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Unit 5 Meds
Cardio Meds
| Question | Answer |
|---|---|
| Diuretics | Lasix, Bumex, Hydrochlorothiazide, Zaroxolyn |
| Hydrochlorothiazide | Thiazide diuretic most commonly used for HTN. Check K+. Less potent, less effective than Lasix & Bumex (won't get massive outputs) |
| Zaroxolyn | Mild diuretic used for HTN, not a thiazide but it acts as one. |
| Lasix & Bumex | Loop diuretics, want massive output if giving IV push 1000 mL/hr. Check K+ & Mag. S/E: ototoxic (ringing in ears). PO onset is within 60 min & lasts up to 8 hrs. IV onset is 5 min & lasts 2 hrs |
| Effects of Angiotensin II | Vasoconstriction & Release of aldosterone which retains Na+ & H2O causing increase workload of heart |
| ACE inhibitors | Used for: HTN, heart failure, MI, Diabetic & non-diabetic nephropathy & high cardiovascular risks. S/E: HTN, cough, hyperkalemia, renal failure, fetal injury, angioedema. Does not allow angiotension I to convert to angiotensin II |
| ACE drug interactions | Diuretics & anti-hypertensives, drugs that raise K+. Watch when giving to asthma or COPD patient b/c of cough |
| ACE drugs | enalapril, lisinopril, captopril (end in pril) |
| Angiotensin II Receptor Blockers (ARB's) | Dilates arteries & veins, prevents pathological changes to heart, decreases release of aldosterone. Used for: HTN, Heart Failure, Diabetic Nephropathy, MI, Stroke prevention |
| ARB drugs | losartan & valsartan (end in sartan) |
| ARB's | S/E: Angioedema, fetal harm, renal failure. Allows Angiotensin I to go to Angiotensin II but it doesn't work, it blocks receptor site. Use this if develop cough from ACE inhibitor |
| Calcium Channel Blocker drugs | Calan, Cardizen, Procardia, Norvasc |
| Calcium Channel Blockers | Reduces heart rate, converts Afib to sinus or rate control, positive inotrope (contractility = increases efficiency of myocardium). Used for: HTN, Afib, cardiac dysrhythmias. |
| Calcium Channel Blockers S/E: | Bradycardia, constipation, edema of ankles & feet |
| Alpha-2 Agonist drug | Catapres |
| Catapres | Blocks sympathetic stimulation. Causes vasodilation & lowers BP. S/E: dry mouth and sedation. Do NOT stop abruptly b/c you get reflux HTN |
| Alpha Adrenergic Antagonist drugs | Prazosin, Terazosin, Doxazosin (end in azosin) |
| Prazosin, Terazosinm, Doxazosin | Prevents stimulation of Alpha I receptors (vasoconstriction. Used for HTN & BPH. S/E: orthostatic HTN especially w/ 1st dose. Start w/ small dose & may get sinus tachy with that |
| Iron supplement drugs | Ferrous Sulfate, INFeD, Sodium Ferric Gluconate & Desferal |
| Desferal | Used for iron toxicity, given IV, excreted in urine. Avoid w/ kidney failure |
| Iron | Avoid taking with antacids. S/E: constipation, dark stools, liquid form stains teeth (use straw) |
| Sodium Ferric Gluconate (INFeD) | Must give with erythorpoietin. Can have severe allergic reaction so give test dose. Watch for hypotension, flushing, chest/back pain. If test dose goes okay can give full dose. Iron supplement given IV |
| Ferrlecit | An iron supplement where test dose is given b/c can cause anaphylaxis. Not as bad a INFeD |
| Hydrea | Inhibits DNA replication, anti-neoplastic, Category X. Increases level of Fetal Hgb (Sickle Cell Anemia Pts). Hold if platelets <95K or Hgb <5.DO NOT HANDLE WITHOUT GLOVES, TOXIC WHEN NURSING/PREGNANT |
| Vasodilator Drugs | Sodium Nitroprusside (Nipride) & Nitroglycerin |
| Sodium Nitroprusside (Nipride) | Venous & Arterial dilator (decreases BP drastically fast), metabolizes to Nitric Oxide causing cyanide poisoning. Only given in hypertensive emergencies in ICU on continuous drip for max 3 days. Needs to be light protected (brown plastic bag) |
| Nitroglycerin | Primarily a venous dilator to decrease BP. S/E: BAD headache, hypotension. Uses: HTN, Angina. Given IV (drug in glass bottle, use special tubing b/c gets absorbed in tubing), Sublingual (spray/tablet), Sustained Release or Transdermal (dosed in inches). |
| Beta-1 Adrenergic Antagonist (Beta Blockers) Drugs | Propranolol, Atenolol, Metoprolol, carvedilol, Labetolol (end in lol) |
| Non-selective Beta Blocker | Propranolol |
| Cardioselective Beta Blockers | Atenolol, Metoprolol |
| Beta blockers w/ vasodilating | Carvedilol, Labetolol |
| Beta Blockers | HTN, angina, cardiac dysrhythmias,MI, heart failure. S/E: impotence & sexual dysfunction, bradycardia, reduced cardiac output, AV heart block, bronchoconstriction (cough) |
| Digoxin | Amino glycoside. + Inotrope (increase contractility), - chronotrope (slows down heart rate increasing cardiac output). Used for heart failure & dysrhythmias |
