects or signs of early toxicity)
    • Central nervous system symptoms: headache, visual disturbances, such as yellow vision and blurred vision (these may be adverse effects or signs of early toxicity)
    • Cardiac dysrhythmias, especially likely with digoxin toxicity (outside the very narrow therapeutic range of 0.5 to 0.8 ng/mL). Any dysrhythmia may occur, with AV block being most common
  3. What are some of the side and/or adverse effects of the direct-acting vasodilator drug hydralazine (Apresoline)?
    • Headache and palpitations (especially in first few hours following first dose, and usually subsiding spontaneously)
    • Tachycardia
    • A systemic lupus erythematosus (SLE)-like syndrome may occur (facial rash, joint pain, fever, nephritis, pericarditis) - most likely with high doses
    • Fluid retention, edema
  4. What are some of the side and/or adverse effects of the class IA/sodium channel blocker drugs quinidine (Apo-Quinidine, Novo-Quinidine) and procainamide (Pronestyl)?
    • Nausea, vomiting, diarrhea
    • Tachycardia (more frequent with quinidine due to anticholinergic effects)
    • Hypotension (less severe with oral administration than IV)
    • Widen the QRS complex and prolong QT interval
    • Ventricular dysrhythmias occur due to toxicity; oral or IV therapy (QRS too wide or QT interval too long)
    • Arterial embolism (caused by dislodging small clots) if treating atrial fibrillation
    • Speed shock with too rapid IV infusion (flushing, headache, irregular heart rate, severe hypotension, loss of consciousness, cardiac arrest)
    • Quinidine: Cinchonism (tinnitus, visual disturbances, headache, nausea, vomiting)
    • Procainamide: SLE (systemic lupus erythematosus) seen in 50% of patients after a year of high dose oral therapy)
    • Agranulocytosis (procainamide with continued use)
  5. What are some of the side and/or adverse effects of the angiotensin receptor blocker (ARB) losartan (Cozaar)?
    • Angioedema (occurs less than with angiotensin-converting enzyme (ACE) inhibitors, but still a potential risk)
    • Headache, insomnia
    • Severe hypotension may occur with overdose or in volume depletion
  6. What are some of the side and/or adverse effects of the class II/beta adrenergic blocker propranolol (Inderal)?
    • Bradycardia due to blockade of beta1 receptors; may lead to reduced cardiac output
    • Heart failure
    • Rebound excitation causing angina pain or myocardial infarction (MI) with sudden withdrawal of beta blocker in patient with coronary heart disease (CHD)
    • Peripheral arterial insufficiency (similar to Raynaud's disease)
    • Central nervous system (CNS) effects: confusion, fatigue, drowsiness
  7. What are some of the side and/or adverse effects of the class IV/calcium channel blocker verapamil (Calan)?
    • Hypotension, especially with IV dose or overdose
    • Bradycardia, especially with IV dose, but also with oral therapy
    • Heart failure, peripheral edema of feet and legs
    • Lightheadedness, dizziness (caused by vasodilation)
  8. What are some of the side and/or adverse effects of the fibrate drug gemfibrozil (Lopid)?
    • Nausea, vomiting, diarrhea
    • Gallstones
    • Myopathy (pain in muscles and joints)
    • Liver toxicity
  9. What are some of the side and/or adverse effects of the alpha/beta blocker carvedilol (Coreg)?
    • Dizziness, hypotension
    • Bradycardia due to blockade of beta1 receptors; may lead to reduced cardiac output
  10. What are some of the side and/or adverse effects of the alpha1 adrenergic blocker doxazosin (Cardura)?
    • Orthostatic hypotension -especially with first dose and with dose increases
    • Reflex tachycardia
    • Headache
  11. What are some of the side and/or adverse effects of the class IB/sodium channel blocker lidocaine (Xylocaine)?
    • CNS effects (toxicity): confusion, drowsiness, restlessness, paresthesias, muscle twitching or tremors, seizures, respiratory arrest
    • Hypotension, bradycardia, heart block with high doses
  12. What are some of the side and/or adverse effects of the direct renin inhibitor aliskiren (Tekturna)?
    • Hyperkalemia
    • Cough or angioedema (swelling of mouth, throat)
    • Diarrhea, abdominal pain
  13. What are some of the side and/or adverse effects of the loop diuretic furosemide (Lasix)?
    • Electrolyte imbalance: hyponatremia, hypochloremia, severe fluid loss (dehydration), and hypokalemia
    • Hypotension
    • Ototoxicity (all loop diuretics): temporary or permanent depending on the specific drug
    • Hyperglycemia (especially in patients who have diabetes mellitus)
    • Increased uric acid levels (hyperuricemia) with possible gouty arthritis in susceptible patients
