Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
255 meds
| Question | Answer |
|---|---|
| THIAZIDE DIURETICS action/use | action-Excrete sodium and water by blocking reabsorption in the diluting tubule of kidney, Vasodilation and decreased peripheral vascular resistance. use-Edema and hypertension *Not effective for immediate diuresis* |
| THIAZIDE DIURETICS common MEDS | Chlorothiazide (Diuril) Hydrochlorothiazide (Hydrodiuril) Metolazone (Zaroxolyn) |
| THIAZIDE DIURETICS routes | PO, IV |
| THIAZIDE DIURETICS considerations | Take the medication early to avoid nocturia Ineffective if creatinine clearance is less than 30 2-4 weeks for maximum effect |
| THIAZIDE DIURETICS side effects | Dizziness, headache, weakness Dehydration, orthostatic hypotension, constipation, frequent urination Electrolyte imbalance, muscle cramps, photosensitivity, impotence, hyperuricemia |
| THIAZIDE DIURETICS nursing care | Monitor for hypotension and tachycardia Monitor K (hypokalemia), BUN, Cre, GFR Monitor I&O and assess for dehydration Teach to eat foods high in potassium Teach to restrict sodium Teach to take early to avoid nocturia |
| LOOP DIURETICS | action-Blocks sodium and water reabsorption in the loop of Henle causing excretion of sodium, water, chloride, and potassium Renal vasodilation increasing GFR and decreasing PVR |
| LOOP DIURETICS use | Low GFR and hypertensive emergencies Edema, pulmonary edema, CHF, CKD, and hepatic cirrhosis Drug overdose |
| LOOP DIURETICS common meds | Bumetanide (Bumex) Furosemide (Lasix) Toresemide (Demadex |
| LOOP DIURETICS route and considerations | PO, IV Take early in the day to avoid nocturia IV administration should be slow because rapid injection can cause hypotension IV furosemide given too fast can cause hearing loss |
| LOOP DIURETICS side effects | Dizziness, headache, orthostatic hypotension, weakness Nausea, vomiting, anorexia, constipation Excessive urination, nocturia OTOTOXICITY Dermatitis, urticaria, pruritis, muscle spasms |
| LOOP DIURETICS nursing care | hypotension and tachycardia Monitor potassium, sodium, calcium, magnesium Monitor weight & I&Os Assess for dehydration Teach to eat foods high in potassium Teach to restrict sodium intake Teach to avoid dehydration, report tinnitus |
| POTASSIUM-SPARING DIURETICS action | Inhibits aldosterone, sodium excreted in exchange for potassium Acts directly on the distal convoluted tubule |
| POTASSIUM-SPARING DIURETICS uses | Hypertension and edema associated with heart failure Spironolactone is also used for detection of primary hyperaldosteronism, hirsutism, and premenstrual syndrome |
| POTASSIUM-SPARING DIURETICS meds | Spironolactone (Aldactone) Amiloride (Midamor) Triamterene (Dyrenium) |
| POTASSIUM-SPARING DIURETICS route and considerations | PO Administration Considerations: Take with food or milk Avoid salt substitutes and high potassium foods |
| POTASSIUM-SPARING DIURETICS side effects | Headache, weakness, dizziness, orthostatic hypotension Impotence, muscle cramps, gynecomastia, breast soreness Dry mouth, photosensitivity |
| POTASSIUM-SPARING DIURETICS nursing care | Stop potassium supplements dehydration potassium, sodium, BUN/Creatinine take with food avoid high potassium foods max diuresis may take up to 3 days and continue 2-3 days once stopped avoid direct sunlight |
| BETA-ADRENERGIC BLOCKERS action | therapeutic doses, blocks Beta 1 receptors. higher doses or non-cardioselective, may block Beta 2 receptors Reduction in renin activity Reduction in BP |
| BETA-ADRENERGIC BLOCKERS uses | Management of HTN, angina, MI, HF, and tachy-dysrhythmias, anxiety,migraines |
