M8: L39: Cardiac Medication Classifications Flashcards
(174 cards)
1
Q
When answering what do we need to determine what it is asking?
A
Intended effect, side effect, or adverse effect.
2
Q
How should you go about studying meds?
A
Learn medications by their classifications because of the similarities that exist among medications in a given classification (e.g., bronchodilators dilate the bronchi of the lungs).
3
Q
How can we remember some of the drugs and what class they belong to?
A
Learn medications belonging to a particular classification by remembering commonalities in their names.
4
Q
What are two big things to know about medications?
A
Learn to recognize the side effects commonly associated with each class of medications and then relate the appropriate nursing interventions to each side effect.
5
Q
What do androgens end in?
A
Most names end with -terone (e.g., testosterone).
6
Q
What do Angiotensin-converting enzyme (ACE) inhibitors end in?
A
Most names end with -pril (e.g., enalapril).
7
Q
What do most antidiuretic Hormones end in?
A
Most names end in -pressin (e.g., desmopressin).
8
Q
What do most antilipemic medications end in?
A
Many end with -statin (e.g., atorvastatin).
9
Q
What do most antivirals end in?
A
Most contain vir (e.g., acyclovir).
10
Q
What do most benzodiazepines end in?
A
Although this class includes medications such as alprazolam and chlordiazepoxide, most names such as diazepam end in -pam. (Another tip for identifying a benzodiazepine: The name includes a vowel-z-vowel combination.)
11
Q
What do most beta-adrenergic blockers end in?
A
Most names end with -lol (e.g., atenolol).
12
Q
What do most calcium channel blockers end in?
A
Most names end in -pine (e.g., amiodipine); exceptions include diltiazem and verapamil.
13
Q
What do most carbonic anhydrase inhibitos end in? What are thery used to treat?
A
Most names end in -mide (e.g., dorzolamide). These medications are used to treat glaucoma.
14
Q
What do most estrogens contain in the name?
A
Most names contain (est) (e.g., estradiol or conjugated estrogen).
15
Q
What do most glucocorticoids and corticosteroids end in?
A
Most names end in -sone (e.g., prednisone).
16
Q
What do most histamine H2 receptor antagonists end in?
A
Most names end in -dine (e.g., cimetidine).
17
Q
What do most nitrates contain?
A
Most names contain nitr (e.g., nitroglycerin).
18
Q
What do most pancreatic enzyme replacments contain?
A
Most names contain pancre (e.g., pancrealipase).
19
Q
What do most proton pump inhibitors names end in?
A
Most names end in -zole (e.g., lansoprazole).
20
Q
What do most sulfonamides include?
A
Most names include sulf (e.g., sulfasalazine).
21
Q
What do most sulfonylureas end in? What are they used to treat?
A
Most names end in -ide (e.g., glipizide). These medications are used to treat diabetes mellitus.
22
Q
What do most thiazide diuretics end in?
A
Most names end in -zide (e.g., hydrochlorothiazide).
23
Q
What do most thrombolytic include?
A
Most names include -ase (e.g., alteplase).
24
Q
What do most thyroid hormones end in?
A
Most names contain thy (e.g., levothyroxine).
25
What do most xanthine bronchodilators end in?
Most names end in -line (e.g., theophylline).
26
What do we use androgens to treat?
Hormon to reduce the levels of male hormones canlled androgens, to stop them from fueling prostate cancer.
27
What are ACE inhibitors used for?
Mainly used for hypertension and heart failure. They work by causing relaxation of blood vessel as well as a decrease in blood volume, which leads to lower BP, and decreased oxegen demand from the heart.
28
What are antidiuretic hormones used for?
Chemical produced by the kidneys to release less water, decreasing the amount of urine produced.
Anti-diuretic hormone helps to control blood pressure by acting on the kidneys and the blood vessels. Its most important role is to conserve the fluid volume of your body by reducing the amount of water passed out in the urine.
29
What are antilipemic (-statin) drugs used for? What do they help prevent?
statins are used to lower your cholesterol and protecting agianst a heart attack and stroke.
30
What are antivirals used for?
Used to treat or stop the reproduction of viral infections.
31
What are benzodiazepines used for?
Used to treat anxiety and insomnia, they have a sedately effect.
