Cardiovascular Medications (162) Flashcards
METOLAZONE: Nursing Considerations
- Diuresis onset 1 hour, peak 2 hours, duration 12–24 hours
- Take with meals or just after to decrease gastric symptoms, slightly decreased absorption
- Avoid changing positions (sitting/standing/lying) rapidly
- Take in morning to avoid interference with sleep
- Rx; Preg Cat B
METOLAZONE: Side Effects
- Dizziness, weakness, fatigue
- Nausea, vomiting, anorexia
- Rash
- Hyperglycemia
- Hypokalemia
- Photosensitivity
- Headache
- Aplastic anemia
- Impotence
- Muscle cramps
METOLAZONE: Purpose
Treatment of edema and hypertension
INDAPAMIDE: Nursing Considerations
- Diuresis onset 1–2 hours, peak 2 hours, duration 36 hours
- Take with meals or just after to decrease gastric symptoms, slightly decreased absorption
- Avoid changing positions (sitting/standing/lying) rapidly
- Take in morning to avoid interference with sleep
- Monitor electrolytes
- Rx; Preg Cat B
INDAPAMIDE: Side Effects
- Headache, dizziness
- Electrolyte changes
- Orthostatic hypotension
- Muscle cramps
- Vision disturbances
- Nausea, diarrhea
- Rash, pruritus
- Increased intraocular pressure
- Hyperglycemia
- Impotence
INDAPAMIDE: Purpose
Treatment of edema and hypertension
HYDROCHLOROTHIAZIDE: Nursing Considerations
- Diuresis onset 2 hours, peak 4 hours, duration 6–12 hours
- Take with meals or just after to decrease gastric symptoms
- Take in morning to avoid interference with sleep
- Hypersensitivity to sulfonamide
- Monitor electrolytes
- Rx; Preg Cat B
HYDROCHLOROTHIAZIDE: Side Effects
- Hypokalemia
- Hyperglycemia
- Nausea, vomiting, anorexia
- Blurred vision
- Fatigue, weakness
- Confusion, esp. in elderly
- Photosensitivity
- Orthostatic hypotension
- Electrolyte changes
- Renal failure
- Aplastic anemia
- Rash, urticaria
- Erectile dysfunction
HYDROCHLOROTHIAZIDE: Purpose
Treatment of edema and hypertension
CHLORTHALIDONE: Nursing Considerations
- Diuresis onset 2 hours, peak 6 hours, duration 24–72 hours
- Take with meals or just after to decrease gastric symptoms
- Take in the morning to avoid interference with sleep
- Weigh daily to determine fluid loss; effect of drug may be decreased if used daily
- Avoid changing positions (sitting/standing/lying) rapidly
- Rx; Preg Cat B
CHLORTHALIDONE: Side Effects
- Aplastic anemia
- Orthostatic hypotension
- Nausea, vomiting, anorexia
- Urinary frequency
- Electrolyte changes
- Headache, dizziness
- Hyperglycemia
- Photosensitivity
- Rash
- Impotence
- Hypokalemia
CHLORTHALIDONE: Purpose
Treatment of edema and hypertension
SPIRONOLACTONE: Nursing Considerations
- Diuresis onset 24–48 hours, peak 48–72 hours
- Take in the morning to avoid interference with sleep
- Take with meals or just after to decrease gastric symptoms
- Avoid food high in potassium: oranges, bananas, salt substitutes, dried apricots, dates
- Weigh daily to determine fluid loss; effect of drug may be decreased if used daily
- Contact provider if cramps, lethargy, menstrual abnormalities, deepening voice, breast enlargement
- Avoid potassium supplements
- Monitor electrolytes
- Rx; Preg Cat C
SPIRONOLACTONE: Side Effects
- Hyperkalemia
- Hyponatremia
- Vomiting, diarrhea
- Bleeding
- Rash, pruritus
- Gynecomastia
- Headache, confusion
- Impotence
- Agranulocytosis
SPIRONOLACTONE: Purpose
Treatment of edema and hypertension and of primary hyperaldosteronism
HYDROCHLOROTHIAZIDE/TRIAMTERENE: Nursing Considerations
- Diuresis onset 2 hours
- Take with meals or just after to decrease gastric symptoms
- Take early in the day to prevent nocturia and sleeplessness
- Diabetes mellitus may become manifest during thiazide treatment
- May increase BUN and serum creatinine
- Rx; Preg Cat C
HYDROCHLOROTHIAZIDE/TRIAMTERENE: Side Effects
- Nausea, vomiting, diarrhea
- Anemia
- Renal stones
- Hyperkalemia
- Hyperglycemia
- Muscle cramps
- Dizziness, headache
- Photosensitivity
HYDROCHLOROTHIAZIDE/ TRIAMTERENE: Purpose
Treatment of edema and hypertension
TICLOPIDINE: Nursing Considerations
- Monitor blood studies in long-term therapy
- Take with meals or just after to decrease gastric symptoms
