Cardiac Medications Flashcards

1
Q

suffix “olol”

A

Beta Blockers
(atenolol, carvedilol, labetalol, metoprolol, propranolol, sotalol)
NOTE: carvedilol and labetalol end in “lol” cause they are alpha/beta blocker drugs)

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2
Q

suffix “sartan”

A

angiotensin II receptor blockers (ARB)

losartan, valsartan, candesartan

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3
Q

suffix “pril”

A

ACE Inhibitors (angiotensin-converting enzyme)
(lisinopril, enalapril, and benazepril)

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4
Q

constipation is a side effect of this group of medications

A

calcium channel blockers

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5
Q

a headache is the most common adverse effect of this medication

A

nitroglycerin

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6
Q

these cardiac medications block the angiotensin converting enzyme from the formation of angiotensin II

A

ACE inhibitors

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7
Q

these drug classifications treat hypertension, heart failure, diabetic nephropathy, and MI

A

ACE inhibitors and ARB’s

Diabetic Retinopathy can be treated with enalapril or losartan

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8
Q

at risk patients will take this medication to help prevent adverse cardiovascular events such as MI and strokes

A

ACE inhibitors

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9
Q

a cough, angioedema, first-dose hypotension, and hyperkalemia are side of effects of this drug class

A

ACE inhibitors

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10
Q

this ACE inhibitor can be administered 2 to 3 times daily due to the short half-live

A

Captopril

all other ACE inhibitors have a prolonged half live and are given only once or twice daily

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11
Q

What ACE inhibitor can be given intravenously?

A

Enalaprilat

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12
Q

ACE inhibitors are used in caution with this patient population

A

patients who have kidney disease

The patient should have a smaller dose and nurses need to watch the patient’s kidney functions (I&O and labs)

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13
Q

potassium retention can be seen in these classes of drugs

A

ACE inhibitors, Potassium Sparing Diuretics, and ARBs

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14
Q

This drug classification blocks the effects of angiotensin II (vasoconstriction, sodium and water retention) by directly blocking the binding of angiotensin II to angiotensin II type 1 receptors.

mechanism of action

A

Angiotensin II receptor blockers(ARBs)

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15
Q

Angioedema, hypotension, hyperkalemia, diarrhea, dizziness, headache, fatigue are adverse effects of this drug classification

A

Angiotensin II Recpector Blockers (ARBs)

Note: ARBs do not have the adverse effect of a cough like ACE inhibitors

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16
Q

lip swelling, facial swelling, itchy hives, shortness of breath, dizziness, or fainting are symptoms of this adverse reaction

A

Angioedema

seen in patient who take ACE inhibitors, ARBs, & aliskiren (direct renin inhibitor) can be life threatening

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17
Q

what labs do you want to check for kidney functions?

A

BUN (blood urea nitrogen) and Creatitine

GFR is an important lab for kidney functions

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18
Q

prior to administration, the nurse should check an apical pulse for this medication

A

digoxin

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19
Q

how long should a nurse check an apical pulse for prior to the administrtation of digoxin

A

60 seconds

teach patients to check their radial pulse for 1 full minute and to hold if the heart rate is less than 60 beats per minute and notifiy their provider

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19
Q

this medication is used to treat heart failure and a-fib

A

digoxin

digoxin is a cardiac glycoside

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20
Q

what is the normal serum levels for digoxin

A

0.5 to 2.0ng/mL

above 2.0 is supratherapeutic which means too much in their system which can increase the adverse effects including dig toxicity

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21
Q

when taking digoxin, what other lab value do we monitor

A

potassium

hypokalemia can trigger digoxin toxicity; however, when a patient has digoxin toxicity, it can then cause
hyperkalemia, patients should also be on telemetry

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22
Q

loop diuretics and thiazide diuretics taken with digoxin increase the risk for

A

hypokalemia

patients should not take these diuretics with digoxin

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23
Q

dopamine and digoxin have a drug to drug interaction causing…

A

tachydysrhythmias

V-tach or V-fib, so patients should be monitored on telemetry when taking digoxin

