Cardiac Medications
Cardiac
Lisinopril (ACE Inhibitor)
- Used for: First-line for hypertension, particularly in patients with diabetes or chronic kidney disease (CKD), as it provides renal protection.
- Avoid in: Patients with a history of angioedema, pregnancy, or severe renal artery stenosis.
Losartan (ARB)
- Used for: Hypertension, especially in patients who cannot tolerate ACE inhibitors due to cough or angioedema.
- Ideal for: Patients with diabetes or CKD, similar to ACE inhibitors, due to its renal-protective effects.
- Avoid in: Pregnancy or severe renal artery stenosis.
Amlodipine (Calcium Channel Blocker)
- Used for: Hypertension and angina; particularly effective in African American and elderly patients.
- Best for: Patients with isolated systolic hypertension, a common issue in older adults.
- Caution in: Heart failure with reduced ejection fraction, as it can worsen edema.
Metoprolol (Beta-Blocker)
- Used for: Hypertension, especially with concurrent heart disease, such as angina or heart failure with reduced ejection fraction (HFrEF).
- Preferred in: Patients with a history of myocardial infarction or arrhythmias.
- Avoid in: Asthma, chronic obstructive pulmonary disease (COPD), and severe bradycardia due to risk of bronchospasm and bradycardia. This only applies for non-selective beta blockers. It is ok to use selective beta blockers in astham/COPD.
Selective Beta blockers
- AMEBA
- Atenolol
- Metoprolol
- Esmolol
- Bisoprolol
- Acebutolol
Hydrochlorothiazide (HCTZ) (Thiazide Diuretic)
- Used for: Hypertension; often a first-line option, especially in African American patients.
- Ideal for: Patients with mild to moderate hypertension without renal disease.
- Caution in: Gout (as it can increase uric acid levels) and in patients with significant kidney disease.
Spironolactone (Aldosterone Antagonist)
- Used for: Hypertension; often a first-line option, especially in African American patients.
- Ideal for: Patients with mild to moderate hypertension without renal disease.
- Caution in: Gout (as it can increase uric acid levels) and in patients with significant kidney disease.
Diltiazem (Calcium Channel Blocker)
- Used for: Hypertension, angina, and certain arrhythmias like atrial fibrillation.
- Preferred in: Patients who need rate control in addition to blood pressure control, such as those with atrial fibrillation.
- Caution in: Patients with heart failure with reduced ejection fraction, as it may exacerbate symptoms.