| BETA-ADRENERGIC BLOCKER meds | Cardioselective: Atenolol (Tenormin) Metoprolol (Lopressor) Non-Cardioselective: Propranolol (Inderal) Carvedilol (Coreg) Sotalol (Betapace) Timolol (Blocadren) PO and IV |
| BETA-ADRENERGIC BLOCKERS admin considerations | Non-cardioselective should be used cautiously with COPD or asthma Give at consistent times Do not stop medication abruptly Hold medication if HR < 60 or SBP < 90 |
| BETA-ADRENERGIC BLOCKERS side effects | Hypotension Bradycardia Bronchospasm/wheezing Impotence Weight Gain Worsening CHF Dizziness/Fatigue Mask CV signs of hypoglycemia in DM |
| BETA-ADRENERGIC BLOCKER nursing care | Assess BP and HR before administering Hold if HR less than 60 or SBP less than 90 Monitor for bronchospasms in COPD/asthma Teach how to take at home Teach not to abruptly stop Teach to change positions slowly |
| CALCIUM CHANNEL BLOCKERS action | Class IV anti-dysrhythmic Inhibit the flow of calcium ions across the cell membrane of vascular tissue and cardiac cells. Negative inotropic and Negative chronotropic effect Vasodilation & relaxation of smooth muscle |
| CALCIUM CHANNEL BLOCKERS use | Angina Prinzmetal angina Primary hypertension Atrial fibrillation, flutter, and SVT (IV route) Vaso-occlusion disorders |
| CALCIUM CHANNEL BLOCKERS meds | PO and IV Diltiazem (Cardizem) Verapamil (Calan SR) Amlodipine (Norvasc) Nifedipine (Procardia) Felodipine (Plendil |
| CALCIUM CHANNEL BLOCKERS admin considerations | Can cause reflex tachycardia, and some (verapamil and diltiazem) may worsen heart failure. Monitor for headache Withhold medication is BP less than 90/60 |
| CALCIUM CHANNEL BLOCKERS side effects | Headache Fatigue Constipation Postural hypotension Peripheral edema |
| CALCIUM CHANNEL BLOCKERS nurse care | Assess BP & ECG, hold if BP <90/60 or heart rhythm of 2nd or 3rd degree heart block Monitor for HA May induce hyperglycemia Teach to report gradual weight gain and/or edema Teach how to take Teach to change positions slowly |
| ANTICHOLINERGICS | IV, Atropine, Action: bind with muscarinic receptors to block cholinergic effects on the heart and smooth muscles of the bronchi and intestines. Uses: bradycardia, cardiopulmonary resuscitation |
| ANTICHOLINERGICS side effects | tachycardia, restlessness, irritability, hallucination, delirium, increased intraocular pressure, urinary retention, dilated pupils, decreased salivation and gastric secretions, decreased GI motility |
| ANTICHOLINERGICS considerations | Given every 3-5 mins (max 3 doses) Contraindicated in narrow closure glaucoma, caution with renal and liver dysfunction and various GI/intestinal disorders |
| ACE INHIBITORS Action | Block conversion of angiotensin I to angiotensin II preventing vasoconstriction and sodium and water retention. Decreases SVR, Afterload, & Preload Reverses ventricular remodeling, can cause angioedema. incr K |
| ACE INHIBITORS use | Hypertension Drug of choice for CHF |
| ACE INHIBITORS meds | Enalapril (Vasotec) Benazapril (Lotensin) Captopril (Capoten) Lisinopril (Prinivil) Ramipril (Altace |
| ACE INHIBITORS admin considerations | PO. Less effective in African- American clients contraindicated in pregnancy Captopril should be taken on an empty stomach |
| ACE INHIBITORS side effects | Headache, dizziness, anxiety, fatigue, insomnia, nervousness, hypotension Constipation, persistent dry nonproductive cough, dyspnea Rash, arthralgia, impotence, dysgeusia |
| ACE INHIBITORS nursing care | one hour before meals Monitor potassium, sodium, liver & kidney function assess bp Teach to change positions slowly Teach not to skip or stop taking Teach to avoid potassium salt subsitiutes |
| inotropic | amount of squeeze on the heart |
| chronotropic | how fast HR is |
| dromotropic | how fast electrical conduction flys through muscle |
