CADSCANS Flashcards
Beta blockers mask the s/s of …….
hypoglycemia in patients with diabetes
End in -pril
ACE Inhibitors
End in OLOL
Beta-blockers
End in -DIPINE
Ca Channel Blockers
Action Of Ace Inhibitors
Block conversion of Angiotensin 1 to Angiotensin 2 ( a potent vasoconstriction) –> vasodilatation thus decreasing PVR (peripheral vascular resistance) –> decreased BP.
Adolsterone is also blocked–> decreased Na+ & H2O retention
Action of Beta-adrenergic blockers
Block B1 receptors in heart–> decreased HR, decreased force of contraction & decreased AV conduction
The action of calcium channel blockers (CCB)
Block calcium influx into the beta receptors, decrease force of contraction, HR, and PVR.
Antihypertensive’s
Ace inhibitors (prils) Beta blockers (OLOL) Calcium channel blockers (Dipine)
Metroprolol (Lopressor)
Category
Beta blocker
Most Frequent Side Effects of BB
Fatigue and weakness
Other side effects include headache, Flushing, dizziness, bradycardia, postural hypertension
Most serious/life threatening complication
Bronchospasm, bronchoconstriction, congestive heart failure (CHF)
Propranolol
Nonselective beta blocker
Blocks both beta-1 and beta-2 receptors
Atenolol (Tenorim)
Cardio selective beta blocker (beta-1 blocker) but it boxed beta-2 at high doses
Coreg (carvedilol)
Third generation beta blocker blocks beta-1, beta-2, and alpha-1
Before giving beta blockers the nurse should…
Obtain BP and Apical heart rate-
hold if SBP </=60bpm
Instruct patient on beta blockers to…
Report any weakness, dizziness, or fainting.
Contraindications for beta blockers
Bradycardia (Bradydysrhythmias)
AV block
Aka very nice drugs
Calcium channel blockers (verapamil, nifedipine, diltiazem)
Contraindications of Nifedipine
Hypersensitivity
Contraindication of Verapamil
Severe left ventricle dysfunction, decreased blood pressure, cardiogenic shock, or heartblock
Digitalis (action)
Increases myocardial contraction, CO
Alters the electrical activity of noncontractile tissues and ventricle muscles.
Inhibits sodium – potassium ATPase.
Digitalis
classification
Cardiac glycoside
Digitalis (uses)
HF (to improve CO)
A fib & Flutter
Digitalis
contraindications
Hypersensitivity, ventricular tachycardia, real insufficiency, hyperkalemia, advanced heart disease, acute myocardial infraction, incomplete atrioventricular block, pregnancy
Side effects digitalis
Most common: Fatigue, anorexia, hyperkalemia, bradycardia, dysrhythmias
Other side effects: Dizziness, HA, malaise, muscle weakness, visual disturbances
Nursing implications for Digitalis
Monitor: the Digoxin serum levels for toxicity; HR hold med & notify MD
DO NOT DOUBLE UP MISSED DOSES
Digitalis (teach)
Do not double up on missed doses
Recognize and report early signs of hypokalemia and Digitalis Toxicity
S/S: early hypokalemia
Muscle weakness
S/S: Digitalis Toxicity
N/V/D, blurred or yellow visual disturbances
End in “sartan”
Angiotensin receptor blockers (ARBS)
HMG Co-A Reductase Inhibitors end in….
Statin
Functions of Ace inhibitors
Promotes vasodilation Tx HF Hypoglycemic Decrease remodeling (post MI & HF) Decrease insulin resistance & progression of type II
Used for the prevention of diabetic nephropathy
ACE inhibitors
Side effects of ACE inhibitors
** Hypoglycemia** Hypotension ***Cough*** Angioedema Hyperkalemia
TX of ACR inhibitor related hyperkalemia
Add a thiazide diuretic
Capozide
Catopril + thiazide
Vaseretuc
Enalapril + thiazide
Prinizide
Lisinopril + thiazide
Do not use ARB with …..
ACE inhibitors (prils)
Beta blocker that is safe during pregnancy ….
Labetalol
If you block B1 receptors on the heart…..
The HR, contractile state, CO, BP, & workload of the heart decrease
(Cardioselective)
Atenolol, metoprolol, betaxolol, bishop roll, nebivolol are carditis elective at doses under…..
10mg
Non–Cardioselective beta blockers cause …
Bronchial constriction and exasperated COPD and asthma; Vasoconstrictor fermoral artery and exasperate PAD
Non-cardio selective beta blockers are not recommended for…
Patients with COPD asthma
Enoxaparin
Lovenox
Lovenox
Classification
Low molecular weight heparin
Anticoagulant
Lovenox
Action
Potentiates action antithrombin 3, inactivates coagulation factor Xa–> anticoagulation factors;
DOES NOT significantly influence bleeding time, PT, aPTT.
Lovenox DOES NOT significantly influence…..
bleeding time, PT, aPTT.
Antidote for Lovenox & Heparin
Protamine Sulfate
Lovenox Dose
30mg BID, 7-10d w/ initial dose w/in 12-24h following Sx
40mg once daily w/in 9-15h
Digitalis (Dose)
PO 0.75-1.5 mg
IV 0.5-1 mg
Furosemide (Lasix)
Classification
Loop Diuretic
Furosemide (Lasix)
Action
Enhances excretion of Na, Cl, K by direct action on the ascending loop of Henle–> Diuresis & decreased BP
Lasix Dose(PO)
20-80mg q6-8h
Max 600mg/day
Lasix Dose (IV)
Max dose 160-200 mg
1 grain
60-65 mg
1 dram
4ml
1 ml
15-16 minims
Beta blockers decrease…
Decrease HR, myocardial contractility, CO, SV, BP, workload, remodeling, & palpations during panic attacks
Beta blocker eyedrops can cause…
Bradycardia and anhedonia
Lipid soluble beta blocker…
Propranolol
Timolol
Metoprolol
Pindolol