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Cardiac meds

Pharmacology NRTC

Digoxin is contraindicated when HR<60BPM
Digoxin is used for what 2 heart abnormalities Heart failure, arrhythmias... afib
This electrolyte imbalance increases the effect of digoxin Hypokalemia
Normal potassium level 3.5-5.0
Normal digoxin level 0.5-2.0
Classic s/s of digoxin toxicity Visual disturbances... Halos around objects
Digoxins action Increased contractility.... Positive inotrope
Digoxins anecdote Digibind
Nitrates action Vasodilation
Nitrates are used for what Angina
Side effects of nitrates headache hypotension dizziness and syncope
Nitroglycerin comes in what form Sublingual transdermal patch extended release tablet and trans lingual spray
How is nitroglycerin stored Dark glass bottle not childproof
Client should feel this when nitro is put under the tongue A tingle or burning sensation
How is nitro taken for angina Can take one tablet under the tongue every 5 minutes for a total of 3 doses
What signs and symptoms may the client have after taking nitro Headache dizziness syncope client can take Tylenol or aspirin for headache
When discontinuing A nitro patch what is the procedure Taper down over several weeks
What is important to know about IV nitroglycerin Must use specialMust use special tubing
What is the action of beta blockers Block epinephrine and cause peripheral vasodilation
Beta blockers are used for what heart conditions hypertension some tachy arrhythmias and angina
What are the side effects of beta blockers Bradycardia hypotension erectile dysfunction
What can beta blockers mask the signs of that is important for diabetics to know Hypoglycemia client should do more finger stick blood sugar tests
What do all clients need to know before taking beta blockers Check apical pulse do not take if less than 60 beats per minute
What can occur if beta blockers are stopped abruptly Rebound hypertension
Beta blockers may cause this type of dysfunction Sexual
What are important teaching topics for clients taking CCBs Take BP and pulse and watch for orthostatic hypotension and edema
name one centrally acting alpha agonist Clonidine
What can happen if clonidine is stopped suddenly rebound hypertension
What is the action of ACE inhibitors Blacks the production of angiotensin ll vasoconstrictor and blocks release of aldosterone
What side effects of ACE inhibitors should be reported to the PCP Persistent dry cough
What diuretic can cause ototoxicity when administered too fast with IV infusion Lasix furosemide
What group of diuretics is commonly combined with ACE inhibitors Thiazide diuretics
What is a common electrolyte imbalance with thiazide diuretics Hypokalemia
Thiazides are contraindicated in what patients Renal failure patients ...unlike loop diuretics
What must a nurse monitor for in patients taking thiazides Vs wait I / O's E-Lites especially K+
What are signs of hypokalemia to teach patients Muscle weakness leg cramps dysrhythmias
Loop diuretics are more potent than thiazides why are they not prescribed as often Less effective as an anti hypertensive
What drug do loop diuretics have a major interaction with Digoxin can cause digoxin toxicity because of hypokalemia
clients should take diuretics at what time of the day Early morning to prevent nocturia
What is important to teach about potassium sparing diuretics Monitor potassium levels periodically, do not take potassium supplements or salt substitutes
Potassium sparing diuretics should not be taken with what class of heart medications? ACE inhibitors both can cause hyperkalemia
What do platelet inhibitors do,? Inhibit aggregation of platelets, decrease clotting
What are the side effects of platelet inhibitors Uncontrolled bleeding
Do platelet inhibitors affect existing clots No effect on thrombi
What platelet inhibitor is commonly given after an acute MI Aspirin
When are anticoagulants used After MI, PE, DVT and ischaemic CVA
Name a common LMWH Enoxaparin, lovenox
What are some advantages to LMWH No need to monitor PTT
What is the antidote for heparin Protamine sulfate
What is the antidote for coumadin, warfarin Vitamin K
What lab is monitored for heparin aPTT
What labs do we monitor for coumadin, warfarin PT / INR
What should INR be 2.0- 3.0
Plan teaching for clients taking anticoagulants? Tell dentist, use soft toothbrush, use electric razor, Cary Medical ID, do not smoke, do not take aspirin, do not take herbs, may interact with anti- coagulant, avoid EtOH
If clients experience bleeding when taking anticoagulants what do they need to do? Apply firm, direct pressure for 5 - 10 minutes
If you are taking an anticoagulant what food must you avoid green leafy vegetables, high in vitamin K
What do thrombolytics do Directly break up blood clots
What drugs must be avoided when taking thrombolytics NSAIDs
Total cholesterol level goal <200
triglyceride level goal <150
LDL goal <130
HDL goal >40
What are serious side effects of statins Elevation of liver enzymes and rhabdomylosis
How long does it take for full therapeutic effects of statins 2 - 4 weeks
When taking statins what food must be avoided Grapefruit, leads to statin toxicity
What lab values are to be expected while on statins Liver function studies, LFTs, lipid profile
Gemfibrozil may increase the risk of what Gallstones
What is a potential side effect of niacin that is not well tolerated Flushing
Important patient teaching in regards to all cholesterol lowering medications includes Take 1 hr before or 4-6 hrs after meals to avoid interference with absorption
Created by: Annettekeith
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