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Cardiac Drugs
| Term | Definition |
|---|---|
| Beta Blocker Action | Inhibit cardiac response to sympathetic nerve stimulation by blocking beta receptors -Inhibit Renin release -Induce Vasoconstriction and Na reabsorption aggravating HTN |
| Beta Blockers Use | Decrease: HR, BP, contractility, conduction, automaticity, CO and renin release |
| Beta Blockers common SE | -Cardio- Bradycardia, peripheral vasoconstriction, heart failure -Respiratory- bronchospasms, wheezing -Endocrine- DM |
| Beta Blockers pt teaching | When to hold HR= <50 -Sudden discontinuation (worsening angina, possible MI) -Meds should be gradually reduced over 1-2 weeks |
| Beta Blockers NI | DM= Hypoglycemia -Not as effective for African Americans -Monitor VS (especially HR, BP) -Avoid in pt with DM, asthma and HF -Check hx of respiratory conditions |
| Beta Blockers Drugs | Drugs ending in "lol" -Atenolol, Carvedilol, Labetalol, Metoprolol, Propanolol, Bisoprolol |
| ACE inhibitors action | Inhibits ACE thus inhibiting conversion of angiotensin I to II=> reducing BP |
| ACE inhibitors use | Reduced BP, pressure CO, and increased renal blood flow |
| ACE inhibitor common SE | -GI- nausea, diarrhea -Neuro- fatigue, headache -Cardio- orthostatic hypotension -Inflammatory- chronic cough |
| ACE inhibitors Patient teaching | Hold med if SBP <100 mm Hg - Do not take with digoxin or lithium -Do not take if pregnant -Do not take if renal failure -Isometric exercise in bed |
| ACE inhibitors NI | In older adults- higher chance of orthostatic hypotension -Monitor VS (especially BP) -Monitor Urine output -Less effective for African Americans -May increase blood levels of dig or lithium -Ask if pt has persistent cough |
| ACE inhibitor Drugs | Drugs ending in "pril" -Benzapril, Captopril, Enalopril, Fosinopril, Lisinopril |
| Diuretics action | Cause vasodepletion, Na excretion and vasodilation of peripheral arteries |
| Diuretics common SE | -Cardio- orthostatic hypotension -GI-gastric irritation -Neuro- Mental confusion, headache |
| Diuretics patient teaching | -About orthostatic hypotension -Instruct patient not to use salt substitutes (especially for K-sparing) -Note any hearing changes |
| Diuretics NI | Obtain BP (postural), Obtain baseline weight and apical pulse, initiate labs, Obtain baseline assessment of patients hydration status |
| Loop Diuretic Drugs | Bumetanide (Bumex), Furosemide (Lasix), Ethacrynic acid (Edocrin), Torsemide (Dermadex) |
| Carbonic Anhydrase Inhibitor Drugs (diuretic) | Acetazolamide (Diamox) |
| Thiazide diuretics | Amiloride (Midamor), Spironolactone (Aldactone), Triamterene (Dyrenium) |
| Calcium Channel Blocker Action | Inhibits movement of Calcium ions across membranes |
| Calcium Channel Blocker Use | Each act by Calcium ion inhibition -used for HR disturbances and angina -Decreased dysrhythmias, HR, BP, automaticity, contractility -Increased vasodilation (coronary and peripheral) |
| Calcium Channel Blocker common SE | Cardio- Hypotension, syncope, edema |
| Calcium Channel Blocker Patient teaching | Do not take Digoxin -Do not eat grapefruit while taking this medication |
| Calcium Channel Blocker NI | Effective for African American and elderly -Obtain baseline BP (orthostatic- SBP <100 hold), apical pulse (HR less than 50 hold) -Obtain baseline weight -If taking dig (monitor for toxicity) |
| Calcium Channel Blocker Drugs | Diltazem (Cardizem), Felodipine, Verapamil (Calan), Amlodipine (Norvasc), Nifedepine (Procardia) |
| Diltazem | Cardizem -Do not eat grapefruit or take with digoxin -Inhibits Ca movement -Decreases contractility, automaticity, dysrhythmia, HR, BP, -Increases vasodilation (CA and peripheral arteries) |
| Angiotensin II Inhibitors Action | ARB- Binds to angiotensin II receptor sites and blocks the vasoconstrictor from binding to receptor sites in target organs |
| Angiotensin II Inhibitors Use | Effective in lowering BP, reduce blood volume |
| Angiotensin II inhibitors common SE | -GI-dyspepsia, cramps, diarrhea -Neuro- headache -Cardio- Orthostatic hypotension |
| Angiotensin II inhibitors patient teaching | Do not take if pregnant -Higher risk of increased K in DM and renal impairment patients |
| Angiotensin II inhibitors NI | -African American patients don't respond well -Monitor K level frequently (risk for Hyperkalemia) -Discourage K or dietary supplements -Obtain BP and apical pulse, hx of bowel elimination (GI symptoms) -initiate labs (renal, CBC) |
| Angiotensin II inhibitors Drugs | End in "sartan" -Candesartan (Atacand), Irbesartan (Avapro), Losartan (Cozaar), Olmesartan (Benicar), Telmisartan (Micardis), Valsartan (Diovan) |
| Vasodilator Action | Relax arterial smooth muscle, decreased peripheral vascular resistance |