| non cardioselective beta blockers | blocks beta receptors in lungs, can cause bronchospasms |
| ANGIOTENSIN RECEPTOR BLOCKERS (ARBS) Action | Block the effect of angiotensin II on receptors preventing vasoconstriction and sodium and water retention |
| ARBS use | Hypertension CHF Routes: PO Administration considerations, Side effects, nursing care: Same as ACEs |
| ARBS common meds | Losartan (Cozaar) Valsartan (Diovan) Candesartan (Atacand) Irbesartan (Avapro) Olmesartan (Benicar) Sacubitril/valsartan (Entresto) |
| Sacubitril is a | neprilysin inhibitor = prevents degradation of vasoactive peptides which leads to diuresis Used in heart failure |
| ALPHA-ADRENERGIC BLOCKERS meds | Doxazosin (Cardura) Terzosin (Hytrin) Prazosin (Minipress) Carvedilol (Coreg) & Labetalol (Normodyn |
| ALPHA-ADRENERGIC BLOCKERS action | Block alpha-receptors in vascular smooth muscle thereby blocking vasoconstriction |
| ALPHA-ADRENERGIC BLOCKERS uses | HTN, PVD, benign prostatic hyperplasia (BPH) |
| ALPHA-ADRENERGIC BLOCKERS admin | May cause syncope 30min-1hr after first dose Do not stop abruptly Effect may take 3-4 weeks |
| ALPHA-ADRENERGIC BLOCKERS side effects | First dose syncope Headache, drowsiness, hypotension, palpitations |
| ALPHA-ADRENERGIC BLOCKERS care | Assess BP & HR Monitor for edema Monitor for hypoglycemia in DM Teach to change positions slowly Teach to not stop abruptly |
| NITRATES AND NITRITES action | Vasodilation of arteries Decrease workload of LV Decrease preload and afterload Decrease myocardial oxygen demand |
| NITRATES AND NITRITES use | Treatment or prevention of angina in clients with CAD and treat symptoms of HF |
| NITRATES AND NITRITES meds | Isosorbide Dinitrate (Isordil) Isosorbide Mononitrate (Imdur) Nitroglycerin SL (Nitrostat) Nitroglycerin SR (Nitro-bid) Nitroglycerin Topical Nitroglycerin Transdermal |
| NITRATES AND NITRITES routes | PO, SL, TOP, IV |
| NITRATES AND NITRITES considerations | TG given one tablet SL every 5 minutes to a total of 3 tablets. If CP not relieved, call for help NTG degrades in heat, light, or moisture (store in dark bottle) NTG tablets need to be replaced every 3-6 months Wear gloves |
| NITRATES AND NITRITE side effects | Headache Postural hypotension Flushing GI upset Contact dermatitis |
| NITRATES AND NITRITE care | Fall precautions when administering Allow SL to dissolve naturally Assess BP for hypotension Teach to rest at least 15 mins after taking Teach when to call 911 Teach to take before an event is anticipated to cause angina |
| ANTIPLATELETS action | Aspirin: Inhibits COX-1 thereby suppressing the production of prostaglandins (dec. inflammation, pain, fever) and thromboxanes (dec. platelet aggregation) Others: prevent or disrupt aggregation of platelets |
| ANTIPLATELETS use | Prevention & Treatment of MI, stroke, & cardiac surgery |
| ANTIPLATELETS meds | Acetylsalicylic acid (ASA) Clopidogrel (Plavix) Ticagrelor (Brilinta) Prasugrel (Effient) |
| ANTIPLATELETS route and considerations | PO, IV Administration Consideration ASA 81-325mg/day, comes in EC Take ASA with food to dec. GI upset |
| ANTIPLATELETS side effects | Bruising Hematuria Tarry stools ASA side effects: GI symptoms Blood dyscrasias |
| ANTIPLATELETS care | Monitor VS, bleeding Should be stopped 7 days before surgery Teach to monitor for signs of bleeding Teach measures to prevent and/or stop bleeding |
| ANTIDYSRHYTHMIC route and action | Action: Slows electrical conduction time through AV node |
| ANTIDYSRHYTHMIC uses | SVT |
| ANTIDYSRHYTHMIC side effects | Bradycardia or cardiac arrest, tachycardia, PVCs, facial flushing |
