Term
Cardiovascular Medications
ACE Inhibitors
Benazepril HCL
(Lotensin)
Purpose: Tx of hypertension |
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Definition
Side effects:
Angioedema Fatigue hepatotoxicity
Cough Hyperkalemia increased renal lab
Headache Nausea/vomiting values
Dizziness constipation
Nursing Considerations
often used in combination w thiazide diuretics
avoid salt substitutes containing potassium because of K+ sparing effect
avoid nonprescription cough medications unless provider directed
Rx
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Term
Cardiovascular Medications
ACE Inhibitors
Captopril
(Capoten)
Purpose: Tx of hypertension, CHF, left ventricular dysfunction after MI, and diabetic nephropathy |
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Definition
Side effects:
bronchospasm, dyspnea, cough dizziness bone marrow supression
orthostatic hypotension loss of taste hyperkalemia
Nephrotic syndrome
Nursing Considerations:
-contact HCP if fever, skin, rash, sore throat, mouth sores, swelling of hands or feet, fast or irregular heartbeat, chest pain, or cough
-take on empty stomach 1hr before meals or 2 hours after; tablets may be crushed and mixed with juice or soft food for ease of swallowing
-avoid changing positions (sitting/standing/lying) rapidly, esp. during the first few days before body adjusts to med
-Do not use OTC (cough, cold, or allergy) meds unless directed by HCP
-avoid potassium supplements, potassium salt substitute, and K+ sparing diuretics
-RX |
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Term
Cardiovascular Medications
ACE Inhibitors
Enalapril
(Vasotec)
Purpose: Tx of hypertension, CHF, and left ventricular dysfunction |
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Definition
Side Effects:
Headache, dizziness, hypotension Tinnitus Bone marrow suppression
Tachycardia, dysrhythmias Angioedema Hepatotoxicity
Persistent cough Insomnia Renal failure
Insomnia
Nursing Considerations:
-contact provider if fever, skin rash, sore throat, mouth sores, swelling of hands or feet, fast irregular heartbeat, chest pain, or cough
-avoid changing positions (sitting/standing/lying) rapidly, esp. during the first few days before body adjusts to med
-Do not use OTC (cough, cold, allergy) meds unless directed by HCP
-avoid K+ supplements, K+ salt substitutes, and K+ sparing diuretics
-may be crushed; give without regard to food
-Rx |
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Term
Cardiovascular Medications
ACE Inhibitors
Lisinopril
(Prinivil, Zestril)
Purpose: Tx of mild to moderate hypertension, adjunctive therapy for systolic CHF and acute MI |
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Definition
Side effects:
Headache, fatigue Hypotension Hepatic failure
Dizziness, vertigo Tachycardia Hyperkalemia
N/V/D Cough Renal Insufficiency
Nursing Considerations:
-avoid changing positions (lying/standing/sitting) rapidly
-may take without regard to food
-avoid K+ supplements, K+ salt substitutes, and K+ sparing diuretics
Rx |
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Term
Cardiovascular Medications
ACE Inhibitors
Ramipril
(Altace)
Purpose: Tx of hypertension and CHF following MI; prophylactic risk reduction of MI, stroke, and death from cardiovascular disorders |
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Definition
Side effects:
Headache, fatigue Hyperkalemia
Hypotension Altered renal and hepatic function tests
Dizziness, vertigo Decreased Hgb and Hct
N/V/D Cough
Nursing Considerations:
-Can mix capsule contents w water, juice, or applesauce to aid swallowing
-avoid changing positions (lying/ sitting/ standing) rapidly
-Contact HCP of persistant dry, nonproductive cough; increased SOB; edema; or unusual bruising or bleeding
-Avoid K+ supplements, K+ salt substitutes and K+ sparing diuretics
-Rx |
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Term
Cardiovascular Medications
Alpha Blockers
Doxazosin Mesylate
(Cardura)
Purpose: Tx of hypertension and benign prostatic hyperplasia |
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Definition
Side Effects:
Dizziness, vertigo Fatigue, Malaise
Orthostatic hypotension Priapism (rare)
Headache Nausea, vomiting, diarrhea
Tinnitus
Nursing Considerations:
-avoid changing positions (lying/sitting/standing) rapidily
-can have first-dose syncope, maintain recumbent for 90 min
-use caution in potentially hazardous activities until stabilized
-Rx |
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Term
Cardiovascular Medications
Alpha Blockers
Prazosin HCL
(Minipress)
Purpose: Tx of hypertension |
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Definition
