Antihypertensives:

Diuretics

-ends in 

-most important fact

Thiazides

These are 1st line treatment of hypertension and also used in Heart Failure

ACE Inhibitors

-work for which main problems

-end in 

work for hypertension and heart failure

end in - pril

ACE Inhibitors

mechanism of action 

inhibits angiotensin 1 from forming, which means it never converts to angio2 (the most potant vasoconstricter) leading to vasodialation, and excretion of sodium & water

ACE Inhibitors

Contraindications

Interactions

Contraindications- history of angioedema, renal impairment, pregnant woman

Interactions- do not interact well with diaretics, potassium supplements, other hypertensives 

ACE Inhibitors

Common Side effect

Life threatening side effects

SE: Excretion of sodium and water, potassium retention. Watch electrolytes (will drop) watch pot levels (will rise)

Prevent further cardiac events 

Life threatening:orthostatic hypotension, dry heavy cough,

hyperkalemia- high potassium, angioedema- swelling of tounge and airway

Antihypertensives: ARBs 

end in 

sartan

Antihypertensives: ARBs 

main med 

Mechanism of action 

losartan

 inhibits angiotensin 2 (the most potant vasoconstricter) leading to vasodialation, and excretion of sodium & water

Antihypertensives: ARBs

-Contraindications

-Indications

-Common side effects

Contraindications - renal dysfunction and pregnancy

Indications- Hypertension stroke prevention heart failure, 2nd choice if client had reaction to ACE

Side effects- Orthostatic hypotension Angioedema

Antihypertensives: Aldosterone Antagonists

meds end in

one

Antihypertensives: Aldosterone Antagonists

MECHANISM OF ACTION

MECHANISM OF ACTION: reduce blood volume by blocking aldosterone production, water and sodium release, potassium retention

Antihypertensives: Aldosterone Antagonists

CONTRAINDICATIONS

CONTRAINDICATIONS: high potassium, kidney impairment, liver impairment, use caution in diabetics 

Antihypertensives: Aldosterone Antagonists

Side Effects

Drug interactions 

SE: hyperkalemia, flu like symptoms

DI: potassium supplements and antihypertensives

Antihypertensives: 

Calcium Channel Blockers

 ends in 

4 drugs 

-pine 

amlodipine

nifedipine

verapamil

diltiazem

Antihypertensives: 

Calcium Channel Blockers

MECHANISM OF ACTION 

block calcium channel which dialtes the arteries 

Antihypertensives: 

Calcium Channel Blockers

Contraindications

Side effects

C: beta blockers and grapefruit 

SE: reflex tachycardia, acute toxicity , orthostatic hypotension, bradycardia 

Antihypertensives: Adrenergic

zosin

prazosin

MOA: block alpha 1 causing venous and arterial dialation

I: Hypertension 

C: Low blood pressure, renal impairement 

SE: Orthostatic hypotension 

Centrally acting adrenergics

main drug

Mechanism of action

MD: clonidine

MOA: work in CNS to decrease outflow resulting in decrease stimulation in adrenergic receptors - alpha 1&2

Centrally acting adrenergics

Indications

Side Effects 

I: hypertension, migraines, menopause flushing 

SE: dry mouth, drowsy sedation, rebound hypertension if stopped abruptly 

Antihypertensives: 

Direct-Acting Vasodilators

main drug

sodium nitroprusside

Antihypertensives: 

Direct-Acting Vasodilators

MECHANISM OF ACTION

INDICATIONS

CONTRAINDICATIONS

 ADVERSE EFFECTS

MECHANISM OF ACTION: rapid decrease of bp,

direct dialation of arteries and veins 

INDICATIONS: hypertensive crisis

CONTRAINDICATIONS: liver and kidney disease. 

 ADVERSE EFFECTS: extreme hypotension, cyanide poisoning - delirium (thiosulfate antidote)

DRUG CLASS: Beta Blockers

end in

Mechanism of action

Contraindications

End in - olol

MOA: slow down HR works on sympathetic nervous system

C:  asthma, diabetics- cardio selective only 

DRUG CLASS: Beta Blockers 

Selective

Nonselective

cardioselective: metoprolol, atenolol, esmolol

nonselective: propanolol, nadolol

DRUG CLASS: Beta Blockers 

Side effects

ADVERSE EFFECTS: decreased hr and contractility and conductively 

severe: bradycardia, will significantly drop hr. less than 50 hold med 

Chronotrope

Rate

Inotrope 

Contraction

dromotrope

Conduction 

DRUG CLASS: Loop Diuretics

end in-

main drug-

prototype name-

end in ide

main drug furosemide

prototype lasix 

DRUG CLASS: Loop Diuretics

Mechanism of action

Indication

Contraindication

MOA- work in the acending loop of henle, block reapsorbtion of sodium to block reabsorption of water 

