Propranalol (Inderal)

HTN, HF, acute MI, diabetic nephropathy

Inhibit beta stimulation by occupying beta receptor sites

Excessive (lethal) hypotension, cyanide toxicity, thiocyanate toxicity

Protect from light, must be given with IV pump, discard if solution turns brown, blue, green or red

Spironolactone (Aldatone)

Used to treat and prevent angina

Block activation of renin-angiotension-aldosterone system

Headache, hypotension

Hold medication for HR less than 60 or greater than 120 in adults

Digoxin (Lanoxin)

HF, HTN

Reduce venous tone, venous return, myocardial oxygen demand

Headache, pedal edema, dizziness, dry mouth, constipation

Draw levels 2 hrs after IV dose & 6-8 hrs after PO dose

Milrinone (Primacor)

HF exacerbation (decompensation)

Slow conduction and velocity and HR,
decrease in workload and heart size

GI disturbances, bluish gray skin discoloration, photosensitivity

Do not discontinue abruptly- rebound HTN and tachycardia

Verapamil (Calan)

Short term management of HF

Decrease myocardial work and oxygen demand,
arterial vasodilaton- decrease afterload, decreases contractility, slow conduction- decrease heart rate

Hypotension, (especially first dose), syncope, SOB

Must be given with IV pump, do not give Lasix in same IV line, do not mix with D5W