10 minute topic Cardiovascular medications Flashcards

1
Q

Nitroglycerin use/function

A

stable angina
vasodilator
decreases O2 demand
Can be used in HF

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2
Q

Nitroglycerin use in variant angina

A

prevents or reduces coronary artery spasm and that provides more oxygen to the myocardium itself

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3
Q

Nitroglycerin cautions

A

use cautiously with antihypotensives due to risk of orthostatic hypotension

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4
Q

IV nitroglycerin

A

given to control angina that did not respond to other meds or to keep BP low

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5
Q

Nitroglycerin PT teaching

A
HA is common
Orthostatic hypotension
Flushing is common
Reflex tachycardia
will develop a tolerance (need to have a nitrate free period)
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6
Q

Nitroglycerin interactions with food

A

ETOH causes hypotension

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7
Q

Instructions for nitrate use

A

Chest pain → stop activity & rest →sublingual nitro x3, 5min apart, →unrelieved 911

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8
Q

Nitroglycerin storage

A

Glass container in a dark place, can’t get too warm so not in a pants packet

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9
Q

metoprolol tartrate (Lopressor) & atenolol (Tenomin) category

A

Beta blockers

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10
Q

metoprolol tartrate (Lopressor) action

A

antidysrhthmic (blocks conduction through SA and AV nodes) and antihyperstensive
Decreases heart rate and contractility therefore it decreases oxygen demand by the myocardium
Blocks renin release

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11
Q

metoprolol tartrate (Lopressor) nursing consideration

A

monitor bradycardia and hypotension
Use in caution with HF
Avoid use in PT’s with asthma due to bronchospasm
Can mask hpyoglycemic sx in DM

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12
Q

streptokinase (Streptase) alteplase (Activase), Reteplase (Retavase) category

A

thrombolytics

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13
Q

thrombolytics action

A

these medications dissolve clots that have already formed

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14
Q

thrombolytics used to tx what

A

treat MI (with MI best to give within 6 hours of infarct), DVT, massive pulmonary emboli and ischemic strokes

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15
Q

thrombolytics nursing considerations

A

do not use in active bleeding
monitor PT, aPTT, INR, fibrinogen levels, CBC
Monitor for allergic reaction (urticaria, itching, flushing)

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16
Q

ASA (salicylic acid), enteric coated is called (Ecotrin), clopidogrel (Plavix) category

A

Antiplatelet agents

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17
Q

Antiplatelet agents use

A

Acute MI- Primary
Prevention of reinfarction
Prevention of stroke
Acute coronary syndromes

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18
Q

Antiplatelet agents nursing considerations

A

can cause GI upset
use cautiously in PT’s with ulcers
Tinnitus is possible side effect or indication of toxicity

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19
Q

Antiplatelet agents teaching

A

take with food
report tinnitus
increased bleeding risk

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20
Q

Eptifibatide (Integrilin) category

A

Glycoprotein IIB/IIIA inhibitors

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21
Q

Glycoprotein IIB/IIIA inhibitors use

A

prevent the binding of fibrogen, in turn by blocking platelet aggregation. It is used in combination with ASA therapy

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22
Q

Glycoprotein IIB/IIIA inhibitors nursing consideration

A

can cause active bleeding, need to report s/sx of bleeding

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23
Q

Diuretics use

A

reduce preload

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24
Q

Loop diuretics

A

furosemide(Lasix) bumetanide (Bumex) – ↓Na reabsorption ↑K+ excretion

25
Q

Thiazide diuretics

A

hydrocholorothiazide (Hydrodiuril)

26
Q

K+ sparing diuretics

A

spironolactone (Aldactone)
in distal tubule prevent NA reabsorption in exchange for K+
watch for hyperkalemia

27
Q

K+ outside normal ranges causes what

A

too low = muscle weakness, irregular pulse

too high = slow heart

28
Q

IV lasix rate

A

no faster than 20 mg.min

29
Q

Heparin category

A

anticoagulant

30
Q

Unfractionated heparin

A

must be given IV

prevents clots from forming or becoming bigger

31
Q

Warfarin (coumadin)

A

given PO

it must be given 3-5 days in concurrence with Heparin or Lovenox to get to a therapeutic levels

32
Q

Anticoagulant nursing considerations

A

monitor platelets

monitor bleeding, PT & INR

33
Q

Labs to monitor with heparin

A

aPTT for titration of dose, so based on what the PTT is the dose will be titrated to that

34
Q

Antidote for heparin

A

protamine sulfate

made from salmon semen

35
Q

Warfarin antidote

A

vitamin K

36
Q

Who takes warfarin?

A

chronic Afib to < risk of clots being tossed

those with prosthetic heart valves

37
Q

ACE inhibitors & ARBs function

A

afterload reducers, they help heart pump more easily by altering the resistance to contraction

38
Q

enalapril (Vasoctec) captopril (Capoten) category

A

ACE inhibitor

39
Q

losartan (Cozaar) candesartan (Atacand) category

A

ARB

40
Q

ARB ending

A

sartan

41
Q

ACE ending

A

pril

42
Q

ACE and ARB contraindications

A

renal deficiency

43
Q

ACE and ARB nursing considerations

A

monitor BP closest after 1st dose for hypotension

monitor for high K+

44
Q

digoxin (Lanoxin), dopamine, dobutamine (Dobutrex) milrinone (Primacor) category

A

Inotropic Agents

45
Q

Inotropic Agents function

A

Increase the force of myocardial contraction and improve cardiac output

46
Q

Inotropic Agents used for what?

A

HF and also in patients who have dysrhythmias, primarily Afib

47
Q

dopamine, dobutamine, milrinone administration

A

IV only

Will be in ICU, monitor ECG, BP and urine output

48
Q

PO digoxin considerations

A

give at the same time daily
no antacids within 2 hours
regular dig and K+ levels

49
Q

Signs of digoxin toxicity

A

fatigue, muscle weakness, anorexia, confusion, vision changes, halos around lights, problems with night vision

50
Q

Interaction of digoxin and loop diuretics

A

increases the risk of digoxin induced dysrhythmias

51
Q

Interaction of digoxin and ACE + ARB

A

increased risk of hyperkalemia and can decrease therapeutic actions of the digoxin

52
Q

Verapamil hydrochloride (Calan) amlodipine (Norvasc) diltiazem (Cardizem) category

A

Calcium channel blocker

53
Q

Verapamil hydrochloride (Calan) amlodipine (Norvasc) diltiazem (Cardizem) function

A

alter the movement of Ca+ ions through the cell membrane causing vasodilation and lower BP
Used for angina and dysrhythmias, primarily Afib, Atrial flutter and SVT

54
Q

Calcium channel blocker cautions

A

HF and heart block, and bradycardia

If using Verapamil or Cardizem be careful when using digoxin or beta blockers

55
Q

Calcium channel blocker education

A

can cause constipation
Bradycardia & AV block can occur
avoid grapefruit juice

56
Q

atorvastatn (Lipitor), simvastatin (Zocor) lovastatin (Mevacor), Pravastatin sodium (Pravachol), Rosuvastatin (Crestor) category

A

Antilipemics - STATINs

57
Q

Antilipemics - STATINs function

A

Lowers LDL levels by suppressing cholesterol synthesis in the liver and increases HDL

58
Q

Antilipemics - STATINs cautions

A

PT’s with liver disease

59
Q

Antilipemics - STATINs adverse effects

A

hepatotoxicity- so we need LFT’s
Myopathy- muscle aches and pain in peripheral extremities
Peripheral neuropathy -tingling in hands and feet