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Cardiovascular drugs
N/A
124
Pharmacology
Undergraduate 2
07/21/2012

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Term
organs effected by HTN
Definition
heart, arteries, eyes, kidneys, brain
Term
diuretic actions (3)
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
thiazide diuretics (4)
Definition
need normal renal function
lose Na Cl K and Mg
gain Ca
causes mod diuersis
Term
hydrochlorothiazide
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
loop diuretics
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
furosemide (lasix)
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
BP K BUN and Cr
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
osmotic diuretics
Definition
work in the proximal tubule
presence in renal tubule pulls water into tubule for excretion
MUST be closely monitored! powerful diuretic!
Term
mannitol (osmitrol)
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
aliskerin (tekturna)
Definition
direct renin inhibitor
used for HTN
Term
aliskerin (side effects)
Definition
increased BUN, Cr, K, Ck.
Cough
Term
aliskerin (before giving drug, check..)
Definition
BP BUN Cr and K
Term
ACE inhibitors
Definition
blocking ACE causes decrease in angiotensin II which decreases BP
(-pril)
Term
lisinopril (ACEI)
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
losartan (Cozaar)(AIIRB)
Definition
treats HTN HF and MI
Term
losartan (side effects)(AIIRB)
Definition
dizziness, hypotension, hyperkalemia
caution with renal impairment
Term
losartan (check these before giving)(AIIRB)
Definition
BP, K, Cr
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
CCB (used for)
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
BP and HR
Term
direct vasodilators
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
alpha 1 antagonist
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
alpha 2 agonist
Definition
decrease BP due to their locaton in CNS. Inhibits impulses to the heart and aterioles which slows HR and decreases BP
Term
clonidine
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
beta blockers
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
metoprolol
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
beta blocker teaching
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
symptoms of HF
Definition
dyspnea
fatigue
fluid overload (edema)
Term
cardiac glycosides
Definition
increase contractility
slows electrical conduction
slows HR
competes with K
NARROW THERAPUETIC INDEX
Term
digoxin (CG)
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
digoxin (toxicity)(CG)
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
stable
Term
CCBs can be used for ___ angina
Definition
stable and vasospastic
Term
atrial dysrthythmias
Definition
prevent proper filling of ventricles and decrease CO by 1/3
Term
ventricular dysrhythmias
Definition
are life threatening and cause ineffetive filling of ventricles and decreased or absent CO
Term
sodium channel blockers
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
lidocaine (side effects)
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
ventricular dysrhythmias
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
adenosine (antidys)
Definition
used for paroxysmal supraventricular tachycardia. Given rapidly or 1-2 seconds. You will see head go into asystole!
Term
CCB as antidysrythmic
Definition
......
Term
diltiazem (anti dys)
Definition
PO for angina and HTN IV for atrial fib or flutter
Term
diltiazem (side effects)
Definition
edema, ha, dizziness, bradycardia, hypotension
Term
LDL levels
Definition
bad cholsterol
should be <100mg/dL
Term
HDL levels
Definition
good cholesterol
should be >60 mg/dL
Term
bile acid sequesterants (antilipidemic)
Definition
decreases LDL
Term
cholestyramine, colesevelam (side effects)
Definition
bile acid sequesterant
(antilipidemic)
constipation, bloating, nausea. Give 4 hours prior or 2 hrs after other meds
Term
fibrates(antilipidemic)
Definition
decreases TG and VLDL
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
fish oil (antilipid)
Definition
(antilipidemic)
GI distress, lousy taste, flu like syndrome
Term
aspirin (ASA)
Definition
used for antiplatelet, inflammatory, pain, fever
Term
aspirin (side effects)
Definition
bleeding, GI irritation, use with caution with allergies nasal polyps asthma
Term
clopidogrel (plavix)
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
fibrinolytics
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
heparin
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
heparin (side effects)
Definition
bleeding and thrombocytopenia
Term
HIT
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
warfarin (coumadin)
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
warfarin side effects
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
Rivaroxaban (anticoag)
Definition
for nonvalvular atrial fib
No lab tests but PT if necessary!
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