Exam 2 Flashcards
Captopril
ACE inhibitor, Capoten, used for hypertension
Use: This drug blocks the enzyme that takes angiotensin I and changes it into angiotensin II. This helps prevent the action of vasoconstrictions and allows the blood vessels to circulate blood more freely.
AE:
- Neutropenia
- Agranulocytosis
- Proteinuria
- Glomerulonephritis
- Angioedema
BB warning: Can cause injury or death to a developing fetus.
Admin: take 1 hr before meal, increases concentration of digoxin + lithium
losartan
Angiotensin II receptor blocker, hypertension
Use: This drug works by blocking vasoconstriction from angiotensin II, which in turn decreases pressure in the arteries and allows blood pressure to lower.
AE:
- Dizziness
- Muscle cramps
- Weakness
- Heartburn
- Diarrhea
- Decreased touch sensitivity.
BB warning: - Can cause injury and or death to a developing fetus
* all end in sartan
amlodipine
Calcium channel blocker, Norvasc, hypertension
Use: The medication works by not allowing calcium ions to cross cardiac and smooth muscle when it is in the depolarization stage which leads to a lowered blood pressure.
AE:
- Peripheral edema
- Pulmonary edema
Never take st johns wart, it lessens the effects, dont stop taking without consulting a doc, no great fruit juice
propranolol
Class II beta adrenergic blockers, cardiac dysrhythmias
Use: This medication uses blocking of beta blockers to lower blood pressure by decreasing the cardiac workload. This releases renin to allow for lower blood pressure.
AE:
- CNS changes
- Sleep disorders
- Agitation
- Fatigue
- Dizziness
- Heart failure
- Stroke
BB warning: Do not end drug abruptly. May cause negative side effects such as cardiac ischemia, increasing the risk for an MI
chronotropic: affects HR ( neg: decreases, pos:increases
inotropic: squeeze of heart
dromotropic: message from SA to AV
nitroprusside
vasodilator, Nitropress, hypertension
Use: This medication works by reducing afterload.
AE:
- Chest pain
- SOB
- Palpitations
- Hypotension
Hydralazine
vasodilators, Hydra-zide, BiDil, hypertension
Use: This medication’s role focuses on the arterioles and making sure vasodilation occurs.
AE:
- Headache
- Constipation
- D/N/V
Digoxin
Cardiac Glycoside, Lasix , heart failure
Use: The contractability of the heart is improved when it inhibits sodium, potassium, and ATPase for which then sodium is invited into the cell.
AE:
- Digoxin toxicity
- Premature ventricular contractions
- Heart rhythm disturbances
low sodium = confusion
Milrinone
Phosphodiesterase inhibitor, Primacor, heart failure
Use: inhibits Phosphodiesterase from working in the myocyte
AE:
- fatal ventricular dysrhythmias
- hypotension
- supraventricular dysrhythmias
- chest pain
- angina
- hypokalemia
Sacubitril/ Valsartan
Angiotensin receptor neprilysin inhibitors, Entresto, Heart failure
Use: The drug is used by blocking receptors angiotensin II usually binds to . By using the combined drug its removes the need to take ACE inhibitors and ARB therapy.
AE:
- Hypotension
- Hyperkalemia
- Cough
- Dizziness
- Renal impairment
BB warning: - Can affect fetal development if taking while pregnant
Enalapril/Maleate
Angiotensin- converting inhibitors, Epaned, Vasotec, hypertension
Use: This drug works by blocking the adaption of angiotensin I to angiotensin II. This is important because it causes the vasoconstriction unable to perform its job.
AE:
- Hypotension
- Hyperkalemia
Metoprolol Succinate
Beta adrenergic blocking agents, Lopressor, heart failure
Use: The sympathetic nervous system is suppressed which can hurt myocardial beta cells, allowing a higher percentage of cardiac output
AE:
- Dizziness
- Drowsiness
- Syncope
- Blurred vision
BB warning: For patients with coronary artery disease: rapid withdrawal can result of angina, MI’s and ventricular dysrhythmias.