32
What do we use beta blockers for?
Used to treat high blood pressure when other medications dont work.. (They work by blocking the epinephrine, also known as adrenaline.)
33
What do we use calcium channel blockers for? How do they work?
They are used to lower blood pressure. They work by preventing calcium to enter the cells of the heart and arteries which would cause them to squeeze.
34
What do we use carbonic anhydrase inhibitors for?
To treat glaucoma.
35
What is glaucoma?
A group of eye diseases that can cause blindness.
36
What do we use estrogens for?
Helps develop and maintain both the reproductive system and female characteristics.
37
What are glucocorticoids used for?
Powerful medications that fight inflammation and work with the immune system to treat a wide range of things.
38
What are corticosteroids used for? What are some conditions?
Corticosteroids are used to reduce inflammation and suppress the immune system. They are used to treat conditions such as asthma, allergic rhinitis, and hay fever.
39
What are histmine H2 receptor aganosits used for?
used for allergic reactions.
40
What are proton pump inhibitors used for?
Used to relieve symptoms of acid reflux, or GERD, heartburn, stomach ulcers.
41
What are sulfamides used to treat?
Used to treat bacterial infections like UTI's, eye infections, Pneumonia, Severe burns.
42
What are nitrates used for? How do they work?
They are used to treat chest pain and symptoms of heart failure. (They widen the blood vessels, allowing more blood to get to the heart.
43
What are thiazide diuretics used for?
Used as one of the first drug treatments to lower blood pressure, and clear fluid from the body.
44
What type of diuretic is used for heart failure?
Loop diuretic takes fluid off the heart.
45
PART 7: CARDIOVASCULAR MEDICATIONS
PART 7: CARDIOVASCULAR MEDICATIONS
46
What are anticoagulants used for?
Anticoagulant medications prevent the extension and formation of clots by inhibiting factors in the clotting cascade and decreasing blood coagulability.
47
What are some conditions that anticoagulants are used to treat?
These medications are used to treat thrombosis, pulmonary embolism, and myocardial infarction and are also given to clients at risk for thromboembolism.
48
What is the effect of heparin in the clot formation?
A therapeutic dosage of heparin does not dissolve clots; instead, it prevents formation of new thrombi.
49
What is the normal APTT with heparin?
normal activated partial thromboplastin time (APTT) is maintained at 1.5 to 2.5 times normal.
50
What is warfarin used for?
Which decreases prothrombin activity and prevents the use of vitamin K by the liver, is used for long-term anticoagulation to prevent thromboembolitic conditions such as thrombophlebitis, pulmonary embolism, and embolism formation caused by atrial fibrillation, thrombosis, myocardial infarction, or heart valve damage.
51
What is the major adverse effect with all anticoagulants?
Bleeding.
52
What are some substance you must avoid while taking anticoagulants?
```
Green leafy vegetables and foods high in vitamin K
Allopurinol
Cimetadine
Corticosteroids
Nonsteroidal antiinflammatory drugs
Oral hypoglycemic agents
Phenytoin
Salicylates
Sulfonamides
```
53
What is the normal aPTT for a patient when on a continious heparin infusion?
Normal activated partial thromboplastin time (aPTT) is maintained at 1.5 to 2.5 times when the client is on a continuous heparin infusion.
54
What is the normal aPTT without a continous heparin infusion?
The normal aPTT is 30 to 40 seconds.
55
When is heparin considered to great and what shoudl the nurse do?
If the APTT is too great (longer than 80 seconds), the dosage should be decreased;
56
When would we consider herpain time to be to short?
If the APTT is too short (shorter than 60 seconds), the dosage should be increased.
57
What is the normal clotting time? What is the desired clotting time with heparin?
Normal clotting time is 8 to 15 minutes; the desired clotting time with heparin is 15 to 20 minutes.
58
What are some things we should be on the lookout with for heparin?
Watch for signs of bleeding (e.g., bleeding gums, bruises, nosebleeds, hematuria, hematemesis, occult fecal blood, petechiae) and implement bleeding precautions.
59
Where do we give heparin injections only and what sized needle do we use?
When administering heparin subcutaneously, inject it into the abdomen with a small needle (25- to 28-gauge) at a 90-degree angle; do not aspirate or rub the injection site.
