10 minute topic Cardiovascular medications Flashcards Preview

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Flashcards in 10 minute topic Cardiovascular medications Deck (59):
1

Nitroglycerin use/function

stable angina
vasodilator
decreases O2 demand
Can be used in HF

2

Nitroglycerin use in variant angina

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

3

Nitroglycerin cautions

use cautiously with antihypotensives due to risk of orthostatic hypotension

4

IV nitroglycerin

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

5

Nitroglycerin PT teaching

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

6

Nitroglycerin interactions with food

ETOH causes hypotension

7

Instructions for nitrate use

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

8

Nitroglycerin storage

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

9

metoprolol tartrate (Lopressor) & atenolol (Tenomin) category

Beta blockers

10

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

11

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

12

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

thrombolytics

13

thrombolytics action

these medications dissolve clots that have already formed

14

thrombolytics used to tx what

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

15

thrombolytics nursing considerations

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

16

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

Antiplatelet agents

17

Antiplatelet agents use

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

18

Antiplatelet agents nursing considerations

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

19

Antiplatelet agents teaching

take with food
report tinnitus
increased bleeding risk

20

Eptifibatide (Integrilin) category

Glycoprotein IIB/IIIA inhibitors

21

Glycoprotein IIB/IIIA inhibitors use

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

22

Glycoprotein IIB/IIIA inhibitors nursing consideration

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

23

Diuretics use

reduce preload

24

Loop diuretics

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

25

Thiazide diuretics

hydrocholorothiazide (Hydrodiuril)

26

K+ sparing diuretics

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

27

K+ outside normal ranges causes what

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

28

IV lasix rate

no faster than 20 mg.min

29

Heparin category

anticoagulant

30

Unfractionated heparin

must be given IV
prevents clots from forming or becoming bigger

31

Warfarin (coumadin)

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

32

Anticoagulant nursing considerations

monitor platelets
monitor bleeding, PT & INR

33

Labs to monitor with heparin

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

34

Antidote for heparin

protamine sulfate
made from salmon semen

35

Warfarin antidote

vitamin K

36

Who takes warfarin?

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

37

ACE inhibitors & ARBs function

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

38

enalapril (Vasoctec) captopril (Capoten) category

ACE inhibitor

39

losartan (Cozaar) candesartan (Atacand) category

ARB

40

ARB ending

sartan

41

ACE ending

pril

42

ACE and ARB contraindications

renal deficiency

43

ACE and ARB nursing considerations

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

44

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

Inotropic Agents

45

Inotropic Agents function

Increase the force of myocardial contraction and improve cardiac output

46

Inotropic Agents used for what?

HF and also in patients who have dysrhythmias, primarily Afib

47

dopamine, dobutamine, milrinone administration

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

48

PO digoxin considerations

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

49

Signs of digoxin toxicity

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

50

Interaction of digoxin and loop diuretics

increases the risk of digoxin induced dysrhythmias

51

Interaction of digoxin and ACE + ARB

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

52

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

Calcium channel blocker

53

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

54

Calcium channel blocker cautions

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

55

Calcium channel blocker education

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

56

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

Antilipemics - STATINs

57

Antilipemics - STATINs function

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

58

Antilipemics - STATINs cautions

PT's with liver disease

59

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