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24
Q

bradycardia, constipation, peripheral edema, hypotension, drowsiness, and dizziness are adverse reactions of this drug class

A

calcium channel blockers

Hint: constipation is only an adverse reaction for calcium channel blockers, not alpha or beta

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25
Q

confusion, loss of appetite, nausea, vomiting, diarrhea, or vision problems, palpations, or an irregular heart beat are signs/symptoms of this adverse reaction

note: anoxeria is a loss of appetite

A

digoxin toxicity

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26
Q

the antidote for digoxin toxicity

A

digoxin immune Fab (Digibind)

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27
Q

weight loss, DASH diet, decrease sodium intake, exercise, smoking cessation and alcohol restriction are

A

lifestyle modifications to help reduce hypertension

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28
Q

normal blood pressure range

A

130/80 or less

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29
Q

these calcium channel blockers are more effective on vasodialtion and less effect on heart functions

A

dihydropyridines

these drugs end in the suffix “-dipine”

30
Q

nifedipine, nicardipine, amlodipine are examples of this drug class

A

calcium channel blockers-dihydropyridines

31
Q

reflex tachycardia

A

it is a decrease in the blood pressure causes the heart to beat faster in an attempt to raise it

vasodilators can cause reflex tachycardia

32
Q

this drug class treats reflex tachycardia

A

beta blockers

33
Q

these drugs can cause reflex tachycardia

A

direct vasodilators

34
Q

diltiazem and verapamil are drugs in this drug classificaiton

A

calcium channel blockers

these two drugs are non-dihydropyridine, they treat hypertension, chest pain, and A-fib/A-flutter

35
Q

fatigue, dizziness, heartburn and swelling in ankles and feet are side effects of this drug class

A

calcium channel blockers

36
Q

the increase in bradykinins promotes a cough when taking this drug classificaiton

A

ACE inhibitors

patients need to report this adverse effect to their providers, the persistent cough can cause bronchospasm, they can be switched to an ARBs

37
Q

a patient with hypertension will be prescribed what drug classifications

A

ACE inhibitors, ARBs, Diuretics, Beta Blockers, Alpha Blockers, Calcium Channel Blockers, Vasodilators, Direct Renin Inhibitors, Central Acting Adrenergic Agents

a patient will be on 2 to 3 blood pressure medications because they function in different parts of the body

38
Q

This drug classificaiton acts directy on the peripheral arteries causing them to dialte which leads to lower blood pressure

A

Direct vasodilators

39
Q

hydralazine, nitroprusside and minoxidil are part of this drug classification

A

direct vasodilators

40
Q

tachycardia and hypernatermia are two common side effects of this drug classification

A

direct vasodilators

41
Q

a diastolic bp that exceeds 120 mmHg is considered a

A

hypertensive crisis

42
Q

excessive hypotension, cyanide poisoning, thiocynate toxicity are severe advers reactions of this drug

A

nitroprusside

43
Q

routes of administration for direct vasodilators

A

Intravenous (IV) is most common but hydralazine can be given oral or intramuscular

44
Q

flu-like symptoms followed by a painful red/purplish rash that spreads and blister skin lesions

A

Stevens-Johnson syndrome

rare serious adverse effect for calcium channel blockers, direct vasodilators, and acetaminophen

45
Q

nursing interventions prior to or when administration of blood pressure medications

A

baseline weight, check for edema, listen to lung sounds, monitor I&Os, check BP/pulses, assess mental status, educate the patient

46
Q

general patient education for blood pressure medications

A

do not stop taking, do not miss a dose, do not double a dose, no abrupt changes to position, monitor weight, check legs/ankle/feet for edema, check pulses/BP, and report any dizziness or lightheadedness

47
Q

patient education for nitroglycerin transdermal patchs

A

remove patch at night, only to wear the patch for 10 to 12 hours daily, rotate sites, wash the skin with soap and water after removal, do not cut patches in half, wear the patch on the chest, back, or abdomen

