Common Medications Flashcards
Hydralazine
Class: Antihypertensive, Vasodilator
MOA: Causes vasodilation to decrease systemic vascular resistance. Inhibits the release of calcium from the sarcoplasmic reticulum and inhibits myosin production in arterial smooth muscle cells
Indication: Management of moderate to severe hypertension, heart failure with reduced ejection fraction
Expected Action: Increases heart rate, stroke volume, cardiac output, and left ventricular ejection fraction
Adverse Reactions: Acute myocardial infarction, angina pectoris, edema, flushing, hypotension, palpitations, tachycardia, dizziness, headache, dyspnea, nausea, vomiting, diarrhea
Nursing Considerations: Monitor blood pressure for hypotension, heart rate for tachycardia, fluid retention, and CBC
Milrinone
Class: + Inotrope, Vasodilator, Phosphodiesterase-3 Enzyme Inhibitor
MOA: Selective phosphodiesterase inhibitor in cardiac and vascular tissue. Causes vasodilation and inotropic effects with little affect to the heart rate
Indication: Acute decompensated heart failure with reduced ejection fraction
Expected Action: Improves cardiac contractility and relaxation. Induces vasodilation, increases cardiac output, and improves left ventricle-arterial coupling which enhances cardiac mechanical efficiency
Adverse Reactions: Ventricular arrhythmias, Angina pectoris, chest pain, hypotension, supraventricular arrhythmia, headache, hypokalemia, thrombocytopenia, tremors
Nursing Considerations: Monitor blood pressure, heart rate, hemodynamic parameters, kidney function, urine output, electrolytes, and platelet count
Amiodarone
Class: Anti-arrhythmic
MOA: Inhibits adrenergic stimulation, affects sodium, potassium, and calcium channels; decreases AV conduction and sinus node function
Indication: Management of recurrent ventricular fibrillation or unstable ventricular tachycardia for patients who are intolerant of other agents used for these conditions
Expected Action: Prevents and treats a fast or irregular heartbeat by slowing down overactive electric signals in the heart which stabilizes the heart’s rhythm
Adverse Reactions: Hypotension, bradycardia, cardiac arrhythmias, edema, flushing, shock, hepatotoxicity, pulmonary toxicity, hyperthyroidism or hypothyroidism, nausea, vomiting
Nursing Considerations: Monitor blood pressure, heart rate, signs of lethargy, peripheral edema, weight loss, LFTs, and electrolytes. Monitor pacing or defibrillation thresholds for patients with ICDs
Diltiazem
Class: Antihypertensive, Calcium Channel Blocker
MOA: Inhibits calcium ions from entering into the myocardium during depolarization. Vasodilates coronary vascular smooth muscle which increases myocardial oxygen delivery
Indication: Hypertension, chronic stable angina, atrial fibrillation or flutter, conversion of supraventricular tachycardia
Expected Action: Relaxes the blood vessels, lowers blood pressure, and increases the supply of blood and oxygen to the heart while reducing its workload
Adverse Reactions: Bradycardia, cardiac arrhythmia, heart failure, hypotension, palpitations, peripheral edema, cutaneous hypersensitivity, constipation, diarrhea, nausea, vomiting, nocturia
Nursing Considerations: Monitor blood pressure, heart rate, liver function. Educate about limiting grapefruit juice
Labetalol
Class: Antihypertensive, Beta Blocker
MOA: Blocks alpha 1, beta 1, and beta 2 adrenergic receptor sites
Indication: Management of hypertension
Expected Action: Lowers blood pressure without a substantial decrease in cardiac output
Adverse Reactions: Orthostatic hypotension, dizziness, fatigue, edema, ventricular arrhythmia, nausea, paresthesia, headache, diaphoresis, increased BUN and creatinine, dyspnea, wheezing
Nursing Considerations: Monitor blood pressure, heart rate, mental alertness, signs and symptoms of bronchospasm, glucose in patients with diabetes
