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cardio/ renal drugs specific Flashcards

1
Q

What is amiodrarone

(not the class)

A

Potassium channel blockers

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2
Q

Classification of amiodarone

A

Antiarrythmic

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3
Q

amiodarone MOA

A

prolongs repolarization by blocking potassium channels in cardiac cells

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4
Q

when is amidarone indicated

A

Indicated only for the treatment of life-threatening recurrent ventricular dysrhythmias when unresponsive to other treatments

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5
Q

what happens when you take amidarone

A

Usually hospitalized during initiation for close monitoring

Monitor BP & HR for profound hypotension and bradycardia

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6
Q

What should you avoid/ consider w/ AMIODARONE

A

Black Box warning: Fatal toxicities (pulmonary, arrhythmia exacerbation, liver, heart block)

Avoid grapefruit juice

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7
Q

Classification of Dilitazem

A

Antiarryhtmic

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8
Q

what does dilitazem do

A

Calcium channel blockers

  • blocks calcium during depolarization
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9
Q

what might patients expieinece using dilitazem

and what should you check

A

Patients may experience:
Bradycardia (assess hr) – Check VItals

Edema (assess lung sounds/presence of edema)

hypotension (assess for orthostatic hypotension, advise slow positional changes)

Headache (assess bp to ensure med is working/provide analgesic)

Dizziness (D/t hypotension – Slow positional changes)

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10
Q

what to avoid with dilitazem

A

Use caution with otc/herbal medications d/t interactions

Avoid grapefruit juice

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11
Q

classification of adenosine

A

antiarryhmics

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12
Q

adenosine use

moa

A

emergent use,

slows conduction

svt–Supraventricular tachycardia

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13
Q

Patients may experience with adenosine

and what to check for

A

Prolonged asystole/absence of pulse (monitor w/ EKG)

Palpitations (monitor pulse for 1 minute)

hypotension (assess for orthostatic hypotension, monitor bp, advise slow positional changes)

Bronchospasms/shortness of breath (assess airway/lung sounds, monitor for severe sob)

Facial flushing (update PCP with presence, maintain skin integrity)

Loss of consciousness (assess loC)

Dizziness (teach on slow positional changes)

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14
Q

clarification of digoxin

A

antiarrythmics

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15
Q

what is digoxin

not the class

A

Cardiac glycosides

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16
Q

what does digoxin do

A

inhibits na/k pump to raise CO/ lower HR

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17
Q

Patients may experience with digoxin

A

Digoxin toxicity (n/v, fatigue, halos/blurring, bradycardia)
—Make sure to monitor digoxin levels (0.8-2.0 therapeutic)

Bradycardia (assess apical pulse x 1 minute – hold <60bpm)

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18
Q

What at risk for with digoxin

A

risk for toxicity d/t hypokalemia (monitor potassium level (3.5-5.0

Increased risk w/ renal impairment – can’t excrete properly so becomes toxic!!!

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19
Q

medication considerations with digoxin

antidote

A

Use extreme caution with other medications that decrease potassium (fureosemide)

Antidote: digibind

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20
Q

classification of nitroglycerin

A

vasodilator

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21
Q

what does nitroglycerin treat

A

treats angina caused by atherosclerosis (chronic pain) or MI (acute pain)

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22
Q

Patients may experience with nitroglycerin

A

Hypotension / dizziness (monitor BP after each dose, advise slow positional changes, sit down!!!)

Headache (d/t vasodilation – increased blood flow)

Sweating (may make you feel like you’re going to pass out)

n/v

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23
Q

what does nitroglycerin come in

A

comes In sl, xr tabs, creams, patches, or iv (wear gloves when applying the patch)

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24
Q

nitroglycerin considerations

don’t give/keep

A

Keep the bottle out of sunlight / away from heat (decomposes)

Do not give with sildenafil!!! (can cause severe hypotension leading to mi/cardiac death)

