Term
|
Definition
| heart, arteries, eyes, kidneys, brain |
|
|
Term
|
Definition
inhibit NA and water reabsorption
increase urine flow
decrease blood volume(decreases BP) |
|
|
Term
| aldosterone antagonists aka.. |
|
Definition
| potassium sparing diuretics |
|
|
Term
| spironolactone (diuretic) |
|
Definition
| aldosterone antagonist given for mild HTN and edema associated with HF and cirrhosis |
|
|
Term
| spironolactone side effects and teaching |
|
Definition
hyperkalemia, hyponatremia, and gynecomastia
before giving check K and BP |
|
|
Term
|
Definition
need normal renal function
lose Na Cl K and Mg
gain Ca
causes mod diuersis |
|
|
Term
|
Definition
| for mild to mod HTN--often first drug prescribed |
|
|
Term
| hydrochlorothiazide (side effects) |
|
Definition
hypokalemia
hypotension(due to decreased blood volume)
hyperglycemia
dehyrdration
dizziness, H/A, fatigue |
|
|
Term
| thiazide diuretics (precautions) |
|
Definition
| renal insufficiency and diabetes |
|
|
Term
| thiazide diuretics (check these before giving)(5) |
|
Definition
| BP K BUN Creatinine and glucose |
|
|
Term
| thiazide diuretics (nursing considerations)(4) |
|
Definition
| monitor I/O, labs, VS, K supplement |
|
|
Term
|
Definition
| block reabsorption of Na and water in ascending loop of henle. very potent!! |
|
|
Term
| loop diuretics (general side effects) |
|
Definition
Excretes Na K Mg Ca Cl
hyperglycemia
hyperuricemia |
|
|
Term
|
Definition
loop diuretic
treats HTN and edema associated with HF, cirrhosis, and renal impairment
IV acts within 5 minutes |
|
|
Term
| furosemide (side effects) |
|
Definition
hypokalemia
hypovolemia
ototoxicity
sulfa allergy |
|
|
Term
| loop diuretics (check these before giving) (4) |
|
Definition
|
|
Term
| loop diuretics (nursing considerations) (4) |
|
Definition
| Monitor I/O, labs, vitals, and K supplement |
|
|
Term
| Patient teaching for Loop and Thiazide diuretics |
|
Definition
-have BP cuff at home
-change positions slowly
-daily weights
-monitor BG if diabetic
-intake of K rich foods
-teach s/sx of hypokalemia
-photosensativity
-report hearing changes immediately with loop diuretics! |
|
|
Term
|
Definition
work in the proximal tubule
presence in renal tubule pulls water into tubule for excretion
MUST be closely monitored! powerful diuretic! |
|
|
Term
|
Definition
osmotic diuretic
increases urine output in renal failure
used to decrease ICP in head trauma pts |
|
|
Term
| manntol (side effects and nursing considerations) |
|
Definition
profound electrolyte imbalances and fluid imbalances
monitor I/O, labs, VS. May see rebound increase in ICP |
|
|
Term
|
Definition
direct renin inhibitor
used for HTN |
|
|
Term
|
Definition
increased BUN, Cr, K, Ck.
Cough |
|
|
Term
| aliskerin (before giving drug, check..) |
|
Definition
|
|
Term
|
Definition
blocking ACE causes decrease in angiotensin II which decreases BP
(-pril) |
|
|
Term
|
Definition
| ace inhibitor used to HTN HF and MI |
|
|
Term
| lisinopril (side effects)(ACEI) |
|
Definition
| COUGH, H/A, dizziness, orthostatic hypotension, angioedema, hyperkalemia |
|
|
Term
| before giving an ACEI, check.. |
|
Definition
BP K Cr
caution with renal impairment |
|
|
Term
| angiotensin II receptor blockers |
|
Definition
block AT I which causes vasodilation, prevents secretion of aldosterone, and prevents cardiac remodeling
(-SARTAN) |
|
|
Term
|
Definition
|
|
Term
| losartan (side effects)(AIIRB) |
|
Definition
dizziness, hypotension, hyperkalemia
caution with renal impairment |
|
|
Term
| losartan (check these before giving)(AIIRB) |
|
Definition
|
|
Term
| calcium channel blockers (action) |
|
Definition
block calcium ion channels in cardiac and arteriolar smooth muscle. When CA channel is blocked it causes relaxation
-DIPINE |
|
|
Term
|
Definition
| HTN, angina, and cardiac dysrhythmias |
|
|
Term
| amlodipine (side effects)CCB |
|
Definition
| PERIPHERAL EDEMA, REFLEX TACHYCARDIA, h/a, dizziness, flushing |
|
|
Term
| CCB (always check this before giving) |
|
Definition
|
|
Term
|
Definition
| work directly on arterial smooth muscle which causes peripheral vasodilation which decreases BP |
|
|
Term
| hydralazine (direct vasodilator) |
|
Definition
used for HTN
very effective for african americans |
|
|
Term
| hydralazine (side effects) |
|
Definition
h/a, tachycardia, palpitations, flushing, n/d, edema.
