Chapter 6: Cardiovascular & Renal System Drugs Flashcards
Quinidine
sodium channel blocker; decreases sodium influx
used for life-threatening ventricular dysrhythmias
sensitivity to light, arrythmia, thrombocytopenia
take medication even if asymptomatic
Sotalol
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
Amiodarone
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
Diltiazem
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
Adenosine
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
Digoxin
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
Nitrates
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
Furosemide
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
Hydrochlorothiazide
thiazide diuretic; distal tubule to promote sodium and water excretion
treat hypertension and edema
monitored for renal impairment and electrolyte depletion
Spironolactone
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
Mannitol
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
Clonidine
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
Metoprolol
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
Captopril
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
Losartan
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
Hydralazine
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
Atorvastatin
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
Ezetimibe
cholesterol absorption inhibitor; blocks absorption of cholesterol to reduce LDL (bad cholesterol)
treat hyperlipidemia and hypercholesterol
arthralgia, rhabdomyolysis, hepatic and impairment
avoid grapefruit juice
Cholestyramine
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
Niacin
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
Heparin
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
Enoxaparin
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
Warfarin
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
Sildenafil
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
