E3: Heart drugs Flashcards
propranolol drug class
beta blocker
how does propranolol work
blocks beta adrenergic receptors of the sympathetic nervous system
(slows heart rate)
big effect for propranolol
slows heart rate!
what is propranolol used for (5)
- hypertension
- heart failure
- post MI
- angina
- arrhythmias
side effect of propranolol
- depression
- hypoglycemia
- importance
- dizziness
because propranolol is a nonselective beta blocker, what can happen
have effect on B2(lungs)
who is propranolol contraindicated in
people with asthma or other lung disorders
what do you need to check before admin of propranolol
make sure pulse is 60 or greater
captopril (capoten) cass
ACE inhibitor
what is the action of captopril (capoten)
block conversion of angiotensin I to angiotensin II which relaxes vessels and reduces reabsorption of fluid (reducing after load)
captopril (capoten) used for
- HTN
- heart failure
- MI
- Diabetic Nephropathy
most common side effect of captopril (capoten)
unrelenting cough
life threatening side effect of captopril (capoten)
angioedema
other side effects of captopril (capoten) (6)
- Hyperkalemia
- renal failure
- GI distress
- Rash
- Neutropenia
- agranulocytosis
what drug does captopril (capoten) interact with
Digoxin (raises digoxin levels)
captopril (capoten) is contraindicated in who
pregnant people
when to take captopril (capoten)
one hour before meals and two hrs apart from antacids
Losartan (Cozaar) class
angiotensin II receptor blockers (ARB)
action of Losartan (Cozaar)
block angiotensin II causing vasodialatio, reduces volume
SE for Losartan (Cozaar)
- Hyperkalemia
- renal failure
- GI distress
- Rash
- Neutropenia
- agranulocytosis
contraindication for Losartan (Cozaar)
Do not take during pregnancy
when to take Losartan (Cozaar)
may take with food
Verapamil (Calan) class
calcium channel blocker
Verapamil (Calan) action
blocks calcium from cardiac cell reducing contraction, causing vasodialation
Verapamil (Calan) uses (4)
- HTN
- Angina
- Arrhythmias
- circulatory conditions
SE of Verapamil (Calan) (3)
- peripheral edema
- constipation
- suppression of cardiac function (heart block, dysrhy, HF)
Verapamil (Calan) interacts with
grapefruit juice and beta blockers
Nifedipine (Procardia) class
calcium channel blocker
Nifedipine (Procardia) action
blocks calcium from cardiac cell reducing contraction causing vasodialation
Nifedipine (Procardia) uses (4)
- HTN
- angina
- arrhythmias
- circulatory conditions
Nifedipine (Procardia) SE
- peripheral edema
- constipation
Nifedipine (Procardia) interacts with what
- grapefruit
- increased hypotension with beta blockers
Hydralazine (Apresoline) action
direct vasodialation of veins and arteries causing rapid drop in BP
Hydralazine (Apresoline) uses
- severe HTN
- heart failure
Hydralazine (Apresoline) SE (5)
- headache
- dizziness
- edema
- chest apin
- reflex tachy
monitor what with Hydralazine (Apresoline)
BP carefully
Sodium Nitroprusside (Nitropress) action
direct vasodialation of veins and arteries causing rapid drop in BP
Sodium Nitroprusside (Nitropress) uses
hypertensie emergency
risk with Sodium Nitroprusside (Nitropress)
risk of cyanide toxicity
those with liver disorders at an increased risk
Sodium Nitroprusside (Nitropress) SE (5)
- headache
- dizziness
- edema
- chest pain
- reflex tachy
Sodium Nitroprusside (Nitropress) admin
do not admin in a line with any other medication (needs own line)
monitor what with Sodium Nitroprusside (Nitropress)
close cardiac monitoring
Digoxin (Lanoxin) class
cardiac glycoside
Digoxin (Lanoxin) action
increases the level of calcium inside the cell by inhibiting the sodium-potassium pump
Digoxin (Lanoxin) uses
- heart failure
- arrhythmias (A-fib)
SE of Digoxin (Lanoxin)
- HA
- seizures
- drowsiness
- arrhhythmias
therapeutic levels for Digoxin (Lanoxin)
.5-2.0 ng/ml
if admin Digoxin (Lanoxin) iv infuse over
5 minutes at least
what to check for Digoxin (Lanoxin)
pulse
less than 60, contract provider
what are the s/s of Digoxin (Lanoxin) toxicity
- yellow halos
- confusion
- N/V