60
Can you ever hang heparin by gravity?
Nope
61
What is the antidote to heparin?
protamine sulfate
62
What is the average prothrombin time? What is the effect of warfarin on the PT?
Prothrombin time (PT) averages 11 to 12.5 seconds; warfarin sodium prolongs the PT.
63
What is an INR?
The normal international normalized ratio (INR) is 0.81 to 1.2. A level of 2.0 to 3.0 is maintained in standard warfarin therapy and a level of 3.0 to 4.5 in high-dose warfarin sodium therapy. If the INR is below the recommended range, the dosage should be increased; if it is above the recommended range, the dosage should be reduced.
64
What do we look for with warfarin?
Monitor the client for bleeding and implement bleeding precautions.
65
What is the antidote for warfarin?
Vitamin K.
66
What are thrombolytic medications?
These medications activate plasminogen, which generates plasmin, the enzyme that dissolves clots.
67
When do we give thrombolytic medications?
Used early in the course of myocardial infarction (within 4 to 6 hours of onset), thrombolytic agents can restore blood flow, limit myocardial damage, preserve left ventricular function, and prevent death.
68
What are the top three nursing considerations for thrombolytic medications?
Monitor the client for bleeding and dysrhythmias.
Monitor the client for neurological changes (e.g., slurred speech, lethargy, confusion, hemiparesis) that might indicate intracranial bleeding.
The antidote to "clot-busting" medications is aminocaproic acid; used only in acute life-threatening conditions.
69
What are the most common thrombolytic medications?
```
Alteplase,
reteplase,
streptokinase,
tenecteplase,
urokinase.
```
70
What do most thrombolytic end in?
- ase.
71
What is nice to know about thrombolytic medications?
Start two IV lines before giving medication (one fo rthis therapy and one for other meds. Invasive procedures should be avoided after given.
72
What is the antidote for thrombolytic medications?
Aminocaproic acid. In a life threatening situation the client may also need whole blood transfusions.
73
What are antiplaltelt medications used for?
They are used in the prophylaxis of long-term complications following myocardial infarction, coronary revascularization, and stroke.
74
What is the mechanism of action for antiplatelets?
Antiplatelet medications inhibit the aggregation of platelets in the clotting process, thereby prolonging bleeding time.
75
What are the nursing considerations for antiplatelets medications?
Monitor the client for bleeding complications and initiate bleeding precautions as needed.
76
What are some of the most common antiplatelets prescribed?
```
Abciximab (ReoPro)
Aspirn,
Clopidogrel (Plavix)
Eptifibatide (Integrilin
Ginko (herbal)
Tirofiban (Aggrastat)
```
77
What conditions are antiplatlets used to treat?
Stoke, MI, PVD.
78
What is a big situation that these meds are prescribed for?
After the placement of a device inside the heart or blood vessels, such as stenst.
79
What is cilostazol often used for?
Patients with PVD to reduce leg pain associated with walking (intermittent claudification) by improving blood flow to leg.
80
Who should never take cilostzol?
Patient with heart failure.
81
What are cardiac glycosides?
Cardiac glycosides increase the force of myocardial contractions and slow the heart rate.
82
What are cardiac glycosides used for?
They are used in heart failure, atrial tachycardia, atrial fibrillation, and atrial flutter.
83
What is the most common cardiac glycoside ?
Digoxin.
84
What is the class of cardiac glycosides?
Antiarrythmic.
85
Who cannot take cardiac glycosides (dioxgin) ?
These medications are contraindicated in clients with ventricular dysrhythmias and second- or third-degree heart block and are used with caution in clients with renal disease, hypothyroidism, and hypokalemia.
86
When taking glycosides cardiac what should you look for in the patiet?
Monitor the client for signs of toxicity, including anorexia, nausea and vomiting, visual disturbances (e.g., diplopia, blurred vision, yellow-green halos), bradycardia, and photophobia.
87
What is the tehrapuetic range for cardiac glycosides?
The therapeutic range is 0.5 to 2.0 ng/mL (depending on laboratory testing); levels above 2.0 ng/mL are toxic.
88
What patients have a increased risk fo rdixogin toxicity?
An increased risk of digoxin toxicity exists in clients with hypercalcemia, hypokalemia, hypomagnesemia, or hypothyroidism; monitor laboratory values and notify the health care provider if abnormalities are noted.