| Vasodilator use | Treat HTN stage II, toxemia of pregnancy, HTN, associated with renal disease |
| Vasodilator common SE | -Neuro- dizziness, numbness, tingling in legs, nausea -Cardio- orthostatic hypotension, palpitations, tachycardia -Respiratory- nasal congestion |
| Vasodilator patient teaching | Do not stand up quickly (orthostatic hypotension) -Check BP and pulse before taking medications -Hold med if SBP <100 and pulse <50 |
| Vasodilator NI | Obtain baseline BP and apical pulse -hold medication if SBP <100 or HR <50 |
| Direct vasodilator Drugs | Hydralazine (Aprensoline), Minoxidil (Loniten), Nitroprusside (Nitropress) |
| Thromboembolic disorder Drugs | Apixaban (Eliquis), Heparin, Warfarin (coumadin) |
| Apixaban (Eliquis) action/classification | Class: Factor Xa inhibitor -Action- reduce risk of stroke and systemic embolism in patients with atrial fibrillation |
| Apixaban therapeutic outcome | Prevention of DVT, and PE -reduce risk of thromboembolism in patients with atrial fibrillation |
| Apixaban common SE | Heme- bleeding |
| Apixaban NI | Obtain baseline VS, initiate labs (renal function, CBC), no need to monitor PT or aPTT, inspect skin and mucous membranes |
| Heparin action/classification | Class: Anticoagulant -Action- in presence of heparin, antithrombin III neutralizes thrombin, factor I Xa, XI, XII and plasmin |
| Heparin common SE | Heme- bleeding, hematoma formation at injection site |
| Heparin NI | Take baseline VS -Always check most recent aPTT, platelets and hematocrit -Inspect skin and mucous membranes for petechiae, ecchymoses, or hematomas -Antidote- protamine sulfates |
| Heparin Rationale | Treat DVT, PE, cerebral embolism -can be given subq, IV, or IV push |
| Warfarin (coumadin) action/classification | Class: Anticoagulant -Action- Inhibits activity of vitamin K, which activates certain clotting factors -Blockade of activation of these factors prevent clot formation |
| Warfarin (coumadin) common SE | Heme- bleeding (skin, mucous membrane, internal bleeding, urine and stool, menstrual flow, surgical dressings and drains) |
| Warfarin (coumadin) NI | Obtain baseline VS -always check most recent PT or INR -inspect skin and mucous membranes for petechiae, ecchymoses, or hematoma -do not give to pregnant patients -provide dietary education on high vitamin K foods |
| Antidote for Warfarin (coumadin) | Discontinue use, vitamin K -note numerous drug interactions |
| Target INR | 2-3 = A. fib, stroke, MI, DVT 2.5-3.5 = Mechanical heart valve device |
| Warfarin (coumadin) rationale | Treatment/prophylaxis of DVT, embolization of A. fib or heart valve replacement, PE |
| Drugs to treat HF | Vasodilators, inotropic agents, diuretics, ACE inhibitors, Natriuretic peptide, ARB-Neprilysin Inhibitor, Beta blocker, phosphodiesterase inhibitor, digitalis glycosides |
| Digoxin (Lanoxin) action/classification | Class: Digitalis Glycosides -Action- Positive inotropy (increased force of beat) -negative chronotropy (slow HR) |
| Digoxin (Lanoxin) common SE | Dig toxicity - Anorexia, nausea, fatigue, visual disturbances, bradycardia -Antidote- Digibind |
| Digoxin (Lanoxin) NI | Take apical pulse (full minute) -Obtain baseline data: VS, lung sounds, weight and labs -Monitor for signs of Dig toxicity |
| Drugs to treat Angina | Beta blockers, CCB, ACE inhibitors, myocardial cell sodium channel blockers, nitro |
| Nitroglycerin action/classification | Class: Nitrates -Action- Decreased O2 demand on heart, dilates arteries and veins, decreased preload on heart |
| Nitroglycerin common SE | -Cardio- excessive hypotension -Neuro- prolonged tolerance with longer acting nitrates -Headache |
| Nitroglycerin NI | -Assess level, location, duration, intensity, and patterns of patient's pain -Ask patient when last dose of nitro was takin -Drug interactions- erectile dysfunction (viagra)- potentially lower BP (fatal drop may occur) |
| Nitro Routes | Sublingual (emergency), transdermal (regulation), IV (accuracy) |
| Treat Fluid overload | TZD diuretics, K-sparing diuretics, combo diuretics, carbonic anhydrase inhibitors, loop diuretics |
| Furosemide (Lasix) action/classification | Class: Loop Diuretic -Action- Inhibit Na and Cl reabsorption in ascending loop of Henle |
| Furosemide (Lasix) common SE | -GI- oral irritation, dry mouth -Cardio- orthostatic hypotension |
| Furosemide (Lasix) NI | Obtain baseline VS, lung sounds, weight, degree of edema, and labs -obtain mental status, muscle strength, muscle cramps, tremors, nausea, general appearance -DM requires baseline BG -check for symptoms of gout -note hearing reduction |
| Furosemide Drug Interaction | Digoxin- may increase risk of toxicity (hypokalemia) -Alcohol, sedatives, opiates (orthostatic hypotension risk) |
Created by:
MCGEEMAIDEN