Side Effects:
Dizziness, drowsiness Syncope
Nausea, vomiting, diarrhea Blurred vision
Headache, vertigo Nasal congestion
Palpitations
Nursing Considerations
-onset 2hrs; peak 1-3hrs; duration 6-12hrs
-can have first doese syncope; take the first dose (and any increment) at bedtime, do not drive for 24hours
-food may delay absorption
-avoid changing positions (lying, sitting,standing) rapidly
-check w HCP before using OTC cold, cough, allergy meds
-Rx |
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Term
Cardiovascular Medications
Alpha Blockers
Terazosin HCL
(Hytrin)
Purpose: Tx of hypertension and benign prostatic hyperplasia |
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Definition
Side Effects:
Dizziness, weakness Syncope
Headache, drowsiness Blurred vision
Nausea Nasal congestion
Nursing Considerations:
-avoid changing positions (lying, sitting, standing) rapidly
-can have first-dose syncope, take the first does (and any increment) at bedtime, do not drive or operate machinery for 4 hours
-check w HCP before using OTC cold, cough, and allergy meds
-Rx |
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Term
Cardiovascular Medications
Angiotensin Receptor Blockers (ARBs)
Losartan
(Cozaar)
Purpose: Tx of hypertension |
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Definition
Side effects:
Dizziness, confusion Diarrhea, anorexia Photosensitivity
Insomnia Dyspepsia Alopecia, rash
Headache Impotence Hyperkalemia
Dysrhythmias, MI Renal failure Hypoglycemia
Blurred vision Thrombocytopenia URI
Nursing Considerations:
-avoid hazardous activities until reaction is known
-avoid grapefruit juice, alcohol, salt substitutes, OTC products
-take without regard to meals
-Rx |
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Term
Cardiovascular Medications
Angiotensin Receptor Blockers
Valsartan
(Diovan)
Purpose: Tx of hypertension, Tx of HF in pts who can't take ACE inhibitors, reduction of cardiovascular mortality post-MI in stable pts w left ventricular dysfunction/failure |
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Definition
Side effects:
Headache Hypotension Hyperkalemia
Dizziness, vertigo Cough Angioedema
Abdominal pain Dysrhythmias Nausea/vomiting/diarrhea
Hepatotoxicity Nephrotoxicity
Nursing Considerations:
-Take once daily for high blood pressure, twice daily for CHF
-Avoid potassium supplements and salt substitutes containing potassium
-Give on an empty stomach
-Rx |
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Term
Cardiovascular Medications
Angiotensin Receptor Blockers
Valsartan Hydrochlorothiazide
(Diovan HCT)
Purpose: Tx of hypertension, Tx of heart failure in pts who cannot take ACE inhibitors |
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Definition
Side effects:
Headache Cough Heptatotoxicity
Dizziness, vertigo Blurred vision Hyperglycemia
N/V/D Photosensitivity Hypo/hyperkalemia
Hypotension Agranulocytosis Nephrotoxicity
Nursing Considerations:
-Take once daily for high blood pressure, twice daily for CHF
-Avoid potassium supplements and salt substitutes containing potassium
-NSAIDs may reduce the effect of diuretic
-May cause exacerbation of SLE
-Rx |
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Term
Cardiovascular Medications
Antianginals
Isosorbide Dinitrate
(Isordil)
Purpose: Tx and prevention of chronic stable angina |
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Definition
Side effects:
Dizziness, orthostatic hypotension Drowsiness
Vascular headache, flushing Nausea, vomiting
Lightheadedness
Nursing Considerations:
-PO 1 hr before food or 2 hours after meals for maximum absorption, but taking with food may reduce or eliminate headache
-Chewable tablet: chew well, hold in mouth for 2 min before swallowing
-SL: dissolve under tongue; do not eat, drink, talk or smoke during use; go to ED if pain not relieved in 15 min
-Avoid changing positions (lying/standing/sitting) rapidly
-Use caution in potentially hazardous activities until stabilized
-Avoid alcohol, smoking, strenuous exercise in hot environment
-Wear medical information tag
-Rx |
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Term
Cardiovascular Medications
Antianginals
Isosorbide Mononitrate
(Ismo)
Purpose: Tx and prevention of chronic stable angina |
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Definition
Side effects:
Dizziness, postural hypotension Drowsiness
Vascular headache, flushing Nausea, vomiting
Nursing Considerations:
-PO:1 hr before food or 2 hours after meals for maximum absorption, but taking with food may reduce or eliminate headache
-Chewable tablet: chew well, hold in mouth for 2 min before swallowing
