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Drug Cards > Cardiovascular Pharmacology > Flashcards

Cardiovascular Pharmacology Flashcards

1
Q

Atenolol (Black Box Alert)

A

Trade Name: Tenormin
Classification: B-Blocker; antiHTN, anti antianginal, antiarrhythmic

Common Side/Adverse Effects: HoTN, constipation, dizziness

Black Box Alert: Do not abruptly discontinue, may vause acute tachycardia, HTN, or ischemia

Nursing Interventions: Monitor BP, pulse, and resp. Monitor bowel activity/consistency. Assess for HF

Teaching Points: Don’t abruptly discontinue taking. Change positions slowly. Avoid tasks that require alertness.

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2
Q

Aspirin (high alert)

A

Trade Names: Bayer, Ascriptin, Bufferin, Durlaza, Ecotrin

Classification: Nonsterioidal salicylate; anti-inflammatory, antipiuretic, anticoagulant

Common Use: mild/mod pain, fever, platelet aggregation

Common side/adverse effects: GI discomfort, nausea, vomiting, tinnitus

Nursing Interventions: Monitor urinary pH for toxicity. Assess for ecchymosis (bruising). Evaluate for therapeutic response.

Teaching Points: Don’t chew/crush/dissolve/divide enteric-coated tabs. Avoid alcohol. Report tinnitus or GI pain/bleeding.

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3
Q

Captopril (Black Box Alert)

A

Trade Name: Capoten

Classification: ACE-Inhibitor; antiHTN, vasodilator

Common Use: HTN, HF, DM neuropathy

Common Side/Adverse Effects: Rash, taste disturbances, HoTN, dry cough, angioedema

Black Box Warning: May cause injury/death to developing fetus

Nursing Interventions: Assess skin for rash, assist w/ ambulation, discontinue if angioedema occurs

Teaching Points: Change positions slowly, take same time each day, no double dosing if one is missed

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4
Q

Digoxin

A

Trade Names: Digitek, Digox, Lanoxin

Classification: Cardiac gycoside; antiarrhthmic, cardiotonic

Common Use: mild/moderate HF, increase C/O, decrease HR

Common Side/Adverse Effects: dizziness, headache, visual disturbances

Nursing Interventions: Monitor pulse and EKG for bradycardia and dysrhythmias. Monitor toxicity signs (GI disturbances, neuro abnormalities).

Teaching Points: Take pulse, contact HCP if pulse is <60 or >100. Don’t double does if missed one. Inform dentist or other physician of taking digoxin.

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5
Q

Digibind

A

Generic Name: Digoxin immune fab

Classification: antidote; antibody fragments

Common Use: Antidote for digoxin toxicity

Possible Side/Adverse Effects: fever, hyper/hypo -kalemia, SOB, swelling

Nursing Interventions

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6
Q

Diltiazem

A

Trade Names: Cardizem, “ CD, “ LA, Cartia XT, Taztia XT, Tiazac

Classification: Ca+ Channel Blocker; antianginal, antiHTN, antiarrhythmic

Common Use: HTN, angina

Common Side/Adverse Effects: peripheral edema, arrhythmias, HF

Nursing Interventions: Assist w/ ambulation, assess for peripheral edema, monitor pulse rate for bradycardia

Teaching points: Change positions slowly. Avoid tasks that require alertness. How to monitor pulse and contact HCP if pulse rate is <50.

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7
Q

Verapamil

A

Trade Names: Calan, “ SR, “ Isoptin SR, Verelan, “ PM

Classification: Ca+ Channel Blaocker; antiHTN, antianginal, antiarrhythmic

Common Use: HTN, angina, dysrhythmia

Common Side/Adverse Effects: constipation, dizziness, lightheadedness

Nursing Interventions: Monitor BP and EKG. Assess pulse quality/rate/rhythm. Assess for peripheral edema.

Teaching points: Change positions slowly. Report persistent angina. Don’t abruptly discontinue med.

