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Pharmacology > cardiovascular agents > Flashcards

cardiovascular agents Flashcards

1
Q

Furosemide (Lasix) MOA

A

effects the ascending limb of loop of henle to block reabsorption of NA and Cl, prevents reabsorption of water

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2
Q

Furosemide (Lasix) indication

A

Pulmonary edema from HF
edema non-responsive to other agents
HTN not controlled by other agents

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3
Q

Furosemide (Lasix) adverse effects

A

decrease Na+ Cl K+ and BP
ototoxicity (ringing in ears)
dehydration with higher risk of thrombosis and emboli
ventricular dysrhythmias if used with digoxin

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4
Q

Furosemide (Lasix) nursing considerations

A

close monitoring of I/O, vitals, weight, hearing and electrolytes
admin in morning-early afternoon
Slow IVP- give 10-2mg/min
educate on K+ rich sources in diet

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5
Q

Hydrochlorothiazide (HCTZ) MOA

A

in distal convoluted tubule to block reabsorption of Na and Cl preventing water reabsorption

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6
Q

Hydrochlorothiazide (HCTZ) indications

A

hypertension
edema secondary to HF, hepatic, or renal disease
diabetes insipidus
postmenopausal osteoporosis

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7
Q

Hydrochlorothiazide (HCTZ) adverse effects

A

decrease Na+ Cl K+ and BP
dehydration with higher risk of thrombosis and emboli
ventricular dysrhythmias if used with digoxin

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8
Q

Hydrochlorothiazide (HCTZ) nursing consideration

A

cant be used with patients with low GFR
watch I/O, vitals, weight, electrolyte
morning-afternoon administrations
education on K+ rich sources in diet

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9
Q

Mannitol (Osmitrol) MOA

A

pulls fluid from interstitial space and moves it into vascular and extravascular space via osmosis

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10
Q

Mannitol (Osmitrol) indications

A

Prophylaxis of renal failure with hypovolemic shock and severe hypotension
Reduction of intracranial and intraocular pressure

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11
Q

Mannitol (Osmitrol) adverse effects

A

Edema, especially in patients with existing heart failure
Fluid & electrolyte imbalances

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12
Q

Mannitol (Osmitrol) nursing considerations

A

use filter needles to avoid microscopic crystals
watch for changes in ICP
if urine output decreases severely, STOP

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13
Q

Spironolactone (Aldactone) MOA

A

blocks action of aldosterone in distal nephron

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14
Q

Spironolactone (Aldactone) indications

A

hypertension, often co-administered with K+ wasting diuretics
edema
HF

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15
Q

Spironolactone (Aldactone) adverse effects

A

hyperkalemia
ednocrine effects menstrual irregularities, impotence, hirsutism and deepened voice

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16
Q

Spironolactone (Aldactone) nursing considerations

A

Watch i/o, vitals, weight,a dn electrolytes
educate pt on K+ rich diet

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17
Q

Kayexalate MOA

A

binds to K+ in intestine and excreted in stool

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18
Q

Kayexalate adverse effects

A

Gastric irritation
N/V
Constipation OR diarrhea
Hypokalemia

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19
Q

Kayexalate nursing considerations

A

Assess for bowel sounds/gastric motility prior to administering!
Monitor EKG
Monitor electrolytes

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20
Q

Lisinopril (Zestril) MOA

A

ACE inhibitor

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21
Q

Lisinopril (Zestril) indications

A

Hypertension, heart failure, & post-MI therapy
Prevention of MI, CVA, and death in patients with high CV risk
Diabetic nephropathy

22
Q

Lisinopril (Zestril) adverse effects

A

First-dose hypotension
Cough
Angioedema
Hyperkalemia
Fetal injury

23
Q

Lisinopril (Zestril) nursing considerations

A

Monitor BP and electrolytes closely
Instruct patients to contact provider if cough and/or angioedema occurs
Daily weights

24
Q

Losartan (Cozaar) MOA

A

ARBs

25
Q

Losartan (Cozaar) indications

A

Hypertension
Reduce risk of stroke, possibly MI and death in patients with high CV risk
Diabetic nephropathy and retinopathy