Furosemide
Loop diuretics, Lasix, fluid overload
Use: This drug is used to fix edemas in patients with heart failure. It works by removing all fluids in the body in order to rebalance fluids
AE:
- Hypokalemia
- Weakness/ fatigue
- Muscle cramps
- Palpitations
Hydrochlorothiazide
Thiazide diuretics, Microzide, Edema
Use: This does not allow potassium and chloride to reabsorb after leaving the renal tube. This helps water and sodium leave the body through urine.
AE:
- Hypokalemia
Spironolactone
aldosterone antagonist, Aldactone, heart failure
Use: This drug does not allow aldosterone induced retention of sodium and water in the body. This in turn helps save urinary potassium loss so a supplement will not have to be given.
AE:
- Hyperkalemia
- Confusion
- Diarrhea
Mannitol
Osmotic diuretics, Osmitrol, oliguria
Use: These drugs work by adding osmotic pressure into the glomerular filtrate. By this action, it in hand increases the blood volume and decreases absorption of water and electrolytes back into its original system which is the renal tubules.
AE:
- Vomiting
- Chest pain
- Renal impairment
Heparin
anticoagulant, Generic Heparin, DVT
Use: Heparin works by binding with antithrombin III which prevents prothrombin from changing to thrombin. This is the enzyme that enhances blood clotting factors.
AE:
- Hemorrhaging
- Hypersensitivity
- Heparin induced thrombocytopenia
Enoxaparin
LMWH, Lovenox, DVT
Use: Helps to prevent the formation of blood clots in the body.
AE:
- Nausea
- Vomiting
- Diarrhea
- Confusion
- Pain/ bruising
C: can cause blood clots on spinal cords
Warfarin
Vitamin K antagonists, Coumadiin, PE
Use: This drug works in the liver. It goes after synthesizing vitamin K dependent clotting factors in the blood. This prevents the blood from being able to clot in patients
AE:
- Hemorrhaging
- Nausea
- Vomiting
- Abdominal pain
- Alopecia
- Urticaria
- Dizziness
- Joint and muscle pain
BB warning: Major or fatal bleeding
Dabigatran
Direct Thrombin inhibitor, Pradaxa, Stroke
Use: This drug works by prohibiting free and fibrin bound thrombin to start the coagulation processes in the body.
AE:
- Bleeding
- Dyspepsia
- Abdominal pain
- Gastritis
- Anemia
Rivaroxaban
Direct factor XA inhibitors, Xarelto, Stroke
Use: It works by inhibiting the activation of platelets and production of fibrin. Along with this, its XA factor prevents intrinsic and extrinsic coagulation
AE:
- Bleeding
- Spinal or epidural hematoma
Clopidigrel
Adenosine diphosphate receptor antagonist, Plavix, myocardial infarction
Use: This drug works to block the ADP receptor on platelets. This prohibits blood coagulation for the platelets lifetime (7-10 days)
AE:
- Pruritus
- Hemorrhage
- Severe neutropenia
BB warning: May not work well in patients with genetic variations.
Aspirin
antiplatelet drug ,Zorprin, MI
Use: This drug inhibits the action of prostaglandin synthesis by of the acetylates cyclooxygenase enzyme. This then prevents thromboxane from producing.
AE:
- Bleeding
- Hemorrhaging stroke
Alteplase
Thrombolytic, Actilyse, Acute coronary arterial thromboembolism
Use: This drug is a protein in the body that gets rid of unwanted blood clots by ruining the chance for plasminogen to convert to plasmin.
AE:
- Bleeding
- Brain hemorrhage
Protamine Sulfate
LMWH, Prosulf, Heparin overdose
Use: The drug works by neutralizing heparin activity
AE:
- Hypertension
- Bradycardia
- Dyspnea
BB warning: Severe hypertension, cardiovascular collapse, noncardiogenic pulmonary edema, catastrophic pulmonary vasoconstriction and pulmonary hypertension
Vitamin K
Reversal of vitamin K antagonist, Mephyton, Warfarin overdose
Use: This is the reversal of warfarin. It works by reestablishing blood loss within 24 hours of taking.
AE:
- Taste changes
- Dizziness
- Rapid weak pulse
- Profuse sweating
- Hypotension
- Dyspnea
- Cyanosis
NI: check PT
Mylanta
Antacid, Mygel, GERD
Use: This drug works to neutralize acids in the body. It is an alkaline substance that can reduce the amount of acid found in the body.
