Cardiac Meds Flashcards
Alpha 1 Receptor Blockers
end in -zosin
2nd line HTN med
Mechanism of action: block peripheral Alpha 1 receptors, leading to vasodilation (relaxes smooth muscle around blood vessels)
Side Effects: orthostatic hypotension, vertigo, palpitations, sexual dysfunction
Alpha 2 Receptor Blockers
includes clonidine, methyldopa
for acute HTN management (hypertensive crisis)
Mechanism of action: centrally acting, reducing sympathetic response in CNS and producing vasodilation (decreasing SVR and BP)
Side Effects: orthostatic hypotension, vertigo, palpitations, sexual dysfunction
Nursing Considerations: if stopped abruptly, can lead to rebound hypertension
Angiotensin Converting Enzyme (ACE) Inhibitors
end in -pril
first line HTN med
Mechanism of Action: prevents conversion of angiotensin I to angiotensin II, significantly reduces BP by decreasing peripheral vascular resistance without increasing CO, HR, or contractility
Side Effects: dry cough, postural hypotension, first dose hypotension, dizziness, angioedema, hyperkalemia
Nursing Considerations: preferred antihypertensive for DM due to renal protective effects
Angiotensin II Receptor Blockers (ARBs)
end in -sartan
1st line HTN med
Mechanism of Action: prevents angiotensin II from binding to receptors on blood vessels, causing decreased peripheral resistance and decreased blood volume
Nursing Considerations: good alternative to ACE inhibitors for those who develop ACE cough, full effect takes 3-6 weeks
Beta Blockers
end in -lol
2nd line HTN med
Mechanism of Action: block beta 1 and 2 receptors in CV system and sometimes respiratory system (bronchoconstriction), thereby decreasing CO by decreasing HR and contractility
Contraindications: asthma, COPD, diabetes
Side Effects: bradycardia, lethargy, GI disturbance, hypotension, depression, can worsen CHF
Nursing Considerations: hold for HR less than 60 bpm, assess HR and BP before giving
Calcium Channel Blockers
end in -dipine
1st line HTN med
Mechanism of Action: relaxes smooth muscle around blood vessels (vasodilation = decreased peripheral resistance) and decreases conductivity and contractility (decrease CO)
Side Effects: peripheral edema, hypotension, bradycardia, headache, abdominal discomfort
Nursing Considerations: do take with grapefruits
Loop Diuretics
includes furosemide, bumetanide
2nd line HTN med
Mechanism of Action: inhibit sodium and chloride reabsorption directly
Contraindications: hepatic coma, severe elyte loss
Side Effects: hyponatremia, hypotension, ototoxicity, dizziness, headache, tinnitus, blurred vision, GI upset
Nursing Considerations: can still be used with diminished kidney function, watch for orthostatic hypotension, K+ supplements
Thiazide Diuretic
includes hydrochlorothiazide, chlorothiazide
1st line HTN med
Mechanism of Action: inhibit sodium, chloride, and potassium reabsorption
Contraindications: hepatic coma, anuria, severe renal failure
Side Effects: orthostatic hypotension, hyponatremia, hypokalemia, hyperglycemia, dehydration, weight loss
Nursing considerations: need for K+ supplements, do not use with diminished kidney function
Potassium Sparing Diuretic
includes amiloride, spironolactone
2nd line HTN med
Mechanism of Action: blocks reabsorption of sodium and water, prevents potassium from being excreted
Contraindications: hyperkalemia, severe renal failure, anuria
Side Effects: hyperkalemia, hyponatremia, dizziness, headache, weakness, urinary frequency, GI upset
HMG CoA Reductase Inhibitors
- statins
Mechanism of Action: lower LDL and TG levels while increasing HDL levels - first line med for hyperlipidemia
Contraindications: pregnancy, liver failure
Side Effects: increased risk for rhabdomyolysis (damage to heart and kidneys)
Nursing Considerations: monitor liver function (LFT’s), take in the evening, monitor for s/s of rhabdo (muscle tenderness, increased creatine kinase levels)
Cholesterol Absorption Inhibitors
- ezetimibe
Mechanism of Action: inhibits absorption of cholesterol
Nursing Considerations: commonly used as an addition to statins
Niacin (Vitamin B3)
Mechanism of Action: inhibits synthesis and secretion of LDL, increases HDL levels
Side Effects: flushing of face and neck (20 min after, may last 30-60 min)
Nursing Considerations: premedicated with ASA/NSAIDS 30 min before to reduce flushing
Fibrates
- fenofibrate, gemfibrozil
Mechanism of Action: reduce triglycerides
Nursing Considerations: give 30 min before AM and PM meals
Bile Acid Sequestrants
- cholestyramine
Mechanism of Action: binds with acids in intestine, forming insoluble complex with cholesterol that is excreted in feces; removal of LDL and cholesterol
Side Effects: constipation, abdominal pain, belching, heartburn, nausea
Nursing Considerations: pill texture is gritty and leaves film in mouth, interferes with absorption of other drugs (digoxin, beta blockers, thiazides); wait 1 hour after giving other meds before giving sequestrant; wait 4 hours after giving sequestrant before giving other drugs
Nitrates
- nitroglycerin, isosorbide
Forms of nitrates: sublingual = short acting/rescue, transdermal patch/PO = long acting/preventative
Indication: prevention/treatment of angina
Mechanism of Action: potent vasodilator, dilates coronary artery vessels and increasing blood supply to heart muscle
Dosage Instructions: 1 tablet when chest pain occurs then wait 5 min, if pain doesn’t clear call 911 and take 2nd dose, wait 5 min and take a 3rd dose if chest pain is not completely gone
Side Effects: hypotension, tachycardia, dizziness, headache, flushing, syncope
Nursing Considerations: carry drug on you at all times, keep in original container, replace every 6 months, should cause fizzling/tingling under tongue, stay sitting after taking
