Captopril (Capoten)

Class?

Action? 

Nursing implication?

• ACE Inhibitor
• Reduces SVR (vasodilation) Decreases afterload with an increase in CO Decreases risk of HF post MI
• Monitor s/s HF (I&O, DWT, LS, EDEMA), BP,SE: cough, Hypokalemia, taste disturbance, renal insufficiency, hypotension Monitor labs: K, BUN, Creatinine
• Expect:      Decrease in s/s HF and BP      Decrease in ventricular remodeling by inhibiting ventricular hypertrophy

Ramipril (Altace)

Class?

Action? 

Nursing implication?

Expected outcomes? 

ACE Inhibitor

• Reduces SVR (vasodilation)

  Decreases afterload with an increase in CO

  Decreases risk of HF post MI

• Monitor s/s HF (I&O, DWT, LS, EDEMA), BP,

  SE: cough, Hypokalemia, taste disturbance, renal insufficiency, hypotension
  
  Monitor labs: K, BUN, Creatinine

• Expect:

  Decrease in s/s HF and BP
  
  Decrease in ventricular remodeling by inhibiting ventricular hypertrophy
  

Aspirin

Class?

Action? 

Nursing implication?

Expected outcomes?

• Antiplatelet Agent
• Inhibits platelet aggregation
• Monitor s/s bleeding (color of stools, nose bleeds, gums bleeding, bruising)
• Prevention of stroke, MI, or vascular related death in clts at risk
  Patency of coronary stent
   

Plavix (Clopidohgrel)

Class?

Action? 

Nursing implication?

Expected outcomes?

• Antiplatelet Agent
• Inhibits platelet aggregation
• Monitor s/s bleeding (color of stools, nose bleeds, gums bleeding, bruising)
• Prevention of stroke, MI, or vascular related death in clts at risk
  Patency of coronary stent

Nitrostat (sl)

Class?

Action? 

Nursing implication?

Expected outcomes?

• Nitrates
• Dilates coronary arteries, Decreases preload, BP, myocardial oxygen consumption
  Increases CO
• Dizziness, HA, hypotension, tachycardia,
  Assess pain characteristics
  1 SL NTG q 5 min x 3
  Monitor BP, HR, Wear gloves when handling oint., Replace Q6 mo, protect from heat (don’t keep in pockets)
  Do not take with Viagra
• Decrease in the frequency of angina attacks, Increase in activity tolerance
  

   

Metoprolol (Lopressor)

Class?

Action? 

Nursing implication?

Expected outcomes

• Beta Blockers (Ends in olol)
• Prophylaxis of angina
  Decrease myocardial contractility, HR, SVR, & BP, decrease myocardial O2 demand
• Can exacerbate HF monitor for s/s of HF,
  Monitor VS, ECG, glucose (can mask signs of hypoglycemia in diabetics), BUN, K
• Decrease in BP, angina, HR. Increase in activity tolerance

Atenolol (Tenormin)

Class?

Action? 

Nursing implication?

Expected outcomes?

• Beta Blockers (Ends in olol)
• Prophylaxis of angina
  Decrease myocardial contractility, HR, SVR, & BP, decrease myocardial O2 demand
• Can exacerbate HF monitor for s/s of HF,
  Monitor VS, ECG, glucose (can mask signs of hypoglycemia in diabetics), BUN, K
• Decrease in BP, angina, HR. Increase in activity tolerance

Verapamil (Calan)

Class?

Action? 

Nursing implication?

Expected outcomes?

• Calcium Channel Blockers
• Coronary & systemic vasodilatation, decreased SVR & myocardial contractility
  Inhibits coronary artery spasm (Prinzmetal’s Angina)
• Potentates action of Digoxin
  Monitor VS, s/s of HF, ECG, 
• Decreased BP, decreases angina
  Increases activity tolerance

Diltazem (Cardizem)

Class?

Action? 

Nursing implication?

Expected outcomes?

• Calcium Channel Blockers
• Coronary & systemic vasodilatation, decreased SVR & myocardial contractility
  Inhibits coronary artery spasm (Prinzmetal’s Angina)
• Potentates action of Digoxin
  Monitor VS, s/s of HF, ECG, 
• Decreased BP, decreases angina
  Increases activity tolerance

Furosemide (Lasix)

Class?

Action? 

Nursing implication?

Expected outcomes?

• Loop Diuretics
• Inhibits NaCl reabsorption in the loop of Henle
• Monitor Lab for F & E imbalances (K, Na, Cl, Mg decreases) VS, Ototoxicity, Hyperglycemia, Orthostatic hypotension
• Decreased edema (fluid overload)
  Increased UOP
  Decreased BP
  Lungs clear

Torsemide (Demadex)

Class?

Action? 

Nursing implication?

Expected outcomes?

• Loop Diuretics
• Inhibits NaCl reabsorption in the loop of Henle
• Monitor Lab for F & E imbalances (K, Na, Cl, Mg decreases) VS, Ototoxicity, Hyperglycemia, Orthostatic hypotension
• Decreased edema (fluid overload)
  Increased UOP
  Decreased BP
  Lungs clear

Spironolactone (Aldactone)

Class?

Action? 

Nursing implication?

Expected outcomes?