Weird rxn in those that dont metabolize drug fast enough--lupus like syndrome (rash, fever, myalgia) |
|
|
Term
| alpha antagonist (blocker) |
|
Definition
blocks alpha receptors which results in vasodilation and smooth muscle relaxation
-used for BPH, raynauds disease and HTN |
|
|
Term
|
Definition
-zosin
often used for BPH, sometimes for HTN |
|
|
Term
| alpha 1 antagonist (side effects) |
|
Definition
| ORTHOSTATIC HYPOTENSION, REFLEX TACHYCARDIA, dizziness, h/a, fatigue, nasal congestion, ED |
|
|
Term
|
Definition
| decrease BP due to their locaton in CNS. Inhibits impulses to the heart and aterioles which slows HR and decreases BP |
|
|
Term
|
Definition
alpha 2 agonist
used for HTN and intractable pain management |
|
|
Term
| clonidine (side effects)(A II agonist) |
|
Definition
| SEDATION, dry mouth, drowsiness, dizziness, do not stop abruptly (rebound HTN) |
|
|
Term
|
Definition
used for HTN
slows HR which decreases CO
blocks release of renin from kidney
ALSO USED FOR: chronic angina, dysrhythmias, HF, MI, migraines, and glaucoma
-LOL |
|
|
Term
| beta 1 in heart, beta 2 in lungs |
|
Definition
| avoid nonselective beta blockers in COPD and asthma pts |
|
|
Term
| beta 1 antagonists (blockers) |
|
Definition
cardioselective
drug of choice for patients with COPD or asthma because it doesnt affect the lungs (beta 2) |
|
|
Term
| nonselective beta blockers (side effects) |
|
Definition
| BRADYCARDIA, MASKS S/SX OF HYPOGLYCEMIA, headache, dizziness, fatigue, ED |
|
|
Term
|
Definition
| used for HTN chronic angina, HF and MI |
|
|
Term
| metoprolol (side effects) |
|
Definition
masks s/sx of hypoglycemia, BRADYCARDIA, dizziness, fatigue, insomnia, N/V
-ALWAYS CHECK BP AND HR |
|
|
Term
|
Definition
Must know patients VS baseline
do not stop abruptly
teach pt how to take own pulse
have BP cuff at home
diabetic pts (masks s/sx of hypoglycemia) |
|
|
Term
| mixed alpha and beta antagonists |
|
Definition
| cause only moderate decrease in HR |
|
|
Term
| carvedilol/labetalol (mixed a and b blocker) |
|
Definition
used for HF and post MI
used for HTN and HTN emergencies |
|
|
Term
| mixed alpha and beta antagonists (side effects) |
|
Definition
orthostatic hypotension
all other beta blocking affects--BRADYCARDIA, MASKS S/SX OF HYPOGLYCEMIA, headache, dizziness, fatigue, ED |
|
|
Term
|
Definition
dyspnea
fatigue
fluid overload (edema) |
|
|
Term
|
Definition
increase contractility
slows electrical conduction
slows HR
competes with K
NARROW THERAPUETIC INDEX |
|
|
Term
|
Definition
cardiac glycoside
causes muscle fibers to contract more efficiently
used for HF and atrial fib or flutter |
|
|
Term
| digoxin (side effects)(CG) |
|
Definition
| BRADYCARDIA, DYSTHRYTHMIAS, DIZZINESS, visual disturbances, headache, mental status changes |
|
|
Term
|
Definition
anorexia, N/V/D, blurred vision, green/yellow halos around objects, confusion, bradycardia, dysrhthmias
-more likely in elderly |
|
|
Term
| digoxin (before administering, student will check..) |
|
Definition
| HR, K, digoxin level (.5-2) |
|
|
Term
| digoxin drug interactions |
|
Definition
hypokalemia and risk of dysrthymias with diuretics
hyperkalemia wit ACE, spironolactone, and K supplements
bradycardia with beta blockers
antacids and cholesterol drugs decrease absorption |
|
|
Term
| nitroglycerin, nitrates (antianginal) |
|
Definition
anti anginal
relax smooth muscle and decrease cardiac oxygen demand
used for acute angina and HF, pulmonary edema, MI, severe HTN
half life of 1-4 min-SL dose given every 5 min 3x. Effect will last about 10 min if no relief call EMS
topical-must have 8-12 hour nitro free period to avoid tolerance |
|
|
Term
| nitroglycerin (side effects)antianginal |
|
Definition
hypotension, H/A, dizziness, syncope, reflex tachycardia
