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d-pharmacology > cardio/ renal drugs specific > Flashcards

cardio/ renal drugs specific Flashcards

1
Q

What is amiodrarone

(not the class)

A

Potassium channel blockers

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2
Q

Classification of amiodarone

A

Antiarrythmic

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3
Q

amiodarone MOA

A

prolongs repolarization by blocking potassium channels in cardiac cells

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4
Q

when is amidarone indicated

A

Indicated only for the treatment of life-threatening recurrent ventricular dysrhythmias when unresponsive to other treatments

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5
Q

what happens when you take amidarone

A

Usually hospitalized during initiation for close monitoring

Monitor BP & HR for profound hypotension and bradycardia

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6
Q

What should you avoid/ consider w/ AMIODARONE

A

Black Box warning: Fatal toxicities (pulmonary, arrhythmia exacerbation, liver, heart block)

Avoid grapefruit juice

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7
Q

Classification of Dilitazem

A

Antiarryhtmic

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8
Q

what does dilitazem do

A

Calcium channel blockers

  • blocks calcium during depolarization
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9
Q

what might patients expieinece using dilitazem

and what should you check

A

Patients may experience:
Bradycardia (assess hr) – Check VItals

Edema (assess lung sounds/presence of edema)

hypotension (assess for orthostatic hypotension, advise slow positional changes)

Headache (assess bp to ensure med is working/provide analgesic)

Dizziness (D/t hypotension – Slow positional changes)

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10
Q

what to avoid with dilitazem

A

Use caution with otc/herbal medications d/t interactions

Avoid grapefruit juice

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11
Q

classification of adenosine

A

antiarryhmics

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12
Q

adenosine use

moa

A

emergent use,

slows conduction

svt–Supraventricular tachycardia

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13
Q

Patients may experience with adenosine

and what to check for

A

Prolonged asystole/absence of pulse (monitor w/ EKG)

Palpitations (monitor pulse for 1 minute)

hypotension (assess for orthostatic hypotension, monitor bp, advise slow positional changes)

Bronchospasms/shortness of breath (assess airway/lung sounds, monitor for severe sob)

Facial flushing (update PCP with presence, maintain skin integrity)

Loss of consciousness (assess loC)

Dizziness (teach on slow positional changes)

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14
Q

clarification of digoxin

A

antiarrythmics

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15
Q

what is digoxin

not the class

A

Cardiac glycosides

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16
Q

what does digoxin do

A

inhibits na/k pump to raise CO/ lower HR

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17
Q

Patients may experience with digoxin

A

Digoxin toxicity (n/v, fatigue, halos/blurring, bradycardia)
—Make sure to monitor digoxin levels (0.8-2.0 therapeutic)

Bradycardia (assess apical pulse x 1 minute – hold <60bpm)

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18
Q

What at risk for with digoxin

A

risk for toxicity d/t hypokalemia (monitor potassium level (3.5-5.0

Increased risk w/ renal impairment – can’t excrete properly so becomes toxic!!!

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19
Q

medication considerations with digoxin

antidote

A

Use extreme caution with other medications that decrease potassium (fureosemide)

Antidote: digibind

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20
Q

classification of nitroglycerin

A

vasodilator

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21
Q

what does nitroglycerin treat

A

treats angina caused by atherosclerosis (chronic pain) or MI (acute pain)

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22
Q

Patients may experience with nitroglycerin

A

Hypotension / dizziness (monitor BP after each dose, advise slow positional changes, sit down!!!)

Headache (d/t vasodilation – increased blood flow)

Sweating (may make you feel like you’re going to pass out)

n/v

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23
Q

what does nitroglycerin come in

A

comes In sl, xr tabs, creams, patches, or iv (wear gloves when applying the patch)

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24
Q

nitroglycerin considerations

don’t give/keep

A

Keep the bottle out of sunlight / away from heat (decomposes)

Do not give with sildenafil!!! (can cause severe hypotension leading to mi/cardiac death)

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25
Q

furosemide classifications

A

loop diuretic

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26
Q

Furosemide MOA

A

prevents reabsorption of na/cl in loop of kidneys

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27
Q

Furosemide uses to treat

A

Used to treat edema, heart failure & hypertension (removes fluid – potassium wasting diuretic!!!

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28
Q

Patients may experience with furosemide

and what to monitor

A

Dehydration (rehydrate w/ electrolytes)

Hypotension / dizziness (monitor BP, advise slow positional changes)

Hypokalemia (monitor kidney function, replace potassium)

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29
Q

Considerations with furosemide

what monitor/when take

A

may need to adjust dose if causing harm to kidneys

Monitor weight (3# in day / 5# in a week) – contact pcp
Do not readjust dose independently if weight gain occurs

Administer IV furosemide Slowly (can cause ototoxicity)

Take early in the morning to prevent nocturia

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30
Q

classification of Hydrochlorothiazide

A

thiazide diuretics

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31
Q

Hydrochlorothiazide Moa

A

– promotes excretion of sodium & water

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32
Q

Hydrochlorothiazide use

A

Used to manage hypertension and edema

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33
Q

Hydrochlorothiazide

Patients may experience:

