Pharmacology ii


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Pharmacology ii

  1. 1. Pharmacology II
  2. 2. Bile Acid Binding Resin• Statin• Niacin• Fibrate• Bile acid resin
  3. 3. niacin• Nicotonic acid—vitamin B3
  4. 4. Statins (HMG-CoA Reductase Inhibitors)• Atorvastatin Liptor 10-40mg daily max 80 mg• Fluvastatin Lescol 20 mg @ bedtime max 80mg• Lovastatin Mevacor 20-40 mg even meal max 80 mg• Pravastatin Pravachol 40 mg daily max 80 mg• Rosuvastatin Zocor 5-20 mg max 80 mg
  5. 5. HMG-CoA Reductase Inhibitor Combination• Atorvastatin-amlodipine caduet 10mg/5mg max 80mg• Lovastatin-niacin advicor max 40/2000mg• Simvastatin-ezetimibe vytorin max 80/10mg
  6. 6. ACEI• Benazepril Lotensin 10mg once daily• Captopril Capoten 25mg BID or TID daily 1 hr before meals• Enalapril Vasotec 2.5-5mg once daily• Fosinopril Monopril 10mg once daily• Lisinopril Prinivil 5-10mg once daily• Moexipril Univasc w/diuretic 3.75mg w/o diuretic 7.5mg 1 or 2 divided dose 1 hr before meals!!• Perindopril Aceon 4mg daily• Quinapril Accupril 10mg dialy• Ramipril Altace 1.25-2.5mg daily• Trandolapril Mavik 1mg daily
  7. 7. ARB’s• Candesartan Atacand 16mg once daily over 4-6 wk max 8-32mg• Eprosartan Teveten 600mg once daily over 2-3 wk max 400-800• Irbesartan Avapro 150mg once daily over 3-4 wk max 300 mg• Losartan Cozaar 50mg once daily over 4-6 wk max 25-100 mg• Olmessartan Benicar 20mg once daily over 2 wk max 20-40 mg• Telmisartan Miscardis 40mg once daily over 4-6 wk max 20-80 mg• Valsartan Diovan 80mg once daily over 4-6 wk 80-320 mg
  8. 8. ARA• Eplerenone Inspra 50 mg once daily w or w/o food• Obtain BP• Hold if BP < 100mmHg contact provider• Hold if HR < 50 contact provider• Obtain bowel elimination• Labs: BUN, creatinine, electrolyte, triglyceride, cholesterol, LFT• Ask about pregnancy• N/D/fatigue, headache, orthostatic hypotension• Serious AE: HYPERKALEMIA, HYPERTRIGLYCERIDEMIA, HYPERURICEMIA, NEPHR OTOXICITY, HEPATOXICITY, GYNECOMASTIA, VAGINAL BLEEDING
  9. 9. CCB• Amiodipine Norvasc 5mg once daily over 14 days• Clevidipine Cleviprex IV 1-2 mg/hr• Ditilazem Cardizem 60-120mg SR twice daily• Felodipine Plendil 5mg daily• Isradipine DynaCirc 2.5mg twice daily• Nicardipine Cardene 20mg TID daily• Nifedipine Procardia 10mg TID daily• Nisoldipine Procar 20mg once dialy• Verapamil Calan 80 mg TID or QID daily
  10. 10. DRI• Aliskiren Tekturna 150mg once daily if no resolve ^ 300mg• Obtain BP (orthostatic BP)• Hold if systolic BP < 100 mmHg• Hold if HR < 50• Lab: BUN, creatinine, electrolyte, & CBC• Bowel elimination patterns• GI symptoms• Frequency of headaches• Dizziness• Fatigue• 150mg once daily• Dyspepsia/cramps/D/headache/orthostatic hypotension• SERIOUS AE: fetal harm, hyperkalemia
  11. 11. Alpha 1 Adrenergic Blocking• Doxazosin Candura 1mg daily am or pm• Prazosin Minipress 1mg BID or TID daily• Terazosin Hytrin 1mg @ bedtime