Drug Suffix

-azepam
-azine
-azole
-barbital
-cillin
-cycline
-ipramine
-navir
-olol
-oxin
-phylline
-pril
-terol
-tidine
-trophin
-zosin

Action
Benzodiazepine
Phenothiazine
Anti-fungal
Barbiturate
Penicillin
Antibiotic
TCA
Protinease Inhibitor
Beta Antagonist
Cardiac Glycoside
Methylxanthine
ACE Inhibitor
Beta 2 Antagonist
H2 Antagonist
Pituitary Hormone
Alpha 1 Antagonist

Examples

CARDIAC DRUGS
ANTIARRTHYMICS MEDICATIONS
(Class I) Na+ Channel Blockers
Class IA
o

Procainamide

Disopyramide

Amiodarone

Quinidine

Therapeutic Uses: SVT, A. Flutter, A. Fib. V. Tach

Adverse Effects:

Systemic lupus syndrome (resolve with d/c medication)

Blood dyscrasias

Cardiotoxicity (QRS, QT)

Contraindications/Precautions: CI: Sens. to quinidine, complete block, lupus

Interactions:

Antihypertensives additive hypotensive effect

Anticholinergics anticholinergic effects

Antidysrhythmics in therapeutic effects / toxicity potential

Class IB
o

Mexiletine

Lidocaine (Xylocaine)

Tocainide

Therapeutic Uses: Short-term use only for ventricular dysrhythmias

Adverse Effects: Respiratory arrest; CNS depression (fatigue, paresthesias, seizures)Tx
seizures phenytoin (Dilantin)
Contraindications/Precautions: CI: Stokes-Adams, Complete block; Pregnancy B
Interactions: Cimetidine, phenytoin, -Blockers effects of lidocaine.
Education: Never administer Lidocaine that has epinephrine in it; Loading dose followed by
maintenance dose of 1-4 mg/min.
Class IC

Flecainide

Encainide

Propafenone

(Class II) Beta-Blockers

Metroprolol

Atenolol

Propranolol

Timolol

Esmolol

Therapeutic Uses: Short-term use only for ventricular dysrhythmias

Adverse Effects: Respiratory arrest; CNS depression (fatigue, paresthesias, seizures)Tx
seizures phenytoin (Dilantin)
Contraindications/Precautions:
Interactions:
Education:

(Class III) K+ Channel Blockers

Sotaolol

Amiodarone

Bretylium

Ibutilide

Expected Action:
Therapeutic Uses:

Conversion of A-fib (oral)

Recurrent V-fib

Recurrent V-tach

Adverse Effects: Pulmonary toxicity, Visual disturbances (can blind), Cardiac effects sinus
bradycardia & AV block / may cause HF / Hypotension, Liver/thyroid dysfunction, Phlebitis:
Central venous line is indicated, CNS effects, GI effects
Contraindications/Precautions: HIGHLY TOXIC; Pregnancy D; CI: AV block, bradycardia,
newborns, infants
Interactions:

Grapefruit toxicity

Cholestyramine [amiodarone]

Quinidine, procainamide, digoxin, diltiazem, warfarin levels of these

-blockers, verapamil, diltiazem bradycardia

Diuretics, antidysrhythmics, macrolide antibiotics risk dysrhythmias

(Class IV) Calcium Channel Blockers

Diltiazem

Verapamil

Expected Action:
Therapeutic Uses: A. Fib, A. Flutter, SVT
Adverse Effects: Orthostatic hypotension, peripheral edema, constipation, cardiac suppression,
dysrhythmias, acute toxicity
Contraindications/Precautions: CI: heart block, hypotension, bradycardia, aortic stenosis, severe
heart failure
Interactions:

Digoxin[digoxin]

Grapefruit Toxicity

-blockers: HF, AV block, bradycardia

Antidysrhythmia- Endogenous Glucoside

adenosine (Adenocard), ibutilide (Corvert)
Therapeutic Uses:

Paroxysmal SVT; Wolff-Parkinson Syndrome

Adverse Effects: Sinus bradycardia, dyspnea, flushed face (usually < 1 min)
Contraindications/Precautions: Pregnancy C; CI: 2/3 block, AV block, atrial flutter, atrial
fibrillation
Interactions:

