Cardiovascular Pharmacology Flashcards
What are 2 ways anti-coagulant drugs work?
- blood thinners – prevention of clot formation
- thrombolytic – clot busters
What are 2 blood thinner medications? Differentiate between the 2.
- warfarin – long-term
- -parin – short-term
What is 1 type of thrombolytic medication?
-teplase
warfarin
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* nursing pro tips
7 nursing pro tips
- purpose: long-term prevention of clot formation
- classification: anti-coagulant
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nursing pro tips:
1. give with heparin to bridge gap between short-term to long-term
2. DO NOT give with NSAIDs or aspirin – will make pts bleed
3. vitamin K (green leafy veggies) block warfarin – vitamin K is a clotting factor and an antidote for warfarin
4. DO NOT taken with green tea – it is a mild anti-coagulant
5. adverse effect = cola colored urine –> indicates blood in urine
6. monitor PT (extrinsic) labs – normal is 11 - 13.5 seconds – therapeutic is 1.5 - 2x (20 seconds is good)
7. monitor INR labs – normal is less than 1.5 – therapeutic is 2.0 - 3.0
-parin
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6 nursing pro tips
- purpose: short-term prevention of clot formation
- classification: anti-coagulant
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nursing pro tips:
1. antidote for heparin = protamine
2. use for PE = IV drip
3. use for children = weight-based
4. monitor aPTT (intrinsic) labs – normal is 25 - 35 seconds – therapeutic is 1.5 - 2.5x
5. enoxaparin is only given subq
6. enoxaparin does not need to monitor aPTT
-teplase
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2 nursing pro tips
- purpose: dissolves newly formed clots
- classification: thrombolytic
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nursing pro tips:
1. want to see a reduction of ST-segment elevation to know drug is working
2. adverse effects = hematemesis and confusion (confusion may be an indicator of intracranial bleeding)
What are the 3 ways that cardiovascular drugs can regulate BP?
- rate
- pipes
- pump
What are the types of drugs that fall under rate regulation?
- beta blockers
- digoxin
- calcium channel blockers
What are the types of drugs that fall under pipe regulation?
- ACE inhibitors
- angiotensin II blockers
- nitroglycerin
- calcium channel blockers
What are the types of drugs that fall under pump regulation?
- diuretics
- digoxin
- calcium channel blockers
digoxin
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4 nursing pro tips
- purpose: treatment of HF and afib; strengthens heart beat, slows HR
- classification: digitalis glycoside
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nursing pro tips:
1. BEFORE giving digoxin, assess apical pulse for 1 full minute; check for N/V and anorexia
2. adverse effects = digoxin toxicity (N/V, abdominal cramps, halo visions, hypokalemia)
3. furosemide interaction –> halos/bright lights
4. combat hypokalemia with potassium-rich foods like tomato juice
nitroglycerin
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4 nursing pro tips
- purpose: treatment of chronic stable angina, acute MI, and HF
- classification: vasodilator; anti-anginal
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nursing pro tips:
1. adverse effects = orthostatic hypotension and h/a
2. should decrease BP – monitor BP
3. replace patches in the AM
4. take tablets ASAP if experiencing chest pain
Name 2 types of loop diuretics.
- -semide
- -tanide
Name 2 types of potassium-sparing diuretics.
- spironolactone
- amiloride
Name 3 types of thiazide diuretics (promotes sodium excretion in addition to water).
- metolazone
- hydrochlorothiazide
- chlorthiazide
-semide & -tanide
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3 nursing pro tips
- purpose: treatment of HF, PE, and peripheral edema
- classification: loop diuretic – promotes excretion of K+ and Na+
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nursing pro tips:
1. monitor I&Os
2. monitor K+ labs for hypokalemia
3. adverse effects = hypokalemia (decreased appetite, anorexia, N/V, decreased GI motility, muscle cramps) – eat foods high in K+
spironolactone & amiloride
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4 nursing pro tips
- purpose: treatment of HTN and edema
- classification: potassium-sparing diuretic (promotes sodium and chloride excretion and retension of potassium)
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nursing pro tips:
1. monitor K+ labs for hyperkalemia
2. monitor Na+ labs for hyponatremia
3. restrict K+ in diet
4. side effects = general weakness, fatigue
-lol
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6 nursing pro tips
- purpose: treatment of HTN, stable angina, and HF
- classification: beta blocker; slows HR (decreases workload on heart)
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nursing pro tips:
1. adverse reactions = bronchospasms, BP drops, and slow, irregular HR
2. BP drops can cause dizziness
3. DO NOT take beta blockers if pt has asthma or COPD due to bronchospasms
4. monitor HR and pulse
5. MI possible if medication is stopped suddenly
6. side effect = decreased sex drive
-pril
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4 nursing pro tips
- purpose: treatment of HTN and HF
- classification: ACE inhibitor (prevents pipe narrowing)
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nursing pro tips:
1. NSAIDs interaction – increases risk of acute renal failure and decreases effectiveness of ACE drug
2. DO NOT take while pregnant
3. monitor K+ labs for hyperkalemia
4. side effects = dry cough – may indicate renal problem, may need to switch HTN med
-sartan
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1 nursing pro tip
- purpose: treatment of HTN
- classification: angiotensin receptor blocker (prevents pipe narrowing)
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nursing pro tips:
1. adverse effects = renal failure and rash
What effect do calcium channel blockers have on the cardiovascular system?
increase contractility (muscles and vessels)
-pamil, -dipine & -tiazem
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4 nursing pro tips
- purpose: treatment of HTN, angina, and dysrhythmias
- classification: calcium channel blockers (vasodilation, heart muscle relaxation); effect on rate, pipes, and pump
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nursing pro tips:
1. BEFORE administering, assess BP and apical pulse
2. interaction with grapefruit juice & mag sulfate – causes drug not to be broken down and stay in system –> potentiation of drug/drug overload
3. adverse effects = rash, dizziness
4. side effect = facial flushing
What are the ABCD’s of cardiac meds?
- ACE -pril, angie -sartan, anti-coagulants
- beta -lol
- calcium channel blockers (very nice drugs – verapamil, nifedipine, diltiazem)
- diuretics (loop, potassium-sparing, and thiazides), digoxin
-statins
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3 nursing pro tips
- purpose: reduction of cholesterol
- classification: antilipemic agent
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nursing pro tips:
1. adverse effect = rhabdomyolysis (muscle weakness or pain)
2. monitor liver and kidney labs
3. adhere to low cholesterol diet