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8
Q

Enalapril

BLACK BOX ALERT

A

Trade Names: Epaned, Vasotec

Classification: ACE-inhibitor; AntiHTN, vasodilator

Common Use: HTN, CHF, LV dysfunction

Common Side/Adverse Effects: Dry cough, angioedema, ortho/hypo, headache
Black Box Warning: Fetal injury

Nursing Interventions: Assist w/ ambulation. Monitor CBC, BUN, K+, creatinine, and BP. Monitor bowl activity/consistency.

Teaching points: Change positions slowly. skipping or discontinuing drug may result in rebound HTN. Report swelling in face/lips/tongue (angioedema).

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9
Q

Furosemide

BLACK BOX ALERT

A

Trade Names: Lasix

Classification: Loop diuretic; diuretic

Common Use: Edema fr HF, HTN

Common Side/Adverse Effects: Dehydration. Hypo -Ca+, -K+, -Na+, Mg, -volemia, -Cl. Nausea. Abd cramps.
Black Box Warning: Large amounts can lead to huge increase of diuresis and electrolyte depletion.

Nursing Interventions: Monitor BP/vitals/I&O/weight/electrolytes. Watch for hypokalemia. Monitor signs of hearing loss.

Teaching points: Take in the morning to avoid nocturia. Report any hearing loss. Eat food high in K+.

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10
Q

Hydrochlorothiazide

A

Trade Names: Microzide

Classification: Sulfonamide derivative; thiazide diuretic, antiHTN

Common Use: HTN, edema, diabetes insipidus

Common Side/Adverse Effects: S/s of ortho/HoTN. Dehydration. Hypo -kalemia, -natremia, -chloremia.

Nursing Interventions: Monitor weight and vitals. Monitor I&O and K+ levels. Monitor s/s of hearing loss.

Teaching points: Take in the morning or early in the day to avoid nocturia. Report any signs of gout. Change positions slowly.

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11
Q

Lidocaine

A

Trade Names: Lidoderm, Xylocaine

Classification: Amide anesthetic; Class 1B Anti-dysrhythmic, anesthetic.

Common Use: Ventricular dysrhythmias

Common Side/Adverse Effects: HoTN, edema, skin irritation

Nursing Interventions: Monitor EKG nd VS during and after administration for dysrhythmias. Drowsiness indicates high serum lvls of lidocaine. Monitor LOC.

Teaching points: Report dizziness, numbness, double-vision, nausea, difficulty breathing

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12
Q

Lisinopril

BLACK BOX ALERT

A

Trade Names: Zestril, Prinivil, Qbrelis

Classification: ACE-inhibitor; antiHTN

Common Use: HTN, HF, MI

Common Side/Adverse Effects: Headache, dizziness, HoTN, dry cough, angioedema
Black Box Warning: May cause fetal injury/mortality.

Nursing Interventions: Assess for edema. Auscultate lungs for rales. Assist w/ ambulation.

Teaching points: Change positions slowly. Report persistent cough, vomiting, swelling in face/lips/tongue (angioedema), diff. breathing. Limit alcohol intake.

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13
Q

Morphine

BLACK BOX ALERT

A

Trade Names: Duramorph, Embeda, Infumorph, Kadian

Classification: Opioid agonist; opioid analgesic

Common Use: Severe pain, decreases anxiety

Common Side/Adverse Effects: Confusion, sedation, HoTN, constipation, resp depression
Black Box Warning: Addiction, abuse, misuse

Nursing Interventions: Take vitals before and after administration. Watch for decreased resp and BP. Monitor bowel activity/consistency.

Teaching points: Change positions slowly, call for assistance when ambulating. Avoid tasks that require alertness. Avoid alcohol and other CNS depressants. Report constipation, urinary retention, and ineffective pain treatment.

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14
Q

Metoprolol

BLACK BOX ALERT

A

Trade Names: Lopressor, Toprol XL

Classification: Beta blocker; antianginal, antiHTN

Common Use: HTN, angina, HF, MI treatment

Common Side/Adverse Effects: Fatigue, weakness, bradycardia, pulmonary edema
Black Box Warning: Abrupt w/drawal may result in life-threatening arrhythmias, HTN, myocardial ischemia.

Nursing Interventions: Monitor vitals for HoTN, SOB. Assess for s/s of HF. Monitor I&O.

