Drug Matrix 1 Flashcards
(77 cards)
1
Q
hydrochlorothiazide is what class of meds
A
thiazide diuretic
2
Q
furosemide is what class of meds
A
loop diuretics
3
Q
spironolactone is what class of meds
A
potassium-sparing diuretic
4
Q
metoprolol is what class of meds
A
beta adrenergic blockers (sympatholytics)
5
Q
propranolol is what class of meds
A
beta adrenergic blockers (sympatholytics)
6
Q
carvedilol is what class of meds
A
beta adrenergic blockers (sympatholytics)
7
Q
metoprolol is [….]
A
selective… just blocks beta 1 (heart)
8
Q
propranolol is [….]
A
non-selective… blocks beta 1 and 2
9
Q
carvedilol is [….]
A
alpha and beta
10
Q
clonidine is what class of meds
A
alpha-2 adrenergic agonist (centrally acting sympathetic) (sympatholytics)
11
Q
doxazosin is what class of meds
A
selective alpha-1 blockers (alpha adrenergic blockers) (sympatholytics)
12
Q
captopril is what class of meds
A
ACE (RAAS)
13
Q
lisinopril is what class of meds
A
ACE (RAAS)
14
Q
lozartan is what class of meds
A
ARBs (RAAS)
15
Q
aliskiren is what class of meds
A
renin inhibitor (RAAS)
16
Q
nifedipine is what class of meds
A
calcium channel blockers
17
Q
nicardipine is what class of meds
A
calcium channel blockers
18
Q
verapamil is what class of meds
A
calcium channel blockers
19
Q
diltiazem is what class of meds
A
calcium channel blockers
20
Q
hydralazine is what class of meds
A
vasodilators
21
Q
atorvastatin is what class of meds
A
statins (HMG-CoA) (HLD)
22
Q
simvastatin is what class of meds
A
statins (HMG-CoA) (HLD)
23
Q
rosuvastatin is what class of meds
A
statins (HMG-CoA) (HLD)
24
Q
ezetimibe is what class of meds
A
cholesterol absorption inhibitor (HLD)
25
-works on distal convoluted tubule to inhibit resorption of sodium/potassium/chloride=decreased cardiac output, results in water loss
-relaxes arterioles=decreased peripheral vascular resistance
MOA of thiazide diuretics
26
-mild hypertension
-given PO
-alone or in combo with others
indications of thiazide diuretics
27
-electrolyte and metabolic disturbances--> hypokalemia (low potassium)
-orthostatic hypotension
-may worsen renal insufficiency
-hyperuricemia--> watch out with gout patients
major adverse reactions of thiazide diuretics
28
-monitor potassium levels
-give potassium supplements
-encourage food rich in potassium
nursing considerations for thiazide diuretics
29
-inhibit kidneys to reabsorb sodium in LOOP OF HENLE
-makes kidneys put more sodium in the urine...water follows sodium--> more peeing out
MOA of loop diuretics
30
-decreases fluid in the blood vessels-->decreases cardiac output
-PROFOUND DIURESIS POSSIBLE
-PO or IV
indications of loop diuretics
31
-hypokalemia and other electrolyte abnormalities
-dehydration
-hypotension
-ototoxicity--> difficulty hearing, usually transient with furosemide
major adverse reactions of loop diuretics
32
-monitor potassium levels
-patients typically receive KCL supplements with their lasix doses
nursing considerations for loop diuretics
33
-block action of aldosterone (sodium and water retention)=potassium retention and excretion of sodium and water
MOA of potassium-sparing diuretics
34
-only PO
-usually given in combo to get more effect with a lower chance of hypokalemia
-only provides small amount of diuresis and hypotensive effect
indications of potassium-sparing diuretics
35
-can see HYPERkalemia
endocrine effects: deepened voice, impotence, irregular menstrual cycles, gynecomastia, hirsutism
major adverse reactions of potassium-sparing diuretics
36
monitor potassium and BP?
nursing considerations for potassium-sparing diuretics
37
-increases nitric oxide=vasodilation response
-blocks stimulation of beta-1 receptors=decreases HR and contractility
-can be given PO/IV
MOA of beta blockers
38
Used to treat many cardiovascular diseases, we will discuss primarily with hypertension
indications of beta blockers
39
-Fatigue/lethargy
-bradycardia
-hypotension
-can mask hypoglycemia prevents tachycardia, be careful with use in diabetics
adverse reactions of beta blockers
40
-wean when discontinuing
-possibility of REBOUND HTN if discontinued abruptly critical rise in BP, high risk of CV event/stroke/death
-if non-selective beta blocker do not use with patients who have asthma or other breathing conditions
-recognize the RISK for hypotension and/or bradycardia, hold and contact provider if HR is less than 60 or a systolic BP less than 100
nursing considerations for beta blockers
41
-decrease sympathetic outflow resulting in decreased stimulation of adrenergic receptors (both alpha AND beta receptors)
MOA of alpha-2 adrenergic agonist
42
-typically, not first-line treatment, high side-effect profile
-main outcome: decreased blood pressure
-primary indication: hypertension
-can be given PO or transdermal (patch)
indications of alpha-2 adrenergic agonist
43
-drowsiness most common, give at night to combat this
-rebound HTN
-may worsen pre-existing liver disease
adverse effects of alpha-2 adrenergic agonist
44
-do not abruptly discontinue--> rebound HTN
nursing considerations of alpha-2 adrenergic agonist
45
-selective alpha-1 blockade...venous AND arterial dilation
MOA of selective alpha-1 blockers
46
-hypertension, not first line
indications of selective alpha-1 blockers
47
-hypotension
-dizziness
adverse effects of selective alpha-1 blockers
48
?
