Lasix (furosemide) class
loop diuretic
Lasix (furosemide) MOA
they act on the ascending loop of henle to inhibit sodium and chloride absorption. vasoconstriction
SE of furosemide (loop diuretics)
Hypotension Hypokalemia Hyperglycemia Ototoxicity Hypocalcemia Dehydration
loop diuretics nursing implications
Do not give dosages before bedtime Perform daily weights, same time, same scale Report weight gain 2lbs in 2 days Pts are frequently taking potassium supplements Dietary teaching for potassium Postural hypotension Maintain adequate fluid intake Don’t double doses if dose missed
Spironolactone (aldactone) class
k sparing
Spironolactone (aldactone) MOA
Synthetic steroid that blocks aldosterone receptors, increases sodium and water excretion while conserving potassium
Spironolactone (aldactone) SE
Hyperkalemia
Hyponatremia
Spironolactone (aldactone) Nursing implications
Do not give potassium supplements
ACE inhibitors can cause hyperkalemia
Avoid prolonged sun exposure
Administration with food increases absorption
A loading dose may be given
Delay in onset of action (several weeks for antihypertensive effect)
metoprolol (lopressor) class
beta blocker
antihypertensive
metoprolol (lopressor) MOA
Block beta receptor sites which are responsive to epinephrine and norepinephrine. Cause a decrease in heart rate. Cause a decrease in blood pressure. Cause a decrease in cardiac output. May cause bronchoconstriction.
metoprolol (lopressor) SE
Headache
Fatigue
Lethargy
Mask hypoglycemia*** especially in diabetics
Asthma: symptoms to monitor for bronchoconstriction
metoprolol (lopressor) nursing implications
Monitor heart rate and blood pressure
Monitor for symptoms of CHF
hold med if BP is too low
Diltiazem (Cardizem) class
calcium channel blocker
antihypertensive
Diltiazem (Cardizem) MOA
block the calcium channels in the specialized tissue of muscle cells of the heart and in the smooth muscle cells in the walls of blood vessels. Dilate coronary arteries. Decrease heart rate. Decrease blood pressure. Decrease cardiac output.
Diltiazem (Cardizem) SE
Headache Flushing (facial flushing from vasodilation) Peripheral edema Fatigue Hypotension
Diltiazem (Cardizem) nursing implications
Monitor heart rate and blood pressure
Grapefruit juice may interfere with actions
Enalapril (Vasotec) class
Ace inhibitors
antihypertensive
Enalapril (Vasotec) MOA
Decreases the formation of angiotensin II. Also decreases the secretion of aldosterone.
Decreases blood pressure.
Improves cardiac output.
no effect on HR
Enalapril (Vasotec) SE
**Cough: 5-10% will develop** Dizziness, headache, vertigo Photosensitivity Abdominal pain Hyperkalemia: inhibits aldosterone
Enalapril (Vasotec) nursing implications
Monitor blood pressure
Monitor serum potassium-kidneys regulate K+
Monitor renal function-Creatinine and sometimes BUN
Antacids may decrease absorption
clonidine (catapres patch) class
vasodilator
antihypertensive
clonidine (catapres patch) MOA
Alpha adrenergic blockers: block alpha receptors that mediate vasomotor tone
Central acting: Causes decreased production of epinephrine
Direct acting vasodilator: act directly on smooth muscle in the walls of the blood vessels to cause relaxation of the vessel wall.
clonidine (catapres patch) SE
Hypotension
Reflex tachycardia-blood pressure goes down and HR goes up
Headache
Orthostatic hypotension
clonidine (catapres patch) nursing implications
Take off patch, clean the place where old patch was, clean where new patch is going, rotate sites
nitroglycerin class
nitrates
antianginals
nitroglycerin MOA
Dilates coronary arteries, veins arteries.
nitroglycerin SE
**Headache** Hypotension Dizziness Flushing Reflex tachycardia
nitroglycerin nursing implications
*Sublingual tablets q5min for three doses if angina
*NTG tablets need to protect from light
*Watch expiration date (3 months)
When taken should feel slight tingling sensation
Sublingual spray is highly flammable
Close mouth immediately after spraying under tongue
Do not swallow or inhale the spray
avoid use with alcohol (vasodilation)
avoid use with viagra (vasodilation)
simvastatin (zocor) class
statins
antilipemic
simvastatin (zocor) MOA
block the last step in the formation of cholesterol
Increase number LDL receptors
simvastatin (zocor) SE
GI: nausea, constipation, bloating, gas
Myopathy: muscle soreness, aches and weakness
Liver dysfunction: jaundice, clay colored stools, dark urine, right upper quadrant pain
simvastatin (zocor) nursing implications
Administer with food at bedtime Monitor lipid levels Avoid pregnancy Report myopathy, liver dysfunction symptoms Monitor LFTs
digoxin (lanoxin) class
cardiac glycoside
antiarrythmics
digoxin (lanoxin) MOA
decreases HR
increases contractility
digoxin (lanoxin) SE
(toxicity)
bradycardia, N/V, visual disturbances.
digoxin (lanoxin) nursing implications
MUST take HR before administration (hold if