Teaching points: Take BP and pulse before taking med. Change positions slowly. Avoid tasks that require alertness.

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15
Q

Methyldopa

A

Trade Names: Aldomet

Classification: Centrally acting antiadrenergics; antiHTN

Common Use: HTN

Common Side/Adverse Effects: Headache, muscle weakness, swelling in ankles or feet

Nursing Interventions: Monitor BP

Teaching points: Change positions slowly. Abrupt w/drawal can result in rebound HTN. Do not take with iron supplements – iron blocks absorption.

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16
Q

Metolazone

A

Trade Names: Zaroxolyn

Classification: Thiazide diuretic; diuretic, antiHTN

Common use: HTN, edema fr HF

Common Side/Adverse Effects: Dizziness, hypokalemia, headache, HoTN

Nursing Interventions: Fall-prevention. Monitor for electrolyte depletion – s/s of hypokalemia and hyponatremia. Monitor I&O and weight.

Teaching points: Change positions slowly. Eat foods high in K+. Caution when exercising – sweating can exaggerate diuretic side effects and cause even more fluid/electrolyte loss.

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17
Q

Nitroglycerine

A

Trade Names: Nitrostat, Rectiv, Nitro-Bid, Nitro-Dur

Classification: Nitrate; Antianginal, antiHTN, coronary vasodilator

Common Use: acute anginal pain

Common Side/Adverse Effects: orthohypo, headache, reflex tachycardia

Nursing Interventions: Check BP before and after administrating. Rotate transdermal patches, on for 12-14hr off for 10-12hr. Assess location, quality, and duration of anginal pain.

Teaching points: Take at first sign of angina, can take another dose if not relieved after 5min. If not relieved after 3 doses w/in 15 min, immediately call HCP or go to ER. Keep containers away from heat. Change positions slowly.

18
Q

Potassium Chloride

A

Trade Names: Klor-Con, Klor-Con M10, Klor-Con M15, Klor-Con M20, K-Tab

Classification: Electrolyte; potassium replenisher

Common Use: Prevents/corrects K+ deficiency

Common Side/Adverse Effects: GI discomfort (nausea, vomiting, diarrhea), hyperkalemia, dysrhythmias

Nursing Interventions: Monitor K+ levels. IV potassium must ALWAYS be diluted before administrating. Be alert to s/s of hyperkalemia.

Teaching points: Report any paresthesia, weakness, tarry/bloody stools.

19
Q

Procainamide

A

Trade Names: Pronestyl

Classification: Membrane stabilizer; antiarrythmic (IA)

Common Use: dysrhythmias

Common Side/Adverse Effects: Diarrhea, dizziness, nausea, vomiting, seizures

Nursing Interventions: Take BP and apical pulse before administration. Monitor BP. HoTN = toxicity.

Teaching points: Do not cut/crush/chew long-acting tablets.

20
Q

Spironolactone

BLACK BOX ALERT

A

Trade Names: Aldactone, Carospir

Classification: diuretics, K+ sparing diuretic

Common Use: HTN, edema

Common Side/Adverse Effects: Hyperkalemia, dehydration, hyponatremia, nausea, vomiting
Black Box Warning: Shown to produce tumors in chronic toxicity studies.

Nursing Interventions: Monitor serum electrolyte values. Monitor I&O and weight. Monitor for s/s of hyponatemia or hyperkalemia.

Teaching points: Limit potassium-rich foods. Report any leg cramps, weakness, fatigue or nausea. Report irregular or slow pulse.

21
Q

Triamterene

A

Trade Names: Dyrenium

Classification: Potassium-sparing diuretic

Common Use: Edema, HTN

Common Side/Adverse Effects: Nausea, diarrhea, dry mouth, dizziness

Nursing Interventions: Monitor serum electrolyte values. Monitor I&O and weight. Monitor for s/s of hyponatemia or hyperkalemia.

Teaching points: Limit potassium-rich foods. Don’t use salt alternatives. Report irregular heartbeats, weakness, or loss of movement immediately.

22
Q

Magnesium (sulfate?)