I- MAINLY FOR HEART FAILURE AND PULMONARY EDEMA

C- mycin drugs, low bp, diabetics 

DRUG CLASS: Loop Diuretics

side effect

key nursing actions 

ADVERSE EFFECTS: extensive diarhea, dehydration, low sodium and chloride, low potassium, can cause hyperglycemia, ototoxicity 

Key Nursing Actions: monitor I/O, monitor daily weight. Do not give meds late at night. Orthostatic hypotension is common. Watch for signs of low potassium and magnesiums signs- weakness muscle twitching tremors 

DRUG CLASS: Thiazides and Thiazide-like Diuretics

main drug

mechanism of action

Indications

hydrochlorothiazide

prevents reabsorbtion of water

These are 1st line treatment of hypertension and also used in Heart Failure

DRUG CLASS: Thiazides and Thiazide-like Diuretics

SE:blood sugar rise, dehydration, hyperkalemia, give first thing in the morning. give high potassium foods, with or after meal. Watch decrease bp and potassium 

C: impaired renal function, low renal output, check bun and creatnine, digoxin, antihypertensives, nsaids, diabetics

DRUG CLASS: Potassium-Sparing Diuretics

main drug

mechanism of action

indications

MD: spironolactone

MOA: MECHANISM OF ACTION: block aldaterone, potassium retention, not given alone. 

I: for heart failure, used with loops, slow acting 12-48 hrs

DRUG CLASS: Potassium-Sparing Diuretics

Side Effects

Contraindications

Interactions

ADVERSE EFFECTS: high pot levels, over 5 too high can give insulin 

CONTRAINDICATIONS: never mixed with potassium supplements. Kidney failure, people with low urine output 

INTERACTIONS: do not mix with ace inhibitors that increase potassium levels - toxicity

DRUG CLASS: Osmotic Diuretics        

Drug

Mechanism of action

D: mannitol

MOA: work in proximal tubial. Decrease intracranial pressure caused by edema, raise osmolarity and pull fluid back into vascular space. 

DRUG CLASS: Osmotic Diuretics      

indications

contraindications

nursing actions

I: Intracranial pressure

C: high bp and *heart failure* or kidney failure 

NA:  use filter because IV med contains crystals that will enter patient 

DRUG CLASS:  Organic Nitrates

drug

what does it do/ what is it for

contraindications

drug: nitroglycerin

Does/for: Vasodialates for angina

CONTRAINDICATIONS: head injuries, alcohol. DO NOT TAKE WITH ED MEDS. Will drop bp to deadly levels 

DRUG CLASS:  Organic Nitrates

Side Effects

Nursing Actions

SE: orthostatic hypotension, reflex tachycardia, tolerance may build. Need med free period. Headache is common 

NA: first thing to do during angina attack. Stop and sit. Place 1 tablet under the tongue. Rest for 5 mins. If the pain is not relieved in 5 mins call 911 and take a 2nd tablet. After 5 additional mins if still in pain take the 3rd pill. DO NOT GO OVER 3 

DRUG CLASS:  Antianginal Agent

Drug

Mechanism of Action

Contraindications

D: ranolazine

MOA: lowers oxygen demand, improves exercise tolerance, decreases pain, used for chronic stable angina

C: liver dysfunction

DRUG CLASS:  Antianginal Agent

SE:watch heart rhythm, prolonged QT interval, increase bp 

I: Digoxin

NA: angina symptoms- chest hurting, heavy feeling, fatigue, epigastric pain in females, R or L shoulder pain, radiating jaw pain 

Heart Failure 

Drug 

Mechanism of Action

digoxin

slows and strenthens heart beat. Very narrow theraputic index. Can cause disrythmias if potassium levels are off. Will not administer at all if apical pulse is less than 60

Digoxin

Side effects 

Contraindications

Theraputic range

Theraputic range 0.5-2

SE: hyperkalemia, Anorexia, GI affects abdominal pain, vommiting. Cns effects are late signs of toxicity. yellow halos in vision 

C: dysrithmias, hyperkalemia . Ace inhibitors and diaretics need to be closely monitored for potassium levels.