• Potassium sparing diuretic
• Reduce K and Na exchange in the distal and collecting tubules
• Monitor labs-can increase K,
  VS, N/V/D, Orthostatic hypotension
• Decreased edema (fluid overload)
  Increased UOP
  Decreased BP
  Lungs clear

ReoPro

Class?

Action? 

Nursing implication?

Expected outcomes?

• Glycoprotein IIB/IIIA Inhibitors
• Prevents the binding of fibrinogen to platelets, blocking platelet aggregation
  Treatment of ACS
• Monitor for S/S of bleeding, including arterial or venous access sites, PTT, H&H,
• Inhibition of platelet aggregation-decreased incidence of new MI or Death

Integrilin

Class?

Action? 

Nursing implication?

Expected outcomes?

• Glycoprotein IIB/IIIA Inhibitors
• Prevents the binding of fibrinogen to platelets, blocking platelet aggregation
  Treatment of ACS
• Monitor for S/S of bleeding, including arterial or venous access sites, PTT, H&H,
• Inhibition of platelet aggregation-decreased incidence of new MI or Death

Dalteparin (Fragmin) 

Class?

Action? 

Nursing implication?

Expected outcomes?

• Low molecular weight heparin
• Prevention of a thromboembolic event (DVT, PE) or ischemic complications in clts with unstable angina or MI
• Monitor PLT, CBC, S/S bleeding
• Prevention of DVT, PE and ischemic complications in clts with unstable angina

Enoxaprin (Lovenox)

Class?

Action? 

Nursing implication?

Expected outcomes?

• Low molecular weight heparin
• Prevention of a thromboembolic event (DVT, PE) or ischemic complications in clts with unstable angina or MI
• Monitor PLT, CBC, S/S bleeding
• Prevention of DVT, PE and ischemic complications in clts with unstable angina

Magnesium Sulfate

Class?

Action? 

Nursing implication?

Expected outcomes?

• Electrolyte
• Hypomagnesemia. Low magnesium levels may increase cardiac irritability and aggravate cardiac arrhythmias\
• Monitor HR, BP, Resp, ECG, UOP
• Normal magnesium level of
  1.3-2.1 mEq/L
  No cardiac arrhythmias

K-Dur

Class?

Action? 

Nursing implication?

Expected outcomes?

• Electrolyte (Potassium)
• Hypokalemia,
  Maintain electrophysiologic balance of the cell
  Essential in contraction of cardiac muscle
• Arrhythmias, GI upset, IV site irritation,
  Monitor for s/s of hypo & hyperkalemia, potassium level especially during diuretic therapy
  With IV infusion monitor pulse, BP, ECG, and IV site
• Normal potassium level 3.5-5.0 mEq/L
  No cardiac arrhythmias

Morphine Sulfate

Class?

Action? 

Nursing implication?

Expected outcomes?

• Opiate Analgesic
• Decreases cardiac workload, lowers O2 consumption, contractility, lowering BP & HR, decrease in preload & afterload via vasodilation
  Reduces anxiety
• Assess level of sedation, VS, pain characteristics
• Decrease in severity of pain

Oxygen

Class?

Action? 

Nursing implication?

Expected outcomes?

• None
• Increase O2 saturation on Hgb
• Monitor LOC, VS, device
• O2 saturation >92%

Lanoxin (Digoxin

Class?

Action? 

Nursing implication?

Expected outcomes?

• Positive inotropic drug
• Improves LV function, increasing force of myocardial contraction, increased CO & decreases HR by decreasing conduction through the SA and AV nodes and prolonging the refractory period of the AV node
• Monitor apical pulse 1 min ac administering hold <60
  Monitor K, Mg, Ca, S/S of CHF, N/V/A, ECG, Dig level
• Increase in CO
  Decrease in severity of CHF
  Decrease in HR
  
  

Docusate Sodium (Colace)

Class?

Action? 

Nursing implication?

Expected outcomes?

• Stool Softener
• Prevents straining & vagal stimulation
• Monitor bowel habits, characteristics of stool, give with a full glass of water
• Soft formed stool

Atorvastatin (Lipitor)

Class?

Action? 

Nursing implication?

Expected outcomes?

• HMG-CoA Reductase Inhibitors “STATINS”
• Management of primary hypercholesterolemia and mixed dyslipidemias
  Slows the progression of CAD
• Monitor for muscle pain, weakness, tenderness, GI,
  LFT, Cholesterol, LDL, HDL
• Progression of CAD is slowed
  Decrease in Chol., LDL, triglycerides, and increase in HDL

Simvastatin (Zocor)

Class?

Action? 

Nursing implication?

Expected outcomes?

• HMG-CoA Reductase Inhibitors “STATINS”
• Management of primary hypercholesterolemia and mixed dyslipidemias
  Slows the progression of CAD
• Monitor for muscle pain, weakness, tenderness, GI,
  LFT, Cholesterol, LDL, HDL
• Progression of CAD is slowed
  Decrease in Chol., LDL, triglycerides, and increase in HDL

Natrecor (nesiritide)

Class?

Action? 

Nursing implication?

Expected outcomes?

• Human B-type natriuretic peptide
• Treatment of acutely decompensated HF in clts with dyspnea at rest or with minimal activity
  Vasodilator, decreases preload & afterload
• Monitor VS, ECG, resp. status, HYPOTENSION!!
  Monitor for decreasing S/S of CHF, BUN, Creatinine
• Improvement in dyspnea
  Increase in CO
  Decrease in pulmonary congestion