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My Class > Medications: Cardiovascular > Flashcards

Medications: Cardiovascular Flashcards

1
Q

What are the drug classes of Acetylsalicyclic Acid (ASA) aka Aspirin

A

Anti-Platelet Aggregator
Salicylate
NSAID

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2
Q

Of its many drug classes, which is the reason ASA (Aspirin) is given for cardiovascular health?

A

Anti-Platelet Aggregator

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3
Q

How does ASA (Aspirin) work in the body as an Anti-Platelet Aggregator?

A

Inhibits platelet aggregation in the arteries

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4
Q

How does ASA (Aspirin) work in the body as a Salicylate and a NSAID

A

Inhibits prostaglandin synthesis to reduce pain and fever

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5
Q

What route is ASA (Aspirin) administered? When is it administered?

A

Given PO
Given daily for anti-platelet aggregator effects
Given daily or PRN for salicylate and NSAID effects

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6
Q

What lab should be monitored when the patient is taking daily ASA (Aspirin)

A

Platelets

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7
Q

What complications are ideally being prevented by administering a daily ASA (Aspirin)

A

Transischemic Attack (TIA)
Stroke
Myocardial Infarction (MI)
Coronary Artery Disease (CAD)

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8
Q

When a patient takes ASA (Aspirin) or Plavix (Clopidogrel) daily, what are they at increased risk for? What education needs to be provided?

A

Increased risk for bleeding
Educate the patient on increased bruising and bleeding more easily
Educate the patient on s/s of bleeding (blood in urine or stool)

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9
Q

If a patient presents with s/s of bleeding, what labs must the nurse assess?

A

Hemoglobin
Hematocrit
RBCs
Platelets

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10
Q

What is the drug class of Plavix (Clopidogrel)?

A

Anti-Platelet Aggregator

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11
Q

How does Plavix (Clopidogrel) work in the body?

A

Inhibits platelet aggregation in the arteries

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12
Q

What complications are ideally being prevented by administering a daily Plavix (Clopidogrel)?

A 
Transischemic Attack (TIA)
Stroke
Myocardial Infarction (MI)
Coronary Artery Disease (CAD)
Stenosis of coronary stents
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13
Q

What are medications that fall under the drug class of a statin?

A

Simvastatin (Zocor)
Atorvastatin (Lipitor)
Pravastatin (Pravachol)

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14
Q

What drug class are the following medications:
Simvastatin (Zocor)
Atorvastatin (Lipitor)
Pravastatin (Pravachol)

A

Statin

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15
Q

How does a statin work?

A

Reduces LDL and total cholesterol by reducing cholesterol synthesis in the liver
Statins can increase HDL levels
Statins can decrease triglyceride level

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16
Q

How is a statin administered? When is it administered? Why?

A

Administered PO

Administered daily, at night; because this is when cholesterol synthesis is the highest

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17
Q

What labs need to be monitored when a patient is taking a statin?

A

HDL, LDL, Triglycerides, Total Cholesterol: These labs will tell us how well the statin is working

AST, ALT, ALP: These labs will tell us if liver function is impaired (statins are hepatotoxic)

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18
Q

How long must a patient remain on a statin?

A

Lifelong, unless other measures (like diet and exercise) are taken to reduce cholesterol.
If high cholesterol is genetic, modifiable risk factors will not change cholesterol levels

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19
Q

What medications fall under the drug class of a loop diuretic?

A

Bumetanide (Bumex)
Furosemide (Lasix)
Tosemide (Demadex)

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20
Q

The medications Bumetanide (Bumex), Furosemide (Lasix), and Tosemide (Demadex) are in what drug class?

A

Loop Diuretic

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21
Q

How does a loop diuretic work?

A

It is a potent diuretic
It increases renal secretion of sodium, chloride, potassium, and water
It increases urine output - thus removing fluid from the body
When fluid is removed, it will decrease intravascular fluid volume, thus lowering blood pressure and decreasing cardiac workload

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22
Q

About how long does it take for diuresis to begin after administration of a PO loop diuretic? How long will it work in the body?