Nicardipine
Class: Antihypertensive, Calcium Channel Blocker
MOA: Inhibits calcium ions from entering into the myocardium during depolarization. Vasodilates coronary vascular smooth muscle which increases myocardial oxygen delivery
Indication: Management of hypertension and chronic stable angina
Expected Action: Relaxes the blood vessels, lowers blood pressure, and increases the supply of blood and oxygen to the heart while reducing its workload
Adverse Reactions: Flushing, edema, hypotension, palpitations, tachycardia, chest pain, supraventricular tachycardia, Headache, dizziness
Nursing Considerations: Monitor blood pressure, heart rate, signs and symptoms of new or worsening heart failure. Educate about orthostatic precautions and to to limit intake of grapefruit juice. Educate that peripheral edema may occur within 2 to 3 weeks of starting the medication
Valsartan
Class: Antihypertensive, Angiotensin II Receptor Blocker
MOA: Produces direct antagonism of the angiotensin II receptors. It displaces angiotensin II and produces blood pressure-lowering effects
Indication: Management of hypertension, treatment of heart failure, Reduces cardiovascular mortality in patients with left ventricular dysfunction or failure
Expected Action: Relaxes the blood vessels and lowers blood pressure which increases the supply of blood and oxygen to the heart
Adverse Reactions: Acute kidney injury, hyperkalemia, dizziness, hypotension, orthostatic hypotension, syncope, diarrhea, neutropenia, fatigue, headache, arthralgia
Nursing Considerations: Monitor blood pressure, serum electrolytes, kidney function, hypotension, signs and symptoms of angioedema
Lisinopril
Class: Antihypertensive, ACE Inhibitor
MOA: Prevents conversion of angiotensin I to angiotensin II, a potent vasoconstrictor, reducing blood pressure
Indication: Management of hypertension and heart failure. Treatment of acute MI within 24 hours to improve survival
Expected Action: Lowers blood pressure and increases the supply of blood and oxygen to the heart which can improve the signs and symptoms of heart failure
Adverse Reactions: Acute kidney injury, angioedema, cough, hyperkalemia, hypotension, dizziness, flushing, syncope
Nursing Considerations: Monitor blood pressure, BUN, creatinine, electrolytes, LFTs, jaundice or signs of hepatic failure, Monitor CBC for patients with vascular disease and/or kidney impairment. Assess risk of airway obstruction with angioedema
Metoprolol
Class: Antihypertensive, Antianginal, Beta Blocker
MOA: Selective inhibitor of beta 1 adrenergic receptors. Blocks beta 1 receptors, with little or no effect on beta 2 receptors. Does not exhibit any membrane stabilizing or intrinsic sympathomimetic activity
Indication: Treatment of angina pectoris, stable symptomatic heart failure, and stable acute MI to reduce cardiovascular mortality. Management of hypertension
Expected Action: Relaxes the blood vessels and slows heart rate which improves cardiac output and blood flow, and decreases blood pressure
Adverse Reactions: Bradyarrhythmias, hypotension, heart failure, palpitations, edema, bronchospasm, dyspnea, CNS effects, potentiation/masking of hypoglycemia, withdrawal, depression
Nursing Considerations: Monitor blood pressure, heart rate, serum glucose, mental alertness
Furosemide
Class: Antihypertensive, Loop Diuretic
MOA: Inhibits reabsorption of sodium and chloride in the renal tubules which causes its natriuretic effect
Indication: Management of edema (associated with heart failure, cirrhosis, kidney disease, and pulmonary edema). Treatment of congestion due to fluid overload
Expected Action: Decrease in edema and weight, increases urinary output
Adverse Reactions: Acute kidney injury, fluid/electrolyte loss, orthostatic hypotension, thrombophlebitis, hypersensitivity reactions, ototoxicity, dizziness, headache