Heart Failure Symptoms 

Edema, enlarged liver, jugular-vein distention, all from fluid backup from the right side of the heart. Left side backup causes pulmonary edema from fluid backup from the left side of the heart back into the lungs. Other  include weak pulses from lack of bloodflow to body and increased HR (tachycardia)

DRUG CLASS: Adrenergic Agonists 

3 drugs

Indications 

epinephrine

dopamine

dobutamine

I: vasoconsitriction, need continues heart monitoring and bp. Monitor for dysrythmias watch and chest pain

epinephrine

hits alpha beta1 and beta 2, increase hr and bp

dopamine

will increase hr and contractility at high dose. When drug goes outside vessel can get nacrossis and loss of a limb. Phentolamine is antidote. Monitor urine output meaning body is not restricting fluid excretion

dobutamine

Antilipemics

end in 

most common drug

statin

atorvastatin

Statin drugs

mechanism of action

indication

contraindication

MECHANISM OF ACTION: Lowers LDL, cholesterol, lower VLDL and triglycerides.  Increase HDL and vasodialation. Decreases plaque and decreases the risk of thromboembolism  

I: cholesterol, MI, coronary event protection 

C: liver failure, pregnancy, alcoholics

Statin drugs

side effects 

Key nursing actions

SE: hepatotoxicity, myopathy and tenderness can progress to rabdomyolysis resulting in limb loss 

NA: diet and exercise are the key to getting levels in range. medication effects liver and kidneys, need baseline lab values. Give medicaton in evening stay away from alchol and grapefruit juics

DRUG CLASS: Cholesterol Absorption Inhibitor

-Drug

-Need to knows about drug

ezetimibe

used alone or combined with statin, leads to increased risk of liver problems if not used with fibrates. Take 4 hours before or after bile sequestrins. Inhibits amount of cholesterol secreted. Lowers LDL level

DRUG CLASS: Bile Acid Sequestrants        

-drug

-need to knows for drug

colesevelam HCL

drug of choice to decrease LDL with statin drug 

constipation likely, take with high fiber foods and increased fluids unless restricted by heart failure or renal failure 

 intereferes with drug absorption. Take other meds 4 hours before sequestrant 

Niacin

Mechanism of action

Contraindications

Side Effects

Nursing Actions

MOA: decreases LDL and triglycerides

C: Gout and Liver disease

SE: decreased liver function, Hyperglycemia, facial flushing hand and feet tingling both common not life threateing take asprin 30mins before to prevent it. 

NA: take with food 

DRUG CLASS: Fibric Acid Derivatives

drug ends in

main drug

Key Points

END IN: has "fibr" in it

gemfibrozil

MECHANISM OF ACTION: decrease triglycerides, increase HDL, decrease LDL

Key Nursing Actions: antlipemics always effect liver and cause muscle pain 

Antidysrhythmia Medications

Sodium Channel Blockers (membrane stabilizers)  

Class 1A

-What is the main drug and key points

 procainamide

levels between 4-8mcg/L

INDICATIONS: a-fib a-flutter v-tachy a-tachy

SE: fast or irregular HR, hypotension, low WBC-nuetropenia, thromboycytopenia- low platelets. Systemic lupus syndrome- fever swollen joints butterfly rash 

Antidysrhythmia Medications

Sodium Channel Blockers (membrane stabilizers)  

Class 1B

-What is the main drug and it's main points 

lidocaine

only give IV. medication is weight based. Increases repolarization. Can cause CNS effects and respiratory arrest. Keep resessitation equipment near, Contraindicated in heart blocks and heart failure 

Antidysrhythmia Medications

Sodium Channel Blockers (membrane stabilizers)  

Class 1C

-What is the main drug & its key points

propafenone

can cause bradycardia and heart failure

contraindicated in heart blocks, heart failure, hypotension, and shock. May slow metabolism down, increase digoxin levels, and decrease coaggulation. Take med with food 

Antidysrhythmia Medications

Sodium Channel Blockers (membrane stabilizers)  

-Umbrella Points

CONTRAINDICATIONS: heart block , cardiac dysrythmias, lupus

Nursing Actions: Monitor liver and kidney function, keep resessitation equipment near, may cause dysrhythmia, monitor HR

Antidyrhythmia Medications

- 4 key drugs

verapamil

diltiazem

adenosine IV

amiodarone

Antidyrhythmia Medications

amiodarone

 -Contraindications

-Side Effects 

-Nursing Actions 

Contraindications: Do not use with Pregnant women, infants, heart blocks, respiratory disfunction. Half life 15-100 days

SE: AV block leading to heart failure, bradycardia, hypotension,  blindness -report changing vision

Nursing Actions: need baseline pulmonary function and chest x-ray, monitor for cough, chest pain, eye function. 

Monitor use with diuretics and Digoxin- dose should be lowered 

Antidyrhythmia Medications

Adenosine 

-Mechanism of action

-Contraindications

-Side Effects 

-Nursing Actions

MOA: correct abnormal cardiac electrophysiological function.