A

Diuresis begins in about 60 minutes

Lasts about 8 hours

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23
Q

What are some reasons diuretic (all types) are given?

A 
To manage:
Hypertension
Chronic Heart Failure
Pulmonary Edema
Edema
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24
Q

When can diuretics be given during the day?

A

They can be given daily or multiple times a day

If only given once a day it should be scheduled in the morning to prevent nocturia

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25
Q

What vital sign should be assessed before and after administering any type of diuretic?

A

Blood pressure

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26
Q

What should be monitored when a patient is taking any type of diuretic?

A 
Blood pressure; monitor for hypotension
Intake and output
Signs and symptoms of dehydration
Weight daily
Electrolyte levels
S/s of electrolyte imbalances
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27
Q

What medications fall under the drug class of a Thiazide diuretic?

A

Hydrochlorothiazide - aka HCTZ - (Microzide or Hydrouril)
Chlorothiazide (Diuril)
Metolazone

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28
Q

The medications Hydrochlorothiazide - aka HCTZ - (Microzide or Hydrouril), Chlorothiazide (Diuril) and Metolazone are in what drug class?

A

Thiazide Diuretic

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29
Q

How does a Thiazide diuretic work?

A

It increases renal secretion of sodium, chloride, potassium, and water
It increases urine output - thus removing fluid from the body
When fluid is removed, it will decrease intravascular fluid volume, thus lowering blood pressure and decreasing cardiac workload

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30
Q

What is the difference between a Thiazide diuretic and a Loop diuretic?

A

A loop diuretic is much more potent than a Thiazide diuretic, it does not produce as much diuresis

Thiazide diuretics aren’t effective in decreased kidney function

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31
Q

About how long does it take for diuresis to begin after administration of a PO Thiazide diuretic? How long will it work in the body?

A

Diuresis begins about 2 hours after administration

Works up to 12 hours

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32
Q

What medication falls under the drug class of a Potassium Sparing diuretic?

A

Spironolactone (Aldactone)

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33
Q

The medication Spironolactone (Aldactone) is in what drug class?

A

Potassium Sparing Diuretics

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34
Q

How does a Potassium Sparing Diuretic work?

A

Blocks actions of aldosterone
Increased excretion of sodium and fluid
Retains potassium

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35
Q

What foods should be avoided when the patient is taking a potassium sparing diuretic?

A

Foods rich in potassium

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36
Q

What medications fall under the drug class of an Angiotensin Converting Enzyme Inhibitor (ACE Inhibitor)?

A

Lisinopril (Prinivil)
Enalapril (Vasotec)
Captopril (Capoten)
Quinapril (Accupril)

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37
Q

The medications Lisinopril (Prinivil), Enalapril (Vasotec), Captopril (Capoten), and Quinapril (Accupril) are in what drug class?

A

Angiotensin Converting Enzyme Inhibitor (ACE Inhibitor)

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38
Q

How does an Angiotensin Converting Enzyme Inhibitor (ACE Inhibitor) work?

A

It blocks synthesis of Angiotensin II
This prevents vasocontriction (promotes vasodilation of arteries –> decreased blood pressure)
Prevents release of aldosterone (increased excretion of sodium and fluid, decreased fluid volume –> decreased blood pressure)

These actions ultimately reduce peripheral vascular resistance which decreases blood pressure
Cardiac workload decreases

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39
Q

Why is an Angiotensin Converting Enzyme Inhibitor (ACE Inhibitor) given?

A

Treatment of:
Hypertension
Chronic Heart Failure

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40
Q

What symptoms does the nurse need to educate on and monitor for when the patient is taking an Angiotensin Converting Enzyme Inhibitor (ACE Inhibitor)

A

New-onset dry, irritating, persistent, nonproductive cough

Angioedema (swollen tongue and lips, narrowed airway –> emergency!)

