Cardiovascular Medications Flashcards
BENAZEPRIL HCL
Lotensin
ACE Inhibitor
Used to treat HTN
Often in combination w/ thiazide diuretics
Indomenthacin may decrease therapeutic effects
Avoid salt substitutes containing K b/c of K-sparing effect
Avoid non-prescription cough medications unless directed
Preg Cat D
Side effects:
Angioedema, Cough, HA, Dizziness, Fatigue
CAPTOPRIL
Capoten
ACE Inhibitors
Treatment of HTN, CHF, Left ventricular dysfunction after MI, diabetic neuropathy
Contact DR: fever, skin rash, sore throat, mouth sores, swelling of hands or feet, fast or irregular heartbeat, chest pain, or cough
Take on empty stomach, 1 hr before meals or 2 hr after
May crush tablets and mix with juice or soft food
Loss of taste might last for first 2-3 mo
Avoid changing positions rapidly, esp during first few days
Do not use OTC meds
Avoid potassium supplements and potassium salt substitute
Preg Cat First Semester C, Second Semester D
Side Effects:
Broncho-spams, dyspnea, cough, orthostatic HTN, dizziness, tachycardia, loss of taste
ENALAPRIL
Vasotec
ACE Inhibitors
Treatment of HTN, CHF, left ventricular dysfunction
Contact Dr: fever, skin rash, sore throat, mouth sores, swelling of hands or feet, fast or irregular heartbeat, chest pain, or cough
Avoid changing positions rapidly, esp during first few days
Cardiovascular adverse reactions may reoccur
Do not use OTC medications
Avoid potassium supplements and potassium salt substitute
Preg Cat First Semester C, Second Semester D
Side Effects:
HA, Dizziness, Hypotension, tachycardia, tinnitus, hyperkalemia, angioedema, persistent cough
FOSINOPRIL
Monopril
ACE Inhibitors
Treatment of HTN, adjunct in treating CHF when not responding to usual meds
Take same time each day
Peaks 2-6 hr
Initial response might include dizziness and lightheadedness
Avoid salt substitutions containing K+
Change positions slowly
Contact Dr: Sore throat, swelling of hands and feet, chest pain, mouth sores, irregular heartbeat
Preg Cat C 1st Tri, Preg Cat D 2nd & 3rd Try
Side Effects:
HA, Dizziness, Fatigue, N/V, Diarrhea, Angioedema, Hepatic Failure, Cough
LISINOPRIL
Prinivil, Zestril
ACE Inhibitors
Treatment of mild to moderate HTN, systolic CHF, acute MI
Change positions slowly
May take w/o regard to food
Avoid high sodium foods (canned soups, lunch meets, cheese)
Avoid high potassium foods (bananas, citrus fruits, raisins)
Preg Cat 1st Tri C, 2ns Tri D
Side Effects:
HA, Dizziness, N/V, Diarrhea, HTN, Tachycardia, Fatigue, SIADH, Cough
RAMIPRIL
Altace
ACE Inhibitors
Treatment of HTN, CHF following MI, reduce risk of death from CV causes in patients with risk factors
Can mix capsule contents with water, juice, or applesauce
Change positions slowly
Contact Dr: persistent dry non productive cough, increased SOB, edema, unusual bleeding or busing
Avoid salt substitutes containing K+
Peg Cat C 1st Tri, Cat D 2nd & 3rd
Side Effects:
HA, Hypotension, Dizziness, Vertigo, Nausea, Cough, Fatigue
DOXAZOSIN MESYLATE
Cardura
Alpha Blockers
Treatment of hypertension, benign prostatic hyperplasia
Change positions slowly
Can have first dose syncope, maintain recumbent for 90 minutes
Full therapeutic effects may require several weeks of therapy
Avoid high sodium, foods
Use caution in potentially hazardous activities until stabilized
Avoid alcohol & smoking
Wear medical info tag
Preg Cat C
Side Effects:
Dizziness, HA, Fatigue, Malaise, Priapism (rare)
PRAZOSIN HCL
Minipress
Alpha Blockers
Treatment of HTN
Onset 2 hr, peak 1-3 hr, lasts 6-12 hr
Can have first dose syncope, take first dose at bedtime, do not drive for 24 hrs
Full therapeutic effects may require 4-6weeks of therapy
Food may delay absorption
Change positions slowly
Check with Dr before using OTC medication
Preg Cat C
Side Effects:
Dizziness, N/V, Diarrhea, Drowsiness, HA, Palpitations, Syncope
TERAZOSIN HCL
Hytrin
Alpha Blockers Treatment of HTN, BPH Change positions slowly Can have first dose syncope, take first dose at bedtime, do not drive or operate machinery for 4 hours Peg Cat C
Side Effects:
Dizziness, HA, Drowsiness, Nausea, Weakness, Syncope
VALSARTAN
Diovan
Angiotensin Receptor Blockers
Treatment of HTN, treatment of CHF in patients who cannot take an ACE inhibitor, reduction of cardiovascular mortality in patients with left ventricular failure or left ventricular dysfunction after MI
Take once daily for HTN, twice for CHF
Avoid salt substitutes containing potassium
Monitor blood creatinine, may decrease kidney function
May have cross allergy to sulfonamides
Preg Cat D
Side Effects:
HA, Dizziness, excessive tiredness, fatigue, stomach back or joint pain, N/V, diarrhea, hypotension, viral infection, cough, flu symptoms, high blood creatinine, rash, vasculitis
VALSARTAN HYDROCHLOROTHIAZIDE
Diovan HCT
Angiotensin Receptor Blocker Treatment of HTN, CHF in patients who can't take an ACE Inhibitor Take once daily for HTN, twice for CHF Avoid salt substitutes containing K+ Monitor blood sugars -- may cause hyperglycemia NSAIDs may reduce effects May cause exacerbation of SLE May have cross allergy to sulfonamides Preg Cat D
Side Effects:
HA, Dizziness, Excessive tiredness, Fatigue, Stomach, back or joint pain, N/V, Diarrhea, hypotension, viral infection, cough, flu symptoms, high creatinine, Rash, Blurred vision, nasopharyngitis, tinnitus, vertigo, GI distress, male sexual dysfunction
ISOSORBIDE DINITRATE
Isordil
Anti-anginals
Treatment/ prophylaxis of angia pectoris, CHF
PO: 1hr before food, 2 after
Taking with food – may reduce or eliminate HA
For chewables – hold in mouth for 2 minutes
Sublingual: dissolve under tongue, do not eat, drink, talk or smoke
Go to ER if not relieved in 15 min
Change positions slowly
Avoid alcohol, smoking, strenuous exercise in hot environments
Wear medical info tag
Preg Cat C
Side Effects:
Dizziness, postural hypotension, vascular headache, flusing, drowsiness, nausea, lightheadedness
ISOSORBIDE MONONITRATE
Ismo
Anti-anginals
Treatment or prophylaxis of angina pectoris
PO: 1hr before food, 2 after
Taking with food – may reduce or eliminate HA
For chewables – hold in mouth for 2 minutes
Sublingual: dissolve under tongue, do not eat, drink, talk or smoke
Go to ER if not relieved in 15 min
Change positions slowly
Avoid alcohol, smoking, strenuous exercise in hot environments
Wear medical info tag
Preg Cat C
Side Effects:
Dizziness, postural hypotension vascular HA, flushing, drowsiness, nausea
NITROGLYCERINE
Nitro-Par, Nitrostat
Anti-anginals
Treatment and prophylaxis of angina pectoris, IV used for control of BP during surgery & CHF associated with acute MI
Take every 6-12hr on an empty tummy
Sublingual- Let dissolve under tongue, dont swallow saliva
Spray- Hold vertically and spray under tongue, close mouth immediately
Ointment- Spread on skin in a thin layer
Transdermal- Apply to clean, hairless skin
Go to ER if not relieved w/ 3 tablets in 15 minutes
Wear medical info tag
Preg Cat C
Side Effects:
Transient HA, postural hypotension, flushing
AMIODARONE HCL
Cardarone, Pacerone
Anti-arrhythmics
Management of ventricular arrhythmias unresponsive to less toxic agents
IV: continuous cardiac monitoring
Assess for signs of pulmonary toxicity: rales/crackles, decreased breath sounds, pleuritic friction rub, fatigue, dyspnea, cough, pleuritic pain, fever
Neurotoxicity
SE may takes weeks or months or years– can persists months after stopping the med
Teach pt to check radial pulse
Use sunscreen & protective clothing
May increase ALT/AST
Preg Cat D
Side Effects:
Dizziness, fatigue, malaise, corneal microdeposits, bradycardia, hypotesion, anorexia, constipation, photosensitivity, neurologic dysfunction, muscle weakness, cardiac arrest, N/V
LIDOCAINE HCL
Xylocaine
Anti-arrhythmics
Used for premature ventricle contractions
Give O2, have resuscitation equipment available
IV: use infusion pump- cardiac monitor
Check BUN, creatinine
Monitor lungs for rales
Preg Cat B
Side Effects:
Hypotension, tremors, double vision, tinnitus, respiratory depression or arrest, confusion, blurred vision, drowsiness, dizziness, twitching, convulsion, bradycardia, visual color disturbances
PROCAINAMIDE
