Cardiovascular Medications Flashcards
(163 cards)
1
Q
Key side effects of direct renin inhibitor aliskiren (Tekturna) for hypertension
A
Hypotension, angioedema, GI upset
2
Q
Captopril (Capoten) and lisinopril (Prinivil, Zestril) are examples of
A
ACE inhibitors
3
Q
Key side effects of ACE inhibitors
A
Hypotension, Angioedema, Cough, Elevated potassium, rash, altered taste
4
Q
Losartan (Cozaar) and valsartan (Diovan) are examples of
A
Angiotensin II Receptor Blockers (ARBs)
5
Q
Key side effects of ARBs
A
Hypotension, dizziness, GI upset
6
Q
Direct Renin Inhibitors, ACE inhibitors, and ARBs all carry a blackbox warning for
A
Fetal toxicity (do NOT use during pregnancy)
7
Q
Patient education for ACE inhibitors and ARBs
A
Change positions slowly
8
Q
ACE inhibitors and ARBs work on different parts of the RAAS system resulting in
A
Vasodilation
9
Q
Eplerenone (Inspra) is an example of an
A
Aldosterone antagonist
10
Q
Key side effect of eplerenone (Inspra)
A
Hyperkalemia (monitor potassium levels during therapy!)
11
Q
Verapamil (Calan), nifedipine (Procardia, Adalat), and diltiazem (Cardizem) are examples of
A
Calcium channel blockers
12
Q
Calcium channel blockers can be used to treat hypertension and
A
Angina
13
Q
Calcium channel blockers work by blocking calcium channel in blood vessels and heart, leading to _________, _________ HR and BP
A
Vasodilation; decreased
14
Q
Key side effects of calcium channel blockers
A
Peripheral edema, hypotension, bradycardia
15
Q
Calcium channel blockers patient education
A
NO grapefruit juice
16
Q
Clonidine (Catapres) is used for the treatment of hypertension by _________ sympathetic outflow to heart and blood vessels, resulting in _________ HR and BP
A
Decreasing; decreased
17
Q
Key side effects of clonidine (Catapres) (HINT: 3 Dās)
A
Dizziness, Drowsiness, Dry mouth
18
Q
Clonidine (Catapres) patient education
A
Suck on hard candy for dry mouth
19
Q
Metoprolol (Lopressor) and atenolol (Tenormin) are examples of
A
Beta1 Blockers
20
Q
Beta1 blockers _________ BP and HR
A
Decrease
21
Q
Key side effects of Beta1 blockers
A
Bradycardia, hypotension, erectile dysfunction
22
Q
Beta1 blockers blackbox warning
A
Abrupt discontinuation of these medications can cause angina and MI
23
Q
Beta1 blockers patient education
A
Change positions slowly
24
Q
Beta1 blockers nursing consideration
A
May mask the signs of hypoglycemia
25
Propranolol (Inderal), labetalol, and carvedilol (Coreg) are examples of
Non-selective beta blockers
26
Non-selective beta blockers work by blocking beta1 receptors in the _____ and beta2 receptors in the _____, by _________ BP and HR
Heart; lungs; decrease
27
Key side effects of nonselective beta blockers
Bronchospasm, hypotension, bradycardia, erectile dysfunction
28
Nonselective beta blockers nursing consideration
DO NOT use in patients with asthma due to side effect of bronchospasm
29
Nitroprusside (Nitropress) is a _________ indicated for hypertensive crisis
Vasodilator
30
Key side effects of nitroprusside (Nitropress)
Hypotension, cyanide and thiocyanate toxicity
31
Nitroprusside (Nitropress) blackbox warning
Severe hypotension
32
Nursing interventions for severe hypotension resulting from nitroprusside (Nitropress)
Elevate legs, decrease dose, increase fluids per facility protocol
33
Nitroglycerin, isosorbide mononitrate (Imdur), and isosorbide dinitrate are examples of
Antianginals
34
Side effects of antianginals
Orthostatic hypotension, headache, reflex tachycardia
35
How should sublingual nitroglycerin be stored?
In a cool/dark place
36
How should the nurse instruct the patient to take sublingual nitroglycerin for chest pain?
Take up to 3 tabs. Place 1st under tongue, wait 5 min. If no relief, call 911. Take 2nd tab, wait 5 min. If no relief, take 3rd.
