Medications Affecting the Cardiovascular System Flashcards
Indications of Angiotensin-Converting Enzyme (ACE) Inhibitors
- hypertension
- HF
- help diabetics prevent kidney problems
What does ACE inhibitors act as
vasodilator
ACE inhibitors examples
-enalapril
-lisinopril
-captopril
(ends in -pril)
What medication ends in (-pril)
ACE inhibitors
What should ACE inhibitors be monitored for
- hypotension
- cough
- edema
- increased BUN
What are antithrombotic agents for
- decreases coagulability (capable of forming clots)
- prevents formation of new clots
What will antithrombotic agents do to existing clots
keep existing clots from growing larger
What does antithrombotic agents not do
dissolve existing clots
What is a contraindication of antithrombotic agents
active bleeding
What does Heparin do
-prevents blood clots
-stops the growth of clots that have already formed
(does not decrease clot that has already formed
What is the antidote of Heparin
Protamine Sulfate
How is Heparin administered
- subQ or IV
- used in small amounts to prevent blood clots from forming in catheters
How often to give Heparin
subQ every 12 hr
-continuous or intermittent IV infusion
What should be monitored when giving Heparin
APTT every 4-6 hour until appropriate dose is determined, then monitor daily
What does PT (prothrombin time) test measure
how much warfarin (coumadin) a person has in there system
What does Warfarin interfere with
vitamin K dependent coagulation factors
Difference from Warfarin and Heparin
Warfarin action is more prolonged then heparin
Administration teaching for Warfarin
Take this medication the same time each day
What lab test does Warfarin affect
PT/INR values
What are antiplatelet agents for
stops platelets from sticking together and forming a clot
What are antiplatelet agents contraindications for
person who has an active bleeding
What should be monitored when taking antiplatelet agents
bleeding
Types of antiplatelet agents medications
- Aspirin.
- Clopidogrel
- Ticlopidine
- Abciximab
- Tirofiban
What are Thrombolytics
dissolves thrombi (blood clot) in the coronary arteries and restores myocardial blood flow during first 6 hours of a MI
Thrombolytics contraindications
- active bleeding
- hypertension
- pregnancy
- recent stroke, surgery, trauma
Types of Thrombolytics medications
-reteokase
-activase
-tenecteplase
(ends in -ase)
What medication class ends in (-ase)
Thrombolytics
What are Antidysrhythmics for
abnormal electrical activity of the heart
-atrial and ventricular dysrhythmias
What should be monitored when a pt is taking Antidysrhythmics
-HR and rhythm
Types of Antidysrhythmics medications
- amiodarone
- lidocaine
- quinidine
- procainamide
What do Statins do
lower cholesterol by blocking enzymes that are essential to the production of cholesterol in the body
Rare reactions of Statins
- myositis, myopathy
- potential of rhabdomyolysis (breakdown of skeletal muscle) leading to kidney failure
Examples of Statins
-Niacin
-Questran
-Gemfibrozil
-lovastatin
-atorvastatin
-atorvastatin
(ends in -statin)
Purpose of Beta Blockers
- hypertension
- angina
- postmyocardial infarction
In patients w/ Mi Beta Blockers decreases
- size of infarction
- ventricular dysrhythmias
- mortality rates
What do Beta Blockers do to the heart
slows the HR and decrease BP
What should be assessed before administering Beta Blockers
Apical pulse, if <60/min hold and notify the provider
Beta Blockers adverse effects
- fatigue
- lethargy
- wheezing
- dyspnea
- HF
- impotence
Contraindications of Beta Blockers
bronchial asthma
Examples of Beta Blockers
-metroprolol
-atenolol
-carvedilol
-propranolol
(ends in -olol)
What medication ends in (-olol)
Beta Blockers
What does Calcium Channel Blockers cause
dilation of peripheral and coronary arteries
What do Calcium Channel Blockers do
enhances vasodilation and lowers BP
-decreases afterload
Calcium Channel Blockers indications
- angina
- hypertension
- dysrhythmias
What should be monitored when giving a Calcium Channel Blockers
- HR and rhythm
- BP
Calcium Channel Blockers examples
- Diltiazem
- Verapamil
- Nifedipine
What are (Positive) Inotropic Agents
increases force of myocardial contraction
What do (Positive) Inotropic Agents do
makes heartbeat slower, regular, and more powerful
Results of (Positive) Inotropic Agents
increased cardiac output
increased blood flow to the kidneys
What has (Positive) Inotropic characteristics but is classified as a Cardiac Glycoside
Digoxin
Digoxin toxicity adverse effects
- anorexia
- nausea, vomiting
- visual disturbances
- lethargy
- bradycardia
- heart block
- tachydysrhythmias
What should be assessed before administering digoxin
apical HR for 1 full min
What is the normal Digoxin level
0.8 to 2.0 ng/mL
What should be monitored when administering digoxin
potassium levels
What if a patient has hypokalemia when taking digoxin
they become dig-toxic, they NEED to eat foods high in potassium
What medication should you watch for toxicity while taking digoxin
Lasix with digoxin
What does Dobutamine do
- increased HR
- increased myocardial contractility
- increased rate of conduction through the AV node
What does Dopamine do
- comlement inotropic action of digoxin
- increases rate and force of heart muscle contraction
- at low doses, increases blood flow to the kidneys
What does Epinephrine do
-stimulates alpha, beta q and beta 2 receptors which causes cardiac stimulation, bronchodilation, decongestion
What do Nitrates do
increases coronary blood flow by dilating coronary arteries and improving blood flow to ischemic regions of the heart
Ways to administer Nitrates
- sublingual (SL)
- IV
- oral (PO)
- transdermal (TD)
What does Nitrates treat
- angina
- hypertension
- MI
- congestive HF (CHF)
How to instruct a patient to take Nitrates (nitroglycerin) for acute anginal attacks
-instruct pt to lie down
-immediately place under tongue to dissolve.
– Repeat at 5-min intervals.
– If pain is not relieved by the first tablet, call 911, then take the second tablet.
– After 5 more min, take a third tablet if pain is still not relieved.
-Do not take more than three sublingual tablets.
Side effects of Nitrates
- headaches
- hypotension
