CAD pharmacology

Question 1

Colesevelam

Answer 1

Decrease in LDL ~20%
MOA: a non absorbable resin that binds bile acid preventing reabsorption
Adverse effect:Not absorbed systemically, GI effects
Nursing considerations: GI assessment for constipation, bloating, indigestion
Can be used together with statins

Question 2

Metoprolol

Answer 2

MOA: blocks b-1 adrenergic receptors, reduces HR, force of contraction, decrease renin secretion
Indication: HTN, Angina, HF, Cardiac dysrhythmias, MI,
Adverse effect: Bradycardia, AV heart block, HF, Arrhythmias (sudden with-drawl)
Nursing consideration: Assess HR, hold if lower than 60
Monitor for HR, chest pain, BP, palpitations, signs of HF
Do not administer if patients has more than 1st degree AV block
Withdraw medication slowly

Question 3

Verapamil

Answer 3

MOA: inhibit Ca influx across cell membrane
Heart: decrease SA/AV conduction, decrease force of contraction
Arteries: block ca channels on vascular smooth muscle causing vasodilation
Vasodilation, slow ventricular rate
Indication: Angina, HTN, cardiac dysrhythmias
Adverse effect: constipation, dizzy, facial flushing, headache, edema to legs and feet
Nursing considerations: Assess HR and hold if HR is low
monitor HR, BP, Palpitations, signs of HF, bowel functioning, assess for regular BMs
Do not give is pt has HF, hypotension

Question 4

Captopril

Answer 4

Block production of angio 2 and prevent breakdown of bradykinin, which result in vasodilation, decrease bld volume, decrease cardiac remodeling, and lead to K retention
Indication: HTN, HF, Post MI, Diabetic nephropathy
Adverse effect: Hypotension, cough, hyperkalemia, renal failure, angioedema

Question 5

Nitroglycerin Spray

Answer 5

Dilate vein in body to decrease venous return and preload which decrease workload
Dilates coronary arteries and increase collateral blood flow to ischemic regions
Relaxes vasospasm in coronary arteries
Indication: Angina (Acute, stable, vasospastic)
Adverse effect: Headache, hypotension, tachycardia
Nursing considerations: VS

Question 6

Isosorbide Dinitrate (Antianginal Medication)

Answer 6

Long-acting nitrate
Dilate vein in body to decrease venous return and preload which decrease workload
Dilates coronary arteries and increase collateral blood flow to ischemic regions
Relaxes vasospasm in coronary arteries
indication: reduces incidence of anginal attacks
Adverse effect: headache, hypotension, tachycardia
Nursing consideration: VS

Question 7

Acetylsalicylic Acid

Answer 7

MOA: suppresses platelet aggregation by causing irreversible inhibition of cyclooxygenase
Relaxes vasoconstriction
Reduces risk of arterial thrombosis
Indication: chronic stable angina, unstable angina, acute MI, primary and secondary prevention of MI
Adverse effect: GI bleeding, abdominal pain, dyspepsia, diarrhea, rash
Nursing consideration: GI assessment, give with food

Question 8

Clopidogrel

Answer 8

Block P2Y ADP receptors on platelets
prevent platelet aggregation
Indication: Prevention stenosis of coronary stents
Secondary prevention of MI
Adverse Effect: GI bleeding, abdominal pain, dyspepsia, diarrhea, rash
Nursing consideration: GI assessment give with food

Question 9

Dalteparin

Answer 9

MOA: enhance activity of antithrombin
Indication: USA, NSTEMI, DCT and PE
Adverse effects: bleeding, bruises, black stool, hematuria, headache, lumbar pain, HIT
Nursing consideration: monitor for bleeding

Question 10

Unfractionated Heparin

Answer 10

MOA: enhance activity of antithrombin
only use in hospital setting
Indication: Acute MI, DVT, PE
Adverse efect: Bleeding, bruises, black stool, hematuria, headache, lumbar pain, HIT
Nursing consideration: Monitor for bleeding

Question 11

Alteplase tPA (Thrombolytic drugs)

Answer 11

MOA: binds to plasminogen –> plasmin
most effective when given within 4-6 hours of symptoms onset
indication: STEMI
Adverse effects: Bleeding (Intracranial hemorrhage)
Nursing consideration: monitor for bleeding