Overview of Cardiovascular Medications Groups

1. Diuretics:

• Sulphonamide Diuretics:

• Uses: Treatment of hypertension, glaucoma, diuretic, alkalization of urine to remove uric acid.

• Side effects: Hypokalemia, hyponatremia; kidney stones; gastrointestinal disorders; metabolic acidosis.

• Contraindications: Chronic cardiopulmonary disease with respiratory insufficiency, cirrhosis, hepatic failure.

• Drugs: Acetazolamide, Dichlorphenamide, Methazolamide (mainly for glaucoma).

• Osmotic Diuretics:

• Uses: Treatment of hypertension, glaucoma, cerebral edema, prevention and treatment of anuria due to renal failure.

• Side effects: Heart failure, pulmonary edema, dehydration, hypernatremia, hypokalemia if not supplemented with water.

• Contraindications: Heart failure, pulmonary edema, anuria due to severe renal failure.

• Drugs: Mannitol.

• Thiazide Diuretics:

• Uses: Treatment of hypertension, edema due to heart, liver, and kidney disease, treatment of idiopathic hypercalciuria, weak prolonged diuretic.

• Side effects: Hyponatremia, hypokalemia; hypermagnesemia, hypercalcemia, hyperuricemia, hyperglycemia; metabolic alkalosis.

• Contraindications: Side effects + hypersensitivity, cirrhosis, renal failure, heart failure, gout.

• Drugs: Hydrochlorothiazide, Chlothalidone, Indapamide.

• Loop Diuretics:

• Uses: Treatment of hypertension (with heart failure, renal failure), acute pulmonary edema, acute hypercalcemia.

• Side effects: Hyponatremia, hypokalemia, hypotension; hyperuricemia, hyperglycemia; metabolic alkalosis.

• Contraindications: Sulfonamide allergy, cirrhosis, renal failure, heart failure.

• Drugs: Furosemide, Bumetanide, Torsemide (Antiandrogen causes gynecomastia in men).

• Potassium-sparing Diuretics:

• Uses:

• Non-aldosterone antagonists: In combination with potassium-losing diuretics to treat hypertension, maintain potassium levels.

• Aldosterone antagonists: Treatment of hypertension (+ with adrenal insufficiency, hypothyroidism), primary, secondary aldosteronism.

• Side effects: Hyperkalemia, hyponatremia; gastrointestinal disorders; metabolic acidosis; arrhythmia, allergy.

• Contraindications: Hyperkalemia, chronic renal failure, liver dysfunction.

• Drugs: Amiloride, Triamterene, Spironolactone.

2. Sympatholytics:

• Centrally Acting Drugs:

• Uses: Treatment of hypertension with renal failure, systolic hypertension, pulmonary arterial hypertension.

• Side effects: Dry mouth, nausea, gastrointestinal disorders, abrupt cessation causes rebound hypertension.

• Drugs: Methyldopa: Orthostatic hypotension, sedation, depression, impotence, edema.

Clonidine, Guabenz: Less likely to cause orthostatic hypotension -> suitable for the elderly.

• Contraindications: Depression, liver failure, hemolytic anemia.

• Ganglionic Blockers:

• Uses: Treat severe hypertensive crises to bring down to permissible levels for a short period of time, lower blood pressure control during surgery.

• Side effects:

• Parasympathetic blockade: Paralytic ileus, constipation, nasal congestion, urinary retention.

• Sympathetic blockade: Orthostatic hypotension.

• Contraindications: Hypersensitivity.

• Drugs: Mecamylamine, Trimethophan.

• Peripherally Acting Drugs:

• Uses: Treatment of mild to moderate hypertension.

• Side effects:

• Reserpine: Depression, drowsiness, weight gain, peptic ulcer, impotence, edema.

• Guanethidine: Orthostatic hypotension, impotence, diarrhea, nasal congestion.

• Contraindications: Depression, do not use with MAOIs, TCAs.

• Alpha Blockers:

• Uses: Treatment of mild to moderate hypertension.

• Side effects: Orthostatic hypotension, first-dose syndrome.

• Drugs:

• Prazosin: Used for severe, difficult-to-control hypertension, take the first dose before bed.

• Terazosin: Debility, drowsiness, dyspnea, edema.

• Contraindications: Hypersensitivity.

• Beta Blockers:

• Uses:

• Mild to moderate hypertension; Combine with the main drug in special clinical conditions .

• Top of the line in stable exertional angina, not used for Prinzmetal because it increases coronary resistance.

• Side effects:

• Reduced myocardial contractility, heart rate.

• Fatigue, drowsiness, dizziness.

• Exacerbates Raynaud’s syndrome.

• Masks hypoglycemic reactions.

• Contraindications: Hypersensitivity, Raynaud’s syndrome, asthma, heart failure, bradycardia.

• Drugs:

• Atenolol, Esmolol, Labetalol, Propanolol: Hypertension + Angina.

• Carvedilol, Metaprolol: Hypertension + Angina + Congestive Heart Failure.

• Bisoprolol: Hypertension + Heart Failure.

3. Vasodilators:

• Uses:

• Moderate to severe, malignant hypertension (hydrazine).

• Hypertension replacing hydrazine in renal failure.

• Emergency hypertension, acute pulmonary edema, severe heart failure.

• Side effects: Headache, vomiting, lupus-like syndrome, increased sympathetic reflex, weight gain, hirsutism.

• Contraindications: Hypersensitivity.

• Drugs: Hydralazine, Minoxidil, Diazoxide, Sodium nitroprusside.