A

Trade Names: Epsom salt, magnesium sulfate injection

Classification: Minerals electrolyte; antacid, anticonvulsant, electrolyte, laxative

Common Use: Dysrhythmias (VF, VT, or torsades de point) from hypomagnesemia

Common Side/Adverse Effects: decreased HR and RR, cardiac arrest, respiratory paralysis

Nursing Interventions: Monitor EKG. RR should be >=16/min and patellar reflex must be present before each parental dose to prevent resp arrest. Seizure precautions.

Teaching points: Report signs of hypermagnesmia: dizziness, palpitations, fatigue, weakness, altered mental status

23
Q

Heparin

A

Trade Names: Hep-lock

Classification: Antithrombotics; anticoagulants

Common Use: Prevent DVT, pulmonary emboli, and emboli fr Afib. STEMI, NSTEMI, unstable angina.

Common Side/Adverse Effects: Bruising or bleeding easily, burning or itching on feet, major hemorrhage

Nursing Interventions: Bleeding precautions. Monitor PPT and aPTT (should be 1.5-2.5 times normal). Monitor/assess urine and stool for occult blood or hematuria. IV 30 min w/in admission.

Teaching points: Use electric razor and a soft toothbrush to prevent bleeding. Blow nose gently. Inform dentist and other physicians of heparin therapy.

24
Q

Warfarin

BLACK BOX ALERT

A

Trade Names: Coumadin, Jantoven

Classification: Coumarins; Anticoagulants

Common Use: Prophylaxis of venous thrombosis, pulmonary embolism, and Afib w/ embolization. Reduce risk of embolism after MI.

Common Side/Adverse Effects: Cramps, nausea, major bleeding
Black Box Warning: May cause major or fatal bleeding. Risk factors: history of GI bleeding, HTN, cerebrovascular disease, heart disease, malignancy, trauma, INR >4.

Nursing Interventions: Monitor INR closely. Assess for signs of bleeding or hemorrhage (hematuria, bruises, bleeding gums, black tarry stools, fall in BP). Vitamin K is an antidote.

Teaching points: Use electric razor and a soft toothbrush to prevent bleeding. Advise all HCP they are taking warfarin. Report symptoms of unusual bleeding or bruising. Frequent lab tests are needed to monitor coagulation factors.

25
Q

Clopidogrel

BLACK BOX WARNING

A

Trade Names: Plavix

Classification: Platelet aggregation inhibitors; Anti-platelet

Common Use: Decrease vascular clotting, MI, stroke, PAD

Common Side/Adverse Effects: Abd pain, diarrhea, bleeding, skin disorders
Black Box Warning: Diminished effectiveness in CYP2C19 metabolizers increases risk for cardiovascular events.

Nursing Interventions: Monitor platelet count for thrombocytopenia. Administer w/ food to reduce GI upset. Assess for s/s of hepatic insufficiency.

Teaching points: Report any unusual bleeding. Medication may be held 5 days prior to surgery. Inform all HCP of taking medication.

26
Q

Propranolol

BLACK BOX ALERT

A

Trade Names: Inderal LA, Hemangeol, InnoPran XL

Classification: Beta-blocker; AntiHTN, antianginal, antiarrhythmic, antimigraine

Common Use: HTN, angina, Afib

Common Side/Adverse Effects: Drowsiness, fatigue, weakness, bradycardia, HoTN
Black Box Warning: Severe angina exacerbation, MI, ventricular dysrhythmias may occur in angina pts after abrupt discontinuation

Nursing Interventions: Monitor EKG for dysrhythmias. Assess pulse for bradycardia. Assess signs of HF.

Teaching points: Don’t abruptly discontinue medication. Change positions slowly. Report if pulse is <50 bpm. Avoid tasks that require alertness.

27
Q

Hydralazine

A

Trade Names: none

Classification: Vasodilator; AntiHTN

Common Use: HTN

Common Side/Adverse Effects: tachycardia, drug-induced lupus, headache, angina, edema

Nursing Interventions: Monitor BP and pulse. Assess for
peripheral edema in hands and feet.