37
Administration of topical nitroglycerin
Wear gloves, remove prior dose, rotate sites, place on hairless site
38
Cardiac glycoside indicated for HF, Afib, and Aflutter
Digoxin (Lanoxin)
39
How does digoxin (Lanoxin) work?
Increases the force of contractions and decreases HR
40
Key side effects of digoxin (Lanoxin)
Dysrhythmias, bradycardia, digoxin toxicity
41
S/S of digoxin toxicity
GI upset (vomiting), sudden fatigue/weakness, vision changes
42
Digoxin (Lanoxin) nursing consideration
Check pulse prior to administration. If pulse <60, hold the dose
43
Digoxin (Lanoxin) therapeutic range
0.5-2 ng/mL
44
_________ increases the risk of digoxin toxicity
Hypokalemia
45
Treatment for bradycardia associated with digoxin (Lanoxin) therapy
Atropine
46
Procainamide and lidocaine (Xylocaine) are examples of class ___ antidysrhythmics
I
47
Class I antidysrhythmics work by blocking _________ channels
Sodium
48
Key side effects of Class I antidysrhythmics
Hypotension, dysrhythmias, lupus, leukopenia, thrombocytopenia
49
Procainamide blackbox warning
May test positive for ANA (Antinuclear antibody) indicating autoimmune response
50
Procainamide therapeutic blood levels
4-8 mcg/mL
51
Propranolol (Inderal), metoprolol (Lopressor), and atenolol (Tenormin) are class ___ antidysrhythmics
II
52
Amiodarone (Nexterone, Pacerone) and sotalol are examples of class ___ antidysrhythmics
III
53
Class III antidysrhythmics block _________ channels
Potassium
54
Amiodarone (Nexterone, Pacerone) side effects
SEVERE: hypotension, bradycardia, pulmonary and liver toxicity, thyroid dysfunction
55
Amiodarone (Nexterone, Pacerone) blackbox warning
Cardiac, liver, and pulmonary toxicity
56
Amiodarone (Nexterone, Pacerone) patient education
NO grapefruit juice
57
Verapamil (Calan) and diltiazem (Cardizem) are examples of class ___ antidysrhythmics
IV
58
Class IV antidysrhythmics block _________ channels
Calcium
59
Adenosine (Adenocard, Adenoscan), digoxin, and magnesium sulfate are examples of class ___ antidysrhythmics
V
60
Adenosine (Adenocard, Adenoscan) side effects
Arrythmias, SOB, hypotension
61
Adenosine (Adenocard, Adenoscan) patient education
Change positions slowly
62
key anticholinergic/antimuscarinic drug used to treat sinus bradycardia, heart block, or to decrease secretions during surgery
Atropine
63
Atropine has _________ side effects
Anticholinergic
64
Route of administration for heparin
IV/Subcutaneous
65
Low molecular weight heparin, or enoxaparin (Lovenox) is only administered
Subcutaneously
66
T or F: heparin works to break up existing clots
FALSE! Heparin is an anticoagulant that PREVENTS new clots from forming
67
Key side effects of heparin
Bleeding, heparin-induced thrombocytopenia (HIT), hypersensitivity
68
What lab should be closely monitored in a patient taking heparin?
aPTT
69
Baseline aPTT
30-40 seconds
70
Therapeutic aPTT for a patient on heparin is ___-___ times the baseline
1.5-2
71
Elevated aPPT carries a risk for _________, while an aPTT below baseline carries a risk for __________
Bleeding; blood clots
72
Warfarin (Coumadin) is an example of an
Oral anticoagulant
73
Key side effects of warfarin (Coumadin)
Bleeding, GI upset, hepatitis
74
What labs should be monitored on a patient taking warfarin (Coumadin)?
PT/INR
75
Therapeutic INR
2-3
76
How long does it take for a patient on warfarin to obtain therapeutic levels?
3-5 days (this is why patients may be started on heparin first, along with warfarin)
77
Normal PT range
11-13 seconds
78
Normal PT for patient on warfarin
1.5-2x baseline PT
79
Warfarin patient education
Maintain consistent intake of vitamin K (too much vitamin K may prohibit warfarin, while too little vitamin K can increase risk for bleeding)
80
Rivaroxaban (Xarelto) and apixaban (Eliquis) are examples of
Factor Xa Inhibitor anticoagulants
81
Key side effects of factor Xa inhibitors (anticoagulants)
Bleeding, elevated liver enzymes
82
Factor Xa inhibitors blackbox warning
Abrupt discontinuation of these meds place patient at risk for thrombotic events
83
What should the nurse monitor for patients on factor Xa inhibitors?