  14. What are some of the side and/or adverse effects of the class III/potassium channel blocker amiodarone (Cordarone)?
    • Nausea, vomiting, constipation
    • Pulmonary toxicity with pneumonitis (causing fever, cough, shortness of breath) - occur most frequently with long-term and/or high-dose use and may lead to pulmonary fibrosis
    • Visual effects: optic neuropathy with possible blindness and corneal microdeposits, which may cause severe sensitivity to light, blurred vision
    • Cardiac effects: bradycardia and hypotension (common with IV dose)
    • Heart failure may be worsened by amiodarone therapy
    • Blue-grey discoloration of skin
    • CNS effects: dizziness, tremor, hallucinations
  15. What are some of the side and/or adverse effects of the calcium channel blocker (dihydropyridine) drug nifedipine (Adalat, Procardia)?
    • Reflex tachycardia causing increased angina pain in patients with angina; this effect is more likely with faster-acting tablets than the sustained-release form
    • Lightheadedness, dizziness (caused by vasodilation)
    • Facial flushing, perception of heat (caused by vasodilation)
    • Peripheral edema of feet and legs
    • Hypotension, especially with overdose
    • Gingival hyperplasia (growth of gum tissue, bleeding gums)
  16. What is a side and/or adverse effect of the aldosterone antagonist spironolactone (Aldactone)?
    Hyperkalemia
  17. What are some of the side and/or adverse effects of the class IC/sodium channel blockers flecainide (Tambocor) and propafenone (Rythmol)?
    • Visual effects: blurred vision, difficulty focusing
    • Worsening of heart failure; edema
    • Widen QRS complex; prolongs QT and PR intervals
    • Potential for 1st degree atrioventricular (AV) block; multiple dysrhythmias may occur
  18. What are some of the side and/or adverse effects of the HMG-CoA reductase inhibitor (statin) drug simvastatin (Zocor)?
    • Myopathy (pain in muscles and joints, which can progress to rhabdomyolysis [breakdown of muscle protein causing kidney damage])
    • Liver toxicity
  19. What are some of the side and/or adverse effects of the nitrate drugs nitroglycerin (Nitrostat, Nitro-Dur, Nitro-Bid) and isosorbide dinitrate (Isordil)?
    • Headache (severe at first, reduced with treatment)
    • Orthostatic hypotension
    • Tachycardia
    • Tolerance develops quickly to all forms (decreased effectiveness)
  20. What are some of the side and/or adverse effects of the beta adrenergic blockers atenolol (Tenormin) and metoprolol (Lopressor)?
    • Bradycardia due to blockade of beta1 receptors; may lead to reduced cardiac output
    • Heart failure - shortness of breath, edema, coughing at night
    • Rebound excitation causing angina pain or myocardial infarction (MI) with sudden withdrawal of beta blocker in patient with coronary heart disease (CHD)
  21. What are some of the side and/or adverse effects of the phosphodiesterase inhibitor milrinone (Primacor)?
    • Hypokalemia
    • Cardiac dysrhythmias, hypotension
    • Anginal chest pain
  22. What are some of the side and/or adverse effects of the potassium-sparing diuretic spironolactone (Aldactone)?
    • Hyperkalemia
    • Menstrual irregularities, abnormal hair growth (e.g. on face), and deepening of voice may occur in women; gynecomastia (growth of breast tissue) may occur in men
  23. What are some of the side and/or adverse effects of the sympathomimetic drug dobutamine (Dobutrex)?
    • Tachycardia
    • Cardiac dysrhythmias
    • Possible angina pain
  24. What are some of the side and/or adverse effects of the thiazide diuretic hydrochlorothiazide (HydroDIURIL)?
    • Electrolyte imbalance: hyponatremia, hypochloremia, severe fluid loss (dehydration), and hypokalemia
    • Hyperglycemia (especially in patients who have diabetes mellitus)
    • Increased uric acid levels (hyperuricemia) with possible gouty arthritis in susceptible patients
  25. What are some of the side and/or adverse effects of the adrenergic neuron blocker reserpine (Serpalan, Sk-Reserpine)?
    • Severe depression and risk for suicide, which may linger after reserpine is discontinued
    • Bradycardia and orthostatic hypotension
    • Gastrointestinal symptoms: diarrhea, abdominal cramping
  26. What are some of the side and/or adverse effects of the angiotensin-converting enzyme (ACE) inhibitor captopril (Capoten)?
    • Severe hypotension following first dose (most likely in patients taking diuretics, with high blood pressure (BP), or who have hyponatremia)
    • Dry, nonproductive cough due to increase in bradykinin
    • Rash and report of metallic taste in mouth
    • Angioedema (swelling of mouth, throat [due to inhibition of kinase II])
    • Hyperkalemia
    • Neutropenia (decrease in white blood cells with increased risk of infection)

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