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A-Patho/pharm 2 > cardiovascular drugs > Flashcards

cardiovascular drugs Flashcards

1
Q

what is atherosclerosis

A

buildup of fatty plaque, loss of elasticity of walls of arteries, narrow, thrombi

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2
Q

cholesterol

A

essential for life but too much LDL is bad

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3
Q

lipids

A
  • LSL is greatest contributor to ASCVD, storage, bad delivery
  • VLDL/triglyceride: deliver and store
  • HDL (removal): healthy/good, promote removal
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4
Q

ASCVD risk assessment

A
  • screen adults and pediatrics
  • race
  • advancing age
  • HTN
  • cigarette smoking
  • diabetes (risk is equivalent)
  • low HDL
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5
Q

therapeutic lifestyle changes

A
  • exercise
  • diet
  • smoking cessation
  • weight control
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6
Q

dyslipidemia drugs

A
  • HMG-CoA reductase inhibitors
  • bile salt sequestrant
  • cholesterol absorption inhibitor
  • fibrates
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7
Q

HMG-CoA reductase inhibitor prototype

A

atorvastatin (Lipitor)

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8
Q

atorvastatin purpose

A
  • reduce LDL
  • increases HDL
  • reduces triglycerides
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9
Q

atorvastatin MoA

A

inhibits HMG-CoA reductase and increased LDL receptor sites

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10
Q

atorvastatin therapeutic uses

A
  • lowers events related to ASCVD
  • heart failure
  • stroke/MI/death
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11
Q

atorvastatin side effects

A
  • hepatotoxicity
  • myopathy
  • GI upset
  • memory loss
  • cat x, do not give to pregnant ppl
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12
Q

atorvastatin nursing interventions/education

A
  • liver function tests before and during therapy
  • jaundice
  • avoid alcohol
  • monitor CK levels and for signs of muscle weakness
  • do not give to ppl with hepatitis
  • use cautiously in older adults
  • administer at bed time
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13
Q

bile salt sequestrant prototype

A

colesevelam or cholestyramine

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14
Q

colesevelam or cholestyramine purpose

A

decreases LDL cholesterol

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15
Q

colesevelam or cholestyramine MoA

A

binds to bile salts and prevents their reabsorption

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16
Q

colesevelam or cholestyramine adverse effects

A

constipation

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17
Q

colesevelam or cholestyramine nursing interventions/education

A
  • dose 1 hour before or 4 hours after thiazides, digoxin, and warfarin
  • cholestyramine decrease uptake of fat-soluble vitamins (ADEK)
  • increase fluids and water
  • take with food and full glass of water
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18
Q

cholesterol absorption inhibitors prototype

A

ezetimibe

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19
Q

ezetimibe purpose

A

reduction of total cholesterol, reduction of LDL

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20
Q

ezetimibe MoA

A
  • inhibits dietary cholesterol absorption in small intestines
  • inhibits reabsorption of cholesterol in bile
  • monotherapy or combined with a statin
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21
Q

ezetimibe adverse effects

A
  • hepatotoxicity
  • muscle pain
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22
Q

ezetimibe nursing interventions/education

A
  • monitor liver function tests, signs of dysfunction (jaundice)
  • monitor CK
  • avoid alcohol
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23
Q

fibrates prototype

A

gemfibrozil

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24
Q

gemfibrozil purpose

A

to decrease triglyceride levels and increase HDL levels

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25
Q

gemfibrozil therapeutic uses

A
  • reduction of VLDL and increase levels of HDL
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26
Q

gemfibrozil MoA

A

decrease TG production and transport

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27
Q

gemfibrozil things to keep in mind

A
  • no effect on LDL
  • no proof of ASCVD mortality reduction
  • many side effect: 3rd line drug of choice
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28
Q

gemfibrozil adverse effects

A
  • rash
  • gi distress
  • gallstones
  • myopathy
  • hepatotoxicity
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29
Q

gemfibrozil nursing interventions/education

A
  • watch for signs of gallbladder disease (RUQ)
  • monitor CK levels and watch for muscle weakness
  • monitor liver function tests
  • increases risk for bleeding when coumadin
  • proceed with caution if also dosed with statins
  • take 30 minutes before breakfast and dinner
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30
Q

hemodynamics review

A
  • circulatory system (veins, capillaries, arteries)
  • pulmonary and systemic
  • cardiac output=HR x stroke volume
  • stroke volume=preload, afterload, and contractility
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31
Q

regulation of blood pressure

A
  • ANS
  • kidneys
  • RAAS
  • natriuretic peptides
32
Q

Current AHA definition of HTN

A
  • primary vs secondary
  • consequences
    • heart disease
    • kidney disease
    • stroke
    • death
  • silent disease
33
Q

diet and lifestyle changes for HTN

A
  • sodium retention
  • DASH diet
  • alcohol restriction
  • exercise
  • smoking cessation
  • weight loss
34
Q

antihypertensive drugs

A
  • angiotensin converting enzyme (ACE) inhibitor
  • angiotensin ll receptor blocker (ARBs)
  • beta adrenergic blockers
  • thiazides diuretics - hydrochlorothiazide
  • calcium channel blockers (CCB)
  • alpha adrenergic blockers
  • alpha 2 agonists
  • vasodilators
35
Q

ace inhibitor prototype

A

captopril

36
Q

captopril purpose/MoA

A

block ace from converting angiotensin l to angiotensin ll

37
Q

captopril therapeutic uses

A
  • hypertension
  • heart failure
  • MI
  • nephropathy
38
Q

captopril adverse effects

A
  • first-dose orthostatic hypotension
  • angioedema
  • cough
  • elevated potassium
  • neutropenia
  • pregnancy cat d
39
Q

captopril nursing interventions/education

A
  • monitor bp 2 hours after initial dose
  • monitor potassium levels and WCW count
  • stop medication if sensitivity reaction occurs
  • caution with potassium sparing diuretics
40
Q

angiotensin ll receptor blockers (ARBs) prototype

A

losartan “sartans”

