Medications - exam 3 Flashcards
Use: work by blocking epinephrine. Used to treat SVT, A-FLUTTER, A-FIB, Sinus Tach, SVT, cardiomyopathy
Effects: Lowers HR and decreases cardiac workload
Special considerations:
* Do not give if HR is less than 60, remember to use apical pulse
* Monitor for hypotension after 1st dose
* Teach pt to rise slowly from seated or lying positions to avoid orthostatic hypotension
* Use cautiously in pt’s w/ HF and asthma
Beta blockers
Use: prevent clot formation
Effects:
Special considerations:
* Monitor CBC
* Bleeding precautions
Anticoagulants
Use: to treat infection, In sepsis use broad spectrum first, then narrow
Effects: offending microorganisms
Special considerations:
* Blood cultures should be obtained before abx are given
* Give 1 hr after arrival to hospital for sepsis
antibiotics
Use: First drug of choice for BP – unresponsive to adequate fluid resuscitation
Effects:
* Increase BP, MAP, CVP, SVR, Cardiac stimulation, peripheral vasoconstriction, renal and splanchnic vasoconstriction
* Can increase or decrease cardiac output
Special considerations:
* Administer via central line
* Monitor pt for dysrhythmias
Vasopressors - Norepinephrine
Use: Prevent seizures, used in treatment of pre-eclampsia
Effects: Depresses CNS
Special considerations:
* Has a narrow window of therapeutic effect so must be monitored closely for S/S of toxicity
Magnesium Sulfate
Use: To treat dysrhythmias like: Sinus Brady, a-fib, a-flutter, SVT, Junctional rhythms, Symptomatic 2nd & 3rd degree heart block, HTN, CAD and angina
Effects: Bradycardia, hypotension, and peripheral edema
Special considerations:
* These drugs are contraindicated in patients who are allergic to eggs.
* Patients should also avoid taking these with grapefruit juice.
* Use cautiously in HF patients
Calcium Channel Blockers
Use: Treat SVT. Restoration of normal sinus rhythm. Antiarrythmic
Effects: MI, ventricular tachycardia, seizures, stroke, hypersensitivity reactions
Special considerations:
* Monitor HR, Asystole may occur following injection, resolve quickly.
* Use cautiously in patients with asthma (May induce bronchospasm)
* Teach patient to change positions slowly.
* Maximum dose: NO MORE THAN 2 DOSES
* May result in asystole
Adenosine
antihyperlipoproteinemic
Use: Treat high cholesterol, increases clearance of LDL in bloodstream
Effects: Reduces Cholesterol synthesis in liver
Special considerations:
* These drugs are contraindicated for patients with active liver disease and pregnant patients.
* S/E: myalgia, myopathy, rhabdomyolysis
* Should also not be given with grapefruit juice because the effects can be increased to an unsafe level, leading to harmful side effects like muscle damage, liver and kidney damage
Atorvastatin
Effects: Dilates coronary arteries allowing for more blood/oxygen to cardiac cells
Use: treating sudden onset of angina; can be given prophylactically prior to activities that may cause angina i.e. exercise. Both caused by CAD
Special considerations:
o Can be given sublingual, Transdermal patch, or as spray
o Tablets can be given every 5 minutes for up to a total of 3 doses in 15 minutes. If 3 doses are taken and/or pain persists, medical attention should be sought immediately
o Also given via a transdermal patch. Remember whenever you are replacing a patch, you need to date and time the new patch, remove the old one, apply the new one and document the location in the MAR
Nitroglycerin - nitrate
Use: Increases contractility= Increased stroke volume, Decreases HR
Effects: positive inotrope which means that is increases cardiac contractility
Special considerations:
* Never give if apical HR is less than 60, always check labs before admin
* Major concern for Toxicity; Theraputic range: 0.5-2ng/mL
* S/S of toxicity: vomiting, HA, visual disturbances – yellow halos around lights
* Bradycardia
* Dysrhythmias
Cardiac glycoside – Digoxin(Lanoxin)
Use: First line medication used to treat HTN, HF, MI. Used to treat cardiomyopathy
Effects: Reduces afterload, relaxes blood vessels, decreases BP
Special considerations:
* Can cause K retention so be careful when administering K sparing diuretics, potassium supplements, and check labs
* Can cause dry, persistent cough
* Angioedema
* Do not give to pregnant pt
Ace Inhibitors
What medication class is this?
- Lisinopril (Prinivil/Zestril)
- Benazepril (Lotensin)
- Enalapril (Vasotec)
Ace inhibitors
Digoxin is an example of what medication class
Cardiac Glycoside
Alteplase or t-PA is an example of what medication class
Fibrolytics
ends in -Plase -Ase
These are all different kinds of what?
- Nitrate
- Nitrostat
- Nitromist
- Nitrotab
Nitroglycerin
Adenosine is an example of what medication class?
Antiarrythmic
Atropine is an example of what medication class?
Calcium Channel blockers
Norepinephrine is what medication class?
Vasopressors
- Metoprolol(Lopressor)
- Labetalol(Trandate)
- Propranolol(Inderal)
- Carvedilol(coreg)
The following are all examples of what medication class?
Beta blockers
Special considerations for Beta blockers
Metoprolol
- Do not give if HR is less than 60, remember to use apical pulse
- Monitor for hypotension after 1st dose
- Teach pt to rise slowly from seated or lying positions to avoid orthostatic hypotension
- Use cautiously in pt’s w/ HF and asthma
Special consideratoins for anticoagulants
- Monitor CBC
- Bleeding precautions
Special considerations for abx therapy
- Blood cultures should be obtained before abx are given
- Give 1 hr after arrival to hospital
Special considerations for Vasopressors
Norepinephrine
- Administer via central line
- Monitor pt for dysrhythmias
Special considerations for Mag sulfate
- Has a narrow window of therapeutic effect so must be monitored closely for S/S of toxicity