Methylxanthines (theophylline, caffeine) Adenosine receptors are blocked

Dipyridamole (Persantine) Uptake is blocked leading to effects

Education:

Very short life (< 1 min)

Administer by IV bolus, flushed with NS

Amiodarone

Action & Side Effects:

6 Ps
o

Prolongs action potential duration

Photosensitivity

Pigmentation of skin

Peripheral neuropathy

Pulmonary alveolitis and fibrosis

Peripheral conversion of T4 to T3 is inhibited hypothyroidism

Drugs Causing QT Prolongation- Torsades de Pointes

Amiodarone
Procainamide
Arsenium
Cisapride
Haloperidol
Erythromycin
Treatment of Supraventricular Tachycardia

[ABCDE]- Adenosine, Beta-Blocker, Calcium Channel Antagonist, Digoxin, Excitation

(vagal stimulation)

HYPERTENSIVE CRISIS
Med Classes:

ACE Inhibitors/ Angiotension II Antagonists

Beta Blockers

Calcium Channel Blockers

Diuretics

Proto: nitroprusside
Others: labetalol (Trandate), diazoxide (Hyperstat), fenoldopam (Corlopam), trimethaphan
(Arfonad)
Expected Action: Direct vasodilation of veins and arteries causing rapid BP
(preload/afterload)
Therapeutic Uses: Hypertensive emergencies, bleeding during surgery by producing
controlled hypotension
Adverse Effects:
Excessive hypotension
Cyanide poisoning: risk liver dysfunction; Give slowly (5 mcg/kg/min) along with
thiosulfate to deactivate cyanide.
Thiocyanate poisoning: Can manifest as altered mental state/psychosis. Avoid prolonged
use (>3 d). Plasma thiocyanate should be <0.1 mg/mL
Contraindications/Precautions: Pregnancy (C)
Education:

Do not mix anything with nitroprusside

Protect solutions from light

Discard solutions that are blue, red, or green

VASODILATORS
Examples:

Verapamil

Minoxidil

Hydralazine

ACE INHIBITORS
Examples:

Lisinopril

Enalapril

Captopril
o

Side Effects:

[CAPTOPRIL]- Cough, Angioedema/Agranulocytosis, Proteinuria/Potassium

excess, Taste changes, Orthostatic hypotension, Pregnancy
contraindication/Pancreatitis, Pressure drop (first dose hypertension), Renal
failure (& renal artery stenosis contraindication)/Rash, Indomethacin
inhibition, Leukopenia/Liver toxicity

ANGIOTENSION II RECEPTOR BLOCKERS (ARBs)

Examples: Losartan (Cozaar)
Others: valsartan (Diovan), irbesartan (Avapro), candesartan (Atacand), olmesartan (Benicar)
Expected Action:

Blocks action of angiotensin arteriole vasodilation, excretion of Na+ & H2O, retention
of K+

ACE and ARB is that cough and hyperkalemia are not side effects of ARB.

Therapeutic Uses:

Stroke prevention (Losartan)

Decrease HTN (all)

Mgt of heart failure / mortality prevention after MI (valsartan)

Delay progression of diabetic neuropathy (irbesartan, losartan)

Adverse Effects: Angioedema, Fetal Injury

Contraindications/Precautions: Pregnancy Class D

CI: Renal Stenosis

Use in caution with pts hx of angioedema

Interactions: Antihypertensives Additive effect ARBs

Education: Can be taken with or without food; Should see renal function evidenced by
proteinuria

BETA BLOCKERS
Examples: Timolol, Nadolol, Esmolol, Pindolol, Atenolol, Labetalol, Propranolol, Metoprolol
Expected Action:
Beta-1: receptors primarily on heart
Beta-2: receptors primarily on lungs
Therapeutic Uses:
Adverse Effects:
Side Effects: Bradycardia, Bronchoconstriction, Claudication, Lipids, Vivid dreams &
Nightmares, Inotropic action, Reduced sensitivity to hypoglycemia
Contraindications/Precautions:
[ABCDE]- Asthma, Block (heart block), COPD, Diabetes mellitus, Electrolyte
(hyperkalemia)
Interactions:
Education:
CALCIUM CHANNEL BLOCKERS
Examples: Proto: nifedipine (Adalat)
Others: amlodipine (Norvasc), felodipine (Plendil), nicardipine (Cardene), verapamil (Calan),
diltiazem (Cardizem)
Expected Action:

Nifedipine: vascular Ca2+channelsvasodilation peripheral & arterioles

Verapamil, Diltiazem: Above + contractility, HR, AV conduction

Therapeutic Uses: Cerebral vasospasm/CHF; Angina (all but felodipine); Migraine; A. Flutter/A.
Fib; Supraventricular tachycardia; HTN (All)

Verapamil, Diltiazem: Hypertension, Angina, Dysrhythmias

Adverse Effects:

Nifedipine: Tachycardia, peripheral edema, acute toxicity

Verapamil, Diltiazem: Orthostatic hypotension, peripheral edema, constipation, cardiac

suppression, dysrhythmias, acute toxicity

Contraindications/Precautions: CI: heart block, hypotension, bradycardia, aortic stenosis, severe

heart failure
Interactions:

Grapefruit Toxicity

-blockers: HF, AV block, bradycardia

Nifedipine: Beta blockers used to decrease reflex tachy

Education: Administer IV over 2-3 minutes

CARDIAC GLYCOSIDES
Examples: Digoxin (Lanoxin)
Expected Action:
Therapeutic Uses: Treatment of HF; Dysrhythmias (A. Fib)
Adverse Effects: GI effects; CNS effects (fatigue, vision changes);
Dysrhythmias, cardiotoxicity: risk fromK+, [digoxin], disease
Contraindications/Precautions: CI: v-fib, v-tach, 2/3 blocks
Interactions:

Quinidine dig toxicity

Verapamil [digoxin]

Sympathomimetics add to inotropic effect

Loop & thiazide diuretics K+ risk of digoxin dysrhythmia

ACE inhibitors / ARBs risk K+ therapeutic digoxin effects

Education:

Check apical pulse: hold < 60 (adults), < 70 (kids), < 90 (infants)

Therapeutic levels = 0.5-2 ng/mL

Tx bradycardia with atropine

Tx dysrhythmias phenytoin or lidocaine

Activated charcoal or cholestyramine can bind digoxin to prevent absorption

DIURETICS
I.

Loop Diuretics:

Hydrocholorothiazide
Indications: CHF, HTN, Insipidous, Calcium calculi
II.

Potassium Sparing Diuretics

Spironolactone
Triamterene
Amiloride
SYMPATHOPLEGICS
Examples:

Beta blockers

Clonidine

Reserpine

Guanethidine

Prazosin:

ORGANIC NITRATES
Examples: Proto: nitroglycerine Others: isosorbide dinitrate (Imdur)
Expected Action:

Therapeutic Uses: Treatment of angina (acute, variant, prophylaxis); IV perioperative BP

control, HF d/t acute MI
Adverse Effects: Headache, Tolerance, Orthostatic Hypotension
Reflex tachycardia - give metoprolol (Lopressor)
Contraindications/Precautions: CI: traumatic head injury ICP
Interactions:

Sildenafil (Viagra)Acute or fatal hypotension

EtOH, -blockers, Ca-blockers, diuretics additive hypotensive effects

Education

Sublingual tab/translingual spray: R onset, S duration

Transmucosal: R onset, L duration

SR caps: S onset, L duration

Transdermal: S onset, L duration (hairless area, min 8 hr/day without med to lower risk of
developing tolerance.

Topical: S onset, L duration

IV: Use glass bottle & mfrs tubing; Start at slow rate (5 mcg/min)

ANTILIPEMICS
I.