dont give with ED drugs!! Hypotension!! |
|
|
Term
| nitroglycerin teaching (antianginal) |
|
Definition
-take at earliest sign of anginal pain
when pain is relieved, spit out remaining tablet
take 5 to 10 min prior to exercise
remove patches at bedtime
avoid alcohol
wear medical alert bracelet |
|
|
Term
| isosorbide mononitrate/dinitrate (antianginal) |
|
Definition
| prevents anginal attacks. Need 6 hr drug free period to avoid tolerance |
|
|
Term
| beta blockers can be used for ___ angina |
|
Definition
|
|
Term
| CCBs can be used for ___ angina |
|
Definition
|
|
Term
|
Definition
| prevent proper filling of ventricles and decrease CO by 1/3 |
|
|
Term
|
Definition
| are life threatening and cause ineffetive filling of ventricles and decreased or absent CO |
|
|
Term
|
Definition
antidysrhytmic
suppress abolity of cardiac tissue to initiate beats outside of the normal conduction system |
|
|
Term
| lidocaine (antidysrhythic) |
|
Definition
antidysrhythmic
used for ventricular dysrhythmias |
|
|
Term
|
Definition
| dysrhythmias, hypotension, siezures, bronchospasm, agitation, anxiety, confusion |
|
|
Term
| propafenone (antidysrhythmic) |
|
Definition
antidysrythmic
used for ventricular dysrhythmias |
|
|
Term
| propafenone (side effects) |
|
Definition
| dysrhythmias, dizziness, n/v |
|
|
Term
| beta blockers used as antidysrhythmic |
|
Definition
|
|
Term
| amioderone (antidysrhythmic) |
|
Definition
antidysrhythmic
used for atrial or ventricular dysrhythmias
long half life. Start with high doses then decrease for maintenence |
|
|
Term
| amioderone (side effects)antidys |
|
Definition
| bradycardia, hypotension, ha, dizziness, fatigue, insomnia, photosensativity, pulmonary toxicity |
|
|
Term
|
Definition
| used for paroxysmal supraventricular tachycardia. Given rapidly or 1-2 seconds. You will see head go into asystole! |
|
|
Term
|
Definition
|
|
Term
|
Definition
| PO for angina and HTN IV for atrial fib or flutter |
|
|
Term
|
Definition
| edema, ha, dizziness, bradycardia, hypotension |
|
|
Term
|
Definition
bad cholsterol
should be <100mg/dL |
|
|
Term
|
Definition
good cholesterol
should be >60 mg/dL |
|
|
Term
| bile acid sequesterants (antilipidemic) |
|
Definition
|
|
Term
| cholestyramine, colesevelam (side effects) |
|
Definition
bile acid sequesterant
(antilipidemic)
constipation, bloating, nausea. Give 4 hours prior or 2 hrs after other meds |
|
|
Term
|
Definition
|
|
Term
| gemfibrozil, fenofibrate (side effects)antilipid |
|
Definition
fibrate (antilipidemic)
abdominal cramping, n/d
DONT GIVE WITH STATINS! (rhabdomyolysis)
displaces warfarin from binding side which increases bleeding |
|
|
Term
| nicotinic acid, niacin (side effects)antilipid |
|
Definition
(antilipidemic)
do NOT use OTC drugs--intense flushing and hot flashes in all patients |
|
|
Term
| HMG-CoA reductase inhibitors (antilipid) |
|
Definition
statins (antilipidemic)
decreases cholesterol synthesis in liver!!! |
|
|
Term
| atorvastatin (lipitor)antilipid |
|
Definition
| decreases LDL, VLDL, and TGs |
|
|
Term
| atorvastatin (side effects)antilipid |
|
Definition
| ha, GI cramping, constipation, rhabdomyolysis, teratogenic. Use cautious with liver impairment |
|
|
Term
| atorvastatin (drug interactions)antilipd |
|
Definition
| increased rhabdomyolysiswith macrolides and azole antifungals. Do not give with fibrates or niacin. Grapefruit interaction. |
|
|
Term
| atorvastatin (addtl teaching)antilipid |
|
Definition
take at bedtime
shoudld be on cholesterol lowering diet |
|
|
Term
| ezetimibe (side effects)antilipid |
|
Definition
(antilipidemic)
abd pain, diarrhea, arthralgia |
|
|
Term
|
Definition
(antilipidemic)
GI distress, lousy taste, flu like syndrome |
|
|
Term
|
Definition
| used for antiplatelet, inflammatory, pain, fever |
|
|
Term
|
Definition