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25
furosemide classifications
loop diuretic
26
Furosemide MOA
prevents reabsorption of na/cl in loop of kidneys
27
Furosemide uses to treat
Used to treat edema, heart failure & hypertension (removes fluid – potassium wasting diuretic!!!
28
Patients may experience with furosemide and what to monitor
Dehydration (rehydrate w/ electrolytes) Hypotension / dizziness (monitor BP, advise slow positional changes) Hypokalemia (monitor kidney function, replace potassium)
29
Considerations with furosemide what monitor/when take
may need to adjust dose if causing harm to kidneys Monitor weight (3# in day / 5# in a week) – contact pcp Do not readjust dose independently if weight gain occurs Administer IV furosemide Slowly (can cause ototoxicity) Take early in the morning to prevent nocturia
30
classification of Hydrochlorothiazide
thiazide diuretics
31
Hydrochlorothiazide Moa
– promotes excretion of sodium & water
32
Hydrochlorothiazide use
Used to manage hypertension and edema
33
Hydrochlorothiazide Patients may experience:
Electrolyte depletion (rehydrate w/ electrolytes) Hypotension / dizziness (monitor BP, slow positional changes) Photosensitivity (use sunscreen) Renal impairment (monitor kidney function)
34
Hydrochlorothiazide considerations
Thiazide diuretics are not effective for immediate diuresis Take at the same time each day Monitor weight
35
spironolactone classification
potassium sparing diuretics
36
spironolactone moa
promotes excretion of sodium & water but retains potassium
37
spironolactone use
Used to manage hypertension and edema in HF
38
spironolactone Patients may experience:
Hyperkalemia (monitor kidney function, limit potassium)---Salt substitutes & Potassium rich foods (bananas, potatoes, oranges) Hypotension / dizziness (monitor BP, advise slow positional Changes) Dehydration (rehydrate
39
Spironolactone considerations
may need to adjust dose if causing harm to kidneys Take at the same time each day
40
clonidine – classification
alpha 2 agonist
41
clonidine moa + do
stimulates alpha-adrenergic receptors = vasodilation & decreased BP
42
clondine use
Used to manage hypertension and adhd
43
Clondine considerations
Monitor heart rate and blood pressure Do not stop abruptly d/t rebound hypertension Avoid alcohol and other cns depressants
44
Patients may experience: clondine
Hypotension (monitor BP, advise slow positional Changes) Dry mouth / dry eyes (rehydrate / keep moist)
45
metoprolol classification
beta 1 antagonist
46
metoprolol – moa
blocks beta-1 receptors = decreased BP & heart rate
47
what is metoprolol used for
Used to manage hypertension, chest pain & tachycardia
48
Patients may experience with metoprolol
bradycardia (monitor apical pulse & hold <60bpm) Shortness of breath d/t bronchoconstriction (caution with breathing diagnosis) Hypotension (monitor bp & use slow positional changes)
49
Metoprolol considerations
Monitor vital signs (heart rate, blood pressure, respiratory rate) Do not stop abruptly d/t rebound hypertension Do not crush extended-release formulas
50
metoprolol can mask what
Can mask hypoglycemia (monitor blood sugars if diabetic) causes Confusion, dizziness, sweating (cool and clammy – eat some candy)
51
classification of captopril
ace inhibitor
52
captopril MOA
blocks conversion of angiotensin I to angiotensin ii
53
what does captopril used for and what does it do
Used to manage hypertension & heart failure = decreased BP
54
what might patients experience with captopril
Dry, non-productive cough (contact pcp, medication will be stopped/changed) Hyperkalemia (monitor kidney function, limit potassium) Hypotension (monitor bp & use slow positional changes) Angioedema
55
nursing considerations for captopril limit
Limit all: salt substitutes & Potassium rich foods (bananas, potatoes, oranges), medications that increase potassium Angioedema (go to ER!!!!) Concern for AIRWAY!!!
56
losartan classification
angiotensin ll receptor blocker
57
losartan moa
– blocks angiotensin ii = decreased BP
58
losartan use
Used to manage hypertension & prevent nephropathy (kidney deterioration)
59
what pt experience with losartan and what might nursing considerations
Hypotension (monitor bp & use slow positional changes) Angioedema (go to ER!!!!) – more likely if used w/ an ace Increased risk for infection (good hygiene/skin integrity, monitor for s/s of infection) Hyperkalemia (monitor kidney function, limit potassium)--Salt substitutes & Potassium rich foods (bananas, potatoes, oranges), medications that increase potassium
60
classification of hydralazine
vasodilator
61
hydralazine used for/moa
relaxes blood vessels to treat hypertension
62
what patients experience with hydralazine
Hypotension / dizziness (monitor BP, advise slow positional changes, sit down!!!) Headache (d/t vasodilation – increased blood flow) Palpitations / angina Tremors, numbness, tingling n/v/d