48
Q

patient education for nitroglycerin sublingual tablets or transligual spray

A

use medication with the first onset of chest pain, use prior to activities that cause chest pain, place tablet under tongue or spray into the mouth, store the medication in a cool, dark place

keep the bottle out of direct sunlight and warm places like a pants pocket, the heat lows the effectiveness of the medication

49
Q

routes of administration for nitroglycerin

A

sublingual, translingual spray, sustained-release oral capsules, transdermal, topical ointment, and intravenous

50
Q

Patient education for taking sublingual nitroglyercin during an angina attack

A

stop activity, sit down or lie down, take the 1st tablet, wait 5 minutes, if no relieve call 911 and take a 2nd tablet, after another 5 minutes and no relieve, take a 3rd tablet and wait for the ambulance, do not take more than 3 tablets

51
Q

Male patients should not take nitroglycerin when taking these medications

A

PDE5 Inhibitors (sildenafil, tadalafil, vardenafil)

the drug to drug interaction is severe life-threatening hypotension, if the male patient has taken these medications, do not give nitro and inform the doctor

52
Q

antagonists

A

will stop or reverse an action

52
Q

normal serum potassium level

A

3.5 to 5.0 mEq/L

52
Q

eplerenone and spironolactone are found in this drug classification

A

aldosterone antagonists

another name is potassium sparing diuretics

53
Q

agonists

A

a drug that binds to the receptor and produces a similar response

54
Q

dobutamine, norepinephrine, dopamine are

A

beta-1 agonists

these drugs bind to the receptors in the heart causing an increase in the heart rate and increase the force of contractions

55
Q

epinephrine and isoproterenol are

A

beta-1 and beta-2 adreneric receptor agonists

these drugs treat bradycardia and heart block, these drugs are bronchodilators too

56
Q

Patient teaching for aldosterone antagonists

A

avoid potassium supplements, avoid salt substitutes (Mrs. Dash),

57
Q

dopamine is used to treat

A

heart failure, shock, and acute kidney injury

58
Q

nursing interventions for patients who are receiving antidysrhythmic medications

A

place on telemetry, monitor vital signs, complete a head to toe physical assessment, monitor lab values (liver & kidney functions)

59
Q

Cinchonism is an adverse effect of quinidine. What is cinchomism?

A

vertigo, n/v, headache, abdominal pain, vision loss or changes, hearing loss, and tinnitus

so when a patient c/o these signs/symptoms, the medication needs to be stopped immediately

60
Q

the life threatening adverse effects of amiodarone are

A

pulmonary toxicity and cardiotoxicity

61
Q

amiodarone is use to treat these heart rhythms

A

v-fib, v-tach and longterm treatment for A-fib

62
Q

this medication is used to treat supraventricular tachycardia

A

adenosine

63
Q

the half life for adenosine is

A

1.5 to 10 seconds

for this reason, the medication is pushed quickly, followed by a flush, and given in a vein nearest to the heart (right antecubital)

64
Q

the first dose of adenosine is ______mg.

A

6mg

follow by a 2nd dose of 12mg

65
Q

patient education for diabetics taking a beta blocker

A

monitor blood sugars and s/sx for hypoglycemia

beta blocker can cause hypoglycemis and mask the symptoms of hypoglycemia, so patient are not experiencing the typical warning signs of hypoglycemia

66
Q

patient education for orthostatic hypotension

A

change positions slowly, report any lightheadedness/dizziness with movement, to remain sitting or lying if dizziness or lightheadedness occurs. notified provider

67
Q

gynecomastia is an adverse effect of this drug class

also hyperkalemia/hyponatremia

A

aldosterone antagonists

eplerenone and spironolactone

68
Q

what drugs cause a first dose hypotension

A

ACE inhibitors, alpha blockers

69
Q

when a patient abruptly discontinues blood medication this adverse effect happens

A

rebound hypertension

70
Q

beta-1 blockers/beta-2 blockers start with letter O through Z are not safe for this type of patient

A

patients who have COPD or Asthma

the beta-2 effects the smooth muscles/lungs