Cardiovascular Flashcards
Loop Diuretics
+ furosemide (Lasix)
INDICATIONS: Pulmonary edema, edema (r/t hear failure, liver disease, and kidney disease), hypertension.
MODE OF ACTION: Blocks reabsorption of Na, Cl, and water in the ascending loop of Henle, causing RAPID diuresis.
SIDE EFFECTS: Dehydration, electrolyte imbalances (hyponatremia, HYPOKALEMIA), HYPOTENSION, OTOTOXICITY, hyperglycemia.
KEY POINTS: Administer during the day vs. night, infuse IV at 20 mg/min, weight patients daily, monitor I&Os, monitor electrolytes, ENCOURAGE FOODS HIGH IN POTASSIUM.
Thiazide Diuretics
+ hydrochlorothiazide (Hydrodiuril)
INDICATIONS: Hypertension (often in combination with antihypertensive meds), edema (r/t hear failure, liver disease, and kidney disease).
MODE OF ACTION: Blocks reabsorption of Na, Cl, water at distal convoluted tubule.
SIDE EFFECTS: Dehydration, HYPOKALEMIA, hyperglycemia, NO ototoxicity.
KEY POINTS: Administer during the day vs. night, weight patients daily, monitor I&Os, monitor electrolytes, ENCOURAGE FOODS HIGH IN POTASSIUM.
Potassium Sparing Diuretics
+ spironolactone (Aldactone)
INDICATIONS: Heart failure, hypertension. Contraindicated in patients with severe kidney failure.
MODE OF ACTION: Blocks aldosterone, promoting excretion of sodium (Na+) and water, BUT RETENTION OF POTASSIUM.
SIDE EFFECTS: HYPERKALEMIA, amenorrhea, gynecomastia, impotence.
KEY POINTS: Monitor potassium levels, teach patients to AVOID SALE SUBSTITUTES containing potassium.
Osmotic Diuretics
+ mannitol (Osmitrol)
INDICATIONS: Edema, increased intracranial pressure (ICP), increased intraocular pressure (IOP).
MODE OF ACTION: Reduces ICP and IOP by increasing serum osmolality, which draws fluid back into the interstitial fluid and plasma.
SIDE EFFECTS: Heart failure, pulmonary edema, renal failure, dehydration, electrolyte imbalances (Na, K).
KEY POINTS: Use filter needle and filter in IV tubing. Monitor weight, I&Os, electrolytes.
ACE Inhibitors
+ captopril (Capoten)
OTHER ACE INHIBITORS: Lisinopril, most end with -pril.
INDICATIONS: Hypertension, heart failure, Mls, diabetic nephropathy.
MODE OF ACTION: Blocks conversion of angiotensin I to angiotensin II, causing vasodilation.
SIDE EFFECTS: HYPOTENSION, aNGIOEDEMA, cOUGH, eLEVATED POTASSIUM, rash.
KEY POINTS: Monitor BP, teach patient to change positions slowly.
Angiotensin II Receptor Blockers
+ losartan (Cozaar)
OTHER ARBS: Valsartan; most end with -sartan.
INDICATIONS: Hypertension, heart failure, Mls, diabetic nephropathy.
MODE OF ACTION: Blocks action of angiotensin II, resulting in vasodilation.
SIDE EFFECTS: Angioedema, GI upset, hypotension.
Antianginal Medication
+ nitroglycerin
INDICATIONS: Angina.
MODE OF ACTION: Vasodilation, decreases preload and myocardial oxygen demand.
SIDE EFFECTS: HEADACHE, ORTHOSTATIC HYPOTENSION, reflex tachycardia.
KEY POINTS: Sublingual - place under tongue. Store in cool/dark place. Take up to 3 tablets (5 minutes apart). Topical - remove prior dose, place over clean/hairless area, avoid touching with your hands (wear gloves).
Antidysrhythmic Medications: Class I
+ procainamide (Pronestyl)
OTHER CLASS I ANTIDYSRHYTHNIC: Lidocaine.
INDICATIONS: SVT, Ventricular tachycardia, atrial flutter, AFIB.
MODE OF ACTION: Sodium channel blocker
SIDE EFFECTS: Hypotension, lupus, leukopenia, thrombocytopenia, arrhythmias.
Antidysrhythmic Medications: Class II
+ propranolol (Inderal)
INDICATIONS: AFIB, atrial flutter, paroxysmal SVT, hypertension, angina.
MODE OF ACTION: Non-selective beta blocker.
SIDE EFFECTS: HYPOTENSION, bradycardia, fatigue, weakness, BRONCHOSPASM.
KEY POINTS: DO NOT USE IN PATIENTS WITH ASTHMA.
Calcium Channel Blockers
+ diltiazem (Cardizem)
OTHER CALCIUM CHANNEL BLOCKERS: Verapamil, nifedipine, many others end in -pine.
INDICATIONS: Hypertension, angina.
MODE OF ACTION: Blocks calcium channels in blood vessels and heart, leading to vasodilation and decreased heart rate.
SIDE EFFECTS: Bradycardia, HYPOTENSION, dysrhythmias, constipation, peripheral edema.
KEY POINTS: NO grapefruit juice, monitor BP and HR carefully.
Antidysrhythmic Medications: Class IV
+ verapamil (Calan)
OTHER CLASS IV ANTIDYSRHYTHMIC: Diltiazem
INDICATIONS: AFIB, atrial flutter, SVT, hypertension, angina.
MODE OF ACTION: Calcium channel blocker
SIDE EFFECTS: Hypotension, bradycardia, GI upset.
Antidysrhythmic Medications: Class III
+ amiodarone (Cordarone)
INDICATIONS: AFIB, ventricular fibrillation, ventricular tachycardia.
MODE OF ACTION”. Potassium channel blocker.