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41
Q

What vital signs should be assessed before and after administration of an Angiotensin Converting Enzyme Inhibitor (ACE Inhibitor)

A

Blood pressure

Monitor for hypotension

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42
Q

What electrolyte does an Angiotensin Converting Enzyme Inhibitor (ACE Inhibitor) retain? What imbalance should be monitored for?

A

Potassium

Monitor for s/s of hyperkalemia

43
Q

What medications fall under the drug class of an Angiotensin II Receptor Blocker (ARB)?

A

Candesartan (Atacand)
Losartan (Cozaar)
Olmesartan (Benicar)

44
Q

The medications Candesartan (Atacand), Losartan (Cozaar), and Olmesartan (Benicar) are in what drug class?

A

Angiotensin II Receptor Blocker (ARB)

45
Q

How does an Angiotensin II Receptor Blocker (ARB) work?

A

Blocks Angiotensin II Receptors
Prevents Angiotensin II from binding to receptors
Promotes vasodilation (reduces blood pressure)
Decreased release of aldosterone (increases excretion of sodium and fluid –> reduces fluid volume –> decreases blood pressure)

These actions ultimately reduce peripheral vascular resistance which decreases blood pressure
Cardiac workload decreases

46
Q

Why is an Angiotensin II Receptor Blocker (ARB) given?

A

Treatment of:
Hypertension
Chronic Heart Failure

47
Q

What symptoms does the nurse need to educate on and monitor for when the patient is taking an Angiotensin II Receptor Blocker (ARB)?

A

New-onset dry, irritating, persistent, nonproductive cough

Angioedema (swollen tongue and lips, narrowed airway –> emergency!)

48
Q

What electrolyte does an Angiotensin II Receptor Blocker (ARB) retain? What imbalance should be monitored for?

A

Potassium

Monitor for s/s of hyperkalemia

49
Q

What vital signs should be assessed before and after administration of an Angiotensin II Receptor Blocker (ARB)

A

Blood pressure

Monitor for hypotension

50
Q

Would a patient be prescribed both an Angiotensin II Receptor Blocker (ARB) and an Angiotensin Converting Enzyme Inhibitor (ACE Inhibitor)?

A

No, they have the same actions on the body.

51
Q

What medications fall under the drug class of a Calcium Channel Blocker (CCB)?

A

Amlodipine (Norvasc)
Nicardipine (Cardene)
Nifedipine (Procardia)
Diltiazem (Cardizem)

52
Q

The medications Amlodipine (Norvasc), Nicardipine (Cardene), Nifedipine (Procardia), and Diltiazem (Cardizem) are in what drug class?

A

Calcium Channel Blocker (CCB)

53
Q

How does a Calcium Channel Blocker (CCB) work?

A

Prevents movement of extracelluar calcium from entering the cell (cardiac cells, smooth muscle cells)

Promotes vasodilation (decreases blood pressure)
Decreases afterload (decreases cardiac workload and blood pressure)
Slows cardiac conduction system (decreases contractility of the myocardium, decreases cardiac workload, decreased myocardial oxygen demand)
54
Q

Why is a Calcium Channel Blocker (CCB) given?

A

To treat:
Hypertension
Cardiac dysrhythmias (atrial fibrillation)

55
Q

What symptoms does the nurse need to educate on and monitor for when the patient is taking a Calcium Channel Blocker (CCB)?

A

Monitor and educate on cardiac dysrhythmias and bradycardia

56
Q

What vital signs should be assessed before and after administration of a Calcium Channel Blocker (CCB)

A

Blood pressure and heart rate

Monitor for hypotension and bradycardia

57
Q

When should a Calcium Channel Blocker (CCB) not be given?

A

If the heart rate is less than 60 bpm

58
Q

What medications fall under the drug class of a Beta Blocker? (differentiate between cardio selective and non selective)

A

Cardio Selective:
Metoprolol Tartrate (Lopressor)
Metoprolol Succinate Extended Release (Toprol XL)
Atenolol (Tenormin)

Non Selective:
Propranolol

59
Q

The medications Metoprolol Tartrate (Lopressor)
Metoprolol Succinate Extended Release (Toprol XL)
Atenolol (Tenormin), and Propranolol are in what drug class?