63
what are you monitoring for with hydralazine
Monitor for infection, increased risk for developing systemic lupus erythematosus (SLE) – immune system attacks its own tissues (fatigue, joint pain, butterfly rash) Consult pcp if 2 or more doses are missed Monitor weight and assess for fluid retention
64
classification of atorovasatin
HMG-COA reductase inhibitor
65
atorvastatin – moa
blocks the enzyme that makes cholesterol
66
what is atorvastatin used for
Used to treat high cholesterol (hyperlipidemia) Assess liver function
67
Patients may experience with atorvastatin –
n/V Dyspepsia (avoid acidic/spicy foods) Increased glucose (monitor sugars with diabetics) Rhabdomyolysis (skeletal muscle breakdown) Muscle pain, tenderness, weakness (contact PCP) Myalgia (muscle pain)
68
what to consider with atorvastatin –
Avoid taking with grapefruit juice May take 2 weeks to reach therapeutic levels
69
classification of ezetimibe
cholesterol absorption inhibitor
70
ezetimibe moa
blocks cholesterol absorption
71
ezetimibe used for
Used to treat high cholesterol (hyperlipidemia)
72
Patients may experience: with ezetimibe
diarrhea Upper respiratory infections (teach pulmonary hygiene) Hepatic impairment (monitor liver function labs) Rhabdomyolysis (skeletal muscle breakdown) Muscle pain, tenderness, weakness (contact PCP) arthralgia (joint stiffness)
73
what to consider with ezetimibe
Avoid taking with grapefruit juice Take as prescribed
74
classification of heparin
anticoagulant
75
heparin moa
heparin – inhibits clot formation
76
heparin used for
Used to prevent clots
77
what might patients expirience with heparin
sudden vital changes (internal bleeding) Low BP & High HR Bleeding (teach bleeding precautions
78
bleeding precautions
Use caution with knives, use soft toothbrush, use electric razor, monitor for blood in stool/urine, IM injections
79
medications consideration for heparin antidote
Monitor ptt with iv use to ensure therapeutic range High-alert medication Avoid medications containing aspirin or nsaids Antidote: protamine sulfate
80
classification of enoxaparin
anticoagulant LMW
81
what does enoxaparin do
Used to prevent blood clots
82
advantages of enoxaparin
NO labs
83
what might patentees expiernce with enoxaparin
Bleeding (teach bleeding precautions) Risk for heparin-induced thrombocytopenia (HIT) – low plt
84
What medications to avoid with enoxaparin and how to inject
Avoid medications containing aspirin or nsaids Injection “love handles” of abdomen – 2” away from belly button Given subcutaneous (bunch skin) Do not massage Do not express air
85
classification of warfarin
anticoagulant
86
warfarin moa
inhibits synthesis of vitamin-k clotting factors
87
warfarin used for
Used to prevent clots/dvt, used for a. fib, stroke prevention
88
pt expirence with warfarin
Bleeding (teach bleeding precautions) – do not give w/ excessive bleeding!!!
89
what to avoid with warfarin and the antidote
Avoid : -grapefruit juice -high contact sports -medications containing aspirin or nsaids Antidote: vitamin k Foods w/ Vitamin K (kale, spinach, turnips, broccoli, dark leafy greens, some vegetables)
90
what to monitor for with warfarin and typical onset
Monitor pt/inr to ensure therapeutic range (2.0 – 3.0) Onset takes 2 – 7 days (may overlap w/ other treatments)
91
classification for Aspirin & Clopidogrel
anti platelet
92
Aspirin & Clopidogrel Moa
inhibits platelet activation and aggregation
93
Aspirin & Clopidogrel use
Used to reduce risk of Myocardial infarction (MI) & Stroke
94
Aspirin & Clopidogrel Patients may experience:
Bleeding (teach bleeding precautions) – do not give w/ excessive bleeding!!! Use caution with knives, use soft toothbrush, use electric razor, monitor for blood in stool/urine Report tinnitus, unusual bleeding/bruising/blood in stool
95
Aspirin & Clopidogrel considerations
duration is 7-10 (life of a platelet)--Must stop taking several days prior to surgery d/t bleeding risk Concurrent use (ASA & Clopidogrel) increases bleeding in elderly Contraindicated in children <12 with flu-like symptoms (reye’s syndrome) Avoid medications containing nsaids Overdose is irreversible
96
sildenafil classification
pde 5 inhibitor
97
sildenafil moa/ use
relaxes smooth muscles (heart) increasing blood flow (causing vasodilation)
98
sildenafil – patients may experience
Hypotension / dizziness (monitor BP, advise slow positional changes, sit down!!!) Headache (d/t vasodilation – increased blood flow) flushing (may make you feel like you’re going to pass out) Vaso-occlusive crisis (occlusion of blood vessel) Priapism (go to er if lasts >4 hours)
99
sildenafil black box
Do not give with other nitroglycerin!!!!! (can cause severe hypotension leading to mi/cardiac death)

1-nursing pharmacology (14 decks)

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