26
Q

Losartan (Cozaar) adverse effects

A

Angioedema, although risk may be lower
Fetal injury

27
Q

Losartan (Cozaar) nurisng considerations

A

ARBs often used when ACEi are not tolerated due to cough
Monitor BP closely, especially if on multiple agents
Instruct patients to contact provider if angioedema occurs

28
Q

Aliskiren (Tekturna) MOA

A

Binds with renin to inhibit cleavage of angiotensinogen into angiotensin I to reduce influence of entire RAAS
direct renin inhibitor

29
Q

Aliskiren (Tekturna) indication

A

HTN

30
Q

Aliskiren (Tekturna) adverse effects

A

Generally well tolerated
Diarrhea
Low risk of hyperkalemia, angioedema, and cough
Fetal injury and death

31
Q

Aliskiren (Tekturna)

A

Close monitoring of I/O, vital signs, weight, and electrolytes, especially if on multiple anti-hypertensive agents

32
Q

Nifedipine (Procardia) MOA

A

Blocks calcium channels on vascular smooth muscle, with minimal activity on heart

33
Q

Nifedipine (Procardia) inidcations

A

angina pectoris and hypertension

34
Q

Nifedipine (Procardia) adverse effects

A

Peripheral edema, flushing, headache, dizziness
Reflex tachycardia

35
Q

Nifedipine (Procardia) nursing considerations

A

Reflex tachycardia suppressed when combined with a beta blocker
Diuretic for peripheral edema
Assess BP and HR pre-administration

36
Q

Verapamil (Calan) MOA

A

Blocks calcium channels on the heart and blood vessels

37
Q

Verapamil (Calan) indications

A

angina pectoris, essential hypertension, and dysrhythmias

38
Q

Verapamil (Calan) adverse effects

A

Constipation is most common
Cardiosuppression with bradycardia, AV block, and decreased contractility with possible cardiotoxicity

39
Q

Verapamil (Calan) nursing consideration

A

Monitor for interactions, particularly with other cardiac medications including digoxin and beta blockers, and grapefruit juice
Assess BP and HR pre-administration
Gastric lavage, activated charcoal, IVF, IV calcium gluconate, and Trendelenburg’s for toxicity

40
Q

Hydralazine (Apresoline) MOA

A

Causes selective dilation of arterioles through actions on vascular smooth muscle to reduce peripheral resistance and blood pressure

41
Q

Hydralazine (Apresoline) indications

A

Essential hypertension
Hypertensive crisis
Heart failure

42
Q

Hydralazine (Apresoline) adverse effects

A

Reflex tachycardia
Increased blood volume
SLE-like syndrome

43
Q

Hydralazine (Apresoline) nursing considerations

A

Combined with isosorbide dinitrate when used for treatment of heart failure
!Co-administer with beta blocker to reduce of reflex tachycardia!
Co-administer with diuretic to reduce risk of sodium and water retention
Monitor vital signs closely, especially for excessive hypotension

44
Q

Nitroprusside (Nipride/Nitropress) MOA

A

causes both venous and arteriolar dilation to decrease BP

45
Q

Nitroprusside (Nipride/Nitropress) indications

A

Drug of choice for hypertensive emergencies
Controlled hypotension during surgery to reduce bleeding

46
Q

Nitroprusside (Nipride/Nitropress) adverse effects

A

Excessive hypotension
Cyanide poisoning most likely in patients with liver disease
Thiocyanate toxicity

47
Q

Nitroprusside (Nipride/Nitropress) nursing consideration

A

minimal reflex tachycardia
continuous vitals and ecg, frequent BP checks
start infusion at 0.3-0.5 mcg/kg/min and tritate slowly
co-admin with PO antihtn
immediate effects trigger Na & water retention-manage with furosemide

48
Q

Loop diuretic

A

severe HF
watch closely for dig toxicity
effective even with <GFR

49
Q

Thiazide diuretics

A

produce modest diuresis
not effective with <GFR, this is why loops are preferred

50
Q

Postassium sparing diuretics

A

produce little diuresis
used to counteract K+ loss from thiazide and loop diuretics
for patients also taking ACE or ARBs- watch K+ levels

Pharmacology (10 decks)

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