MANY SERIOUS SIDE EFFECTS: Hypotension, bradycardia, pulmonary toxicity, visual disturbances, GI upset, liver toxicity, thyroid dysfunction.
Centrally Acting Alpha 2 Agonists
+ clonidine (Catapres)
INDICATIONS: Hypertension.
MODE OF ACTION: Decreases sympathetic outflow to heart and blood vessels, resulting in decreased HR, cardiac output and blood pressure.
SIDE EFFECTS: Drowsiness, dry mouth.
KEY POINTS: Suck on hard candy. Increase fluid intake. DO NOT CONFUSE WITH CLOZAPINE (WHICH IS AN ATYPICAL ANTIPSYCHOTIC).
Vasodilator (for Hypertensive Crisis)
+ nitroprusside (Nitropress)
INDICATIONS: Hypertensive crisis.
MODE OF ACTION: Direct vasodilation of arteries and veins, rapidly decreasing BP (preload and after load).
SIDE EFFECTS: HYPOTENSION, CYANIDE POISONING, THIOCYANATE TOXICITY.
Cardiac Glycosides
+ digoxin (Lanoxin)
INDICATIONS: Heart failure, treatment of AFIB.
MODE OF ACTION: inotropic effect (increased force and efficiency of heart contractions) and Chronotropic effect (decreased HR).
SIDE EFFECTS: Dysrhythmias, bradycardia, TOXICITY (SX: GI UPSET, FATIGUE/WEAKNESS, VISION CHANGES).
KEY POINTS: Check pulse rate before administration (DO NOT ADMINISTER FOR PULSE <60 BPM). Monitor digoxin levels during therapy (should be between 0.5-2.0 ng/mL). Hypokalemia increases risk of digoxin toxicity. Increase intake of high-potassium foods. Treat bradycardia w/atropine, overdose with Digibind.
Adrenergic Agonists
epinephrine (Adrenaline):
INDICATIONS: cardiac arrest, asthma. Causes bronco dilation, vasoconstriction (increased BP, increased HR/CO.
dopamine (Inotropin):
INDICATIONS: shock, heart failure. Improves renal blood flow (at low/moderate doses), increased HR/CO.
dobumatine
INDICATIONS: Heart failure. Increases cardiac output (less effect on HR or BP).
SIDE EFFECTS FOR ALL: Hypertensive crisis, dysrhythmias, angina.
Nonselective Beta Blockers (Beta 1 and 2)
+ propranolol (infernal)
OTHER NONSELECTIVE BETA BLOCKERS: Carvedilol, labetalol; most end in -olol.
INDICATIONS: Hypertension, angina, arrhythmias, MI.
MODE OF ACTION: Blocks beta 1 (heart) and beta 2 (lungs) receptors. Decreases BP, heart rate.
SIDE EFFECTS: BRONCHOCONSTRICTION, fatigue, hypotension, bradycardia, decreased cardiac output.
KEY POINTS: DO NOT USE IN PATIENTS WITH ASTHMA.
Beta I Blockers
+ metoprolol (Lopressor)
OTHER BETA 1 BLOCKERS: Atenolol; most end in -olol.
INDICATIONS: Hypertension, angina, HF, MI.
MODE OF ACTION: Blocks beta 1 (heart) receptors. Decreases BP, heart rate.
SIDE EFFECTS: Bradycardia, decreased cardiac output, hypotension, fatigue, erectile dysfunction.
KEY POINTS: Teach patients to change positions slowly. Take BP and pulse at home daily.
Antilipemic Agents: statins
+ atorvastatin (Lipitor)
OTHER STATINS: Simvastatin; most end in -statin.
INDICATIONS: Hypercholesterolemia; prevent Mls.
MODE OF ACTION: Decreases production of LDL, increases production of HDL.
SIDE EFFECTS: HEPATOTOXICITY, GI upset, MUSCLE PAIN, RHABDOMYOLYSIS.
KEY POINTS: Administer w/evening meal (cholesterol is synthesized at night). Monitor liver function and CK levels. Avoid alcohol.
Antilipemic Agents: Cholesterol Absorption Inhibitor
+ ezetimibe (Zetia)
INDICATIONS: Hypercholesterolemia.
MODE OF ACTION: Inhibits absorption of cholesterol in the small intestine.
SIDE EFFECTS: HEPATOTOXICITY, MUSCLE PAIN.
KEY POINTS: Monitor liver function and CK levels.
Antilipemic Agents: Bile Acid Sequestrant
+ colesevelam (Welchol)
INDICATIONS: Hypercholesterolemia.
MODE OF ACTION: Binds bile acids in intestine, causing increased excretion of cholesterol. Lowers LDL cholesterol.
SIDE EFFECTS: CONSTIPATION.
KEY POINTS: Increase dietary fiber and fluids! Take with food and a full glass of water. Interferes with absorption of fat soluble vitamines (A,D,E,K) and oral contraceptives.
Antilipemic Agents: Niacin
+ niacin, nicotinic acid
INDICATIONS: Hypercholesterolemia.
MODE OF ACTION: Decreases lipoprotein and triglyceride synthesis (in large doses). Lowers LDL cholesterol and triglyceride.
SIDE EFFECTS: Flushing of face, GI distress, hepatotoxicity, hyperglycemia.
KEY POINTS: Monitor liver function, blood glucose levels.
Antilipeic Agents: Fibrates
+ gemfibrozil (Lopid)
INDICATIONS: Hypercholesterolemia
MODE OF ACTION: Decreases triglyceride production and transport. Increases HDL levels.
SIDE EFFECTS: GI upset, gallstones, hepatotoxicity, muscle pain.
KEY POINTS: Give 30 minutes before breakfast and dinner. Monitor liver function, CK levels.