A

Electrolyte depletion (rehydrate w/ electrolytes)

Hypotension / dizziness (monitor BP, slow positional changes)

Photosensitivity (use sunscreen)

Renal impairment (monitor kidney function)

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34
Q

Hydrochlorothiazide considerations

A

Thiazide diuretics are not effective for immediate diuresis

Take at the same time each day

Monitor weight

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35
Q

spironolactone classification

A

potassium sparing diuretics

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36
Q

spironolactone moa

A

promotes excretion of sodium & water but retains potassium

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37
Q

spironolactone use

A

Used to manage hypertension and edema in HF

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38
Q

spironolactone

Patients may experience:

A

Hyperkalemia (monitor kidney function, limit potassium)—Salt substitutes & Potassium rich foods (bananas, potatoes, oranges)

Hypotension / dizziness (monitor BP, advise slow positional Changes)

Dehydration (rehydrate

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39
Q

Spironolactone considerations

A

may need to adjust dose if causing harm to kidneys

Take at the same time each day

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40
Q

clonidine – classification

A

alpha 2 agonist

41
Q

clonidine moa + do

A

stimulates alpha-adrenergic receptors = vasodilation & decreased BP

42
Q

clondine use

A

Used to manage hypertension and adhd

43
Q

Clondine considerations

A

Monitor heart rate and blood pressure

Do not stop abruptly d/t rebound hypertension

Avoid alcohol and other cns depressants

44
Q

Patients may experience:
clondine

A

Hypotension (monitor BP, advise slow positional
Changes)

Dry mouth / dry eyes (rehydrate / keep moist)

45
Q

metoprolol classification

A

beta 1 antagonist

46
Q

metoprolol – moa

A

blocks beta-1 receptors = decreased BP & heart rate

47
Q

what is metoprolol used for

A

Used to manage hypertension, chest pain & tachycardia

48
Q

Patients may experience with metoprolol

A

bradycardia (monitor apical pulse & hold <60bpm)

Shortness of breath d/t bronchoconstriction (caution with breathing diagnosis)

Hypotension (monitor bp & use slow positional changes)

49
Q

Metoprolol considerations

A

Monitor vital signs (heart rate, blood pressure, respiratory rate)

Do not stop abruptly d/t rebound hypertension

Do not crush extended-release formulas

50
Q

metoprolol can mask what

A

Can mask hypoglycemia (monitor blood sugars if diabetic)

causes Confusion, dizziness, sweating (cool and clammy – eat some candy)

51
Q

classification of captopril

A

ace inhibitor

52
Q

captopril MOA

A

blocks conversion of angiotensin I to angiotensin ii

53
Q

what does captopril used for and what does it do

A

Used to manage hypertension & heart failure

= decreased BP

54
Q

what might patients experience with captopril

A

Dry, non-productive cough (contact pcp, medication will be stopped/changed)

Hyperkalemia (monitor kidney function, limit potassium)

Hypotension (monitor bp & use slow positional changes)

Angioedema

55
Q

nursing considerations for captopril

limit

A

Limit all:
salt substitutes & Potassium rich foods (bananas, potatoes, oranges),
medications that increase potassium

Angioedema (go to ER!!!!) Concern for AIRWAY!!!

56
Q

losartan classification

A

angiotensin ll receptor blocker

57
Q

losartan moa

A

– blocks angiotensin ii = decreased BP

58
Q

losartan use

A

Used to manage hypertension & prevent nephropathy (kidney deterioration)

59
Q

what pt experience with losartan and what might nursing considerations

A

Hypotension (monitor bp & use slow positional changes)

Angioedema (go to ER!!!!) – more likely if used w/ an ace

Increased risk for infection (good hygiene/skin integrity, monitor for s/s of infection)

Hyperkalemia (monitor kidney function, limit potassium)–Salt substitutes & Potassium rich foods (bananas, potatoes, oranges), medications that increase potassium

60
Q

classification of hydralazine

A

vasodilator

61
Q

hydralazine used for/moa

A

relaxes blood vessels to treat hypertension

62
Q

what patients experience with hydralazine

A

Hypotension / dizziness (monitor BP, advise slow positional changes, sit down!!!)