4. Calcium Channel Blockers (CCBs):

• Uses: Angina, effective for all types of angina, especially Prinzmetal, hypertension.

• Side effects: Congestive heart failure, bradycardia, suppression of atrioventricular conduction, edema, headache, dizziness.

• Contraindications: Heart failure, atrioventricular block, do not combine with Beta-blockers, Digitalis.

• Drugs:

• DHP group: Amlodipine, Nifedipine, Nicardipine (CCĐ aortic stenosis).

• Non-DHP group: Diltiazem, Verapamil.

5. Angiotensin-Converting Enzyme Inhibitors – ACEIs:

• Uses:

• First-line drug in hypertension (with diabetes, chronic kidney disease CKD).

• Chronic congestive heart failure CHF.

• Side effects: Hypotension when first used, hyperkalemia, dry cough, angioedema, renal failure in people with bilateral renal artery stenosis.

• Contraindications: Pulmonary arterial hypertension, history of angioedema, hyperkalemia, bilateral renal artery stenosis.

• Drugs:

• Captopril: Chronic hypertension (with DM, CHF). Take 1 hour before meals/ 2 hours after meals.

• Enalapril: Hypertension, CHF, left ventricular dysfunction.

• Lisinopril: Hypertension, heart failure, myocardial infarction (take at the beginning).

• Fosinopril: Hypertension, CHF.

• Perindopril: Hypertension, stable coronary artery disease CAD. Take before meals.

6. Angiotensin Receptor Blockers – ARBs:

• Uses: Alternative drug when experiencing dry cough from ACEIs.

• Side effects: Similar to ACEIs, less dry cough than ACEIs.

• Contraindications: Similar to ACEIs.

• Drugs: Losartan, Valsartan, Candesartan.

7. Heart Failure Treatment:

• Cardiac Glycosides:

• Uses: Congestive heart failure with low output, treatment of arrhythmias (atrial fibrillation, atrial flutter).

• Side effects: Gastrointestinal disorders, vision, nervous system, cardiovascular (sinus bradycardia, ventricular fibrillation, atrioventricular block).

• Contraindications: Conduction disorders, increased ventricular excitability, sick sinus syndrome.

• Drugs: Digoxin, Digitoxin, Oabain.

• Diuretics:

• Mild chronic heart failure: thiazide

• Severe congestive heart failure: loop

• Vasodilators: Severe acute heart failure

• ACE inhibitors: CHF

• New Inotropic Drugs:

• Uses: Progressive heart failure in a short period of time.

• Side effects: Headache, nausea, arrhythmias, thrombocytopenia.

• Contraindications: Hypersensitivity, arrhythmias.

• Administration: Intravenous infusion.

• Beta-Blockers:

• All patients with heart failure, mild or severe, need to use if there are no contraindications -> prolongs life for patients.

• New Inotropic Drugs:

• Uses: Progressive heart failure in a short period of time.

• Side effects: Headache, nausea, arrhythmias, thrombocytopenia.

• Contraindications: Hypersensitivity, arrhythmias.

• Administration: Intravenous infusion.

8. Angina Treatment:

• Organic Nitrates:

• Uses: Exertional angina, stress; prevention of myocardial infarction, hypertension, CHF.

• Side effects: Orthostatic hypotension, increased intracranial pressure, flushing, long-term high doses cause drug tolerance, causing Met-Hb blood.

• Contraindications: Hypotension, glaucoma, increased intracranial pressure, rapid heart rate (>100) slow heart rate (<80).

• Drugs: Nitroglycerin, Amylnitrite, Isosorbide dinitrate.

• Calcium Channel Blockers:

• Beta Blockers:

9. Dyslipidemia Treatment:

• Statins:

• Uses: Dyslipidemia, primary prevention of cardiovascular events (myocardial infarction, stroke).

• Side effects: Gastrointestinal disorders, headache, muscle pain, elevated liver enzymes.

• Contraindications: Pulmonary arterial hypertension, hypersensitivity, progressive liver disease on a chronic background.

• Drugs: Ator, Lo, Sim, Pra, Flu, Rosu, Pita +vastatin.

• Administration: Take at night to increase drug efficacy (because cholesterol synthesis in the liver mainly occurs at night).

• Fibrates:

• Uses: Hyperlipidemia (with gout, risk of pancreatitis), primary beta-lipoprotein disorder.

• Side effects: Gastrointestinal disorders, liver dysfunction, elevated liver enzymes, gallstones.

• Contraindications: Liver dysfunction, biliary disease, primary biliary cirrhosis, hypersensitivity, renal failure, pulmonary arterial hypertension.

• Drugs:

• Clofibrate: Take with food.

• Gemfibrozil: Take 30′ before breakfast and dinner.

• Bile Acid Sequestrants:

• Uses:

• Dyslipidemia, prevent cardiovascular complications (stroke, heart attack).

• Combine with Statin, Niacin to reduce TC, LDL.

• Side effects: Throat irritation, gastrointestinal disorders (constipation, bloating, vomiting…).

• Contraindications:

• TG>400mg/dL (Familial hyperlipidemia), bile duct obstruction.

• Caution TG>200 mg/dL.

• Hypersensitivity.

• Drugs:

• Cholestyramine, Colestipol, Colesevelam (at night): Take with plenty of water, with breakfast and dinner.

This translation closely mirrors the original text, maintaining the organization and information. However, it is important to note that this is a general overview and does not substitute for professional medical advice. It is crucial to consult with a healthcare professional for specific diagnoses and treatment plans.