Anti-arrhythmics
Management of life-threatening ventricular dysrhythmias and maintain NSR following conversion of atrial arrhythmia
IV: monitor BP q5-15min, keep recumbent, monitor CBC, blood levels, I&O, daily weight
PO: Best on an empty stomach, may take food to decrease GI upset
Take at equal intervals around the clock
Teach pt to check radial pulse
Avoid caffeine
May increase alkaline phosphatase, bilirium, lactic dehydrogenase, AST
Preg Cat C
Side Effects:
Hypotension, Bradycardia, N/V, fever, rash, Dizziness, Neutropenia, Anxiety
QUINIDINE
Anti-arrhythmics Used for atrial or ventricular arrhythmias and to test malaria May increase toxicity for digitalis Monitor liver function tests and I&O Check apical pulse and BP Monitor EKG and BP Avoid changing positions rapidly Avoid alcohol, caffeine, and smoking Wear a medical info tag Preg Cat C
Side Effects:
Anemia, hypotension, N/V, diarrhea, HA, heart block, tinnitus, fever, fatigue, vision changes
SOTALOL
Betapace
Anti-arrhythmics
Managemnet of life-threatening ventricular arrhythmias
Teach pt to check radial pulse, <50 hold med and contact DR
Avoid activities that require alertness until drug response known
Contact DR: slow pulse, difficulty breathing, wheezing, cold hands and feet, dizziness, confusion, depression, rash, fever, sore throat, unusual bleeding or bruising
Milk products may decrease absorption
Preg Cat B
Side Effects:
Fatigue, weakness, impotence, bradycardia, dyspnea, life threatening ventricular arrhythmias, hyperglycemia
BISOPROLOL
Zebeta
Anti-hypertensives Treatment of mild to moderate HTN Peak 2-4hr, therapeutic 1-2 weeks Do not stop abruptly Do not use OTC meds with stimulants Avoid alcohol, smoking, sodium intake Contact Dr: Signs of CHF, difficulty breathing, night cough, swelling of extremities Preg Cat C
Side Effects:
GI upset, Fatigue, Weakness, Dizziness, HA
CLONIDINE PATCH
Catapres
Anti-hypertensives Treatment of HTN, severe cancer pain Avoid changing positions rapidly Avoid alcohol, CNS depressants, smoking, strenuous exercise in hot environment Avoid high sodium foods Use caution w/ hazardous activities Apply patch to a non hairy area, rotate sites Wear medical tag Caution with contact lens -- dry eyes May cause a positive Coombs test Preg Cat C
Side Effects:
Drowsiness, sedation, Severe rebound HTN, Dry mouth and eyes, dizziness, HA, Constipation
HYDRALAZINE HCL
Anti-hypertensive
Used to treat essential HTN, heart valve replacement and treatment of CHF
PO: give with meals
Observe mental status, weight gain, edema
Change positions slowly
Contact DR: chest pain, severe fatigue, fever, muscle, joint pain
NOT HYDROXYZINE
Preg Cat C
Side Effects:
HA, palpitations, tachy, angina, edema, lupus, anorexia, tremors, dizzy, anxiety, flushing, rash, N/V, diarrhea
HYDROCHLOROTHIAZIDE/ LISINOPRIL
Prinzide, Zestoretic
Anti-hypertensive Treatment of essential HTN Change positions slowly May take with or w/o food Avoid high soidum foods and high potassium foods Preg Cat C 1st Tri, Preg Cat D 2nd & 3rd
Side Effects:
HA, dizzy, N/V, diarrhea, hypotension, tachy, fatigue, cough, muscle cramps, angioedema
MINOXIDIL
Rogaine as topical agent
Anti-hypertensive
Teach pt to take radial pulse
Check for weight gain and edema
Topical application to promote hair growth
Do not use with children or infants
Avoid contact with eyes, mucous membranes, sensitive skin area
Preg Cat C
Side Effects:
Edema
Increase in body hair
Rash
ATORVASTATIN CALCIUM
Lipitor
Anti-lipemic Agent
Used to lower cholesterol levels, digital toxicity, biliary obstruction pruritus and diarrhea, decrease risk of MI and stoke in pt with type 2 DM
Take other medications 1hr before or 4 hr after
Mix in applesauce or liquid – do not take dry
Monitor for bleeding gums, tarry stool, hematuria, bruising
Monitor liver enzymes
Avoid grapefruit
Preg Cat X
Side Effects:
Constipation, decreased Vit A,D,K, abdominal pain, nausea, arthralgia, myopathy, nasopharyngitis, UTI
COLESTIPOL
Colestid
Antilipemic Agents
