10 minute topic Cardiovascular medications Flashcards by Sarah Blevins

Nitroglycerin use/function

stable angina
vasodilator
decreases O2 demand
Can be used in HF

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Nitroglycerin use in variant angina

prevents or reduces coronary artery spasm and that provides more oxygen to the myocardium itself

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Nitroglycerin cautions

use cautiously with antihypotensives due to risk of orthostatic hypotension

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IV nitroglycerin

given to control angina that did not respond to other meds or to keep BP low

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Nitroglycerin PT teaching

HA is common
Orthostatic hypotension
Flushing is common
Reflex tachycardia
will develop a tolerance (need to have a nitrate free period)

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Nitroglycerin interactions with food

ETOH causes hypotension

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Instructions for nitrate use

Chest pain → stop activity & rest →sublingual nitro x3, 5min apart, →unrelieved 911

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Nitroglycerin storage

Glass container in a dark place, can’t get too warm so not in a pants packet

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metoprolol tartrate (Lopressor) & atenolol (Tenomin) category

Beta blockers

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metoprolol tartrate (Lopressor) action

antidysrhthmic (blocks conduction through SA and AV nodes) and antihyperstensive
Decreases heart rate and contractility therefore it decreases oxygen demand by the myocardium
Blocks renin release

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metoprolol tartrate (Lopressor) nursing consideration

monitor bradycardia and hypotension
Use in caution with HF
Avoid use in PT’s with asthma due to bronchospasm
Can mask hpyoglycemic sx in DM

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streptokinase (Streptase) alteplase (Activase), Reteplase (Retavase) category

thrombolytics

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thrombolytics action

these medications dissolve clots that have already formed

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thrombolytics used to tx what

treat MI (with MI best to give within 6 hours of infarct), DVT, massive pulmonary emboli and ischemic strokes

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thrombolytics nursing considerations

do not use in active bleeding
monitor PT, aPTT, INR, fibrinogen levels, CBC
Monitor for allergic reaction (urticaria, itching, flushing)

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ASA (salicylic acid), enteric coated is called (Ecotrin), clopidogrel (Plavix) category

Antiplatelet agents

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Antiplatelet agents use

Acute MI- Primary
Prevention of reinfarction
Prevention of stroke
Acute coronary syndromes

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Antiplatelet agents nursing considerations

can cause GI upset
use cautiously in PT’s with ulcers
Tinnitus is possible side effect or indication of toxicity

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Antiplatelet agents teaching

take with food
report tinnitus
increased bleeding risk

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Eptifibatide (Integrilin) category

Glycoprotein IIB/IIIA inhibitors

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Glycoprotein IIB/IIIA inhibitors use

prevent the binding of fibrogen, in turn by blocking platelet aggregation. It is used in combination with ASA therapy

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Glycoprotein IIB/IIIA inhibitors nursing consideration

can cause active bleeding, need to report s/sx of bleeding

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Diuretics use

reduce preload

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Loop diuretics

Study These Flashcards

furosemide(Lasix) bumetanide (Bumex) – ↓Na reabsorption ↑K+ excretion

Thiazide diuretics

hydrocholorothiazide (Hydrodiuril)

K+ sparing diuretics

spironolactone (Aldactone) in distal tubule prevent NA reabsorption in exchange for K+ watch for hyperkalemia

K+ outside normal ranges causes what

too low = muscle weakness, irregular pulse | too high = slow heart

IV lasix rate

no faster than 20 mg.min

Heparin category

anticoagulant

Unfractionated heparin

must be given IV | prevents clots from forming or becoming bigger

Warfarin (coumadin)

given PO | it must be given 3-5 days in concurrence with Heparin or Lovenox to get to a therapeutic levels

Anticoagulant nursing considerations

monitor platelets | monitor bleeding, PT & INR

Labs to monitor with heparin

aPTT for titration of dose, so based on what the PTT is the dose will be titrated to that

Antidote for heparin

protamine sulfate | made from salmon semen

Warfarin antidote

vitamin K

Who takes warfarin?

chronic Afib to < risk of clots being tossed | those with prosthetic heart valves

ACE inhibitors & ARBs function

afterload reducers, they help heart pump more easily by altering the resistance to contraction

enalapril (Vasoctec) captopril (Capoten) category

ACE inhibitor

losartan (Cozaar) candesartan (Atacand) category

ARB

ARB ending

sartan

ACE ending

pril

ACE and ARB contraindications

renal deficiency

ACE and ARB nursing considerations

monitor BP closest after 1st dose for hypotension | monitor for high K+

digoxin (Lanoxin), dopamine, dobutamine (Dobutrex) milrinone (Primacor) category

Inotropic Agents

Inotropic Agents function

Increase the force of myocardial contraction and improve cardiac output

Inotropic Agents used for what?

HF and also in patients who have dysrhythmias, primarily Afib

dopamine, dobutamine, milrinone administration

IV only | Will be in ICU, monitor ECG, BP and urine output

PO digoxin considerations

give at the same time daily no antacids within 2 hours regular dig and K+ levels

Signs of digoxin toxicity

fatigue, muscle weakness, anorexia, confusion, vision changes, halos around lights, problems with night vision

Interaction of digoxin and loop diuretics

increases the risk of digoxin induced dysrhythmias

Interaction of digoxin and ACE + ARB

increased risk of hyperkalemia and can decrease therapeutic actions of the digoxin

Verapamil hydrochloride (Calan) amlodipine (Norvasc) diltiazem (Cardizem) category

Calcium channel blocker

Verapamil hydrochloride (Calan) amlodipine (Norvasc) diltiazem (Cardizem) function

alter the movement of Ca+ ions through the cell membrane causing vasodilation and lower BP Used for angina and dysrhythmias, primarily Afib, Atrial flutter and SVT

Calcium channel blocker cautions

HF and heart block, and bradycardia | If using Verapamil or Cardizem be careful when using digoxin or beta blockers

Calcium channel blocker education

can cause constipation Bradycardia & AV block can occur avoid grapefruit juice

atorvastatn (Lipitor), simvastatin (Zocor) lovastatin (Mevacor), Pravastatin sodium (Pravachol), Rosuvastatin (Crestor) category

Antilipemics - STATINs

Antilipemics - STATINs function

Lowers LDL levels by suppressing cholesterol synthesis in the liver and increases HDL

Antilipemics - STATINs cautions

PT's with liver disease

Antilipemics - STATINs adverse effects

hepatotoxicity- so we need LFT's Myopathy- muscle aches and pain in peripheral extremities Peripheral neuropathy -tingling in hands and feet

10 minute topic Cardiovascular medications Flashcards

(59 cards)