Headache (d/t vasodilation – increased blood flow)

Palpitations / angina

Tremors, numbness, tingling

n/v/d

63
Q

what are you monitoring for with hydralazine

A

Monitor for infection, increased risk for developing systemic lupus erythematosus (SLE) – immune system attacks its own tissues (fatigue, joint pain, butterfly rash)

Consult pcp if 2 or more doses are missed

Monitor weight and assess for fluid retention

64
Q

classification of atorovasatin

A

HMG-COA reductase inhibitor

65
Q

atorvastatin – moa

A

blocks the enzyme that makes cholesterol

66
Q

what is atorvastatin used for

A

Used to treat high cholesterol (hyperlipidemia)
Assess liver function

67
Q

Patients may experience with atorvastatin –

A

n/V

Dyspepsia (avoid acidic/spicy foods)

Increased glucose (monitor sugars with diabetics)

Rhabdomyolysis (skeletal muscle breakdown)

Muscle pain, tenderness, weakness (contact PCP)

Myalgia (muscle pain)

68
Q

what to consider with atorvastatin –

A

Avoid taking with grapefruit juice

May take 2 weeks to reach therapeutic levels

69
Q

classification of ezetimibe

A

cholesterol absorption inhibitor

70
Q

ezetimibe moa

A

blocks cholesterol absorption

71
Q

ezetimibe used for

A

Used to treat high cholesterol (hyperlipidemia)

72
Q

Patients may experience:
with ezetimibe

A

diarrhea

Upper respiratory infections (teach pulmonary hygiene)

Hepatic impairment (monitor liver function labs)

Rhabdomyolysis (skeletal muscle breakdown)

Muscle pain, tenderness, weakness (contact PCP)

arthralgia (joint stiffness)

73
Q

what to consider with ezetimibe

A

Avoid taking with grapefruit juice

Take as prescribed

74
Q

classification of heparin

A

anticoagulant

75
Q

heparin moa

A

heparin – inhibits clot formation

76
Q

heparin used for

A

Used to prevent clots

77
Q

what might patients expirience with heparin

A

sudden vital changes (internal bleeding)

Low BP & High HR

Bleeding (teach bleeding precautions

78
Q

bleeding precautions

A

Use caution with knives, use soft toothbrush, use electric razor, monitor for blood in stool/urine, IM injections

79
Q

medications consideration for heparin

antidote

A

Monitor ptt with iv use to ensure therapeutic range

High-alert medication

Avoid medications containing aspirin or nsaids

Antidote: protamine sulfate

80
Q

classification of enoxaparin

A

anticoagulant

LMW

81
Q

what does enoxaparin do

A

Used to prevent blood clots

82
Q

advantages of enoxaparin

A

NO labs

83
Q

what might patentees expiernce with enoxaparin

A

Bleeding (teach bleeding precautions)

Risk for heparin-induced thrombocytopenia (HIT) – low plt

84
Q

What medications to avoid with enoxaparin and how to inject

A

Avoid medications containing aspirin or nsaids
Injection

“love handles” of abdomen – 2” away from belly button
Given subcutaneous (bunch skin)
Do not massage
Do not express air

85
Q

classification of warfarin

A

anticoagulant

86
Q

warfarin moa

A

inhibits synthesis of vitamin-k clotting factors

87
Q

warfarin used for

A

Used to prevent clots/dvt, used for a. fib, stroke prevention

88
Q

pt expirence with warfarin

A

Bleeding (teach bleeding precautions) – do not give w/ excessive bleeding!!!

89
Q

what to avoid with warfarin and the antidote

A

Avoid :
-grapefruit juice
-high contact sports
-medications containing aspirin or nsaids

Antidote: vitamin k
Foods w/ Vitamin K (kale, spinach, turnips, broccoli, dark leafy greens, some vegetables)

90
Q

what to monitor for with warfarin and typical onset

A

Monitor pt/inr to ensure therapeutic range (2.0 – 3.0)

Onset takes 2 – 7 days (may overlap w/ other treatments)

91
Q

classification for Aspirin & Clopidogrel

A

anti platelet

92
Q

Aspirin & Clopidogrel Moa

A

inhibits platelet activation and aggregation

93
Q

Aspirin & Clopidogrel use

A

Used to reduce risk of Myocardial infarction (MI) & Stroke

94
Q

Aspirin & Clopidogrel

Patients may experience:

A

Bleeding (teach bleeding precautions) – do not give w/ excessive bleeding!!!
Use caution with knives, use soft toothbrush, use electric razor, monitor for blood in stool/urine

Report tinnitus, unusual bleeding/bruising/blood in stool

95
Q

Aspirin & Clopidogrel considerations

A

duration is 7-10 (life of a platelet)–Must stop taking several days prior to surgery d/t bleeding risk

Concurrent use (ASA & Clopidogrel) increases bleeding in elderly

Contraindicated in children <12 with flu-like symptoms (reye’s syndrome)

Avoid medications containing nsaids

Overdose is irreversible

96
Q

sildenafil classification

A

pde 5 inhibitor

97
Q

sildenafil moa/ use

A

relaxes smooth muscles (heart) increasing blood flow (causing vasodilation)

98
Q

sildenafil – patients may experience

A

Hypotension / dizziness (monitor BP, advise slow positional changes, sit down!!!)

Headache (d/t vasodilation – increased blood flow)

flushing (may make you feel like you’re going to pass out)

Vaso-occlusive crisis (occlusion of blood vessel)

Priapism (go to er if lasts >4 hours)

99
Q

sildenafil black box

A

Do not give with other nitroglycerin!!!!! (can cause severe hypotension leading to mi/cardiac death)

d-pharmacology (14 decks)

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