Medication Exam - Cardio Drugs Flashcards
HYDROCHLOROTIAZIDE
- largest, most common prescribed for HTN
- gentler than loop
- TREAT MILD TO MODERATE HTN AND EDEMA ASSOCIATED WITH HEART, HEPATIC, AND RENAL FAILURE
Monitor all electrolytes ESPECIALLY POTASSIUM -hypokalemia
Monitor BG -Hyperglycemia
Monitor upon standing -Dizziness
Monitor BP and VS -Hypotension
Drug Interaction -most mild and require monitoring; SULPHA DRUGS
AM dosing
Tell pt there will be increase urination
LOOP DIURETICS - Furosemide
-most effective diuretic
- REDUCE EDEMA ASSOCIATED WITH HEAT, HEPATIC, or RENAL FAILURE
- not so much BP maintenance
Monitor electrolytes - K and Na
Dietary Management - reduce Na and K foods
Monitor Uric acid -risk for gout and BUN
Kidney fxn - SCr
Monitor I and O, daily weights
BP, BGM, Urine output and signs of edema
Tell pt to report wt loss/gain, report fatigue and muscle cramps, change position slowly, warn about increased urine volume and timing of meds
Cardio Selective CCB - DILTIAZEM
Heart > Blood Vessels
Adverse Eff: Dizziness Hypotension Headaches Flushing REFLEX TACHYCARDIA Constipation Peripheral edema
Requires Heart Rate Monitoring because vasodilation
Vasodilation will cause reflex tachycardia
Monitor Hypotension esp in Elderly
Monitor BP, Pulse, HR, ECG sometimes (more for Cardio Selective), BM, signs of edema, dizziness, headahe, flushing (Peripheral vasodilaton)
AVOID GRAPEFRUIT - toxicity due to CYP34A inhibition
Adrenergic Antagonists - Beta blockers - Atenolol and Metoprolol
Introduce slowly and never stop abruptly
Primary use is angina, arrhythmias, HF and Post MI
First choice for prevention of variant angina
Off label use for Migraine Prevention or Performance Enhancing Drug
AE: Hypotension Bradycardia Hyper/Hypoglycemia Hyperlipidemia Nausea Sob Dizziness
Do not discontinue abruptly -taper or rebound tachycardia - taper slowly over 1-2 weeks
Monitor for FED -Fatigue, Edema and Dyspnea
Monitor respiratory status
Monitor BP, HR, BGM, cholesterol panel and difficulty breathing
Liver fxn, monitor for hepatic toxicity and renal impairment
Continuous monitoring of VS
Evaluate risk for hypotension
Report pulse if below 50 bpm
Usually Beta blockers in Diabetes type 1 and 2 are avoided and pts with risk for hypoglycemia esp elderly
Beta blockers contraindicated in pts with Heart block, sever bradycardia, ASTHMA, COPD, ELDERLY AND DIABETICS
African Americana and Asians be more or less sensitive to doses of beta blockers
Nurse’s Role HTN
Balance diet
Reduce or eliminate tobacco and alcohol
Increase fitness level
Obtain baseline VS including ht and wt
Order labs - electrolytes, SCr
Encourage adherence
Assess client and family’s knowledge of HTN
Nurse’s Role - HF
Keep feet elevated when sitting
Proper foot wear and pressure stockings
K and Na restrictions
ASA - antiplatelets
Can be given along anticoagulants but bleeding risk if combined
Cause GI upset
Post MI regimen
Effects of 1 dose lasts 7-10 days irreversible binding
ENSURE CORRECT DOSAGE - sensitivity
Watch for > 1 medication that can risk bleeding (NSAID and ASA) for additive effects
AE:
Nausea
Dyspepsia
Increased risk for bleeding
81 mg - baby aspirin for prevention of cardiac event in high risk pts
Monitor for signs of bleeding and clotting, drug interactions, food interactions
Adhere to lab tests
Caution w/ dental procedures
Anticoagulant - Low Molecular Weight Heparins - Tinzaparin and Enoxaparin
More predictable response
Less injections per day due to longer duration
Leas thrombocytopenia = less bleeding risk
Less lab tests and hospital stays
Dose is acc to pt wt and what we’re treating
Tinzaparin -produce from unfractionated from porcine intestinal mucosa
Unfractionated Heparin - Anticoagulant
Prevents but does not dissolve clot
SC Or IV only
Do not massage injection site - bleeding and bruising
Dose is dependent on condition