41
Q

losartan purpose/MoA

A

blocks angiotensin ll from working (vasodilation and excretion of sodium and water)

42
Q

losartan therapeutic uses

A
  • hypertension
  • heart failure
  • prevents MI and stroke
43
Q

losartan adverse effects

A
  • angioedema (less than ACE inhibitors)
  • lower incidence of cough
  • fetal harm
44
Q

losartan nursing interventions/education

A
  • watch for facial swelling and treat with epinephrine
  • do not give during pregnancy
45
Q

calcium channel blockers prototype

A
  • diltiazem or nifedipine
46
Q

diltiazem or nifedipine purpose/MoA

A
  • blocks calcium channels in blood vessels
  • causes vasodilation and prevents vessel spasms
  • decreases heart rate and contractility
47
Q

diltiazem or nifedipine therapeutic uses

A
  • hypertension
  • angina
  • tachycardia/dysrhythmias
48
Q

diltiazem or nifedipine adverse effects

A
  • reflex tachycardia
  • peripheral edema
  • acute toxicity
  • hypotension, bradycardia
49
Q

diltiazem or nifedipine nursing interventions/education

A
  • monitor HR
  • monitor for edema, weight gain and give diuretic
  • monitor VS and EKG
  • use cautiously in older adults
  • do not give with grapefruit
50
Q

alpha adrenergic blockers prototype

A

prazosin

51
Q

prazosin purpose/MoA

A

blocks alpha 1 receptors causing venous dilation and smooth muscle relaxation

52
Q

prazosin therapeutic uses

A

hypertension (BPH)

53
Q

prazosin adverse effects

A

first dose orthostatic hypotension, reflex tachycardia, nasal congestion

  • pregnancy cat C
54
Q

prazosin nursing interventions/education

A
  • first dose is given at night
  • educate about orthostatic hypotension-safety measures
  • take with food
55
Q

alpha 2 agonists prototype

A

clonidine

56
Q

clonidine purpose/MoA

A
  • act within the CNS to decrease stimulation of alpha and beta receptors of the heart and vasculature system
  • lowers heart rate and cardiac output, vasodilation
57
Q

clonidine therapeutic uses

A
  • hypertension
  • pain (migraines), ADHD
  • off label use: withdrawal and tourettes
58
Q

clonidine adverse effects

A
  • drowsiness and sedation
  • dry mouth (xerostomia)
  • rebound hypertension if abruptly discontinued
  • pregnancy cat c
59
Q

clonidine nursing interventions/education

A
  • avoid activities that requires mental alertness
  • chew gum or suck on hard candy
  • do not discontinue treatment-wean off
  • if given in addition with other antihypertensives, monitor for hypotension
  • do not give with other drugs that cause CNS depression or alcohol
  • given twice a day-larger dose at bedtime
  • transdermal patches changes every 7 days
60
Q

beta adrenergic blocks “olols” prototype

A

propranolol

61
Q

propranolol purpose/MoA

A
  • blocks beta 1 and beta 2 receptors cauging
    • beta 1 -decrease heart rate, contractility, BP and cardiac output
    • beta 2-constricts bronchi in the lungs
62
Q

propranolol therapeutic uses

A
  • hypertension
  • angina
  • tachycardia
  • heart failure
  • MI
  • selective vs nonselective????
63
Q

propranolol adverse effects

A
  • bradycardia (may worsen HF)
  • decreased cardiac output
  • orthostatic hypotension
  • masks signs of hypoglycemia
  • beta 2 blockade
    • bronchoconstriction
64
Q

propranolol nursing interventions/education

A
  • monitor heart rate and hold drug if <60bpm/monitor bp
  • use cautiously in clients with heart failure and watch for worsening
  • educate on orthostatic hypotension
  • avoid nonselective beta blockers if client has asthma or other lung diseases
  • may mask symptoms of hypoglycemia-monitor blood glucose levels in diabetics closely
65
Q

vasodilators prototype

A

nitroprusside

66
Q

nitroprusside purpose/MoA

A

direct vasodilation of arteries and veins causing rapid reduction in blood pressure

67
Q

nitroprusside therapeutic uses

A
  • hypertensive crisis
68
Q

nitroprusside adverse effects

A
  • lots of them
  • excessive hypotension
  • cyanide poisoning
  • toxicity
69
Q

nitroprusside nursing interventions

A
  • protect IV tubing and container from light
  • continuous monitoring of vitals and ECG
70
Q

antihypotensive drugs

A

sympathetic adrenergic agonists

vasopressor

71
Q

sympathetic adrenergic agonist prototype

A

epinephrine

72
Q

epinephrine purpose/MoA

A
  • increase BP, blood volume, strength of cardiac contraction
  • bronchodilation and treatment of bronchospasms
  • used to treat shock or anaphylaxis
73
Q

epinephrine adverse effects

A
  • severe vasoconstriction
  • hypertensive crisis
  • dysrhythmias, angina
  • hyperglycemia
74
Q

vasopressors/vasoconstrictors prototype

A

dopamine or dobutamine

75
Q

dopamine/dobutamine

A
  • drugs that raise BP and increase the rate and force of heart contractions
  • used to maintain blood flow to vital organs
  • always administer on an infusion pump
  • vesicants

A-Patho/pharm 2 (3 decks)

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