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PHARM > Drugs for HTN, HF, Dyslipidemia > Flashcards

Drugs for HTN, HF, Dyslipidemia Flashcards

1
Q

atorvastatin therapeutic class

A

dyslipidemia, lipid-lowering medication

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2
Q

atorvastatin pharmacologic class

A

HMG-CoA reductase inhibitor, needed for biosynthesis of cholesterol in liver

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3
Q

atorvastatin action

A

strongly decrease LDL cholesterol, decrease triglycerides, increase HDL cholesterol, actions only occur when actively taking medication (must stay on for life to decrease cholesterol) slows progression of CAD and reduces mortality

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4
Q

atorvastatin side effects

A

headache, GI cramping, diarrhea, constipation; possible liver damage in small number of patients.

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5
Q

atorvastatin adverse effects

A

rhabdomyolysis (muscle breakdown), increase digoxin levels, grapefruit juice inhibits metabolism of drug

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6
Q

atorvastatin contraindications

A

pregnancy category X - teratogenic (abnormality causing factor in birth)

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7
Q

atorvastatin other

A

give @ night (liver makes cholesterol at night); PO only with food to reduce GI distress

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8
Q

cholestyramine therapeutic class

A

anti-hyperlipidemic

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9
Q

cholestyramine pharmacologic class

A

bile acid sequestrant (collector)

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10
Q

cholestyramine action

A

binds with bile acids in an insoluble complex that is excreted in feces; drug is NOT absorbed in small intestine; liver makes more LDL receptors and causes a drop in LDL cholesterol

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11
Q

cholestyramine side effects

A

gas, bloating, constipation, nausea

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12
Q

cholestyramine contraindications

A

taking with food could impair absorption; patients with gall bladder issues

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13
Q

cholestyramine other

A

comes in powder; give other drugs either 2 hours before or 4 hours after

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14
Q

gemfibrozil therapeutic class

A

anti-hyperlipidemic

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15
Q

gemfibrozil pharmacologic class

A

fibric acid drug

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16
Q

gemfibrozil actions

A

increase lipoprotein lipase which increases breakdown and elimination of triglyceride; increases HDL and decrease VLDL by 50%

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17
Q

gemfibrozil side effects

A

GI issues, nausea, diarrhea, abdominal pain, dyspepsia (pain in upper middle stomach region)

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18
Q

gemfibrozil contraindications

A

don’t use if hepatic impairment is present

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19
Q

gemfibrozil other

A

may increase likelihood of gallstones, affect liver function; may increase effect of anticoagulant medications; may increase risk of myopathy & rhabdomyolysis with statin.

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20
Q

hydrochlorothiazide therapeutic class

A

diuretic

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21
Q

hydrochlorothiazide pharmacologic class

A

thiazide, potassium-wasting diuretic

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22
Q

hydrochlorothiazide action

A

reduce blood volume through excretion of water and potassium, reducing blood volume, and blood pressure.

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23
Q

hydrochlorothiazide side effect

A

hypokalemia, hyponatremia, hypotension, dizziness, dehydration

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24
Q

hydrochlorothiazide patient consideration

A

observe for hypokalemia (what signs/symptoms would patient have?); increase potassium containing food; do NOT give to patients who don’t make urine (anuresis)

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25
Q

furosemide therapeutic class

A

diuretic, antihypertensive

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26
Q

furosemide pharmacologic class

A

loop diuretic, potent potassium-wasting diuretic

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27
Q

furosemide action

A

works in loop of Henle to promote excretion of sodium and water thereby reducing blood vessel; causes potassium-wasting. When given IV, produces rapid diuresis

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28
Q

furosemide side effect

A

hypokalemia (check serum K-levels before administer); orthostatic hypotension, dizziness, fainting, ototoxicity (rare but permanent) and nephrotoxicity, hyperglycemia

29
Q

furosemide nursing considerations

A

monitor intake/output, K+ levels, blood glucose, causes of hearing changes or losses. Use cautiously with other drugs that deplete potassium.

30
Q

spironolactone therapeutic class

A

antihypertensive, reduces edema

31
Q

spironolactone pharmacologic class

A

potassium-sparing diuretic, aldosterone antagonist

32
Q

spironolactone action

A

inhibits aldosterone (secreted by adrenal cortex) which increases water and sodium excretion (RAAS). Commonly used to treat HTN along with other anti-HTN drugs, slows the progression of heart failure

33
Q

spironolactone side effects

A

hyperkalemia (especially taken with ACE inhibitors or ARBs)

34
Q

spironolactone nursing considerations

A

give with food to increase absorption of drug; do NOT give K+ supplements or use salt-substitute; warn male patients about gynecomastia which resolves when drug discontinued.

