HTN/Cardiac/Antiarrhythmics/Angina/Hyperlipidemia/Anticoagulant Concepts Flashcards
- List classes of medications used in the treatment of hypertension, be sure to include examples of each and specific nursing actions
Diuretics: HCTZ is usually a frontline choice.
Loop diuretic: furosemide, bumetanide
- Monitor K+ levels
Beta blockers (“lol” family): metoprolol, atenolol, labetalol, propranolol
- BLACK BOX WARNING: Do not stop abruptly, need to taper off
- Use cautiously in diabetic patients as it can mask signs of hypoglycemia
- Should not be used in patients with asthma as it can block the effectiveness of rescue
inhalers in acute asthma attacks
ACE Inhibitors (“pril” famly): captopril, enalapril, ramipril
- ADR: dry cough, angioedema, significant first dose hypotension
Angiotensin Receptor Blockers (ARB’s) (“sartan” family): losartan, irbesartan, valsartan,
olmsartan, candesartan
- Doesn’t cause the cough like ACE’s
Calcium Channel Blockers: amlodipine, nifedipine, nicardipine (DHP) / verapamil,
diltiazem (Non-DHP)
- More effective in African Americans
Less common options:
Potassium sparing diuretics: spironolactone, eplerenone
Alpha blockers (“zosin family): doxazosin, terazosin, etc. Great choice for HTN and BPH or
stand-alone medication for BPH as it relaxes the bladder and allow for better urination
Direct Alpha Agonist: clonidine. Not common, but the patch form is beneficial to some
patient populations.
What rhythm disturbance is this med used for?
Amiodarone
DOC Ventricular Tachycardia with or without
pulse, ventricular fibrillation
What rhythm disturbance is this med used for?
Adenosine
Supraventricular tachycardia > 150 beats per
minute
RAPID IV push
What rhythm disturbance is this med used for?
Atropine
Symptomatic Bradycardia
What rhythm disturbance is this med used for?
Digoxin
A-Fib with Congestive Heart Failure
What rhythm disturbance is this med used for?
Diltiazem
DOC A-Fib or A-Fib with rapid ventricular
response
What rhythm disturbance is this med used for?
Magnesium Sulfate
Sustained polymorphic Ventricular
Tachycardia
- What would be the recommended treatment for a patient experiencing chest pain/angina?
- Oxygen (or rest if prehospital)
- Nitroglycerin (sublingual)
- chewable baby aspirin up to 324 mg
- What important patient teaching would need to be the nurse need to do for this patient?
- Only take up to 3 tablets, 5 minutes apart, after 2nd pill, call 911
- Tingling indicates tablet is still good
- Contraindicated with other vasodilators like erectile dysfunction medications
(the “afil” family) - Avoid light and heat exposure (photosensitive)
- Sublingual tablets are ineffective if swallowed
- acetaminophen for nitro induced headache, no NSAIDS or ibuprofen
- What is the “drug of choice” used for the treatment of hyperlipidemia? (list the class of
medication and examples of medications in this class, hint they have a family name)
HMG-CoA reductase inhibitors “Statins”, examples: pravastatin, lovastatin, simvastatin,
atorvastatin, rosuvastatin (most common ones)
- Since this is a popular class of medication, commonly prescribed, what key considerations
should the nurse be aware of?
- Lowers LDL’s and increases HDL’s, some triglyceride lowering effects
- Promotes plaque stability = less risk for rupture of thrombosis
- Reducing atherosclerotic risk, shown to reduce risk of stroke and MI, even with normal
cholesterol levels
ADR: GI distress, liver dysfunction, muscle aches and weakness, impaired cognitive
functioning especially with dementia - More effective to take in PM since most cholesterol is produced at night
- How do you monitor the EFFECTIVENESS of these medications?
Lipid panel, HDL, LDL levels
- How do you monitor for an adverse drug reaction to these medications?
ALT/AST
Monitor for headache, dizziness, unusually tired, digestive system problems (constipation,
diarrhea, indigestion), muscle pain, sleep problems – CALL DOCTOR IMMEDIATELY
- renal function studies, especially if complaining of muscle pain or weakness
- monitor for protein in the urine (rosuvastatin)