Teaching points: Change positions slowly. Weigh twice a week and assess feet and ankles for fluid retention. Report muscle/joint aches, fever, lupus-like reaction.

28
Q

Nifedipine

A

Trade Names: Adalat CC, Afeditab CR, Procardia, Procardia XL

Classification: Calcium channel blocker; Antianginal, antiHTN

Common Use: Prinzmetal’s variant angina, chronic stable angina, HTN

Common Side/Adverse Effects: Peripheral edema, headache, dizziness, flushed skin

Nursing Interventions: Assess for peripheral edema. Monitor BP for HoTN. Assist w/ ambulation if dizziness occurs.

Teaching points: Change positions slowly. Report palpitations, SOB, nausea and increased angina. Avoid grapefruit juice.

29
Q

Amlodipine

A

Trade Names: Norvasc, Katerzia

Classification: Calcium channel blocker; antiHTN

Common Use: HTN, CAD

Common Side/Adverse Effects: Peripheral edema, headache, flushing

Nursing Interventions: Assess BP (w/hold if systolic is <90mm Hg). Assess for peripheral edema. Assess skin for flushing.

Teaching points: Don’t abruptly disc. taking med. Avoid tasks that require alertness. Avoid eating grapefruit products.

30
Q

Bumetanide

BLACK BOX ALERT

A

Trade Names:

Classification: Loop diuretic; diuretic

Common Use: Edema associated with HF, renal or hepatic disease

Common Side/Adverse Effects: Muscle cramps, HoTN, hypokalemia, hyponatremia
Black Box Warning: Excess dosage can lead to increased diuresis w/ fluid and electrolyte loss.

Nursing Interventions: Monitor vitals, electrolytes, I&O, weight. Watch for s/s of hypokalemia (muscle weakness, tremor, cramps, cold/clammy skin). Digoxin toxicity

Teaching points: Report hearing abnormalities (tinnitus fullness in ears). Eat foods high in K+. Change positions slowly.

31
Q

Clonidine

BLACK BOX ALERT

A

Trade Names: Catapres, Catapres-TTS, Duraclon, Kapvay

Classification: adrenergics; antiHTN

Common Use: HTN, ADHD, severe pain

Common Side/Adverse Effects: Dry mouth, dizziness, sedation, HoTN
Black Box Warning: Not to be used for perioperative, obstetric, or postpartum pain.

Nursing Interventions: Monitor BP, pulse, mental status. Slowly reduce med dosage over 2-4 days if it is to be discontinued.

Teaching points: Sugarless gum, sips of water may relieve dry mouth. Change positions slowly. Skipping or discontinuing doses may result in severe rebound HTN.

32
Q

Lostartan

BLACK BOX ALERT

A

Trade Names: Cozaar

Classification: Angiotensin II receptor antagonists; antiHTN

Common Use: HTN

Common Side/Adverse Effects: Upper respiratory tract infection, dizziness, HoTN
Black Box Warning: May cause fetal unjury/mortality. Discont. asap once pregnancy is detected.

Nursing Interventions: Maintain hydration, Assess for signs of upper rep infection or cough. Monitor BP, pulse.

Teaching points: Avoid tasks that require alertness. Female pts of childbearing age take measures to avoid pregnancy. Report any signs of infection or CP.

33
Q

Aliskiren

BLACK BOX ALERT

A

Trade Names: Tekturna

Classification: Renin inhibitor; antiHTN

Common Use: HTN

Common Side/Adverse Effects: Angioedema, periorbital edema, general edema
Black Box Warning: May cause fetal injury/mortality. Discont asap once pregnancy detected.

Nursing Interventions: Assess for edema. Monitor I&O, weigh daily. Monitor BP, K+, renal function

Teaching points: Report signs of angioedema. Pregnant pts should avoid exposure to med on second and third trimester.

34
Q

Enoxaparin

BLACK BOX ALERT

A

Trade Names: Lovenox

Classification: antithrombotics, low molecular weight heparins; anticoagulant

Common Use: Prevention of DVT, pulmonary embolism, ischemia complications fr unstable angina, MI, STEMI

Common Side/Adverse Effects: Immune-mediated thrombocytopenia, bleeding episodes

Nursing Interventions: Antidote is protamine sulfate. Monitor CBC esp platelet count. Monitor for bleeding.