| ANTIDYSRHYTHMIC considerations | Rapid IV push (1-2 seconds), followed by rapid normal saline flush, half life 10 secs Crash cart in room with ECG monitoring Expect SUDDEN slowing of HR, even asystole for a brief period |
| ANTIDYSRHYTHMIC care | Monitor ECG continuously Baseline VS then Q15 mins |
| POTASSIUM CHANNEL BLOCKER ANTIDYSRHYTHMIC | Amiodarone (Cordarone) Form: PO or IV Action: Blocks potassium from re-entering cell to repolarize causing a prolonged refractory period and decrease automaticity Uses: Vtach, Vfib, SVT, atrial fib, atrial flutter |
| POTASSIUM CHANNEL BLOCKER ANTIDYSRHYTHMIC side effects | Dizziness, fatigue, hypotension, bradycardia, thyroid problems, N/V, photosensitivity, paresthesia, ataxia |
| POTASSIUM CHANNEL BLOCKER ANTIDYSRHYTHMIC .. admin | May take with food; stay consistent w/ or w/o food Avoid grapefruit juice, direct sunlight Many drug interactions |
| POTASSIUM CHANNEL BLOCKER ANTIDYSRHYTHMIC . considerations | Monitor BP, HR, & ECG Monitor thyroid & liver function Assess for pulmonary & neuro toxicity Report HR <60 bpm |
| POSITIVE INOTROPES | Dobutamine (Dobutrex), dopamine Mimics fight-or-flight response of SNS Stimulates alpha and beta adrenergic receptors = increased BP and incr rate of contraction Route: IV drip Uses: hypotension, shock |
| POSITIVE INOTROPES side effects | headache, bradycardia, hypertension, dysrhythmias, vtach, cardiac arrest |
| POSITIVE INOTROPES considerations | Frequent vital sign monitoring Monitor for angina Administer with IV pump and monitor infusion site |
| CARDIAC GLYCOSIDES action/med | Digoxin (Lanoxin) Action: Positive inotropic and Negative chronotropic effects thereby increasing CO PO, IV |
| CARDIAC GLYCOSIDES use and effects | CHF & Atrial Dysrhythmias (Atrial fibrillation, atrial flutter). Nausea Loss of “usual appetite” Headache |
| CARDIAC GLYCOSIDES considerations | Never give IM: causes tissue irritation/sloughing Watch for Digoxin Toxicity Lots of drug interactions |
| CARDIAC GLYCOSIDES .. nurse care | Assess apical pulse for 1 full minute prior to administration, hold for HR < 60 Monitor potassium, magnesium, calcium Antidote: Digoxin immune Fab to eat foods high in potassium how to take check pulse before taking Teach S/S of toxicity |
| CARDIAC GLYCOSIDES . toxicity | S/S Toxicity (Risk increased with Hypokalemia) Fatigue Muscle weakness Headache Hallucinations Confusion Dysrhythmias AV heart block N/V/D Visual disturbances |
| NICOTINIC ACID meds/action | Niacin, Niaspan ER Action: Lowers most lipoprotein levels and increases HDL Causes peripheral vasodilation PO |
| NICOTINIC ACID uses/considerations | High cholesterol levels Adjunctive therapy for client where dietary management is ineffective, take with meals to prevent GI upset Should be taken with cold water Contraindicated in liver disease and hypotension |
| NICOTINIC ACID effects | Flushing Postural hypotension, vasovagal attacks Pruritus, Dyspepsia, nausea |
| NICOTINIC ACID care | Teach flushing is expected within 2 hours of taking Teach to change positions slowly Teach alcohol causes increased flushing |
| ORAL ANTICOAGULANTS action/uses | Prevent or delay blood coagulation, varies with different drugs Uses: DVT, PE, AMI, heart valve replacement, atrial fibrillation |
| ORAL ANTICOAGULANTS meds | Warfarin (Coumadin)—decreases Vitamin K Dabigatran (Pradaxa)—direct thrombin inhibitor Rivaroxaban (Xarelto)—anti-Xa inhibitor Apixaban (Eliquis)—anti-Xa inhibitor |
| ANTICOAGULANTS effcts | Bruising or bleeding GI problems Hypotension Thrombocytopenia |
| ANTICOAGULANTS considerations | Warfarin: Multiple drug & food interactions Full anticoagulant effect takes 1 week PT & INR routinely, INR goal usually 2.0- 3.0 Antidote: Vitamin K |
