Cardiovascular meds Flashcards
Action of ACEs
block conversion of of angiotensin 1 to angiotensin 2
Action of ARBs
selectively block the binding of angiotensin 2 to AT1 receptors found in tissues
Therapeutic use of ACE/ARBs (4)
- HTN
- Heart failure
- MI
- Diabetic nephropathy
Side/adverse effects of ACE/ARBs (3)
- Persistent, non-productive cough
- Angioedema
- Hypotension
Calcium channel blocker action
Slows movement of calcium into smooth muscle cells causing arterial dilation and decreased blood pressure
Therapeutic uses for calcium channel blockers (2)
- Angina
- HTN
Precautions for ACE/ARBs
- Diuretic therapy
Precautions for calcium channel blockers (3)
- Use caution in patients taking digoxin and beta blockers
- Don’t use in patients with heart failure, heart blocks, bradycardia
- No grapefruit juice
Side/adverse effects for calcium channel blockers (4)
- Constipation
- Reflex tachycardia
- Peripheral edema
- Toxicity
Things to monitor while on ACE/ARBs (2)
- Potassium
- Blood pressure
Nursing interventions for calcium channel blockers (3)
- IV injection given over 2-3 minutes
- Slowly taper
- Monitor heart rate and bp
Alpha adrenergic blockers action
Selectively inhibits alpha1 adrenergic receptors causing dilation in peripheral arteries and veins and lowering bp
Alpha adrenergic blockers meds (2)
- Prazosin
- Doxazosin mesylate
Therapeutic use of alpha adrenergic blockers (2)
- Primary HTN
- Doxazosin used to treat BPH
Precautions for alpha adrenergic blockers (2)
- Increased risk for hypotension/syncope if taken with other antihypertensives, beta blockers, diuretics
- NSAIDS decrease effectiveness of Prazosin
Nursing interventions for alpha adrenergic blockers (2)
- Monitor heart rate/bp
- Take at bedtime to decrease effects of hypotension
Side/adverse effects of alpha adrenergic blockers (2)
- Dizziness
- Fainting
Centrally acting alpha2 agonists action
Stimulate alpha2 in brain reducing peripheral vascular resistance, heart rate, bp
Centrally acting alpha2 agonists meds (3)
- Clonidine
- Guanfacine HCL
- Methyldopa
Therapeutic use for centrally acting alpha2 agonists (3)
- Primary HTN
- Hypertensive crisis
- Severe cancer pain (epidural)
Precautions for centrally acting alpha2 agonists (4)
- Can’t be used with anticoagulants, hepatic failure, MAOIs
- Methyldopa can’t be given through the same IV as barbiturates, sulfonamides
- Use caution in CVA, MI, diabetes, major depression, chronic renal failure
- Don’t use if lactating
Side/adverse effects of centrally acting alpha2 agonists (5)
- Dry mouth
- Drowsiness/sedation that resolves over time
- Rebound HTN
- Black/sore tongue
- Leukopenia
Nursing interventions for centrally acting alpha2 agonists (4)
- Monitor for adverse CNS effects, CBC, heart rate, bp, weight gain, edema
- Watch for rebound HTN 48 hours after stopping
- Never skip a dose
- Take at bedtime to decrease hypotension
- Notify provider of involuntary, jerky movements, prolonged dizziness, rash, yellow skin
Beta blocker action
Blocks stimulation of receptor sites causing decreased cardiac excitability, cardiac output, myocardial oxygen demand, lowers bp by decreasing release of renin in kidneys
Therapeutic uses for beta blockers (5)
- Primary HTN
- Angina
- Tachydysrhythmias
- Heart failure
- MI
Precautions for beta blockers (4)
- Don’t give to patients with AV block, sinus bradycardia
- Don’t give non-selective beta blockers to patients with asthma, bronchospasm, heart failure
- Propranolol can mask symptoms of hypoglycemia in diabetic patients
- Don’t give labetalol in same IV as furosemide
Selective beta blocker meds (3)
- Metoprolol
- Metoprolol succinate
- Atenolol
Non-selective beta blocker meds (3)
- Propranolol
- Nadolol
- Labetalol
Side/adverse effects of beta blockers (5)
- Bradycardia
- Nasal stuffiness
- AV block
- Rebound myocardium excitation when stopped abruptly
- Bronchospasm
Nursing interventions for beta blockers (4)
- Administer 1-2 times daily
- Don’t stop without talking to provider
- Hold med if systolic bp <100 or pulse is <60
- Monitor diabetic patients for s/s of hypoglycemia