-SL:dissolve under tongue; do not eat, drink, talk or smoke during use; go to ED if pain not relieved in 15 min
-Avoid changing positions (lying/sitting/standing) rapidly
-Use caution in potentially hazardous activities until stabilized
-Avoid alcohol, smoking, strenuous exercise in hot environment
-Wear medical information tag
-Rx
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Term
Cardiovascular Medications
Antianginals
Nitroglycerin
(Nitro-Par, Transderm-Nitro/Nitrostat)
Purpose: Tx of chronic stable angina; prophylaxis of angina pain, CHF, and acute MI; controlled hypotension for surgical procedures |
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Definition
Side effects:
Postural hypotension
Nausea, vomiting
Headache, flushing, dizziness
Nursing Considerations:
-Sustained-released: take every 6-12 hours on an empty stomach; onset 20-45 min, duration 3-8
-SL: pt sitting/lying should let tablet dissolve under tongue and not swallow saliva; onset 1-3 min, duration 30 min
-Spray: hold canister vertically, spray on tongue, close mouth immediately, do not inhale spray; onset 2 min, duration 30-60 min
-IV: use infusion pump and special non-PVC tubing; onset 1-2 min, duration 3-5min
-Ointment: spread on skin in thin uniform layer; onset 30-60 min, duration: 2-12hrs
-Transdermal: apply to clean hairless area; rotate sites; onset 30-60 min, duration 12-24hrs
-Go to ED if pain not relieved with 3 tablets in 15 min
-Wear medical information tag
-Rx |
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Term
Cardiovascular Medications
Antiarrhythmics
Amiodarone HCL
(Cordarone, Pacerone)
Purpose: management of ventricular arrhythmias not controlled first-line agents |
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Definition
Side effects:
Dizziness, fatigue, malaise Corneal microdeposits Peripheral neuropathy
Anorexia, constipation Photosensitivity Hepatotoxicity
Nausea, vomiting Hypo/hyperthyroidism Rash
Bradycardia, hypotension Muscle weakness Neurotoxicity
Cardiac arrest
Nursing Considerations:
-IV: continuous cardiac monitoring
-Assess for signs of pulmonary toxicity: rales/crackles, decreased breath sounds, pleuritic friction rub, fatigue, dyspnea, cough, pleuritic pain, fever
-Side effects may not appear until several days, weeks, or years and may persist for several months after stopping med
-Teach pt to check radial pulse
-May increase ALT, AST
-Rx |
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Term
Cardiovascular Medications
Antiarrhythmics
Flecainide
(Tambocor)
Purpose: Management of life-threatening ventricular dysrhythmias, sustained ventricular tachycardia, and atrial flutter/fibrillation |
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Definition
Side effects:
Headache CHF Change in taste
Dizziness, irritability Tachycardia Impotence
Suppression Blurred vision Urinary retention
Tremors Tinnitus Leukopenia
Hypotension, bradycardia N/V/constipation Respiratory depression
Nursing Considerations:
-Take with meals to minimize GI upset
-May adjust dose every 4 hours
-reduce dosage as soon as dysrhythmia is controlled
-Avoid changing positions rapidly
-DO NOT skip or double doses; if dose is missed, take as soon as possible within 6 hours of next dose
-Wear medical identification tag
-RX |
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Term
Cardiovascular Medications
Antiarrhythmics
Lidocaine HCL
(Xylocaine)
Purpose: Management of ventricular tachycardia and ventricular dysrhythmias during cardiac surgery |
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Definition
Side effects:
Hypotension, tremors Drowsiness, dizziness
Blurred vision Seizures
Tinnitus Bradycardia
Respiratory depression/arrest Nausea, vomiting, anorexia
Confusion Rash, petechiae
Nursing Considerations:
-Give oxygen; have resuscitation equipment available
-IV: use infusion pump; patient on cardiac monitor
-Rx |
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Term
Cardiovascular Medications
Antiarrhythmics
Procainamide
Puropose: management of life-threatening ventricular dysrhythmias |
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Definition
Side effects:
Hypotension Bone marrow suppression
Nausea, vomiting SLE syndrome
Fever, rash Confusion, restlessness
Dizziness Angioedema
Nursing Considerations:
-IV: use infusion pump; monitor BO every 5-15 min; on cardiac monitor; keep pt recumbent
-IV: monitor CBC, blood levels, I&O, daily weight
-May increase alkaline phosphate, bilirium, AST, ALT
-Rx |
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Term
Cardiovascular Medications
Antiarrhythmics
Quinidine
Purpose: managment of atrial or ventricular arrhythmias and malaria |