35
Q

lisinopril therapeutic class

A

drug for HTN and HF

36
Q

lisinopril pharmacologic class

A

ACE inhibitor

37
Q

lisinopril action

A

inhibits ACE which is responsible for converting angiotensin I to angiotensin II which ultimately blocks effects of aldosterone

38
Q

lisinopril side effects

A

well-tolerated, but be alert for cough (possible switch to an ARB) or Angioedema (1% of patients); patients must report coughing, swelling, tongue fullness, difficulty breathing/talking; hyperkalemia (use cautiously in pts. receiving potassium-sparing diuretics); hypotension; often used concurrently with thiazide diuretics

39
Q

losartan therapeutic class

A

drug for HTN

40
Q

losartan pharmacologic class

A

angiotensin II receptor blocker

41
Q

losartan actions

A

vasodilation and reduced blood volume (due to its effects on blocking aldosterone release)

42
Q

losartan side effects

A

hypoglycemia, dizziness, stuffy nose, fatigue, hypotension

43
Q

losartan BBW

A

do NOT use in pregnancy! Causes fetal injury/death = Teratogen!

44
Q

losartan nursing considerations

A

when given with potassium sparing diuretics — increased risk for hyperkalemia

45
Q

metoprolol therapeutic class

A

drug for HTN and HF

46
Q

metoprolol pharmacologic class

A

beta-adrenergic blocker (beta blocker) — selective for B1 (affecting heart by decreasing HR)

47
Q

metoprolol actions

A

reduces sympathetic stimulation of the heart thus decreasing cardiac workload
*preferred for patients with respiratory disease (due to cardio-selective B1 action)

48
Q

metoprolol side effects

A

hypotension, bradycardia, may enhance hypoglycemic affects of insulin/oral diabetic drugs — watch for hypoglycemia

49
Q

metoprolol BBW

A

acute withdrawal from drug may make angina worse or cause myocardial infarction

50
Q

metoprolol contraindications

A

heart block, cardiogenic shock, hypotension, overt cardiac failure

51
Q

nifedipine therapeutic class

A

drug for HTN

52
Q

nifedipine pharmacologic class

A

calcium channel blocker

53
Q

nifedipine actions

A

blocks calcium channels in myocardial and vascular smooth muscle including coronary arteries which results in coronary artery dilation, less oxygen consumption by heart an increase in CO and a fall in BP

54
Q

nifedipine side effects

A

dizziness, hypotension, headache

55
Q

nifedipine nursing considerations

A

well-tolerated, give cautiously with other antihypertensive medications, it increases serum levels of digoxin which can lead to bradycardia and dig toxicity. do not take with grapefruit juice. avoid alcohol potentiates vasodilating action

56
Q

digoxin therapeutic class

A

drug for HF

57
Q

digoxin pharmacologic class

A

cardiac glycoside

58
Q

digoxin actions

A

increases contractility of heart (positive inotrope); inhibits Na+K+ATPase, the enzyme responsible for pumping sodium (Na+) ions out of the myocardial cell in exchange for potassium (K+) ions. As sodium accumulates, calcium are released from their storage areas in the cell. The release of calcium produces a more forceful contraction of the heart fibers; Increases CO&raquo_space; increases urine production&raquo_space; decreases BV, relieves distressing; suppresses sinoatrial node (decreases HR)

59
Q

digoxin administered alerts

A

take apical pulse for 1 full minute, note rhythm and quality. If HR less than parameter set by HC provider (usually less than 60bpm) then withhold the dose and notify the provider; check serum digoxin levels before administering (narrow therapeutic range); use cautiously in elderly and pediatric patients due to renal and hepatic immaturity or decreased function

60
Q

digoxin adverse effects

A

concurrent use of digoxin and diuretics can lead to hypokalemia, leading to dysrhythmias; periodic check of drug levels required.

61
Q

digoxin contraindications

A

do NOT give to those with AV block or ventricular arrhythmias unrelated to HF as digoxin can worsen conditions

62
Q

digoxin Drug-Drug interactions

A

concurrent use with ACE I can cause hyperkalemia and reduce therapeutic action of digoxin

63
Q

digoxin antidote

A

digibind

64
Q

milrinone therapeutic class

A

drug for acute HF

65
Q

milrinone pharmacologic class

A

phosphodiesterase (PDE) inhibitor

66
Q

milrinone actions/uses

A

blocks enzyme phosphodiesterase in cardiac and smooth muscle, increases force of cardiac contraction and increases CO, very short half-life; heart increases calcium availability to heart muscle&raquo_space; increases contraction; vessels — PDE inhibition prevents cGMP metabolism in the smooth musculature causing vasodilation

67
Q

milrinone adverse effects

A

ventricular dysrhythmia — which occurs in every 1 in 10 patients — need continuous ECG monitoring during infusion to prevent hypotension. Correct hypokalemia as it can risk of dysrhythmia! Can cause headache, nausea and vomiting (usually related to vasodilation)

68
Q
A

PHARM (5 decks)

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