89
What drugs taken with dioxigin can cause hypokalemia?
Monitor the client taking a potassium-losing diuretic or corticosteroids for hypokalemia.
90
What age group is most likely to experiance dioxigin toxicicty?
Older
91
What kind of foods should people taking dioxigin take?
Advise the client to eat foods high in potassium (e.g., fresh and dried fruits, fruit juices, vegetables, potatoes) unless he or she is taking a potassium-retaining diuretic (discussed later in this lesson).
92
What vital is important to monitor?
Monitor the apical pulse rate; if it is slower than 60 beats/min, the medication should be withheld and the health care provider notified.
93
What do we teach cardiac glycosides patients to do?
Teach the client how to measure the pulse and stress the need to notify the health care provider if the pulse rate is slower than 60 or faster than 100 beats/min or as specified by the health care provider.
Teach the client the signs and symptoms of toxicity.
94
What is an antidote for extreme digoxin toxicity?
Digoxin immune Fab, an antidote, is used in cases of extreme toxicity.
95
What are the four subclasses of diuretics?
Loop, osmotic, thiazide, and potassium-retaining.
96
What are the main things at diuretics are used for?
They are used in cases of hypertension, peripheral edema (refer image), and heart failure or pulmonary edema.
97
What are common are common side effects of diurteics?
Common side effects include hypokalemia, hyponatremia, hyperglycemia, hyperuricemia, hypovolemia with signs of dehydration, hypotension, and photosensitivity.
98
Use diuretic medications with caution in the clients who take what? Why?
Use these medications with caution in the client taking digoxin or lithium, because toxicity may occur.
99
What is the major adverse effect for potassium retaining diuretics?
hyperkalemia
100
What should we monitor for with loop diuretics?
Ototoxicity = ear.
101
What are the three key things to monitor with diuretics?
Blood pressure, weight, and urine output + electrolyte levels. Extermeities for periphreal edema.
102
When should we instruct the client to take diuretics?
Instruct the client to take the medication in the morning to avoid nocturia and sleep interruption.
103
What are they key teaching points for diuretics?
Teach the client how to take his or her blood pressure.
Instruct the client to eat foods high in potassium (except for clients taking potassium-retaining diuretics).
Explain to the client how to take potassium supplements, if they are prescribed.
Instruct the client to change positions slowly to prevent postural hypotension.
104
What is a key teaching point for patients taking thiazide diuretics?
Use sunscreen in directs sunlight.
105
What should we teach for a diabetic taking thiazide diuretic?
to watch for increases in blood glucose, which may be caused by the diuretic.
106
What are loop diuretics used for?
Treat acute pulmonary edema, and reduce intracranial pressure .
107
What is the most common diuretics?
Furosemide (Lasix)
108
What are some other Loop diuretics?
Bumetanide (bumex),
Ethacrynic acid (edencrin)
Fursoemide (lasix)
torsemide (demadex)
109
How do loop diuretics work?
The work in the asending limb of the loop of henle where magnesium and calcium are reabsorbed.
110
What is the most common adverse effect of loop diuretics?
hypotension.
111
Clients taking loop diuretics may need to also take what?
Potassium, folic acid, and vitamin b.
112
What are osmotic diuretics do?
Produce a rapid loss of sodium and water by inhibiting their reabsorption in kidney tubles and the loop of henle.
113
What is the main use of osmotic diuretics?
Managing cerebral edema to decrease intracranial pressure.
114
What are the two osmotic diuretics?
mannitol (osmitrol)
| urea (generic)
115
How fast following IV administration does intercrainail pressure fall?
falls within 60 to 90 min.
116
What is good to know about mannitol?
Extravasation of mannitol can cause edema and skin necrosis.
117
How do potassium sparing diuretics work?
These medications conserve potassium in clients receiving thiazide or loop diuretics.
118
What are potassium sparing used to treat?
heart failure, since they do not significantly lower BP.
119
Whats good to know about potassium sparing diuretics?
weak diuretic and hypertensive properties.
120
What may decrease the effectiveness of diuretic drugs?
NSAIDs can decrease blood flow to the kidneys and may also interfere with sodium and water excretion.