A

Beta Blocker

60
Q

How does a Beta Blocker work?

A 
Blocks beta receptors from binding to epinephrine, which causes:
Decreased heart rate
Decreased cardiac output
Decreased cardiac workload
Decreased myocardial oxygen demand
Prevents release of renin

Indirectly decreases blood pressure

61
Q

Why is a Beta Blocker given?

A

To treat:
Hypertension
Tachycardia

62
Q

What symptoms does the nurse need to educate on and monitor for when the patient is taking a Beta Blocker?

A

Monitor and educate on hypotension and bradycardia

Hypoglycemic Unawareness in Diabetics

63
Q

What vital signs should be assessed before and after administration of a Beta Blocker

A

Heart rate and blood pressure

64
Q

When should a Beta Blocker not be given?

A

If heart rate is less than 60 bpm
If blood pressure is less than 100 mmHg systolic

Do not administer a nonselective beta blocker (propranolol) to a patient with asthma or COPD

65
Q

What medications fall under the drug class of a combo drug (Alpha and Beta Blocker)?

A

Carvedilol

Labetalol

66
Q

The medications Carvedilol and Labetalol are in what drug class?

A

Combo drug (Alpha and Beta Blocker)

67
Q

How does a combo drug (Alpha and Beta Blocker) work?

A

Blocks alpha and beta receptors from binding to epinephrine, which causes the follow effects

Beta Antagonist Actions:
Decreased heart rate
Decreased cardiac output
Decreased cardiac workload
Decreased myocardial oxygen demand
Prevents release of renin

Indirectly decreases blood pressure

Alpha Antagonist Actions:
Promotes vasodilation of arteries (decreased blood pressure)

68
Q

Why is a combo drug (Alpha and Beta Blocker) given?

A

To treat:
Hypertension
Tachycardia

69
Q

What symptoms does the nurse need to educate on and monitor for when the patient is taking a combo drug (Alpha and Beta Blocker)?

A

Monitor and educate on hypotension and bradycardia

Hypoglycemic Unawareness in Diabetics

70
Q

What vital signs should be assessed before and after administration of a combo drug (Alpha and Beta Blocker)

A

Heart rate and blood pressure

71
Q

When should a combo drug (Alpha and Beta Blocker) not be given?

A

If heart rate is less than 60 bpm
If blood pressure is less than 100 mmHg systolic

Do not administer a nonselective beta blocker (propranolol) to a patient with asthma or COPD

72
Q

Are combo drugs (Alpha and Beta Blocker) cardio selective or non selective?

A

Non selective

73
Q

What medication falls under the drug class of an Alpha 2 Agonist?

A

Clonidine

74
Q

The medication Clonidine is in what drug class?

A

Alpha 2 Agonist

75
Q

How does an Alpha 2 Agonist work?

A

Inhibits sympathetic nervous system activity

Thus reduces blood pressure

76
Q

Why is an Alpha 2 Agonist given?

A

To treat hypertension

77
Q

What symptoms does the nurse need to educate on and monitor for when the patient is taking an Alpha 2 Agonist?

A

Dry mouth

Rebound HTN

78
Q

What vital signs should be assessed before and after administration of an Alpha 2 Agonist

A

Blood Pressure

79
Q

What medication falls under the drug class of a direct vasodilator?

A

Hydralazine

80
Q

The medication Hydralazine is in what drug class?

A

Direct Vasodilator

81
Q

How does a direct vasodilator work?

A

Relaxes smooth muscle (arteries)

Vasodilates arteries, decreases blood pressure

82
Q

Why is a direct vasodilator given?

A

To treat hypertension

83
Q

What symptoms does the nurse need to educate on and monitor for when the patient is taking a direct vasodilator?