| bleeding, GI irritation, use with caution with allergies nasal polyps asthma |
|
|
Term
|
Definition
antiplatelet
used for coronaey interventions, evolving MI, unstable angina, post MI or stroke, post CABG
irreversible |
|
|
Term
| clopidogrel (side effects)(antipatelet) |
|
Definition
| bleeding, GI irritation, ha, flue like symptoms |
|
|
Term
| abciximad, eptifibitide, tirofiban (antiplatelet) |
|
Definition
glycoprotein inhibitors, antiplatelet
given IV beofre/during/after PCI |
|
|
Term
| abciximad, eptifibitide, tirofiban (side effects)(antiplatelet) |
|
Definition
| bleeding, thrombocytopenia, hypotension |
|
|
Term
|
Definition
| BREAK DOWN CLOTS. Used for life threatening clots!! Converts plasmingoen to plasmin which breaks down fibrin in clots |
|
|
Term
| alteplase, reteplase, tenecteplase (fibrinolyric) |
|
Definition
| given IV for MI PE and CVA. Can be used to dissolve clots in access lines |
|
|
Term
| alteplase, reteplase, tenecteplase (side effects)fibrinolytic |
|
Definition
| bleeding, hypotension, fever |
|
|
Term
|
Definition
anticoagulants
used for treatment and prophylaxis(5000 units) of blood clots. Can be used in lines to keep from clotting |
|
|
Term
| heparin IV infusion is based on.. |
|
Definition
disease process, weight of pt.
Must get PT/INR, PTT, and CBC before starting |
|
|
Term
| heparin dosage based on..... |
|
Definition
| aPTT (normal range is 25-35 sec) |
|
|
Term
|
Definition
| bleeding and thrombocytopenia |
|
|
Term
|
Definition
| progressive fall in paltelet count that leads to clotting, not bleeding. Must start Lepirudin, which is a direct thrombin inibitor in order to anticoagulate oneself |
|
|
Term
| low molecular weight heparins |
|
Definition
have very little effect on aPTT
-PARIN |
|
|
Term
| enoxaparin (lovenox)(anticoag) |
|
Definition
for dvt prophylaxis--give less bc half life is 2-4x longer (30-40mg daily)
for treatment of PE MI DVT (img/kg/dose 2x daily)
monitoring not usually necessary |
|
|
Term
| enoxaparin (side effects)anticoag |
|
Definition
| bleeding, fever, pain at injection site |
|
|
Term
| fondaparinux (atrixa)anticoag |
|
Definition
| DVT prophylaxis in orthopedic patients |
|
|
Term
| protamine sulfate (anticoag) |
|
Definition
antidote for heparin overdose
(watch for fish allergies or vasectomies) |
|
|
Term
|
Definition
anticoagulant
used for prophylaxis and treatment of DVT PE ad post MI |
|
|
Term
| warfarin dosing based on... |
|
Definition
PT/INR
INR should be 2-3 unless mechanical heart valve is present (2.5-3.5)
must have frequent lab draws |
|
|
Term
|
Definition
| bleeding, GI distress, teratogenic |
|
|
Term
| warfarin nursing implications (hospital) |
|
Definition
monitor for bleeding
check labs frequently (LFTs CBC PT/INR)
soft bristle toothbrush electric razor
fall precautions (bruising)
no IM injections |
|
|
Term
| takes a long time to get warfarin to a therapuetic level! so.. |
|
Definition
| you could be on warfarin and heparin at the same time! |
|
|
Term
| warfarin nursing implications (home) |
|
Definition
monitor for bleeding
blood draw schedue
soft bristle toothbrush
watch drastic changes in vit K
medical alert bracelet
avoid NSAIDS
no OTC or herbs without consulting PCP |
|
|
Term
| dabigatran etexilate (pradaxa)anticoag |
|
Definition
for nonvalvular atrial fib
first oral form of direct thrombin inhibitor. No frequent labs and no common labs correlate with effectiveness!!
However, short expiration and very expensive |
|
|
Term
| dabigatran etexilate (side effect and precautions)anticoag |
|
Definition
many drug interactions
renal disease
GI upset, N/D
stop 1-2 days prior to surgery and 3-5 days if renal impairment
SAME NURSING IMP AS WARFARIN |
|
|
Term
|
Definition
for nonvalvular atrial fib
No lab tests but PT if necessary! |
|
|