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Definition
Side effects:
Anemia Tinnitus
Hypotension, bradycardia Vision Changes
N/V/D Respiratory depression
Headache, dizziness Heptatotoxicity
Heart block Thrombocytopenia
Nursing Considerations:
-May increase toxicity for digitalis
-Monitor EKG, BP, and pulse
-Avoid changing positions (lying/sitting/standing) rapidly
-Avoid use w alcohol, caffeine, smoking
-Wear medical information tagg
-Rx |
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Term
Cardiovascular Medications
Antiarrhythmics
Sotalol
(Betapace)
Purpose: management of life-threatening ventricular arrythmias |
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Definition
Side effects:
Fatigue Life-threatening vent. N/V/D
Weakness arrhythmias Hyperglycemia
Dizziness, drowsiness Dyspnea Impotence
Bradycardia Bronchospasms Visual changes
Nursing Considerations:
-Teach pt to check radial pulse; if less than 50, hold med and contact provider
-PO: give 1 hr before or 1 hr after meals
-change positions (sitting/standing/lying) slowly
-Avoid activities that require alertness until drug response known
-Contact provider if slow pulse, difficulty breathing, wheezing, cold hands and feet, dizziness, confusion, depression, rash, fever, sore throat, unusual bleeding or bruising
-Milk products may decrease absorption
-Wear medical information tag
-Avoid alcohol, smoking, and sodium intake
-Rx |
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Term
Cardiovascular Medications
Antihypertensives
Bisoprolol
(Zebeta)
Purpose: treatment of mild to moderate hypertension |
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Definition
Side effects:
GI upset Postural hypertension
Dizziness, vertigo Impotence
Headache, fatigue Increased AST/ ALT
Bronchospasms, dyspnea
Nursing Considerations:
-Peak: 2-4 hours
-Therapeutic response in 1-2 weeks
-Do Not stop med abruptly; may precipitate angina
-Do not use OTC meds with stimulants, such as nasal decongestants or cold meds, unless directed
-Avoid alcohol, smoking, sodium intake
-Contact HCP if signs of CHF: difficulty breathing, night cough, swelling of extremities
-Teach pt to check radial pulse
-Rx |
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Term
Cardiovascular Medications
Antihypertensives
Clonidine Patch
(Catapres, Catapres TTS oral tablets)
Purpose: Tx of hypertension, severe pain in cancer patients, and ADHD |
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Definition
Side effects:
Drowsiness, sedation Hyperglycemia Impotence
Severe rebound hypertension N/V/Constipation Taste change
Dry mouth and eyes Orthostatic hypotension Dizziness
Headache Rash
Nursing Considerations:
-Avoid changing positions (lying/sitting/standing) rapidly
-Avoid use w alcohol, CNS depressants or OTC meds w stimulants
-Avoid high-sodium foods (canned soups, lunch meats, cheese)
-Avoid alcohol, smoking, strenuous exercise in hot enviroment
-Apply patch to nonhairy area (upper outer arm, anterior chest), rotate sites, do not apply to scarred or irritated area
-Wear medical information tag
-Rx |
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Term
Cardiovascular Medications
Antihypertensives
Hydralazine HCL
Purpose: Tx of essential hypertension and hypertensive emergency |
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Definition
Side effects:
Headache Anxiety
Palpitations, tachycardia, angina Rash
Edema Nausea, vomiting, diarrhea
Lupus like syndrome Hepatotoxicity
Anorexia Leukopenia
Dizziness Orthostatic hypotension
Nursing Considerations:
-Avoid changing positions (lying/standing/sitting) rapidly
-Contact HCP if chest pain, severe fatigue, fever, muscle, or joint pain
-Do not confuse with hydroxyzine
-Rx |
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Term
Cardiovascular Medications
Antihypertensives
Hydrochlorothiazide
(Prinzide, Zestoretic)
Purpose: Tx of essential hypertension |
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Definition
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Term
Cardiovascular Medications
Antilipemic Agents
Atorvastatin Calcium
(Lipitor)
Purpose: reduction of cholesterol levels |
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Definition
Side effects:
Constipation Arthralgia Increased liver enzymes
Abd. pain Impotence Lens opacities
Nausea, diarrhea Headache, insomnia
Nursing Considerations:
-Peak 1-2 hours
-Take without regard to food
-Avoid grapefruit products
-Contact provider immediately if unexplained muscle pain, tenderness, or weakness; in rare cases, can cause breakdown of skeletal muscle tissue, leading to kidney failure
-Rx |
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