Nursing Considerations: Montior blood pressure, kidney function, dehydration, fluid intake and output, electrolyte imbalance, and postural hypotension
Lidocaine
Class: Antiarrhythmic
MOA: Suppresses automaticity of conduction tissue, by increasing electrical stimulation threshold of the ventricles during diastole. Blocks both the initiation and conduction of nerve impulses which results in inhibition of depolarization
Indication: Acute treatment of ventricular arrhythmias
Expected Action: Prevents and treats ventricular arrhythmias
Adverse Reactions: Headache, bradycardia, cardiac arrhythmia, shock, edema, flushing, hypotension, local thrombophlebitis, agitation, anxiety, confusion, disorientation, dizziness, drowsiness, lethargy, loss of consciousness, paresthesia, seizure, slurred speech
Nursing Considerations: Monitor blood pressure, heart rate, respirations, and liver function. Monitor for hypotensive effects and signs and symptoms of CNS toxicity
Sildenafil
Class: Phosphodiesterase-5 Enzyme (PDE5) Inhibitor
MOA: Inhibits PDE-5 in smooth muscle of pulmonary vasculature which results in pulmonary vasculature relaxation. Vasodilation in the systemic circulation could occur
Indication: Treatment of pulmonary hypertension
Expected Action: Treats pulmonary arterial hypertension by relaxing the blood vessels and lowering the blood pressure on the lungs, making it easier for the heart to pump blood to the rest of the body
Adverse Reactions: Hearing loss, hypotension, priapism, flushing, diarrhea, dyspepsia, headache, pain, visual disturbance, epistaxis
Nursing Considerations: Monitor blood pressure, heart rate, and signs and symptoms of pulmonary edema
Nitroprusside
Class: Antihypertensive, Vasodilator
MOA: Causes peripheral vasodilation on venous and arteriolar smooth muscle which reduces peripheral resistance. Increases cardiac output by decreasing afterload
Indication: Management of acute decompensated heart failure and hypertensive crises
Expected Action: Rapidly decreases blood pressure and reduces afterload
Adverse Reactions: Bradycardia, flushing, palpitations, hypotension, substernal pain, apprehension, dizziness, headache, diaphoresis, hypothyroidism, abdominal pain, nausea
Nursing Considerations: Monitor blood pressure, heart rate, venous oxygen saturation and acid-base status
Clopidigrel
Class: Antiplatelet Agent
MOA: Irreversibly blocks the P2Y12 component of ADP receptors on the platelet surface, which reduces platelet aggregation. Platelets blocked by clopidogrel are affected for the remainder of their lifespan, 7-10 days
Indication: Reduces the rate of MI and stroke in patients with a history of recent MI, stroke, or peripheral atherosclerotic disease
Expected Action: Prevents platelets from clotting if there is an increased risk
Adverse Reactions: Bleeding, hypotension, hypersensitivity reactions, thrombotic thrombocytopenic purpura, confusion, headache
Nursing Considerations: Monitor for signs and symptoms of bleeding, trend hemoglobin and hematocrit
Spironolactone
Class: Antihypertensive, Potassium Sparing Diuretic
MOA: Increases sodium chloride and water excretion while conserving potassium and hydrogen ions. Blocks the effect of aldosterone on arteriolar smooth muscle
Indication: Management of edema with heart failure and cirrhosis, and hypertension
Expected Action: Increases the amounts of sodium and water being excreted, while retaining potassium, which helps to prevent damage to the tissues pf the heart and improve heart function
Adverse Reactions: Hyperkalemia, gynecomastia, vasculitis, pruritus, Stevens-Johnson syndrome, urticaria, amenorrhea, decreased libido, electrolyte imbalance, confusion, dizziness, drowsiness, headache, abdominal cramps, nausea, vomiting, diarrhea
Nursing Considerations: Monitor blood pressure, electrolytes, uric acid, glucose, kidney function, volume status, and CNS changes