| ANTICOAGULANTS (CONT) care | Monitor PT/INR, bleeding Teach to monitor for bleeding Teach about routine blood testing Teach to use soft bristle toothbrush and electric razor Teach to not skip doses Teach to decrease or maintain intake of green leafy vegetables |
| ANTICOAGULANTS injectables | Heparin—forms complex that inhibits conversion of fibrinogen to fibrin (SQ or IV) Enoxaparin (Lovenox)—low molecular weight heparin (SQ) |
| ANTICOAGULANTS injectables effects | Hemorrhage, hematuria, epistaxis, bleeding gums Thrombocytopenia, HIT |
| ANTICOAGULANTS (CONT.) injectable conisderatins/subq | Given IV or SQ PTT to monitor and trend Lovenox—prefilled syringes Heparin Antidote: Protamine sulfate |
| ANTICOAGULANTS (CONT.) care | Monitor PTT, bleeding Rotate injection sites Teach to monitor for bleeding |
| THROMBOLYTICS action/uses | Action: Dissolve or break down a thrombus Use: Acute MI Aterial thrombosis DVT PE Occlusion of catheters or shunts Route: IV |
| THROMBOLYTICS meds | Streptokinase (Kabikinase, Streptase) Alteplase (Activase) Urokinase (Abbokinase) TNKase (Tenecteplase) tPA (tissue plasminogen activator) |
| THROMBOLYTICS contradictions | Active bleeds Recent history of CVA Uncontrolled HTN Recent trauma Neoplasm Pregnancy |
| THROMBOLYTICS side effects | Hemorrhage Hypersensitivity reactions Hypotension Cardiac dysrhythmias |
| THROMBOLYTICS care | Assess and monitor VS Monitor for bleeding Limit invasive procedures Teach to reduce risk of bleeding |
| HMG-COA REDUCTASE INHIBITORS action/uses | Action: Work in the liver to affect cholesterol synthesis by blocking HMG-CoA Reductase. Use: Lowers LDL cholesterol levels Effect on HDL cholesterol is dose dependent No effect on lipoprotein levels |
| HMG-COA REDUCTASE INHIBITORS (CONT) meds | Lovastatin (Mevacor) Simvastatin (Zocor) Pravastatin (Pravachol) Atorvastatin (Lipitor) PO |
| HMG-COA REDUCTASE INHIBITORS considerations | Administration is usually at night which increases the effectiveness of the drug |
| HMG-COA REDUCTASE INHIBITORS side effects | GI upset Dyspepsia Flatulence Pain and myalgias Elevated liver functions |
| HMG-COA REDUCTASE INHIBITORS care | Administer with evening meal Monitor LFTs Teach to report unexplained muscle pain, yellowing of skin or eyes, loss of appetite Alcohol should be limited or avoided |
| FIBRIC ACID DERIVATIVES | Action: stimulate cellular fatty acid uptake resulting in decreased triglyceride levels Use: Elevated triglyceride levels and whose cholesterol levels have been resistant to dietary management |
| FIBRIC ACID DERIVATIVES meds | Clofibrate (Abitrate, Atromid-S) Fenofibrate (Tricor) Gemfibrozil (Lopid) |
| FIBRIC ACID DERIVATIVES (CONT) effects | Abdominal or epigastric pain Jaundice, headache, and depression Rash, dermatitis Back pain, myalgia |
| FIBRIC ACID DERIVATIVES care/considerations | Give 30 minutes before morning and evening meals Nursing Care Monitor baseline labs Monitor for side effects Monitor for RUQ pain Teach how to take Teach to notify if gallbladder disease occurs |
| NICOTINIC ACID action/uses | PO. Action: Lowers most lipoprotein levels and increases HDL Causes peripheral vasodilation Use: High cholesterol levels Adjunctive therapy for client where dietary management is ineffective |
| NICOTINIC ACID meds | PO. Niacin, Niaspan ER |
| NICOTINIC ACID considerations | Take with meals to prevent GI upset Should be taken with cold water Contraindicated in liver disease and hypotension (due to vasodilation properties) |
| NICOTINIC ACID effects | Flushing Postural hypotension, vasovagal attacks Pruritus, Dyspepsia, nausea |
| NICOTINIC ACID care | Teach flushing is expected within 2 hours of taking Teach to change positions slowly Teach alcohol causes increased flushing |
Created by:
cwehner125