cardio meds

Question 1

ORAL ANTICOAGULANT MEDS - names

Answer 1

Aspirin
Clopidogrel (Plavix)
Ticagrelor (Brilinta)
Apixaban (Eliquis)
Warfarin (Coumadin)

Question 2

SQ/IV ANTICOAGULANT MEDS - names

Answer 2

Unfractionated heparin (SQ, IV)
Low molecular weight heparin (Lovenox - SQ)

Question 3

Aspirin, Clopidogrel, Ticagrelor - action + nursing considerations

Answer 3

inhibits platelets from sticking together, preventing clot formation

NOTE: no antidote for Clopidogrel; liver failure may occur with Aspirin

Question 4

Apixaban - action

Answer 4

inhibits factor Xa which decreases thrombin and clot formation

Question 5

Warfarin (Coumadin) - action + notes

Answer 5

interferes with function of vitamin K in the liver which is needed for coag –> decreased clot formation

NOTES: monitor INR (therapeutic level: 2-3)
no NSAIDS, garlic, ginkgo biloba, turmeric
ANTIDOTE: Vit K

Question 6

Heparin - action + notes

Answer 6

inhibits reactions that lead to clotting

NOTES: monitor aPTT levels (therapeutic level: 50-70)

Question 7

ANTICOAGULANTS - side effects

Answer 7

BLEEDING - coffee ground emesis, black tarry stools

Question 8

Nitroglycerin

Answer 8

Class: Nitrate
Routes: sublingual, oral, paste, patch, oral spray, IV
Action: arteriolar and venous dilation
Uses: LONG ACTING = chronic stable angina; SHORT ACTING = unstable angina, MI
S/E: HoTN, HA, dizziness, flushing, sublingual burning
Notes: Monitor BP and pain; pt should be sitting/lying when taking

Question 9

Morphine

Answer 9

Class: opioid
Routes: Oral, IV
Action: –
Uses: ACS - chest pain
S/E: respiratory depression, constipation, N/V, decreased LOC
Notes: monitor LOC, RR, pain level

Question 10

Colchicine

Answer 10

Class: anti-inflammatory
Routes: Oral
Action: decreases inflammation
Uses: Pericarditis
S/E: –
Notes: –

Question 11

Iron

Answer 11

Class: mineral
Routes: oral, IM, IV
Action: iron is carried to bone marrow, where it’s incorporated into hgb
Uses: iron deficient anemia
S/E: black stools, constipation, nausea, teeth/skin stain
Notes: IM – use Z track; vit C with oral; liquid – straw

Question 12

Vitamin B12

Answer 12

Class: vitamin
Routes: oral, IM, IV
Action: –
Uses: pernicious anemia/vit B12 deficiency
S/E: –
Notes: –

Question 13

BETA BLOCKERS

Answer 13

Names: “-olol” (metoprolol, atenolol, carvedilol)
Action: blocks nor/epinephrine, causing heart to beat more slowly and with less force and promotes vasodilation (decrease contractility, HR, and afterload)
Uses: HTN, angina - chronic stable, MI; tachycardia
S/E: H-TN, bradycardia, impotence, bronchoconstriction
Notes: contraindicated for acute HF and asthma; monitor BP/HR before and after administering (hold <90/50 BP, <50 HR)

Question 14

CALCIUM CHANNEL BLOCKERS

Answer 14

Names: “-pine” (amlodipine, nicardipine, nifedipine)
Action: blocks calcium entry into cells of vascular smooth muscle and myocardium, dilating arteries (decrease afterload)
Uses: HTN, chronic stable angina, post MI
S/E: HoTN
Notes: Monitor BP before and after administering (hold <90/50 BP)

Question 15

CALCIUM CHANNEL BLOCKERS - Diltiazem and Verapamil

Answer 15

Action: decreases contractility and decreases AV nodal conduction; 2nd = vasodilation
Uses: tachycardia
S/E: HoTN, bradycardia
Notes: monitor HR and BP (hold <90/50 BP, <50 HR)

Question 16

ACE INHIBITORS

Answer 16

Names: “-pril” (lisinorpil, ramipril, captopril)
Action: interferes with RAAS, blocking conversion of angiotensin I to angiotensin II, causing vasodilation and increased water excretion (decrease BP, decreased afterload, decreased preload)
Uses: HTN, chronic stable angina, post MI, HF
S/E: HoTN, dry cough
Notes: monitor BP before and after; D/C if dry cough occurs

Question 17

ARBS

Answer 17

Names: “-sartan” (Losartan, valsartan)
Action: blocks binding of angiotensin II resulting in relaxation of blood vessels and increased water excretion (decreased BP, decreased afterload, decreased preload)
Uses: HTN, chronic stable angina, HF
S/E: HoTN
Notes: monitor BP before and after

Question 18

LOOP DIURETICS

Answer 18

Name: Furosemide (Lasix)
Action: inhibits sodium reabsorption in loop of Henle, enhancing sodium and water loss
Uses: HF, fluid overload, HTN, pulmonary edema
S/E: polyuria, HoTN, hypokalemia, tinnitus
Notes: monitor I&O, daily weights; monitor BP before and after; monitor K

Question 19

THIAZIDE DIURETICS

Answer 19

Name: Hydrochlorothiazide
Action: acts on loop of Henle by increasing excretion of water, sodium, chloride, potassium
Uses: HF, fluid overload, HTN, pulmonary edema
S/E: polyuria, HoTN, hypokalemia
Notes: monitor I&O, daily weights; monitor BP before and after; monitor K

Question 20

POTASSIUM SPARING DIURETICS

Answer 20

Name: Spironolactone
Action: competes with aldosterone in kidneys which causes excretion of sodium chloride and water, and retention of potasisum and phosphate
Uses: fluid overload, HF, HTN, diuretic induced hypokalemia
S/E: hyperkalemia, polyuria, HoTN
Notes: monitor I&O, daily wts; monitor BP before and after administration

Question 21

STATINS

Answer 21

Name: “-statin” (atorvastatin, rosuvastatin, simvastatin, pravastatin)
Action: blocks synthesis of cholesterol and increases LDL receptors in liver, decreasing LDL and triglycerides and increasing HDL
Uses: hyperlipidemia, high cholesterol, high LDL levels
S/E: muscle pain; severe = liver toxicity and rhabdomyolysis
Notes: monitor lipid panel