HMG CoA Reductase Inhibitors (Statins)

Proto: atorvastatin (Lipitor) Others: simvastatin (Zocor), lovastatin

(Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor)Expected:

Therapeutic Uses:
1 hypercholesterolemia
HDL
Prevention of stroke and coronary events
Adverse Effects:
Peripheral neuropathy

 Myopathy (monitor CK)

Hepatotoxicity evidenced by serum transaminase
Contraindications/Precautions
Pregnancy (X)
rosuvastatin in Asians
Caution ketoconazole
CI: Pregnant / viral or EtOH hepatitis
Interactions
Fibrates risk of myopathy
Med that suppress CYP3A4 (ketoconazole, erythromycin) statin
levels
Grapefruit juice and (lovastatin or simvastatin) Toxicity
Education
Lovastatin evening meal (others OK food)
Atorvastatin or fluvastatin should be used with renal insufficiency
II.

Fibrates

Proto: gemfibrozil (Lopid) Others: fenofibrate (Tricor)Expected Action:

Therapeutic Uses: plasma VLDL, plasma HDL

Adverse Effects:
Gall stones
Hepatoxicity
Myopathy
Contraindications/Precautions
Pregnancy C
Caution statins

 CI: liver disorders / severe renal dysfunction / gallbladder disease

Interactions
Statins myopathy
Cholestyramine absorption
Warfarin risk of bleeding (monitor PT and INR)

III.

Cholesterol Absorption Inhibitor

Proto: ezetimibe (Zetia)

Therapeutic Uses: Adjunct to modified diet to help LDL (alone or statin)

Adverse Effects: Well-tolerated no adverse effects
Contraindications/Precautions
Pregnancy X
Caution with breastfeeding
CI: renal dysfunction
Interactions
Bile acid sequestrants (cholestyramine) absorption
Use with fibrates (gemfibrozil) risk of gall stones and myopathy
Cyclosporine levels of ezetimibe
Education Taken once per day without regard to food

IV.

Bile-Acid Sequestrants

Proto: cholestyramine (Questran) Others: colestipol (Colestid)

Therapeutic Uses: Adjunct with HMG CoA reductase inhibitor (eg

atorvastatin) & diet LDL
Adverse Effects:

 No systemic effects (not absorbed in GI tract)

Constipation
Contraindications/Precautions
CI: biliary disease or VLDL Interactions
Interactions
Digoxin, warfarin, thiazides, tetracyclines form complexes
absorption
Education
Dissolve in water or applesauce to prevent esophageal irritation or
impaction
OTHER:
Dopamine (Intropin)
Expected Action:
Low Dose (Dopamine receptors) Renal vasodilation
Moderate Dose (Dopamine, B1) Above + HR, contractility, AV conduction
High Dose (Dopamine, 1, 1) Above + vasoconstriction
Therapeutic Uses:
Shock
Heart Failure
Adverse Effects:
Necrosis can occur from extravasation of high doses
Dysrhythmias/ myocardial O2 demand angina
Contraindications/Precautions:

Pregnancy C

CI: Pheochromocytoma

Interactions:

Education: Stop infusion with evidence of extravasation; treat with -blocker (phentolamine)

Epinephrine (Adrenaline)
Expected Action:
Binds to: 1 vasoconstriction
1 HR, contractility, & AV conduction
2 Bronchodilation
Therapeutic Uses:

absorption of local anesthetics or extravasated meds

Manage superficial bleeding

Treatment of AV block & cardiac arrest

Manage superficial bleeding

congestion of nasal mucosa

BP

Asthma

Adverse Effects:
Hypertensive crisis
Necrosis from extravasation

Dysrhythmias / myocardial O2 demand angina

Contraindications/Precautions: Pregnancy C
Interactions:

MAOIs effect and duration

TCAs block uptake of epi.

General anesthetics lead heart to be hypersensitive to epi dysrhythmias

-adrenergic blockers (phentolamine)

-adrenergic blockers (propanolol)

Education:

Stop infusion with evidence of extravasation; treat with -blocker (phentolamine)

Dobutamine (Dobutrex)
Expected Action:
Therapeutic Uses:
Heart failure
Adverse Effects:

HR

Contraindications/Precautions:
Pregnancy B
Interactions:
Education: Stop infusion evidence of extravasation; treat with -blocker (phentolamine)