| Digoxin S/E: | Cardiac dysrhythmias (WATCH K+), bradycardia, AV block, Vfib. Toxicity s/s: blurred/yellow tinged vision, appearance of halos around dark object. Tx: Digibind, charcoal |
| Antidysrhythmics | Na+ (Lidocaine & Procainamide) & K+ (Amiodarone) channel blockers, & Adenocard |
| Na+ Channel Blockers (Lidocaine & Procainamide) | Used for ventricular arrythmias -- ACCELERATES repolarization, slows conduction & reduces automaticity |
| K+ Channel Blocker (Amiodarone) | Used for ventricular & atrial tachy dysrhythmias (runs of Vtach & Afib),SLOWS repolarization & conduction & reduces automaticity |
| Amiodarone S/E: | Pulmonary Toxicity (congestion, pulmonary fibrosis), toxic in pregnancy/breast feeding, visual changes, blue/gray discoloration |
| Adenocard | Used with tachy SVT's, wipes out electrical activity of heart puting you into asystole for 3-5 seconds then hopefully SA node kicks in. MUST MONITOR ECG |
| Anti-Platelets | ASA (aspirin), Plavix, Pletal, Aggrenox. Used for MI, HTN, stroke |
| Aspirin | Decreases platelet aggregation |
| Plavix | Blocks receptor site on platelets and inhibits platelet aggregation. Will NOT increase INR or PTT. Used for coronary artery disease or peripheral vascular disease |
| Pletal | Platelet inhibitor and vasodilator. Used for intermittent claudication |
| Aggrenox | Combination of Dipyridamole/ASA -- together they decrease platelet aggregation |
| Anticoagulant | Short-term blood thinner. Used for PE, DVT, AMI, Stroke. Monitor PTT and platelets. S/E: hemorrhage & Heparin induced thrombocytopenia (HIT) |
| Direct Thrombin Inhibitors drugs: | Angiomax, Refludan, Agatroban |
| Angiomax, Refludan, Agatroban | Used for patients requiring anticoagulation with HIT. Given IV drip and very expensive. Monitor PTT |
| Warfarin (Coumadin) | Acts on Vit K dependent clotting factors. Used for DVT, PE, prosthetic heart valves & Afib. Monitor PT/INR. Category X Pregnancy S/E: Hemorrhage. Very high risk for bleeding when used w/ Aspirin or Plavix |
| Glycoprotein IIb/IIIa Receptor Antagonis Drugs | Reopro, Integrilin |
| Reopro OR Integrilin | Total block of platelet aggregation used short term post angioplasty for stent placement or acute coronary syndromes S/E: bleeding. Given IV continuous drip up to 48 hrs. Monitor ACT (activating clotting time), or BT (Bleeding Time) |
| Tissue Plasminogen Activator (tPA) | Breaks up clots in acute stage only. Given IV bolus then drip at site where clot is. Used for AMI's, PE. Contraindicated: stroke in last 3 months, brain bleed, surgery <3 weeks, pregnancy, uncontrolled HTN |
| Cholesterol | We either eat it or produce it within the liver from saturated fats. Cholesterol <200, Triglycerides <150, LDL <100, HDL >50-60 |
| HMG-CoA Reductase Inhibitors Drugs: | Atorvastatin, Lovastatin, Pravastatin, Simvastatin, Rosuvastatin |
| Statins | Goal is to lower LDL's and increase HDL's, max effect seen in 4-6 weeks, given at night. Used to prevent CV events, post MI therapy & DM. S/E: Category X, Hepatotoxic & myopathy |
| Anti-cholesterol miscellaneous drugs: | Niacin, Zetia, Lopid, Fish Oil & Estrogen |
| Niacin | Lowers LDL's & Triglycerides and Increases HDL. S/E: Hepatotoxic, severe flushing of face, neck and ears |
| Zetia | Blocks cholesterol absorption. S/E: Hepatotoxic |
| Lopid | Primarily used to increase triglycerides. Do NOT use w/ statins. S/E: Increased risk for gallstones & Hepatoxic |
| Fish Oil | Omega 3 Fatty Acids. Lowers triglycerides & LDL. Decreases inflammation & platelet aggregation. S/E: Belch up fishy taste |
| Estrogen | Post menopausal women have higher risk of cardiovascular disease |
| Vasoconstrictor drugs | Dopamine & Levophed |
| Vasoconstrictors | Extremely caustic to tissues. Usually given thru central line, if given peripherally put REGITINE in bag to prevent infiltrate. Used to increase BP when fluid levels are acceptable in body. Do NOT use on dehydrated patients. |
| Dopamine | Vasoconstrictor that increases heart rate |
| Beta I Adrenergic Receptor drug | Dobutamine |
| Dobutamine | Increases contractility. Used for heart failure. Given IV drip. S/E: tachycardia, may see BP go up OR down |
| Emergency Meds | Epinephrine & Atropine |
| Epinephrine | Given in emergent situations (code blue) IV push fast and hard or IV drip. Natural adrenaline. Goal is to increase heart rate & BP. Comes either 1:1,000 (subQ-IM/epi-pens) or 1:10,000 (emergent) |
| Atropine | Used in emergency situations for brady cardia. Works by increasing sinus node output, need a heart beat to start with. Will NOT work with asystole |
Created by:
kristyd02
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