Chapter 6: Cardiovascular & Renal System Drugs

Question 1

Quinidine

Answer 1

sodium channel blocker; decreases sodium influx

used for life-threatening ventricular dysrhythmias

sensitivity to light, arrythmia, thrombocytopenia

take medication even if asymptomatic

Question 2

Sotalol

Answer 2

beta blocker; slowdowns the heart

used for life-threatening arrythmias, not recommended for less than severe arrythmias

heart failure, palpitations, thyroid abnormalities, hypotension, hypoglycemia, orthostatic hypotension

black box warning; increase QT interval

not recommended for diabetics because it masks tachycardia

Question 3

Amiodarone

Answer 3

potassium channel blocker; prolong repolarization by blocking potassium channels

emergency treatment of ventricular dysrhythmias

neurological impairments, vision change, photosensitivity

black box warning; pulmonary toxicity, exacerbation of arrythmia, liver injury, heart block

avoid grapefruit juice

Question 4

Diltiazem

Answer 4

calcium channel blocker; relaxes the heart by inhibiting calcium to decrease heart workload

treat angina, hypertension, supraventricular tachycardia

heart failure, worsening of symptoms bradycardia, hypotension, hepatic injury

avoid grapefruit juice, gingival sensitivity, photosensitivity

Question 5

Adenosine

Answer 5

10 second half life

heart stops then starts up in normal sinus rhythm

given all at once

should not be given to people with 2nd or 3rd degree AV block, sinus node disease, or hypersensitivity

may see no electrical activity on an ECG for a couple of seconds before normal sinus rhythm

extremely uncomfortable feeling

Question 6

Digoxin

Answer 6

cardiac glycoside; inhibit sodium and potassium pump

serum digoxin and potassium should be monitored

yellow or green halo visual effects may happen (signifies toxicity)

narrow therapeutic index

digibind treat toxicity

Question 7

Nitrates

Answer 7

antianginal; promotes dilation of coronary arteries and veins

immedient relief, used to treat angina

sublingual should be taken sitting down since causes hypotension

palpitations, headache

if no burning sensation, then it is probably not going to work

call 911 after first dose if not improved or worse

Question 8

Furosemide

Answer 8

loop diuretic; in loop of Henle, inhibits sodium and chloride absorption

potassium wasting; hypokalemia

treat edema

must be given slowly through IV to prevent ototoxicity

Question 9

Hydrochlorothiazide

Answer 9

thiazide diuretic; distal tubule to promote sodium and water excretion

treat hypertension and edema

monitored for renal impairment and electrolyte depletion

Question 10

Spironolactone

Answer 10

potassium sparring; sodium and water excreted but potassium is retained

hypertension and edema w/ heart failure or liver dysfunction

hyperkalemia, hyperglycemia, renal impairment, may increase risk of lithium toxicity

avoid salt substitutes and high potassium

Question 11

Mannitol

Answer 11

osmotic diuretic; inhibits the reabsorption of water and electrolytes, promoting excretion

treats renal failure, cerebral edema, and intracellular pressure

promotes excretion of toxic substances

kidney dysfunction

maintain adequate hydration

Question 12

Clonidine

Answer 12

antihypertensive and alpha-2 agonist; causes vasodilation and decreased blood pressure

treat hypertension and ADHD

do not abruptly stop, could cause rebound hypertension

avoid alcohol and CNS depressants

Question 13

Metoprolol

Answer 13

antihypertensive and beta-1 antagonist; decreases heart rate and decreases blood pressure

too much can block beta-2 receptors causing bronchoconstriction

do not give to asthmatics

treat high blood pressure and chest pain from poor blood flow

black box: taper dosage when discontinuing, abrupt stop may cause chest pain or MI

take med at the same time each day

extended release should not be crushed

masks symptoms of hypoglycemia

Question 14

Captopril

Answer 14

ace inhibitor; blocks conversion of angiotensin 1 to angiotensin 2

treat hypertension and heart failure

Hypokalemia and angioedema

Black box: pregnant should discontinue due to fetal harm or death

“ace cough” (persistent cough), skewered sense of taste

Question 15

Losartan

Answer 15

angiotensin 2 blocker; produces vasodilation

treat hypertension snd prevent neuropathy in diabetics

increased facial swelling or difficulty swallowing/breathing should seek emergency attention

black box: pregnant should discontinue due to fetal harm

Question 16

Hydralazine

Answer 16

vasodilator; action unknown, causes vasodilation lowered blood pressure, decreased vascular resistance, increased cardiac output

treat hypertension

systemic lupus erythematosus

consult if doses are missed. Assess fluid retention in feet and ankles

Question 17

Atorvastatin

Answer 17

antilipemic and HMG-CoA reductase inhibitor; reduce hyperlipidemia that leads to stroke, MI, angina and heart failure

assess liver function, kidney failure, rhabdomyolysis (skeletal muscle breakdown), tea colored urine, and irregular heartbeat

avoid grapefruit juice, muscle pain or weakness should be reported

Question 18

Ezetimibe

Answer 18

cholesterol absorption inhibitor; blocks absorption of cholesterol to reduce LDL (bad cholesterol)

treat hyperlipidemia and hypercholesterol

arthralgia, rhabdomyolysis, hepatic and impairment

avoid grapefruit juice

Question 19

Cholestyramine

Answer 19

bile acid sequestrants; binds to bile acid, prevents reabsorption and promoting their excretion in feces

used to reduce amount of bile salts, leading to decreased cholesterol

constipation and gas

increase fluid and fiber

Question 20

Niacin

Answer 20

inhibits synthesis of triglycerides and LDL cholesterol

reduce bad cholesterol (LDL) and increase good cholesterol (HDL)

flush features

avoid hot beverages and alcohol, liver toxicity may occur, so liver tests, diabetics should monitor glucose, take with meals to minimize adverse effects

Question 21

Heparin

Answer 21

anticoagulant; prevents future clots from forming but not current clots

PTT tells how long clot takes to form

High risk of bleeding

avoid medications containing aspirin or NSAIDS

Question 22

Enoxaparin

Answer 22

low molecular weight heparin; higher anti-factor XA to anti-factor 2a activity than heparin

prevention and treatment of deep vein thrombosis, used w/ aspirin for MI

bleeding and hemorrhage, heparin induced thrombocytopenia (w/ thrombosis)

black box: epidural or spinal hematomas may occur, could lad to long-term or permanent paralysis

notify healthcare professional immediately of bleeding or bruising

avoid aspirin or NSAIDS

Question 23

Warfarin

Answer 23

inhibits vitamin k-dependent clotting factors and anticoagulant proteins C and S

treats prophylaxis, venous thrombosis, pulmonary embolism

vitamin k is the reversal agent

contraindicated hemorragic tendencies or blood dyscrasias, CNS or eye surgery

Question 24

Sildenafil

Answer 24

sildenafil and erectile agent; inhibits phosphodiesterase in pulmonary smooth muscle and corpus cavernosum, allowing relaxation

treats pulmonary hypertension and erectile dysfunction

hypotension visual and hearing loss, priapism, vasoocclusive crisis

do not use w/ nitroglycerin