Cardiopulmonary Flashcards
Angiotensin-Converting Enzyme (ACE) Inhibitor Agents
- Action: decrease blood pressure and afterload by suppressing the enzyme that converts angiotensin I to II
- Indications: HTN, CHF
- Side Effects: hypotension, dizzy, dry cough, hyperkalemia, hyponatremia
- Implications: avoid sudden changes in posture due to fainting risk, avoid rapid increases in PA
- Examples:
- capoten (captopril)
- vasotec (enalapril)
- prinivil (lisinopril)
- altace (ramipril)
Anti Cholinergic Agents
Used with IV for heart block or bradycardia, Inhibit acetylcholine at the parasympathetic nerves, blocking vagal effectson SA and AV nodes
Side Effects: palpitations, HA, restlessness, ataxia, dry mouth and blurred vision
Antiarrhythmic Agents
Action:
- Class 1 - sodium channel blockers - excitation/conduction
- Class 2 - Beta blockers inhibit sympathetic
- class 3 - potassium/sodium channel prolong repolarization
- Class 4 - calcium channel blockers depress depolarization/conduction through AV node
Indications: cardiac arrhythmias
Side Effects: unique to the specific agent, exacerbation of arrhythmias, dizziness, hypotension
Implications: encourage pts to adhere to schedules
Examples:
- sodium - quinidine, xylocaine (lidocaine)
- beta - tenormin (atenolol)
- prolong repolarization - cordarone (amiodarone)
- calcium - cardizem (diltiazem)
Anticoagulant Agents
Action: inihibit platelet aggragation and thrombus form
Indications: post CABG, percutaneous coronary angioplasty, DVT prevention, pts with a fib
Side Effects: hemorrhage, increased risk of bleeding, GI distress
Implications: avoid 2nd injury, bleeding, bruising, pt education
Examples:
- heparin
- coumadin (warfarin)
- lovenox (enoxaparin)
Antihyperlipidemia Agents (statins)
Action: inhibit enzyme action in cholesterol synthesis, break down low density lipoproteins, decrease triglyceride levels and increase HDL
Indications: hyperlipidemia, atherosclerosis, prevent coronary events, diabetes, PVD
Side Effects: HA, GI distress, myalgia, rash
Implications: aerobic exercise can maximize drug effect and increase HDLs
Examples:
- lipitor (atorvostatin)
- Zocor (simvistatin)
- Tricor (fenobibrate)
Diuretic Agents
Action: increase excretion of sodium and urine = reduction in plasma volume which decreases blood pressure.
Indications: htn, edema w. HF, pulmonary edema, glaucome
Side Effects: dehydration, hypotension, electrolyte imbalance, polyuria, increased LDL, arrhythmias
Implications: orthostatic changes, pay attention to signs and symptoms of electrolyte imbalance
Examples:
- thiazide: diuril (chlorothiazide)
- loop: lasix (furosemide)
- potassium sparing: dyrenium (triameterene)
Nitrate Agents
Action: decrease ischemia through smooth muscle relaxation and dilation of peripheral vessels
Indications: angina pectoris
Side Effects: HA, dizzy, OH, reflex tachy, n/v
Implications: OH, sublingual implentation
Examples:
- nitrostat (nitroglycerin)
- isordil (isosorbide dinitrate)
- amyl nitrite solution for inhalation
Positive Inotropic Agents
Action: increase the F and velocity of myocardial contraction, slow the HR, decrease conduction velocity through AV node, and decrease the degree of activation of sympathetic nervous system
Indications: heart failure, a-fib
Side Effects: cardiac arrhythmias, GI distress, blurred vision
Implications: monitor HR closely during activity, teach pt to take pulse, seek HCP advice for rates < 60 or >100bpm
Examples:
- Lanoxin (digoxin)
Thrombolytic Agents
Action: facilitate clot dissolution through conversion of plasminogen to plasmin. Plasmin breaks down clots and allows occluded vessels to re-open to maintain blood flow
Indications: acute MI, PE, ischemic stroke, arterial or venous thrombosis
Side Effects: hemmorhage (specifically intracranial), allergic reaction, cardiac arrhythmia.
Implications: avoid situations that cause trauma due to altered clotting activity
Examples:
- lynlytic (urokinase)
- activase (alteplase)
Antihistamine Agents
Action: block the effects of histamine resulting in a decrease in nasal congestion and symptoms of the common cold, mucosal irritation, sinusitis, conjunctivitis, and allergies
Indication: respiratory seasonal allergies, rhinitis and sneezing, allergic conjunctivitis, motion sickness, PD
Side Effects: arrhythmias, postural hypotension, gastro intestinal distress, dizzy, drowsy, HA, blurred vision, fatigue, nausea, thickening of bronchial secretions
Implications for PT: increase guarding when rising from a sitting or lying positio for OH, closely monitor pt during exercise
Examples:
- benadryl (diphenhydramine)
- allegra (fexofenadine)
- zyrtec (cetirizine HCL)
- Claritin (loratadine)
Pulmonary Inhaled Anti-inflammatory agents
Action: inhaled corticosteroids, leukotrine modifiers, and mast cell stabilizers help prevent inflammatory mediated bronchoconstriction.
Indication: bronchospasm, asthma
Side Effects: corticosteriods: decreased with inhaled but still no beuno. Leukotriene: liver dysfunction; mast cell stabilizer: bronchospasm, throat and nasal irritation, cough, GI distress
Implications for PT: look for signs of liver dysfunction, NOT the same as bronchodilaters etc, keep clean
Examples:
- corticosteroids: Qvar, pulmincort, aerobid
- leukotriesine: zyflo
- mast-cell stabilizer: nasalcrom
Bronchodilater agents:
Action: stimulate receptors that cause bronchial smooth muscle relaxation or by blocking the receptors that trigger bronchoconstriction (anticholinergic, sympathomimetics, and xanthine)
Indication: bronchospasm, wheezing, SOB, COPD
Side Effects: paradoxical bronchospasm, dry mouth, GI, chest pain, palpitations, tremor, nervousness, soemtimes increased risk of asthma death
Implications for PT: bring rescue medications with them, take per prescription, cardiac or vision abnormalities may indicate toxicity
Examples:
- anticholinergic: atrovent, spiriva
- sympathomimetics: ventolin (albuterol), primatene mist (epinephrine), serevent (salmetrol)
- xanthine: theo-dur, aminophyline
Mucolytic Agents
Action: decrease viscosity of mucus secretions by altering their composition and consistency, making them easier to expectorate. the are diminished by a nebulizer
Indications: viscous mucus secretions due to pneumonia, emphysema, chronic bronchitis, and cystic fibrosis
Side effects: pharyngitis, oral mucosa inflammation, rhinitis, chest pain
Implications: can exploit effects of drugs by performing airway clearance interventions within one hour after drug administration.
Examples:
- pulmozyme (dornase alpha)
- Mucosil or mucomyst (acetylcysteine)
