Drugs on Cardiovascular System

Question 1

Digoxin (Lanoxin, Lanoxicaps)

IS FOR

Answer 1

Heart failure

dysrhythmia

Question 2

Digoxin (Lanoxin, Lanoxicaps)

MOA

Answer 2

• Increase contractility (positive inotropic)
• Slow electrical conduction (negative dromotropic)
• Slow heart rate (negative chromotropic)
• Inhibit Na+-K+ ATPase (compete with potassium)
• Narrow therapeutic index (therapeutic level at 0.5-2.5ng/mL)

Question 3

Digoxin (Lanoxin, Lanoxicaps)

ADVERSE EFFECTS

Answer 3

CV – AV block, dysrhythmias 
GI – Anorexia and N/V 
Vision – colored vision (yellow) and halo vision 
Precaution 
Older adults 
Renal impairment

Question 4

Nursing process
for Digoxin (Lanoxin, Lanoxicaps)

Answer 4

• Complete health history and PE including SOB, Peripheral and pulmonary edema
• If apical pulse<60, withhold digoxin
• I/O and daily weight
• Lab values (hypokalemia predisposes dig toxicity and digoxin level)

Question 5

Antilipidemic drugs

Answer 5

Lovastatin (Mevacor), Simvastatin (Zocor), Fluvastatin (Lescol)

Question 6

Lovastatin (Mevacor), Simvastatin (Zocor), Fluvastatin (Lescol)
MOA

Answer 6

Inhibits precursor of cholesterol to lower cholesterol (HMG-CoA Reductase Inhibitors)

Question 7

Lovastatin (Mevacor), Simvastatin (Zocor), Fluvastatin (Lescol)
Adverse Effects:

Answer 7

Diarrhea
Constipation
rhabdomyolysis

Question 8

Lovastatin (Mevacor), Simvastatin (Zocor), Fluvastatin (Lescol)
Nursing Concerns:

Answer 8

• Cannot be taken with Digoxin
• Patient should avoid grapefruit
• Administer in the evening when cholesterol synthesis is at its peak

Question 9

Warfarin (Coumadin)

antidote

Answer 9

Vitamin K (Aqua-MEPHYTON)

Question 10

Warfarin (Coumadin)

lab

Answer 10

PT/INR every day until discharge; weekly to biweekly afterwards

Question 11

Warfarin (Coumadin) Nursing/safety concerns:

Answer 11

-Bruising from venipuncture
monitor for subclinical bleeding (gums, urine, stool)
-Use soft toothbrush
-No OTC drugs without physician approval
-No ASA or NSAIDs
-For warfarin, avoid cabbage, cauliflower, kale, spinach, some cheeses, egg yolks, liver and tomatoes

Question 12

Potassium-Sparing Diuretic

Answer 12

Spironolactone (Aldactone)

Question 13

Spironolactone (Aldactone)

Adverse effect:

Answer 13

hyperkalemia → life-threatening cardiac dysrhythmias
Electrolyte imbalances
Dehydration
Hypotension

Question 14

Spironolactone (Aldactone) used for

Answer 14

Hypertension 
Heart failure 
renal failure 
Liver Failure/Cirrhosis
Pulmonary edema

Question 15

Spironolactone (Aldactone) Nursing concerns:

Answer 15

Health Hx
Vitals, BP and LOC
baseline and electrolyte labs
monitor for hypotension and syncope
Monitor Older adults
give in the AM
Daily Weight and I/O
not for breastfeeding
monitor for cerebral and pulmonary edema

Question 16

Osmotic Diuretics

Answer 16

Mannitol (Osmitrol)

Question 17

Mannitol (Osmitrol)

used for

Answer 17

• Increased intracranial and intraocular pressure

- Renal failure

Question 18

Mannitol (Osmitrol)

Adverse effect:

Answer 18

Rebound increase in ICP and extravasation

Question 19

Loop Diuretics

Answer 19

Furosemide (Lasix)

Question 20

Furosemide (Lasix)

used for

Answer 20

Hypertension

Question 21

Furosemide (Lasix)

MOA

Answer 21

Block Na+, K+ and Cl- reabsorption at ascending loop of Henle

Question 22

Furosemide (Lasix) Adverse effect:

Answer 22

ototoxicity 
Drug interactions
Electrolyte imbalances 
Dehydration 
Hypotension

Question 23

ACE inhibitor

Answer 23

Enalapril (Vasotec)

Question 24

Enalapril (Vasotec)

used for

Answer 24

Heart failure, Hypertension

Question 25

Enalapril (Vasotec)

Adverse Effect:

Answer 25

persistent cough
postural(orthostatic) hypotension
hyperkalemia
angioedema

Question 26

Enalapril (Vasotec) Nursing Concerns:

Answer 26

• Complete health history/assessment
• BP and pulse before drug administration
• EKG and lab values including electrolytes
• Daily weight and I/O to monitor possible fluid retention
• No OTC/herbal meds without physician consent
• Evaluate sedation/dizziness for patient safety

Question 27

HEPARIN ANTIDOTE

Answer 27

Protamine sulfate

Question 28

Heparin Labs

Answer 28

APTT every 6hrs

Question 29

Nifedipine (Procardia)
Nife(-dipine) and Verapamil
used for

Answer 29

Heart failure, dysrhythmia, angina pectoris, and hypertension
Calcium channel blockers

Question 30

Nifedipine (Procardia)

Nife(-dipine) and Verapamil Nursing Concerns:

Answer 30

• Complete history/assessment
• Vitals including BP 30-60 minutes before administration and withhold if systolic BP is less than 90
• Orthostatic hypotension/chest pain
• Weight, I/O, edema daily
• Avoid grapefruit (CYP450)
• Constipation/Nausea
• No sudden withdrawal
• Palpitations
• No smoking/alcohol
• No breastfeeding

Question 31

Hydrochlorothiazide (Esidrex, HydroDIURIL, HCTZ)

adverse effects

Answer 31

gout attacks and blood dyscrasias

Question 32

Hydrochlorothiazide (Esidrex, HydroDIURIL, HCTZ) used for

Answer 32

Most commonly prescribed for Diuretic-Related problems (HF and Hypertension)

Question 33

Bethanechol (Urecholine)

used for

Answer 33

treats urinary retention

cholinergic agent that stimulates bladder contraction and therefore promoting urine flow

Question 34

Bethanechol (Urecholine) adverse effects

Answer 34

urinary incontinence
nausea/belching
hypotension
dizziness, fainting, fatigue

Question 35

Carbonic Anhydrate Inhibitors

Weak diuretics

Answer 35

Acetazolamide (Diamox)

Question 36

Acetazolamide (Diamox)

used for

Answer 36

glaucoma

Question 37

Acetazolamide (Diamox) adverse effects

Answer 37

metabolic acidosis