AE:
- Constipation
- Hypophosphatemia
- Osteomalacia
Dont take at the same time as other drugs; 1 and 3 ours after meal or befire bed, avoid prolonged use
Cimetidine
Histamine2 receptor antagonist, Tagamet HB, GI bleed
Use: This drugs works by not allowing histamine2 to work in the stomach, which creates a less acidic environment.
AE:
- Diarrhea
- Dizziness
- Drowsiness
- Headaches
- Confusion
- Gynecomastia
* take with meal
Omeprazole
Proton Pump Inhibitors, Prilosec, GERD
Use: This drug helps to prevent the release of acid from the proton pumps in the body. It binds directly to it for a direct defense.
AE:
- Nausea
- Diarrhea
- Headache
- Increased risk of bone fractures w long term use, take before meals, give ordered tab
Misoprostol
Synthetic Prostaglandin E1 analog, Cytotec, GI bleed
Use: The gastric acid secretions are reduced by this medication while simultaneously increasing mucus and bicarbonate secretions, mucosal blood flow and musical repair in the stomach acid.
AE:
- Diarrhea
- Abdominal cramping
- Nausea
- Vomiting
- Headache
- Vaginal bleeding
- Uterine cramping
BB warning: Women that are at risk of getting pregnant, may induce abortion, premature birth or birth defects
Sucralfate
Protectants, Carafate, Peptic ulcer disease
Use: This drug works by balancing acid in the stomach instead of inhibiting it. It could work by binding to an ulcer, creating space between mucus, bile, and pepsin from the gastric acid
AE:
- Constipation
- Dry mouth
Bismuth Subsalicylate
Salicylates, Pepto- Bismol, diarrhea
Use: This drug is used to order to protect ulcers from stomach acid.
AE:
- Darkening of stool or tongue
- Ringing of the ears
- Hearing loss
coats ulcers, do not give with aspirin allergy
hypertension overview
Normal 120/80
Elevated: 120-129/80
Stage 1: 130-139/80-90
Stage 2: >140/ > 90
- pay attention
to cardiac ouput
RAAS system: keeps homeostasis
- first tsep make lifetsyle chnages
Nursing considerations for HTN
assess bp and HR
fluid retention
education
report dizziness
Compenstaory mechanisms
Hormones released: epinephrine and norepinephrine ( causes heart rate to go up and can raise blood pressure ventricular remodeling: hypertrophy and stiffening RAAS system: decreased flow to the kidneys. triggers retention of sodium and water BNP: produced by ventricular cardiac muscle and released as a response to over stretching of the ventricle, will case diuresis and articular and ventricle dilation (means they have heart failure)
heart failure development vs functional status
HFD: cannot move back on severeness
- risk factors but no signs
- elevated heart pressure, no s/s
- current or past s/s of heart failure
s/s interfere with daily life
FS: can go back and forth
- no s/s
- mild s/s w ordinary activities
- limitation w physical activity but okay at rest
- severe limitation and distress w activity and rest
left sided vs right sided
R: heart loses ability to move oxygen depleted blood to the lungs to pick up new oxygen, caused by left sided HF
symtpoms: fatigue, increased vebous pressure, enlarged liver and spleen, DVT, anorexia, feet and hand swelling, dependent edema
L: most common type, heart loses ability to pump good around the body after its been re-oxygenated, usually caused by CAD
symptoms: dyspnea, orthopnea, bendopnea, edema, fatigue, crackles, delayed cap refill, weak pulses, cool skin temp
Heart failure nursing considerations
daily weights
monitor for edema
pink frothy sputum
breath sounds
o2 therapy
cardiac restrictions
Contributing factors to GERD
Contributing factors: asthma meds, pregnancy, spicy foods, alcohol, smoking fatty foods, caffeine, chocolate, H pylori (50% of cases) S/S: pyrosis ( heart burn), dry cough, regurgitation, globus sensation, dyspepsia, dysphagia, epigastric pain, inflammation of the esophagus
peptic ulcer disease
Duodenal ulcer pain is worse at night because you are not eating.
- endoscopy for diagnosis
Beers criteria
list of meds that have been found inappropriate for use