C: more than 2/3 AV block, Cardio shock

SE: dysrythmias, prolongation of QT interval,  hypersensitivity nausea vomitting weakness

NA: revew ekg, bp, heart sounds, cardiac ouput, apical radial pulse, urine output, cap refill, renal and hepatic function, pulse rate 

Lab Values

ALT

0-35

Lab Values

AST

Lab Values

BUN

10-20

Lab Values

Creatnine

0.5-1.2

Lab Values

Digoxin

0.5-2

Lab Values

WBC

4.1- 11.2

Lab Values

HGB Hemoglobin

Male 

Female 

Male 13-17.3

Female 11.5-15.5

Lab Values

HCT Hematocrit

Male 

Female

Male 40.1-52.1

Female 35-46.1

Lab Values

Serum Cholesterol

below 200

Lab Values

Triglycerides 

below 200

Lab Values

HDL

good cholesterol 

Above 60

Lab Values

LDL

Bad Cholesterol

Below 100

Lab Values

VLDL

below 130

Albuterol

Causes Vasodialation and slight tachycardia and tremors. The ONLY fast acting medication for acute respiratory attacks. also prevents exercise induced asthma 

Avoid caffiene, not for client with initial high HR, will counteract beta blockers 

Inhale albuterol before Glucocorticoid 

causes relaxation of bronchial muscle

for longterm control orally or IV emergency

narrow theraputic index- monitor serum levels between 5-15mcg/mL anything greater than 20 is toxic- nausea seizures vomitting 

Contraindicated in liver and kidney disease NO caffiene!

Inhaled Anticholinergics:

end in

key points 

end in opium 

block bronchi receptors causing bronchidilation

not for acute attack but longterm management 

mainly used for COPD

Anticholinergic effets

cant see cant pee cant spit cant shit

contraindicated with peanut allergies and GI issues

Glucocorticoid

ends in 

key points 

end in -sone

decreases inflammation

used for asthma and in fetuses to inhance lung maturity 

Always rinse mouth after use. 

Does the work of adrenal glands, must stop gradually 

Glucocorticoid

Contraindications

side effects

nursing actions

SE: bone loss, hyperglycemia, edema, candidiasis-thrush

NA: monitor electrolytes and fluid levels and potassium levels. monitor for myopathy, PUD, infection, & black tarry stools 

C: not given with live vaccines or systemic fungal infection caution in diabetics

Leukotriene Modifiers

DRUG

important thing to know

montelukast

supress inflammation, mucus production, and airway edema

oral med can be used in kids as young as 1

take once a day at bedtime 

never used with liver disfunction 

Antitussives- Opioid

Drug

3 main points

codeine

Used for chronic dry non-productive cough. Supresses cough reflex

Affects CNS NARCS-U

Not for patients with head truama or use with alcohol or depressants  

Antitussives - Nonopioids

2 drugs

key points 

dextromthorphan

benzonatate

suppresses cough through CNS - mirrors Opioid.

For dry non productive cough 

Antitussives- Expectorants 

drug 

main points 

guaifenesin

used in gunky productive coughs. Promotes coughing by increasing mucus secretion. This decreases congestion. Watch for allergic reactions and slight drowsyness.

Always increase fluids. Caution in children 

Antitussives- Mucolytics

drug

what is this drug also for

main points referring to Mucolytics

acetylcysteine

Acetaminophen overdose 

destroys mucus. Enhances flow of secretions,

not OTC used for COPD and Cystic Fibrosis.

Can cause bronchospasms.

Be prepared to suction if aspirating.

Medication smells like rotten eggs. 

Decongestants 

drug

main points

phenylephrine

OTC drug stimulates alpha 1

reduces inflammation, vasoconstriction, hypertension. Contraindicated in heart problems and hypertension. Cannot take longer than 5 days or will cause rebound congestion 

Glucocorticoids

Upper repiratory infections 

drugs end in 

main points 

drugs end in sone 

decrease inflammation, snezing, itching, running nose.

Administer daily may take up to 7day to see effects. You can take up to 21 days 

diphenhydramine

drug class 

key points 

Antihistamines 1st Generation H1 Antagonists

Used commonly for season allergies.

less common for anaphalaxis, motion sickness, insomia

Block H1 receptors, have anticholinergenic effects.

May cause sedation.

Avoid with glaucoma and urinary retention patients.  

promethazine

class 

contraindication 

Antihistamines 1st Generation H1 Antagonists

contraindicated in contraindicated in cardiac dysrythmias 

2nd Generation H1 Antagonists

3 drugs

loratadine

detirizine

fexofenadine

2nd Generation H1 Antagonists

difference from 1st generation 

Do not cause sedation