Cardiac Drugs

Question 1

Furosemide

Answer 1

Drug Class: Loop Diuretics

MOA: Inhibits reabsorption of Na and Cl in the Loop of Henle. Can cause HYPOKALEMIA!

Common SE: Electrolyte imbalances, hypotension, dehydration, postural hypotension, ototoxicity, increases risk of digoxin/lithium toxicity, increases uric acid (gout)

Nursing Considerations: Potassium levels/replacement, teach K+ rich foods, risk of dysrhythmias, fall risk from postural hypotension, not safe in pregnancy.

Question 2

Hydrochlorothiazide

Answer 2

Drug Class: Thiazide Diuretic

MOA: Inhibits Na and Cl reabsorption in the distal tubule. Can cause HYPOKALEMIA!

Common SE: Electrolyte imbalances, dehydration, hypovolemia, hyperglycemia (DM), increases uric acid, increases risk of digoxin/lithium toxicity

Nursing Considerations: Potassium levels/replacement, teach K+ rich foods, risk of dysrhythmias, fall risk from postural hypotension

Question 3

Spironolactone

Answer 3

Drug Class: Potassium Sparing Diuretic

MOA: Blocks aldosterone in the distal tubule resulting in less water and most potassium.

Common SE: Hyperkalemia, reduction or testosterone, gynecomastia

Nursing Considerations: Check potassium levels. Do not use with RAAS drugs or K+ supplements.

Question 4

What drug classes increase the risk of hypokalemia?

Answer 4

1. Loop Diuretics
2. Thiazide Diuretics

Question 5

What drug classes increase the risk of hyperkalemia?

Answer 5

1. Potassium-sparing diuretics
2. ACE Inhibitors
3. ARBs
4. NSAIDs

Question 6

What drugs are contraindicated in pregnancy?

Answer 6

1. Loop diuretics
2. ACE Inhibitors
3. ARBs/ARNIs
4. Direct Rennin Inhibitors
5. Potassium-sparing diuretics
   6.

Question 7

What drug class prevents cardiac remodeling?

Answer 7

ACE Inhibitors

Question 8

Lisinopril

Answer 8

Drug Class: ACE Inhibitors

MOA: Inhibits conversion of angiotensin I to angiotensin II.

Indications: HTN, HF

Common SE: Dry cough, angioedema, 1^st dose hypotension, Increased potassium

Nursing Considerations: Do not use in pregnancy.

Heart failure: Arterial dilation reduces afterload and increases renal blood flow. Venous dilation reduces preload. Suppresses aldosterone. Prevents cardiac remodeling.

Question 9

Valsartan

Answer 9

Drug Class: ARBs

MOA: Blocks angiotensin II receptors

Common SE: Cough, angioedema, increased potassium

Nursing Considerations: Orthostatic hypotension. Do not use in pregnancy.

Question 10

Sacubitril/valsartan

Answer 10

Drug Class: ARNI

MOA: Blocks effects of RAAS. Increases natriuretic peptides in the heart to signal body to get rid of fluid.

Common SE: Hypotension, increased potassium, cough,

Nursing Considerations: Used instead of ACE inhibitor, must stop ACE inhibitor 36 hours before starting. Do not use in pregnancy.

Heart Failure: Reduces death and hospitalization in patients with Class 2- Class 4 HF.