121
What are the four common potassium sparing diuretics?
spironolactone (Aldactone)
Triamterene (Dyrenium)
amiloride (midamor)
eplerenone (inspra
122
What are the 5 common type of drugs used to treat hypertension?
α-adrenergic blockers, angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs), beta-adrenergic blockers, and calcium channel blockers; these medications may also be used to treat such cardiac disorders as angina and dysrhythmias.
123
What is a big saftey concern with antihypertensives?
Antihypertensives can cause orthostatic hypotension, and the client must be instructed in safety measures, such as changing positions slowly.
124
What should we teach the client BP with antihypertensives?
The client’s blood pressure must be monitored, and the client should be taught how to measure it and told when it is necessary to contact the health care provider.
125
Can you stop antihypertensives abruptly?
Instruct the client not to discontinue the medication, because abrupt withdrawal can cause severe rebound hypertension.
126
What should be avoided when taking ACE inhibitors and ARBs?
Potassium supplements and potassium-retaining diuretics are avoided with the use of ACE inhibitors and ARBs because of the risk of hyperkalemia.
127
What is a common complaint for people taking ACE inhibitors?
A persistent dry cough is a common complaint amongst clients taking ACE inhibitors; instruct the client to contact the health care provider if this side effect occurs and persists.
128
What is something to look out for when taking beta blockers?
Beta-adrenergic blockers can mask the early signs of hypoglycemia (e.g., nervousness, tachycardia).
129
Why cant you stop beta blockers abruptly?
Beta-adrenergic blockers should not be discontinued abruptly because severe, rebound hypertension and tachycardia can occur.
130
When patients are taking antihypertensives what is critical to remind them?
Many clients experience distressing side effects, and the nurse should emphasize the importance of contacting the health care provider rather than discontinuing the medication if side effects occur.
131
What are thiazide diuretics used to treat?
Alone or in combination with loop diuretics, treat hypertension or edema due to heart failure other causes.
132
What is nice to know about thiazide diuretics?
Best taken early in the day.
133
What is really importnat to know about thiazide diuretics?
Tend to raise blood sugar.
134
What is the most common thiazide?
hydrochlorothiazide (hydrodiuril.
chlorothiazide (Hygroton)
indapamide (Lozol)
metolazone (zaroxolyn)
135
What is nitrites used for?
Treat and prevent attacks of (acute) angina.
136
How do nitrates work?
Dilkate the blood vessels, improve blood flow and allow more oxygen rich blood reach the heart muscle. They also relax the veins.
137
What are the two most common nitrates?
Nitroglycerein
isosorbide mononitrate
_______
138
How long after opening a bottle of nitroglycerin is the bottel effective?
3 months after opening the bottle.
139
How should nitroglycerine be store?
airtight,dark glass botle with metal cap.
140
What can nitroglycerin cause?
Dizziness, headaches, and hypotension. Have the patient lay down before taking it.
141
Who should not take nitrates?
Nitrates are contraindicated in the client with marked hypotension, increased intracranial pressure, or severe anemia.
142
Can you stop taking nitrates abruptyly?
Avoid abrupt withdrawal of long-acting preparations to prevent the rebound effect of severe pain from myocardial ischemia.
143
What are some side effects of nitrates?
Headache, postural (orthostatic) hypotension, dizziness, weakness, flushing or pallor, reflex tachycardia, and paradoxical bradycardia are possible.
144
What are Direct-Acting Arteriolar Vasodilators?
They are used in the client with moderate to severe hypertension and during acute hypertensive emergencies.
145
How do Direct-Acting Arteriolar Vasodilators work?
These medications relax the smooth muscle of the blood vessels, mainly the arteries, causing vasodilation.
146
How do peripheral vasodilators work?
This type of vasodilator decreases peripheral resistance by exerting direct action on the arteries or on both the arteries and the veins, increasing blood flow to the extremities.
147
When do we use peripheral vasodilators?
These medications are used in peripheral vascular disorders of venous and arterial vessels such as disorders resulting from vasospasm (e.g., Raynaud disease).
148
What are the side effects of DIRECT-ACTING ARTERIOLAR AND PERIPHERAL VASODILATORS?
Side/adverse effects include hypotension, reflex tachycardia, edema, dizziness, and headache.