A

Headache

Skin flushing

84
Q

What vital signs should be assessed before and after administration of a direct vasodilator

A

Blood pressure

85
Q

What medication falls under the drug class of an Antidysrhythmic Agent?

A

Amiodarone (Cordarone or Pacerone)

86
Q

The medications Amiodarone (Cordarone or Pacerone) are in what drug class?

A

Antidysrhythmic Agent

87
Q

How does an Antidysrhythmic Agent work?

A

Decreases cardiac contractility
Promotes dilation of coronary arteries and peripheral blood vessels

Controls rhythm and rate during atrial fibrillation

88
Q

Why is an Antidysrhythmic Agent given?

A

To control heart rate and rhythm

89
Q

What vital signs should be assessed before and after administration of an Antidysrhythmic Agent

A

Blood pressure and heart rate

Also need to assess heart rhythm

90
Q

What medication falls under the drug class of a Cardiac Glycoside/Inotrope?

A

Digoxin (Lanoxin)

91
Q

The medication Digoxin (Lanoxin) is in what drug class?

A

Cardiac Glycoside/Inotrope

92
Q

Why is a Cardiac Glycoside/Inotrope given?

A

To control heart failure

93
Q

What symptoms does the nurse need to educate on and monitor for when the patient is taking a Cardiac Glycoside/Inotrope

A

Digitalis Toxicity
Bradycardia
S/S of hypokalemia

94
Q

How does a Cardiac Glycoside/Inotrope work?

A

Increases the force of contraction within the ventricles
Increases stroke volume
This increases cardiac output so that heart rate can decrease and heart doesn’t have to work as hard

Heart works smarter not harder.. each beat/pump of the ventricles is efficient, so its rate doesn’t have to increase to maintain cardiac output.

95
Q

What education needs to be given to the patient when they are taking a Cardiac Glycoside/Inotrope?

A

Take the medication at the same time each day
Educate on the signs and symptoms of Digitalis Toxicity
If Digitalis Toxicity s/s are present, report ASAP
Monitor heart rate before taking the medication, do not take if <60 bpm

96
Q

What serum levels should be monitored when the patient is taking Digoxin? What is the appropriate range?

A

Digoxin Levels

Should be between 0.8-2.0

97
Q

If serum Digoxin levels are < 0.8, what does this mean?

A

There is not enough medication in the body, the medication is not working to its full potential

98
Q

If serum Digoxin levels are > 2.0, what does this mean?

A

The patient is at risk for or may have developed Digitalis Toxicity. This needs to be treated immediately

99
Q

What vital signs should be assessed before and after administration of a Cardiac Glycoside/Inotrope

A

Heart rate
Do not administer if heart rate is <60 bpm

Monitor for bradycardia

100
Q

What can cause Digitalis Toxicity?

A

High serum levels of Digoxin

Hypokalemia

101
Q

List the signs and symptoms of Digitalis Toxicity. If these symptoms occur, what does the nurse do?

A 
Anorexia (Loss of appetite)
Nausea, Vomiting, Diarrhea
Abdominal Discomfort
Blurred vision, yellow/green halos visualized
Fatigue
Confusion
Decreased LOC

If these s/s are noted or reported the nurse must inform the provider

102
Q

What is the relationship between Digoxin and Potassium?

A

Digoxin and Potassium compete for the same receptors

They are in direct competition to attach to receptors

103
Q

If potassium levels are low and the patient is taking Digoxin, what can happen?

A

There are more available receptors for Digoxin to attach to because of the low potassium levels

When Digoxin attaches to these receptors, there is more “active” Digoxin in the blood, which increases serum Digoxin levels

When serum Digoxin levels increase, it puts the patient at risk for Digitalis Toxicity

104
Q

If potassium levels are high and the patient is taking Digoxin, what can happen?

A

More potassium will be attached to receptor sites

There aren’t as many receptors available or open for Digoxin to attach to

Serum Digoxin levels will decrease which causes decreased therapeutic response of the medication

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