Used to lower cholesterol levels, digital toxicity, biliary obstruction pruritus and diarrhea, decrease risk of MI and stoke in pt with type 2 DM
Take other medications 1hr before or 4 hr after
Monitor for bleeding gums, tarry stool, hematuria, bruising
Do not crush, cut or chew tablets, drink lots of water
Preg Cat N/A
Side Effects:
Constipation, decreased vit A,D,K, pruritus, abdominal pain, nausea, diarrhea
FENOFIBRATE
(TriCor, Fenoglide, Lipfen, Triglide)`
Antilipemic Agents Used to lower total cholesterol, triglycerides, LDL cholesterol, increase HDL cholesterol Take once daily with or w/o food Stop if no improvement in 2mo Diet regimen Report unexplained muscle pan Monitor prothrombin levels with warfarin Monitor liver function tests Preg Cat C
Side Effects:
N/V, diarrhea, constipation, HA. heartburn, pain in back, arms and legs
GEMFIBROZIL
Lopid
Antilipemic Agents Used to lower cholesterol levels, type IV and V hyperlipidemia Take 30 min before meals Check CBC, liver function May stop if no improvement in 3 mo Preg Cat C
Side Effects:
Abdominal pain, diarrhea, GI upset, Fatigue, cholelithiasis, nausea
LOVASTATIN
Mevacor
Antilipemic Agents
Used to lower choesterol levels, primary and secondary prevention of coronary events
Use sunscreen
Liver function tests every 1-2mo for 1.5 years
Take with food
Contact Dr: unexplained muscle pain, tenderness or weakness, especially if with fever or malaise
Preg Cat X
Side Effects:
Flatus, constipation, abdominal pain, nausea, diarrhea, GI upset, heartburn, muscle cramps, dizziness, HA, tremor, blurred vision, rash, pruritus
NIACIN
Niacor, Niaspan
Antilipemic Agents Treatment of pellagra, hyperlipidemias, peripheral vascular disease Take with meals 325mg ASA before dose to reduce flushing Change positions slowly May be used with simvastatin or lovastatin Monitor liver enzymes May increase glucose levels OTC, Preg Cat C
Side Effects:
HA, Nausea, postural hypotension, myopathy, Flushing, cough, pruritus
NICOTINIC ACID
Slo-Niacin, Vitamin B
Antilipemic Agents
Treatment of pellagra, hyperlipidemias, peripheral vascular disease
Take with meals
325mg ASA before dose to reduce flushing, NSAIDs may also help
Change positions slowly
May alter blood sugar, monitor liver enzymes
OTC, Preg Cat C
Side Effects:
HA, Nausea, Postural hypotension, flushing, dry skin
PRAVASTATIN
Pravachol
Antilipemic Agents
Treatment of hypercholesterolemia, apo B, risk reduction of recurrent MI, atherosclerosis
Schedule Liver function tests semiannually
Take w/o regard to food
Conact Dr: unexplained muscle pain, tenderness, weakness, fever, malaise
Preg Cat X
Side Effects:
constipation, abdominal pain, diarrhea, heart burn, flatus
ROSUVASTATIN CALCIUM
Crestor
Antilipemic Agents Use as adjunct therapy to diet to reduce LDL cholesterol and increase HDL, slows progression of atherosclerosis Discontinue in case of pregnancy Caution if hx of large alcohol consumption Liver function tests q12 weeks Pt should keep tight control of diet May use in children 10-17 yo Asian pts may require lower dose Do not use with niacin Preg Cat X
Side Effects:
Myalgia, constipation, abdominal pain, nausea, myopathy, rhabdomyolysis
SIMVASTATIN
Zocor
Antilipemic Agents
Treatment of hypercholesterolemia, hypertriglyceridemia, hyperlipoproteinemias, coronary artery disease
Eye exam before, 1 mo after, and annually
Schedule liver function tests semiannually
Take w/o regard to food
Contact Dr: unexplained muscle pain, tenderness or weakness, especially with fever or malaise
Asian pts should not take niacin
Preg Cat X
Side Effects:
Eye lens opacities, liver dysfunction, URI, HA, Abdominal pain, constipation, nausea
ATENOLOL
Tenormin, Tenoretic
Beta Blockers Used in treatment of HTN, MI, prophylaxis of angina Masks signs of hypoglycemia in diabetes Teach pt about radial pulse Check pulse, <50 hold med and call dr PO: Take before meals, at bedtime May be crushed Do not stop abruptly Preg Cat D
Side Effects:
Bradycardia, cold extremities, postural hypotension, bronchospams in overdose, heart block, insomnia, fatigue, dizziness, mental changes, nausea, diarrhea, CHF