- cardiac disturbances
what does Digoxin (Lanoxin) interact with
- electrolyte disturbance
- hypokalemia with potassium wasting diuretics
Dopamine (Intropin) class
catecholamine (same fam as epi)
Dopamine (Intropin) uses
- heart failure
- shock
(EMERGENCY drug)
SE of Dopamine (Intropin)
- necrosis when solution extravastes
- dysrhythmias
- angina
low dose Dopamine (Intropin)
renal vasodialation
“renal dose)
mod dose Dopamine (Intropin)
renal dose + increase HR, contractility, AV conduction
high dose Dopamine (Intropin)
renal dose + increase HR, contractility, AV conduction + VASOCONSTRICTION
what to monitor with Dopamine (Intropin)
continuous cardiac monitoring
Hydrochlorothiazide class
thiazide diuretic
Hydrochlorothiazide action
prootes urine production by blocking the reabsorption of sodium and chloride in the early segment of the distal convoluted tubule
Hydrochlorothiazide uses
- HTN
- edema
SE of Hydrochlorothiazide
- dehydration
- electrolyte imbalances
Hydrochlorothiazide interacts with what
digoxin
Furosemide (Lasix) action
inhibits chloride reabsorption in ascending loop of henle
what is a problem with Furosemide (Lasix)
high loss of K in urine
Furosemide (Lasix) (4)
- HTN
- hypertensive emergencies
- edema
- pulmonary edema
SE of Furosemide (Lasix)
- dehydration
- electrolyte imbalances
- ototoxicity
Furosemide (Lasix) interacts with what
digoxin (hyperkalemia)
Spironolactone (Aldactone) classeS
- aldosterone antagonists
- potassium sparing diuretic
Spironolactone (Aldactone) action
reduces blood volume by blocking aldosterone receptors in kidney and increases excretion of sodium and water
Spironolactone (Aldactone) uses
- HTN
- heart failure
SE of Spironolactone (Aldactone) (4)
- hyperkalemia
- hyponatremia
- flu like symptoms
- dizziness
Lidocaine (Xylocaine) use
use only for VENTRICULAR dysrhythmias in hospital
SE of Lidocaine (Xylocaine) (3)
- respiratory arrest
- seizures
- fatigue
how is Lidocaine (Xylocaine) dosed
started with high loading dose and lower maintenance dose
Amiodarone (Cordarone) class
potassium channel blockers
Amiodarone (Cordarone) action
decreases conduction, automaticity, repolarization rate and contractility
Amiodarone (Cordarone) uses
- recurrent A fib
- V fib
- V tach
SE of Amiodarone (Cordarone)
MANY
-major SE is pulmonary toxicity
Amiodarone (Cordarone) interacts with
grapefruit and many cardiac drugs
Amiodarone (Cordarone) has a long what
half life- interactions can take place even after cessation of drug
Adenosine (Adenocard) class
endogenous glucoside
Adenosine (Adenocard) action
decreased conduction through the AV node
Adenosine (Adenocard) use
- antiarrhythmic
- paroxysmal SVT
Adenosine (Adenocard) speed
FAST
short half life
how to admin Adenosine (Adenocard)
quick IV push with quick saline flush
after admin what might happen
may be short moment of asystole before normal rhythm begins
Adenosine (Adenocard) is contraindicated in (3)
- a-fib
- a-flutter
- heart block
Lovastatin (Mevacor) class
HMG-CoA reductase inhibitor
Lovastatin (Mevacor) ation
inhibits HMG CoA reductase in liver limiting cholesterol synthesis
Lovastatin (Mevacor) decreases
- cholesterol
- LDL
- VLDL
- triglycerides
Lovastatin (Mevacor) increases
HDL
SE of Lovastatin (Mevacor) (6)
- GI distress
- Headache
- Myalgia (muscle soreness)
- rhabdomyolysis (muscle wasting
- weakness
- ocular and liver toxicity
when do results appear with Lovastatin (Mevacor)
6-12 months
when to take Lovastatin (Mevacor)
evening meal
Lovastatin (Mevacor) is contraindicated in
pregnancy and in those with liver problems
Nitroglycerin (Nitrostat) class
organic nitrate
angina=
need for O2
Nitroglycerin (Nitrostat) action
nicto decreases cardiac O2 demand by dilating veing and decreasing venous return (preload)
relaxes coronary arteries increasing o2 supply
has a significant first pass effect
Nitroglycerin (Nitrostat)
Nitroglycerin (Nitrostat) admin
sublingual
take with pain, wait 5, call 911 and take another, take 3rd in another 5
do not take with Nitroglycerin (Nitrostat)
viagra or booze
SE of V
- headache
- reflex tachy