149
What should we monitor for with DIRECT-ACTING ARTERIOLAR AND PERIPHERAL VASODILATORS?
Side/adverse effects include hypotension, reflex tachycardia, edema, dizziness, and headache.
150
What should we monitor the client on DIRECT-ACTING ARTERIOLAR AND PERIPHERAL VASODILATORS for?
Monitor the client for signs of inadequate blood flow to the extremities (e.g., pallor, coldness of extremities, pain).
151
How should you take DIRECT-ACTING ARTERIOLAR AND PERIPHERAL VASODILATORS with meals or without?
Instruct the client to take the medication with meals if GI disturbances occur.
152
how should we teach the client on DIRECT-ACTING ARTERIOLAR AND PERIPHERAL VASODILATORS to move?
Encourage the client to change position slowly to help prevent postural hypotension.
153
How long does it take DIRECT-ACTING ARTERIOLAR AND PERIPHERAL VASODILATORS to work?
3 months
154
How should we adminsister sodium nitroprusside?
During administration of sodium nitroprusside, the solution needs to be protected from light and covered with the supplied opaque sleeve, aluminium foil, or other opaque material; if properly protected from light, a freshly diluted solution will remain stable for 24 hours.
155
When should you dicards sodium nitroprusside?
Discard the sodium nitroprusside if it is red or blue.
156
What are antidysrthymic medications?
These medications suppress dysrhythmias by inhibiting abnormal pathways of electrical conduction through the hear
157
What are the side effects of antidysrythmics?
Side/adverse effects vary, depending on the medication, but include worsening or new dysrhythmias, hypotension, heart failure, nausea and vomiting, diarrhea or constipation, dizziness, and bradycardia or tachycardia.
158
What are the three main things to monitor on a antidystrythmic?
Monitor heart rate, respiratory rate, and blood pressure.
159
What should you do before adminsitering lidocain?
Before administering lidocaine, always check the vial label to prevent administering a form that contains epinephrine or preservatives; such solutions are used for local anesthesia only.
160
What should you do before adminsitering lidocaine?
Before administering lidocaine, always check the vial label to prevent administering a form that contains epinephrine or preservatives; such solutions are used for local anesthesia only.
161
What should you teach client about antidysrythmic?
Instruct the client to change position slowly to help prevent postural hypotension.
Advise the client to limit fluid and salt intake to minimize fluid retention.
162
What should you teach client about antidysrythmic?
Instruct the client to change position slowly to help prevent postural hypotension.
Advise the client to limit fluid and salt intake to minimize fluid retention.
163
How are antiarrhythmics generally classifies?
There cardiac conduction tissue.
164
What can antidysrthmics do to your heart?
slow down the heart, and slow the hearts electrical impulses by blockig the hearts potassium channels.
165
What is something good to know about amiodarone?
Causes skin to take a blue gray color, especially in areas of exposed to the sun. The coloring will go away when the medication is stopped.
166
What is the therapeutic range of digoxin?
0.5 to 2
167
What can happens with low potassium levels in patient do when taking digoxin?
Cause dioxin toxicity.
168
What are the common anti-dysrythmics?
```
Aminodarone (Cordarone)
Digoxin (Lanoxin)
Lidocaine (Xylocaine)
Propranolol (Indernal)
Phenytoin (Dilantin)
```
169
What are the andrenegic agonists?
Dobutamine
Dopamine Hydrochloride
Epinephrine
Norephrine
170
Why do we give doubutamine?
It is used in heart failure and for clients undergoing cardiopulmonary bypass surgery.
171
Why do we give dopamine hydrochrloride?
It is used to treat hypotension and mild kidney failure caused by low cardiac output.
172
What is the epinephrine?
This medication is used for cardiac stimulation in cardiac arrest.
173
Why do we give norepinephrine?
Norepinephrine stimulates the heart in cardiac arrest.
It induces vasoconstriction and increases blood pressure in hypotension and shock.
Isoproterenol Hydrochloride.
This medication is used to induce cardiac stimulation and bronchodilation.
174
What should you be on the lookout for with adrenergic agonists?
Be alert for side effects (e.g., dysrhythmias, angina, restlessness, urinary urgency or incontinence).
Monitor the ECG.
Monitor vital signs and urine output.
