The Meducator
April 2001
Volume 1, Issue 1
 
SPECIFIC 
INDICATIONS 
SPECIFIC
CONTRAINDICATIONS 
SIDE EFFECTS 
(ADVERSE& BENEFICIAL)
Alpha-1-blockers
  • men with symptomatic prostatism
 
  • lower LDL cholesterol
  • raise HDL cholesterol
  • improve insulin sensitivity
  • dizziness, weakness
  • headache
ACE inhibitors 
  • chronic renal failure (diabetic nephropathy)
  • congestive heart failure
  • diabetes mellitus
  • LVH
  • post-infarction
  • hyperkalemia or patients with reduced renal function who may develop hyperkalemia
  • pregnancy 
  • few toxic side effects other than dry cough
  • glucose utilization enhanced
  • regress LVH
Angiotensin II receptor antagonists
  • cough on ACE inhibitors
   
Beta-blockers
  • resting tachycardia
  • migraine headaches
  • glaucoma
  • previous infarction/angina
  • asthma and COPD
  • peripheral vascular disease
  • Raynaud's phenomenon
  • depression
  • bradycardia, heart block
  • hypoglycemia-prone diabetes
  • must not discontinue abruptly in patients with heart ischemia
  • elevation of plasma glucose
  • increased insulin resistance
  • reduced HDL cholesterol
  • elevated triglycerides
  • fatigue, depression
  • decreased exercise capacity
Calcium channel blockers
  • older or low plasma renin patients (no compliance with dietary sodium restriction)
  • patients on NSAID's
  • black patients
  • angina pectoris
  • supraventricular tachycardia
  • heart block
  • congestive heart failure (& systolic dysfunction)
  • short-acting calcium channel blockers
  • dihydropyridines activate sympathetic nervous system and renin-angiotensin
  • increase sodium excretion
  • dizziness, headache, flushing
  • peripheral edema
  • decreased cardiac contractility, reduced cardiac conduction, and constipation (verapamil)
Thiazide diuretics
  • black patients
  • edema
  • congestive heart failure
  • nephrolithiasis
  • gout
  • cardiac arrhythmias
  • diabetics
  • sexual dysfunction
  • hypokalemia
  • hyperuricemia
  • mild cholesterol elevation
  • mild glucose elevation
  • hyperinsulinemia