- Monitor for signs of cholestasis (jaundice, dark urine, light-colored stools)
- Avoid all OTC products unless approved by provider
- Discontinue 10–14 days before surgery
- Rx; Preg Cat B
TICLOPIDINE: Side Effects
- Rash
- Diarrhea
- Bleeding
- Decrease in WBCs
- Thrombocytopenia
- Nausea
- GI distress
- Purpura, rash
- Headache, dizziness
- Tinnitus
- Hypercholesterolemia
TICLOPIDINE: Puspose
Prevention of stroke in high-risk patients
CLOPIDOGREL: Nursing Considerations
- Monitor blood studies in long-term therapy
- Report signs of unusual bruising, bleeding; it may take longer to stop bleeding
- Discontinue 5 days before elective surgery
- Take without regard to food
- Rx
CLOPIDOGREL: Side Effects
- GI bleeding
- Nausea, vomiting, diarrhea, GI discomfort
- Depression
- Bleeding, including life-threatening bleeding
- Rash
- Headache, dizziness
- Edema
- Chest pain
- Glomerulonephritis
- Hepatic failure
- URI, bronchospasms
- Arthralgia
CLOPIDOGREL: Purpose
Risk reduction for stroke, MI, peripheral arterial disease in high-risk patients, acute coronary syndrome, TIA, and angina
FUROSEMIDE: Nursing Considerations
- PO: diuresis onset 60 minutes, peak 1–2 hours, duration 6–8 hours
- IV: diuresis onset 5 minutes, peak 30 minutes, duration 2 hours
- PO: take with food or milk to prevent GI upset, slightly lessened absorption, tablets may be crushed
- Take early in the day to prevent nocturia and sleeplessness
- Avoid changing positions (sitting/standing/lying) rapidly
- Do not give IV faster than 4 mg/min; may cause ototoxicity
- Rx; Preg Cat C
FUROSEMIDE: Side Effects
- Orthostatic hypotension
- Hypokalemia
- Hyperglycemia
- Nausea, diarrhea
- Polyuria
- Rash, pruritus
- Muscle spasm
- Headache, fatigue
- Ototoxicity
- Renal failure
- Electrolyte imbalances
- Thrombocytopenia
- Photosensitivity
FUROSEMIDE: Purpose
Treatment of pulmonary edema, edema in CHF and other conditions, and hypertension
BUMETANIDE: Nursing Considerations
- PO: diuresis onset 30–60 minutes, peak 1–2 hours, duration 3–6 hours
- IM: diuresis onset 40 minutes, peak 1–2 hours, duration 4–6 hours
- IV: diuresis onset 5 minutes, peak 15–30 minutes, duration 3–6 hours
- Weigh daily
- Do not take at bedtime to prevent nocturia
- Encourage potassium-containing foods
- Monitor BUN, CBC, calcium, and uric acid
- Rx; Preg Cat C
BUMETANIDE: Side Effects
- Electrolyte imbalance
- Hypovolemia
- Ototoxicity
- Hyperglycemia
- Hypotension
- Chest pain
- Rash, pruritus
- Muscle weakness
- Tinnitus
- Headache, dizziness
- Nausea, diarrhea
- Increased cholesterol levels
- Hypokalemia
- Renal failure
- Thrombocytopenia
- Polyuria
BUMETANIDE: Purpose
Treatment of edema in CHF
DIGOXIN: Nursing Considerations
- Check pulse; if less than 60 beats per minute (adult) or 90 beats per minute (infant), hold the med and contact provider
- PO: with or without food; may crush tablets and mix with food/fluids
- Do not open, chew, or crush capsule
- Contact provider if loss of appetite, lower stomach pain, diarrhea, weakness, drowsiness, headache, blurred or yellow vision, rash, depression
- Eat a sodium-restricted and potassium-rich (bananas, orange juice) diet to keep potassium level normal
- Avoid OTC meds and herbal meds; many adverse interactions may occur
- Do not stop product abruptly
- Rx; Preg Cat C
DIGOXIN: Side Effects
- Headache
- Fatigue
- Bradycardia
- Nausea
- Atrial tachycardia (in children)
- Blurred vision
- Mental disturbances
- Vomiting
- Dysrhythmias
DIGOXIN: Purpose
Treatment of heart failure and atrial fibrillation
VERAPAMIL: Nursing Considerations
- PO: take before meals, except sustained-release which is to be taken with food
- Do not open, chew, or crush sustained- or extended-release capsule
- Teach patient how to take radial pulse and keep record of pulse rate
- Avoid hazardous activities until stabilized on drug
- Do not use OTC products or alcohol unless directed by provider; limit caffeine
- Avoid grapefruit juice
- Rx; Preg Cat C
VERAPAMIL: Side Effects
- Edema
- Nausea, constipation
- Headache
- Drowsiness
- Fatigue
- CHF
- Dizziness
- Bruising
- Dysrhythmias
- Impotence
- Nocturia
- Rash