Liver function, Hgb, Hct
84
Clopidogrel (Plavix) and abciximab are examples of
Antiplatelets
85
Side effects of abciximab
Bleeding, hypotension, dysrhythmias
86
Side effects of clopidogrel (Plavix)
Bleeding, GI upset, rash
87
Abciximab nursing considerations
Monitor EKG and vitals
88
Argatroban and dabigatran (Pradaxa) are examples of
Thrombin inhibitors
89
Key side effects of argatroban
Bleeding, hypotension
90
Key side effects of dabigatran (Pradaxa)
Bleeding, GI upset, angioedema
91
Aminocaproic acid (Amicar) is indicated for hemorrhage and carries a risk for
Hypercoagulation (assess for thromboembolism)
92
Alteplase (Activase, tPA), streptokinase (Streptase), and reteplase (Retavase) are examples of
Thrombolytics
93
Key side effect of thrombolytic medications
Bleeding
94
Thrombolytics medications are contraindicated in
- patients who have had a hemorrhagic stroke
- internal bleeding
- recent trauma/surgery
- severe hypertension
95
Thrombolytics are indicated for ischemic strokes and should be administered within ___ hours of symptoms
3
96
Thrombolytic nursing considerations
Limit venipunctures and IM injections
97
Medication used to increase production of RBCs for the treatment of anemia related to chronic kidney disease, HIV, chemotherapy
Epoetin Alfa (Epogen)
98
Key side effects of epoetin alfa (Epogen)
Hypertension, increased risk of DVT, stroke, MI, and seizures
99
A patient receiving epoetin alfa (Epogen) should also be taking
Iron
100
Medication that increases production of neutrophils to decrease risk of infection in neutropenic patients (r/t chemotherapy)
Filgastrim (Neupogen)
101
Side effects of Filgastrim (Neupogen)
Bone pain, leukocytosis (high WBCC), splenomegaly (enlarged spleen)
102
Vasopressor indicated for severe allergic reactions, anaphylaxis, and advanced cardiac support
Epinephrine (Adrenalin, EpiPen)
103
Epinephrine works by stimulating alpha 1 sites (causing __________), beta 1 receptors (causing _________ HR), and beta 2 receptors (causing _________)
Vasoconstriction; increased; bronchodilation
104
Side effects of epinephrine
Hypertension, dysrhythmias, angina, nervousness, tremor
105
T or F: when given for shock, hypovolemia should be corrected FIRST before using vasopressors
True
106
Vasopressors used for shock and severe hypotension
Norepinephrine (Levophed)
107
Side effects of norepinephrine (Levophed)
Hypertension, dysrhythmias
108
Vasopressors indicated for shock, sepsis, HF, and renal failure
Dopamine (Intropin)
109
Dopamine (Intropin) stimulates alpha 1 receptors (causing _________), beta 1 receptors (causing increased ___ and ___), and dopaminergic receptors (causing increased __________)
Vasoconstriction; CO, HR; renal perfusion
110
Side effects of dopamine (Intropin)
Dysrhythmias, angina
111
Norepinephrine (Levophed) stimulates alpha 1 sites (causing _________) and beta 1 receptors (increasing _________).
Vasoconstriction; cardiac output
112
Medication indicated for cardiogenic shock and HF by stimulating beta 1 receptors (causing increased CO) without much effect on HR and BP
Dobutamine (Dobutrex)
113
Dobutamine (Dobutrex) side effects
Hypertension, dysrhythmias, angina
114
Colloid (volume expander) indicated for shock, hemorrhage, and burns
Albumin
115
Albumin works by
Maintaining osmotic pressure in plasma by drawing fluid from extravascular space to intravascular space
116
Albumin side effects
Fluid overload, pulmonary edema, hypertension
117
Albumin is contraindicated for what patients?
HF patients
118
Atorvastatin (Lipitor) and simvastatin (Zocor) are indicated for
Hypercholesterolemia, prevention of coronary heart disease
119
How do -statins work?
