Med cards

Question 1

Ramipril
- Therapeutic class
- Pharm class
- Mechanism of action
- indications
- routes
- Side effects
- contraindications
- Evaluation

Answer 1

• antihypertensive
• ACE inhibitors
• prevents ACEi from converting angiotensin I to angiotensin II; decrease aldosterone secretion –>
  systemic vasodilation
• HF, HTN, post MI
• PO/IV (only enalaprilat)
• Headache, dizziness, fatigue, constant dry and irritating cough, angioedema,
  hypotension, tachycardia, hyperkalemia, kidney injury
• Concurrent use of potassium-sparing diuretic
  Hyperkalemia and pregnancy
• Decreased SSx of HF
  No side effects
  Assess vitals, edema, weight trends, auscultate dyspnea, fatigue, orthostatic hypotension
  Diagnostics: urinalysis, electrolytes, renal function, ECG, pregnancy test

Question 2

Losartan
- Therapeutic class
- Pharm class
- Mechanism of action
- indications
- routes
- Side effects
- contraindications
- Evaluation

Answer 2

• antihypertensive
• Angiotensin 2 receptor antagonist (ARB)
• blocks angiotensin II binding to blood vessels and adrenal glands; decrease aldosterone secretion–> Vasodilation and natriuresis (excretion of Na/H20)
  HF, HTN,
  PO

Headache, Dizziness, Drowsiness, Angioedema, Hypotension, Hypoglycemia, Hyperkalemia

Pregnancy, Hypotension, Hypovolemia, Hyperkalemia, Renal or hepatic disease

Decreased SSx of HF
No side effects
Assess vitals, edema, weight trends, auscultate dyspnea, fatigue, orthostatic hypotension
Diagnostics: urinalysis, electrolytes, renal function, ECG, pregnancy test

Question 3

Digoxin
- Therapeutic class
- Pharm class
- Mechanism of action
- indications
- routes
- Side effects
- contraindications
- Evaluation

Answer 3

• anti-arrhythmic
• glycosides
• Increases contractility/slows HR (positive inotropic, negative chronotropic)
• Prolongs refractory period of AV node and decreased conduction through SA/AV nodes by inhibiting NA/K ATPase enzyme
  A fib, CHF
  PO, IV, IM
• Unusual tiredness, anxiety, hallucinations, poisoning/toxicity
• Ventricular tachycardia
• Decreased SSx of HF, No side effects, Assess vitals, edema, weight trends, auscultate dyspnea, fatigue,
  Diagnostics: BNP, electrolytes, renal function, ECG, EF%

Question 4

Furosemide/Lasix

Answer 4

• Loop diuretic
• Blocks chloride pump
  in the ascending
  Loop of Henle, where
  30% of filtered Na is
  reabsorbed Results
  in. ↓reabsorption of
  Na and chloride.
• acute HF, acute pulmonary
  edema and edema
• PO
• Hyperkalemia, hypotension, kidney dysfunction (nephrotoxic)

Question 5

Med card for bisoprolol:
- therapeutic/pharm class
- mechanism of action
- side effects
- what to assess for at the bedside

Answer 5

• antihypertensive/beta blocker
• Decrease sympathetic nervous system activation by blocking beta 1 receptors so epi/norepi can’t activate
  Decreases contractility/conduction through the AV node → decrease HR ( helps with fill time), and decreases CO (bad side effect if you have HF)
  Decreases RAAS activation
• Drowsiness, fatigue, weakness, bronchospasm, hypotension, pulmonary edema, ED, behaviour changes, nightmares, depression
• assess for decreased ssx of HF and CHEST PAIN r/t decreased cardiac output

Question 6

Med card for pantoprazole
- therapeutic/pharm class
- mechanism of action
- side effects
- what to assess for at the bedside

Answer 6

• anti-ulcer agent/proton pump inhibitor
• for healing erosive esophagitis associated with GERD, prevents transport of H+ into gastric lumen
• assess for epigastric pain

Question 7

Med card for bisoprolol:
- therapeutic/pharm class
- mechanism of action
- side effects
- what to assess for at the bedside

Answer 7

• antihypertensive/beta blocker
• Decrease sympathetic nervous system activation by blocking beta 1 receptors so epi/norepi can’t activate
  Decreases contractility/conduction through the AV node → decrease HR ( helps with fill time), and decreases CO (bad side effect if you have HF)
  Decreases RAAS activation
• Drowsiness, fatigue, weakness, bronchospasm, hypotension, pulmonary edema, ED, behaviour changes, nightmares, depression
• assess for decreased ssx of HF and CHEST PAIN r/t decreased cardiac output

Question 8

Med card for spironolactone:
- therapeutic/pharm class
- mechanism of action
- side effects
- what to assess for at the bedside

Answer 8

• K+ sparing diuretic
• Blocks action of aldosterone
  Causes loss of Na and H20 but potassium is retained
  Lowers the amount of fluid in the body
• Hyperkalemia, hypotension, kidney dysfunction
• assess for decreased ssx of HF such as decreased edema, monitor K+ levels and BP, signs of nephrotoxicity

Question 9

Med card for statins (general)
- therapeutic/pharm class
- mechanism of action
- side effects
- what to assess for at the bedside

Answer 9

• lipid-lowering agents/ HMG-CoA reductase inhibitors (to manage cholesterol/dislipidemia)
• limits total and LDL cholesterol production and increases HDL by inhibiting HMG-CoA enzyme
• rash, cramps, constipation, diarrhea, flatus, heartburn
• decrease in LDL, increase in HDL, slowed progression of CAD

Question 10

Med card for Warfarin
- therapeutic/pharm class
- mechanism of action
- side effects
- what to assess for at the bedside

Answer 10

• anticoagulant/coumarins
• prevents thromboembolic events by blocking Vitamin K dependent clotting pathways
• bleeding
• assess for signs of bleeding/hemorrhage, monitor PT/INR