CVD Flashcards
furosemide (Lasix) class
parenteral and enteral loop diuretic
furosemide (Lasix) MOA
acts in the thick segment of ascending limb of Henle’s loop to block reabsorption of Na and Cl to prevent passive reabsorption of water
furosemide (Lasix) indications
- pulmonary edema from HF
- edema non-responsive to other agents
- HTN not controlled by other agents
furosemide (Lasix) AEs
- decreased Na, Cl, K, and BP
- transient ototoxicity; increased risk with other ototoxic meds
- dehydration; with increased risk for thrombosis emboli
- ventricular dysrhythmias with concurrent digoxin use
furosemide (Lasix) nursing considerations
- monitor: I/O, VS, weight, hearing, electrolytes
- slow IVP (10-20 mg/min)
- admin in morning or early afternoon
- education on potassium-rich sources in diet
hydrochlorothiazide (Thiazide) class
enteral thiazide diuretic
hydrochlorothiazide (Thiazide) MOA
acts in the early segment of the DCT to block reabsorption of Na and Cl to prevent passive reabsorption of water and modest diuresis
hydrochlorothiazide (Thiazide) indications
- essential HTN
- edema secondary to HF, hepatic or renal disease
- DI
- postmenopausal osteoporosis
hydrochlorothiazide (Thiazide) AEs
similar to loop diuretic, but no ototoxicity
hydrochlorothiazide (Thiazide) nursing considerations
- contraindicated in pts with low GFR
- monitor: I/O, VS, weight, electrolytes
- admin in morning or early afternoon
spironolactone (Aldactone) class
enteral potassium-sparing diuretic/aldosterone antagonist
spironolactone (Aldactone) MOA
blocks the action of aldosterone in the distal nephron to produce diuresis; little UOP as monotherapy, often combined with others
spironolactone (Aldactone) indications
- essential HTN when co-administered with potassium-wasting diuretics
- edema
- HF
spironolactone (Aldactone) AEs
- hyperkalemia
- endocrine effects: menstrual irregularities, impotence, deep voice, and hirsutism
spironolactone (Aldactone) nursing considerations
- monitor: I/O, VS, weight, electrolytes
- educated pt on monitoring intake of potassium-rich sources in diet
mannitol (Osmitrol) class
parenteral osmotic diuretic
mannitol (Osmitrol) MOA
once filtered in nephron, creates osmotic force that inhibits passive reabsorption of water; increases serum osmolality to draw fluid back into vascular and extravascular space
mannitol (Osmitrol) indications
- prophylaxis of renal failure w/ hypovolemic shock and severe hypotension
- reduction of intracranial and intraocular pressure
mannitol (Osmitrol) AEs
- edema (especially with existing HF)
- fluid and electrolytes imbalance
mannitol (Osmitrol) nursing considerations
- use filter needles and IV tubes
- store at room temp to prevent crystallization
- monitor for changes in ICP (if severe decline in urine output STOP MED!)
lisinopril (Zestril) class
ACE inhibitor
lisinopril (Zestril) MOA
reduce level of angiotensin II through inhibition of ACE and increase levels of bradykinin to dilate blood vessels, reduce blood volume, and prevent/reverse changes in heart and blood vessels mediated by angiotensin II and aldosterone
lisinopril (Zestril) indications
- HTN, HF, and post-MI
- prevention of MI, CVA, and death in pts with high CV risk
- diabetic neuropathy
lisinopril (Zestril) AEs
- first dose (syncope) hypotension
- dry cough
- angioedema (due to increased bradykinin)
- hyperkalemia (secondary to suppression to aldosteron release)
- fetal injury
lisinopril (Zestril) nursing considerations
- monitor: BP, electrolytes, daily weights
- educate pt: changing positions slowly, contact provider if angioedema or dry cough occurs, and potassium intake
losartan (Cozaar) class
angiotensin II receptor blocker (ARB)
losartan (Cozaar) MOA
blocks the actions of angiotensin II by blocking blocking access to its receptors in blood vessels, adrenals, and other tissues to cause dilation of vessels, prevent cardiac structural changes, and release of aldosterone
losartan (Cozaar) indications
- HTN
- HF
- reduce stroke risk, MI, and death in pts with high CV risk
- diabetic neuropathy and retinopathy
losartan (Cozaar) AEs
- angioedema (lower risk than ACE)
- fetal injury
losartan (Cozaar) nursing considerations
- ARBs used if pt not tolerating ACE due to cough
- monitor BP
- educate pt to contact provider if angioedema occurs
liskiren (Tekturna) class
enteral direst renin inhibitor
liskiren (Tekturna) MOA
binds with renin to inhibit cleavage of angiotensinogen into angiotensin I to reduce influence of entire RAAS
liskiren (Tekturna) indications
hypertension
liskiren (Tekturna) AEs
- diarrhea
- fetal injury
liskiren (Tekturna) nursing considerations
monitor: VS, I/O, weight, electrolytes
nifedipine (Procardia) class
duhydropyridine calcium channel blocker
nifedipine (Procardia) MOA
blocks calcium channels on vascular smooth muscle with minimal activity on heart
nifedipine (Procardia) indications
- HTN
- angina pectoris
nifedipine (Procardia) AEs
- peripheral edema
- flushing
- headache
- dizziness
- reflex tachycardia
nifedipine (Procardia) nursing considerations
- assess BP before admin
- monitor: reflex tachycardia, edema, daily weight
- add diuretic for peripheral edema
verapamil (Calan) class
non-dihydropyridines calcium channel blocker
verapamil (Calan) MOA
blocks calcium channels on the heart and blood vessels
verapamil (Calan) indications
- HTN
- angina pectoris
- dysrhythmias
verapamil (Calan) AEs
- constipation
- cardiac depression risk in pts with bradycardia, HF, and AV heart block