Teaching points: Don’t take OTC meds esp aspirin w/o consulting HCP. Report unusual bleeding or bruising.

35
Q

Alteplase

High Alert

A

Trade Names: Activase, Cathflo Activase, tissue plasminogen activator, t-PA

Classification: plasminogen activators; thrombolytics

Common Use: Acute ischemic stroke, pulmonary embolism, acute MI, occluded catheters

Common Side/Adverse Effects: Decreased BP, bleeding

Nursing Interventions: Continuous cardiac monitoring for dysrhythmias. Check BP, pulse, resp every 15 min until stable.

Teaching points: Avoid activities that may increase risk of bleeding or injury.

36
Q

Atorvastatin

A

Trade Names: Lipitor

Classification: Hydroxymethylglutaryl CoA reductase inhibitor; lipid-lowering agents

Common Use: High cholesterol, reduce risk of angina, stroke, MI

Common Side/Adverse Effects: Headache, myalgia, cataracts, rash, photosensitivity

Nursing Interventions: Monitor for headache. Assess for rash. Monitor cholesterol and triglyceride.

Teaching points: Follow special diet, Do not crush/chew/dissolve/cut tablets. Report dark urine, muscle fatigue, bone pain.

37
Q

Niacin

A

Trade Names: Niaspan, vitamin B3

Classification: Antihyperlipidemic, water-soluble vitamin

Common Use: Dyslipidemia, recurrent MI, CADm hypertriglyceridemia

Common Side/Adverse Effects: Face and neck flushing, GI upset, pruritus

Nursing Interventions: Ceck for headache, dizziness, blurred vision. Monitor bowel activity, stool consistency. Evaluate degree of GI upset.

Teaching points: Report dizziness. Report nausea, vomiting, loss of appetite, yellowing skin, dark urine.

38
Q

Amiodarone

BLACK BOX ALERT

A

Trade Names: Nexterone, Pacerone

Classification: Cardiac agent; Antiarrhythmics

Common Use: VF, unstable VT

Common Side/Adverse Effects: visual impairment, cardiotoxicity, pulmonary toxicity, photosensitivity
Black Box Warning: Pts should be hospitalized when med is initiated. Alternative therapies should be tried first before using amiodarone.

Nursing Interventions: Only indicated for pts w. life-threatening dysrhythmias. Monitor signs of pulmonary toxicity (worsening cough). Assess pulse for quality rhythm, bradycardia.

Teaching points: Report SOB or cough. Protect against photosensitivity reaction on skin exposed to sunlight.

39
Q

Adenosine

A

Trade Names: Adenocard

Classification: Cardiac agent; antidysrhythmic

Common Use: Dysrhythmias, PSVT (paroxysmal supraventricular tachycardia). Restarts for 6 sec.

Common Side/Adverse Effects: facial flushing, dyspnea, transient short-lasting heart block,

Nursing Interventions: Monitor BP, apical pulse, RR. Auscultate breath sounds for clarity. Monitor I&O.

Teaching points: Report continued cp, lightheadedness, difficulty breathing, head/neck pain. May induce feelings of impending doom, but resolves quickly.

40
Q

Fish Oil

A

Trade Names:

Classification: supplement

Common Use: HTN, hyperlipidemia, hypertriglyceridemia

Common Side/Adverse Effects: can increase chance of bleeding, heartburn, loose stools, nosebleeds

Nursing Interventions: May have additive effect w/ antiHTN meds

Teaching points:

41
Q

Sildenafil

A

Trade Names: Viagra, Revatio

Classification: erectile dysfunction agents, vasodilators

Common Use: Pulmonary arterial HTN (PAH), erectile dysfunction

Common Side/Adverse Effects: headache, heartburn, muscle aches, sensitivity to light, flushing

Nursing Interventions: Monitor cardiovascular status. Monitor diet (high fat meals can slow absorption)

Teaching points: Never take drug with nitrates. Report painful urination, dizziness, rash, loss of vision.

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