nursing considerations for selective alpha-1 blockers
49
-blocks angiotensin-converting enzyme (ACE)…inhibits production of angiotensin-2 (powerful vasoconstrictor), inhibits aldosterone secretion less water retention
MOA of ACE inhibitors
50
Safe and efficacious first-line therapy for hypertension & heart failure
-slows progression of left ventricular hypertrophy associated with HTN
-drug of choice for DM has some renal protective effects
-NOT APPROPRIATE FOR USE IN PREGNANCY
indications for ACE inhibitors
51
-first dose hypotension common, 15-20% drop in 6-8 hours
-dry, nonproductive, PERSISTENT cough largest complaint from patients often reason people switch
-dizziness
-rash
-serious: ANGIOEDEMArare, but more common in African Americans (5.5% in African Americans, 0.1-0.7% in others)
adverse effects of ACE inhibitors
52
-renal insufficiency use cautiously in patients with history of renal disease
-captopril can cause neutropenia monitor WBC
-risk of hyperkalemia especially if patient on potassium supplements
nursing considerations for ACE inhibitors
53
-blocks the action of angiotensin 2 AFTER it is formed
-causes vasodilation
-increased sodium and water excretion
MOA of ARBs
54
-hypertension
-heart failure
-stroke progression
-many more
indications of ARBs
55
-well tolerated
-some risk of angioedema, not the racial disparity seen in ACEi
adverse effects of ARBs
56
-DO NOT USE IF PREGNANT, requires use of contraception if patient is of childbearing age
-use cautiously in patients with renal problems
-ACEi & ARBs only given PO
nursing consideration of ARBs
57
-Direct inhibition of renin, induces vasodilation, decreases blood volume, decreases SNS, and inhibitors cardiac and vascular hypertrophy
MOA of renin inhibitors
58
-hypertension?
-PO
indications of renin inhibitors
59
-well tolerated
-GI discomfort
-when given with ACEi watch for hyperkalemia, especially in patients with diabetes
adverse reactions of renin inhibitors
60
-takes several weeks to see full effect (half-life)
-do NOT take pregnant
nursing considerations of renin inhibitors
61
-Blocks calcium access to cells causing decreased contractility and decreased conductivity of the heart=lower demand for oxygen
MOA of calcium channel blockers
62
-hypertension and chest pain (angina pectoris)
-diltiazem and verapamil also used to treat heart rhythm disorders
-can also be given for refractive hypertension IV (nicardipine)
-PO or IV
indications of calcium channel blockers
63
-Orthostatic hypotension
-peripheral edema
adverse effects of calcium channel blockers
64
-CCB are often best for elderly and African Americans
-diuretics can be given for peripheral edema
nursing considerations of calcium channel blockers
65
-vasodilators work directly on arterial and venous smooth muscles and cause relaxation
-direct vasodilation cause decreased systemic and peripheral vascular resistance
MOA of vasodilators
66
-hypertension
-PO or IV
-PO often used in combination with other anti-hypertensive agents
-IV used in emergency settings or when PO cannot be tolerated
indications of vasodilators
67
-hypotension
-dizziness, headache, tachycardia, edema, dyspnea, GI upset
adverse effects of vasodilators
68
?
nursing indications of vasodilators
69
-takes 2 weeks to see effect
-inhibiting HMG-CoA reductase
-less cholesterol is produced by liver
-liver makes more LDL receptors
-more LDL is removed from blood (not making as much cholesterol, removing more LDL from the blood)
-NOT A PERMANENT DROP IN LEVELS, need to keep taking the drug
-stabilize plaque and decrease inflammation
MOA of statins
70
?
indications of statins
71
?
adverse effects of statins
72
?
nursing considerations for statins
73
-blocks absorption of cholesterol in jejunum, dietary, cholesterol secreted in bile
-in combination with statin
MOA of cholesterol absorption inhibitor
74
-2nd line therapy to statins
-
indications for cholesterol absorption inhibitor
75
?
adverse effects of cholesterol absorption inhibitor
76
?
nursing indications for cholesterol absorption inhibitor
77
