Medications Flashcards
Beta blockers- Decrease HR/contractility.
Treats HTN, angina, dysrhythmias, MI, HF
ADR: bradycardia, HF
monitor for s/sx HF (SOB, edema, orthopneic)
atenolol, metoprolol, carvedilol
Direct-Acting Vasodilators (relaxes smooth muscle)- HTN
Give with meals. TAPER
ADR: reflex tachy, dizzy, fluid retention
hydralazine (Apresoline)
phosphodiesterase inhibitor- increases CO
*short term/bridge treatment acute or severe HF
Do not give in acute MI, valve issues, renal impairment.
Monitor digoxin levels
milirinone
alpha blockers- HTN, BPH
Give @ bedtime
ADR: othostatic hypotension, reflex tachy, HA, dizzy
DO NOT GIVE WITH VIAGRA, children, liver dx
doxazosin (Cardura), prazosin (Minipress)
HMG-CoA reductase inhibitor (-statin)
Increase HDL, lower LDL & total cholesterol (treat high cholesterol)
Give in evening
Myopathy (rhabdo) & hepatotoxicity
GRAPEFRUIT, liver dx, ETOH
Warfarin increases bleeding
Report muscle pain, jaundice, abd pain, fatigue
LIVER FX TEST
atorvastatin (Lipitor), simvastatin (Zocor), lovastatin (Mevacor), rosuvastatin (Crestor)
Increase oxidation of fatty acids—> most effective decreasing serum triglycerides, increasing HDL
Give c/ food
GI effects (N/V/abd pain), hepatotoxicity, gallstones, myopathy
Warfarin increases bleeding. Increased myopathy c/ statins.
Report muscle pain, abd pain, fatigue, jaundice
LIVER FX test
gemfibrozil (Lopid), fenofibrate (TriCor) - fibrates
vasodilator to treat angina and acute CP d/t MI
HA, hypotension, dizzy, bradycardia, syncope
DO NOT GIVE C/ VIAGRA
HOLD FOR HR <60/SBP <90
nitroglycerin (Nitrostat, Nitro-Dur), isosorbide (Isordil)
Acts like Ca+ blocker—> treats SVT
IV—> short 1/2 life, push FAST thru IV
adenosine
Minimizes Ca+ into cell—> decreased contraction
Torsades de point
magnesium
Class 1- Na+ channel blocker—> decreases contraction rate
Ventricular dysrhythmias, MI, cardiac cath/surgery
Hypotension, bradycardia, other dysrhythmias
Teragtrogenic
OTC cold/asthma/appetite suppressants -> irregular HR
lidocaine
Na+ channel blocker—> slows conduction—> AFIB
BB: fatal arrhythmias & death c/ recent MI
Worsening HF, widened QRS, dysrhythmias.
Heart blocks, HF
OTC asthma, cold, appetite—> irregular HR
flecainide (Tambocor)
K+ channel blocker-> slows depolarization/refractory—>slowed HR
Life threatening ventricular/atrial tachy dysrhythmias
BB: long term use= fatal pulmonary toxicity
Heart block, HF, teratogenic.
GRAPEFRUIT, B blockers, digoxin, phenytoin
OTC cold/asthma/appetite—> irregular HR
amioderone (Cordarone)
Ca+ channel blockers
Vasodilators in smooth muscle—> HTN, stable angina
Reflex tachy, Vasodilatory (HA, dizzy, flushing), gingival hyperplasia, peripheral edema
D-D, GRAPEFRUIT, HEART BLOCK
nifedipine (Adalat), amlodipine (Procardia)
Ca+ channel blockers—> slower conduction—>atrial tachycardia
Dizzy, bradycardia, HEART BLOCK
OTC cold/asthma/appetite suppressants—>irregular HR
HOLD HR<60/SBP<90
diltiazem (Cardizem), verapamil (Calan)
cardiac glycoside (inhibit Na+, K+)—> increase contractility (Ca+)—> HF
Push thru IV SLOWLY-5MIN
NARROW WINDOW 0.5-2
Ventricular dysrhythmias, AV block, hypokalemia
D-D, HERBAL
TAKE SAME TIME/ 1HR ac ANTACID
Hold HR <60
Antidote = DIGIBIND (antigen binding fragments)
digoxin (Lanoxin)
Sympathomimetics—> Beta 1 agonist—> increased CO
SEVERE HF (*short term)
Tachy, dysrhythmias, angina
MAOIs, TCA, GENERAL ANESTHESIA
Monitor I&O
dobutamine, dopamine
ACE inhibitors (-pril)
Decreased vasoconstriction, increased vasodilation. K+ retention
HTN & HF
Dry cough, hypotension, hyperkalemia, angioedema, taste distortions, rash
TERATOGENIC, LIVER DX, NSAIDS, SALT SUBS
captopril, lisinopril, elanopril, ramipril
ARBs (-sartan)
Vasodilation & retention of K+—> HTN
Angioedema, dizzy, hypotension, HA, insomnia
TERATOGENIC, NSAIDS, RENAL DYSFX
losartan, valsartan, irbesartan (Cozaar, Diovan, Avapro)
K+ sparing diuretic (aldosterone antagonist)—> HF, ascites (liver dx), HTN <3
Give c/ food
Dizzy, HA, abd cramping, diarrhea
TERATOGENIC, INC RISK HYPERKALEMIA C/ ACE/ARBS
I&O/ weights/ SALT SUB
spironolactone (Alactone)
Loop diuretics—> inhibits Na+, K+, Cl reabsorption—>RAPID relief edema
(HF, HTN, renal, liver dx)
Push thru IV SLOWLY- ototoxic)
Hypokalemia, hyponatremia, hypochloremia, dehydration, hypotension
Hyperglycemia, hyperuricemia
CRE, BUN, GFR
LITHIUM TOXICITY, OTHER OTOTOXIC, DIGOXIN
furosemide (Lasix), bumetanide (Bumax), torsemide (Demadex)
Distal convoluted tube—> inhibits reabsorption of Na+, Cl, H20 & H2C03
HTN, edema d/t HF (*must have renal fx)
Give c/ food
Electrolyte imbalances (hyponatremia, hypokalemia, hypochloremia)
Hyperglycemia, Hyperuricemia
LITHIUM TOXICITY
CRE, BUN, GFR, I&O
hydrochlorothiazide (Microzide) chlorothiazide (Diuril)
Retention of K+ & excretion of H20 & Na+
HTN & sx of HF s/p MI
Up to 4 wks for effect
Hyperkalemia
TERATOGENIC, AVOID K+ INCREASING MEDS, LITHIUM, NSAIDS
eplerenone (Inspra), spironolactone (Aldactone)
Prevents synthesis of vit-K in liver—> prevention of clotting (thromboembolic dx)
DVT, PE, Afib, mechanical heart valve
Up to 3-5 days for effect, INR 2-3 (too thin or too thick?)
Bleeding—>NARROW WINDOW. ETOH, GI, thrombocytopenia
TERATOGENIC, D-D, HERBS
Antidote = VIT. K
warfarin (Coumadin)
Inhibits platelet aggravation—> MI, CVA/TIA, Coronary stents
GI upset, renal damage, bleeding
Caution c/ anticoags, Ibuprofen decreases effects
ACE/ARBs increase renal damage
ETOH increases bleeding
SALICYLISM = TOXICITY (tinnitus, HA, dizzy)
aspirin (ASA)