Decreased production of LDL, increase production of HDL
120
-statin side effects
Hepatotoxicity, muscle pain, rhabdomyolysis, GI upset
121
Why should -statins be administered with evening meal?
Because cholesterol is synthesized at night
122
Nursing considerations for patients on -statins
Monitor liver function and CK levels (rhabdo)
123
Patient education for -statins
Avoid alcohol; NO grapefruit juice
124
Colesevelam (Welchol) and cholestyramine (Questran) are examples of
Bile acid sequestrants for hypercholesterolemia
125
Side effects of bile acid sequestrants
GI upset, constipation
126
Patient education for administration of bile acid sequestrants
- increase fiber and fluid intake (to combat constipating effects)
- take with food and full glass of water
127
Bile acid sequestrants can interfere with absorption of
Fat-soluble vitamins (A, D, E, K)
128
Water-soluble vitamin indicated for treatment of hypercholesterolemia
Niacin (B3)
129
Side effects of niacin (B3)
Flushing of face, pruritis, hepatotoxicity, hyperglycemia
130
Niacin (B3) nursing consideration
Use cautiously in patients with diabetes due to risk for hyperglycemia
131
Vitamin indicated for megaloblastic and macrocytic anemia, and prevention of neural tube defects during pregnancy
Folic acid (Folate, vitamin B9)
132
How does folic acid work?
Stimulates production of RBCs, WBCs, and platelets
133
Folic acid side effects
Rash, change in urine color (more intensely yellow)
134
Vitamin indicated for pernicious anemia
Cyanocobalamin (B12)
135
Route of administration for B12 for treatment of pernicious anemia
Nasal spray (for malabsorption d/t lack of intrinsic factor)
136
Cyanocobalamin (B12) side effects
Hypokalemia, hypersensitivity, GI upset
137
Higher doses of folic acid can mask a _____ deficiency, leading to deterioration in cognitive function
B12
138
Vegetarians are at high risk for ___ and ___ deficiency
B9; B12
139
Oral iron supplement indicated for iron deficiency anemia
Ferrous sulfate
140
Side effects of ferrous sulfate
Constipation, teeth staining (drink with straw!), dark green/black stools (harmless)
141
IV/IM iron supplement indicated for iron deficiency anemia
Iron dextran
142
Iron dextran side effects
Staining at IV site, hypotension, flushing
143
__________ increases absorption of iron
Vitamin C
144
Iron supplement administration patient education
- take on empty stomach (1 hour before or 2 hours after meals)
- increase fiber and fluid intake to prevent constipation
145
If giving IM iron dextran, use _________ method
Z-track
146
Calcium carbonate and citrate are indicated for
Hypocalcemia and prevention of post-menopausal osteoporosis
147
Medication used for emergency treatment of hyperkalemia and hypermagnesemia
Calcium gluconate
148
_________ is an essential electrolyte needed for bone/teeth formation, nerve and muscle function, and clotting
Calcium
149
Side effects of calcium supplements
Constipation, arrythmias, bradycardia
150
Supplement indicated for hypokalemia
Potassium chloride
151
Key electrolyte needed for maintenance of intracellular fluid, nerve function, and regulation of muscle and heart contractions
Potassium
152
Side effects of potassium chloride
Arrythmias, weakness
153
IV potassium side effects
Irritation at site (patient can request for K+ to be administered with lidocaine to minimize burning)
154
PO potassium side effects
GI upset (BIG horse pill or powder mixed into water ā does not taste good!)
155
Alkalinizing agent indicated for metabolic acidosis or PUD that works by promoting acid-base balance and neutralizing stomach acid
Sodium bicarbonate
156
Sodium bicarbonate side effects
Metabolic alkalosis
157
Agent indicated for hyperkalemia
Kayexalate
158
Kayexalate side effects
Constipation, fecal impaction, N/V, hypokalemia
159
Supplements indicated for hypomagnesemia, preterm labor, and torsades de pointes
Magnesium supplements such as magnesium chloride, magnesium gluconate, magnesium oxide
160
Essential electrolyte for nerve and muscle function, bone formation, biochemical reactions, and slowing uterine contractions
Magnesium
161
Side effect of magnesium supplements
Diarrhea
162
S/S of magnesium toxicity
Decreased DTRs, UO < 30 mL/hr, respiratory depression, hypotension
163
Treatment for magnesium toxicity
Calcium gluconate
