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Cardiovascular Drug Side Effects Explained

The document summarizes side effects of various cardiovascular medications and indications for coronary artery bypass grafting. Statins, niacin, and fibric acid derivatives can cause liver dysfunction and myositis. Hydralazine is an arterial vasodilator that has shown a clear mortality benefit in patients with systolic dysfunction. Calcium channel blockers like verapamil and diltiazem without increasing heart rate are used for coronary artery disease in patients who cannot tolerate beta blockers due to asthma. Coronary artery bypass grafting lowers mortality in specific circumstances with severe disease such as three vessels with 70% stenosis, left main artery occlusion, two-vessel disease with diabetes, or persistent symptoms despite medical therapy.

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64 views2 pages

Cardiovascular Drug Side Effects Explained

The document summarizes side effects of various cardiovascular medications and indications for coronary artery bypass grafting. Statins, niacin, and fibric acid derivatives can cause liver dysfunction and myositis. Hydralazine is an arterial vasodilator that has shown a clear mortality benefit in patients with systolic dysfunction. Calcium channel blockers like verapamil and diltiazem without increasing heart rate are used for coronary artery disease in patients who cannot tolerate beta blockers due to asthma. Coronary artery bypass grafting lowers mortality in specific circumstances with severe disease such as three vessels with 70% stenosis, left main artery occlusion, two-vessel disease with diabetes, or persistent symptoms despite medical therapy.

Uploaded by

larazahabi
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd

ACE I Side effects: Cough, hyperkalemia (ARB too)

Hydaralazine: arterial vasodilator clear mortality effect with systolic


dysfunction
Should be used together with Nitrates (to dilate coronary arteries too)

Most common adverse effect of statin: Liver dysfunction


If full lipid control not achieved with statins, add niacin
Gemfibrozil lowers TG a bit more than statins but fibrates cause
myositis in combination with statins

Statins Elevations of transaminases (liver function tests),


myositis
Niacin Elevation in glucose and uric acid level, pruritus
Fibric acid Increased risk of myositis when combined with
derivatives statins
Cholestyramine Flatus and abdominal cramping

Ezetimibe Well tolerated and nearly useless

Dihydropiridine Calcium channel blockers (Nifepidine etc) INCREASE


mortality in patients with CAD (bcause of reflex tachycardia)

The CCBs verapamil and diltiazem, which do not increase heart rate, are used
in those who cannot tolerate beta blockers because of severe asthma. However,
70% of patients with reactive airway diseases such as asthma
can still tolerate the use ofbeta-1 specific beta blockers.
Use CCBs (verapamil/diltiazem) in CAD only with:
Severe asthma precluding the use of beta blockers
Prinzmetal variant angina
Cocaine-induced chest pain (beta blockers thought to be contraindicated)
Inability to control pain with maximum medical therapy

Adverse Effects of CCBs


Edema
Constipation (verapamil most often)
Heart block (rare)

oronary artery bypass grafting (CABG) lowers mortality on


ific circumstances with very severe disease such as:
Three vessels with at least 70% stenosis in each vessel
Left main coronary artery occlusion
Two-vessel disease in a patient with diabetes
Persistent symptoms despite maximal medical therapy

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