Cardiovascular Pharmacology Flashcards

Question

Clopidogrel | BLACK BOX WARNING

Answer 1

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.

Answer 2

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.

Answer 3

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.

Answer 4

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.

Answer 5

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.

Answer 6

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.

Answer 7

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.

Answer 8

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.

Answer 9

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.

Answer 10

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.

Answer 11

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.

Answer 12

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.

Answer 13

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.

Answer 14

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.

Answer 15

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.

Answer 16

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:

Answer 17

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.