Cardiac & Renal Drugs

---

---

DRUG

MoA

USE

SE

---

Thiazide

• Loc: distal convoluted tubule
• Resorbs: Ca, lipids, uric acid
  Rids: Na, K

USE

CI: gout, hyperuricemia

Lasix / Furosemide

• ↑ SVR, and ↓ CO 
• Diuresis occurs in 20 min-2hrs
• NSAIDS may block response  

• diuresis
• early oliguric renal failure
  

Ototoxicity, hypokalemia, hypoMg, hypoCl, and metabolic alkalosis; contraindicaitons: sulfa allergy, hepatorenal syndrome, and edema from nephrotic syndrome

Glucagon

• increases HR and contractility independent of b effect

• Reverses B-blocker overdose
  
• Electromechanical dissociation

HypoK
HyperGLU

Labetalol

• Blocks a & b
  
• ↓ BP with NO ↑ HR or change CO

• HTN

Nitroglycerin

• arterial vasodilator (> 200 mg/min) 
• venous vasodilation (< 50 mg/min) 
• increases coronary BF
  
• ↓ development of tolerance with intermmittent infusion or N-acetylcysteine (replenishes – SH groups)

• MI
• pulmonary HTN
• CHF

HA, methemoglobinemia that causes cyanosis with nl ABG. Tx: methylene blue


CI: ↑ ICP, and closed-angle glaucoma

Sodium Nitroprusside 

• arterial and venous vasodilator 
• ↑ stroke volume and does not change HR

• hypertensive emergencies    
  

Cyanide toxicity (in smokers with ↓ thiosulfate (Cn converted → thiocyanate in liver and is excreted from kidneys. Sx: HA, nausea, vomiting, weakness, hypotension, lactic acidosis, tolerance. Keep cyanide < 5mg/ml; prevent with thiocyanate infusion- but thiocyante toxic: renal failure, MS Ds. 

CI: B12 deficiency, renal failure
   

Trimethaphan    

• sympathetic and parasympathetic ganglion blocker 
  
• dilates arteries and veins    
  

Digoxin   

•   
  

USE

Dysrhythmias, AV block
Tx: K+, Mg2+, Lidocaine, charcoal, digoxin Ab

---