30:725:460 Lecture Notes - Lecture 2: Creatinine, 2-Step Garage, Coronary Artery Bypass Surgery

• School: Rutgers University
• Department: Pharmacy Practice and Administration
• Course: 30:725:460
• Professor: All

Document Summary

Cardio ihd lecture 2: -adrenergic blocking agents mainstay of therapy for pts with cad, also used in acs. Mechanism - decreased mvo2 resulting from decreased heart rate, contractility and blood pressure (reduce afterload and decreases wall stress); resulting increases in ventricular volume and ejection time may offset benefit: there is no increase in myocardial oxygen supply. Any beta blocker can be used, but you may look at doa, qd dosing convenience, renal insufficiency. Want a metabolized drug, someone with liver issues want a renally cleared bb. B1 selectivity vs nonselective - both are effective but if you have someone who has bronchospastic disease - want to use b1 selective agent. Neither copd or asthma are absolute contraindications - if they are actively wheezing you may not want to risk it , but if well controlled a b1 selective agent can be used. No difference in efficacy between agents, however pharmacokinetic profile may help guide selection (eg. half-life, route of elimination)