Home
Revision Guides
Pharmacology
Anticoagulation
Painkillers
CVS
Respiratory
GI
Endocrine & Psychiatric
Common drug charts
This site is in active development. Please express your opinions on what we should offer.

Cardiovascular Drugs

Diuretics

Thiazides

Mechanism: Na/Cl co-transporter inhibitor in the distal convoluted tubules
Uses:
  1. Relieve oedema in heart failure, e.g. Bendroflumethiazide 5-10mg daily in morning
  2. Hypertension e.g. Bendroflumethiazide 2.5mg daily in morning.
Adverse effects: Postural hypotension, ↓K, ↑Ca, ↓Mg, ↑Urate (→gout), impotence
Contraindications:  ↓K, ↓Na, ↑Ca, hyperuricaemia, Addisons

Loop Diuretics

Mechanism: Na/2Cl/K co-transporter inhibitor (ascending loop)
Uses:
  1. Pulmonary oedema: IV Furosemide 80-250mg over 1 hour
  2. Chronic stable heart failure: Oral furosemide 40mg in morning
  3. Oliguria due to renal failure: evidence is tending away from this use nowadays. Correct hypovolaemia first.
  4. Refractory hypertension
Adverse Effects: Dehydration, ↓Na, ↓K, ↓Ca, ototoxic, urinary retention if enlarged prostate
Contraidications: Renal failure with anuria, pre-comatose states associated with liver cirrhosis

Potassium Sparing

Mechanism: Inhibit sodium reabsorption in the distal convoluted tubules and collecting ducts
Uses: Oedema, Heart failure, potassium conservation with thiazide/loop diuretics
Dose: 5mg daily
Adverse Effects: GI upset, ↑K
Contraindications: Hyperkalaemia, renal failure

ACE Inhibitors

Mechanism: Inhibit the conversion of angiotensin I to angiotensin II
Uses: Heart failure, hypertension, diabetic nephropathy, prophylaxis of CVS events]
Dose: Hypertension/heart failure - Captopril 25mg bd
Adverse Effects: Cough, hypotension, renal impairment, anaphylaxis, rash, pancreatitis, URT sx, GI sx
Contraindications: Hypersensitivity, renovascular disease

Beta Blockers

Mechanism: Block beta receptors in heart, vasculature, bronchi, pancreas, liver
Uses: Hypertension, angina, MI, rate controlling arrhythmias including AF (by attenuating the SNS), heart failure, thyrotoxicosis, portal hypertension
Dose: Hypertension: Propanolol 80mg bd
Adverse Effects: Precipitate asthma, fatigue, coldness of extremities, nightmares
Contraindications: Asthma, uncontrolled heart filure, bradycardia, hypotension, severe peripheral arterial disease

GTN

Uses: Angina, LVF, anal fissure
Dose: Sublingual 0.3 mg prn
Adverse Effects: Postural hypotension, ↑HR, headache, dizziness
Contraindications: Hypersensitivity, hypotension, hypertrophic cardiomyopathy, aortic stenosis, cardiac tamponade

Digoxin

Mechanism: Decreasing the conduction of electrical impulses through the AV node
Uses: Heart failure, supraventricular arrhythmias
Dose: Maintenance 500 micrograms daily
Adverse Effects: Usually excessive dosage: anorexia, nausea, vomiting, diarrhoea, abdominal pain, visual disturbances
Contraindications: Heart block (because of effect on on AV node), Wolf-Parkinson-White syndrome, VT/VF, hypertrophic cardiomyopathy

Statins

Mechanism: HMGCoA reductase inhibitor
Uses: ↑Cholesterol, ↑lipids, symptomatic CVS disease (↓risk irrespective of initial level), asymptomatic prophylaxis of ↑risk CVS disease, consider in diabetes
Dose: Simvastatin: 10-40mg od at night
Adverse Effects: Are rare but include reversible myositis, headache, liver impairment, paraesthesae
Contraindications: Active liver disease, pregnancy

Amiodarone

Mechanism: Beta blocker-like and calcium channel blocker-like actions on the SA and AV nodes, increases the refractory period via sodium- and potassium-channel effects, and slows intra-cardiac conduction of the cardiac action potential, via sodium-channel effects.
Uses: SVT, Refractory VF, haemodynamically stable VT, AF (acutely rhythm conversion, 3rd line for rate control)
Dose: Oral maintenance. IV infusion (5mg/kg→subsequent given)
Adverse Effects: Corneal microdeposits (rarely interfere with vision), nausea, vomiting, slate-grey skin discoloration
Contraindications: Bradycardia, sino-atrial block, thyroid dysfunction.
Copyright PassMED, 2008. Disclaimer