Nitrates Flashcards

1
Q

Nitrates Drug Names

A

Isosorbide dinitrate

Isosorbide mononitrate

Nitroglycerin

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2
Q

Nitrates Therapeutic Actions

A

• Acts directly on smooth muscle to cause relaxation and depress muscle tone of blood vessels (major vasodilation)

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3
Q

Nitrates Indications

A
  • Prevention and treatment of attacks of angina pectoris
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4
Q

Nitrates Contraindications and Cautions

A
Contraindication:
•	Allergy 
•	Severe anemia 
•	Head trauma or cerebral hemorrhage
•	Pregnancy and lactation
Caution: 
•	Hepatic or renal disease 
•	Hypotension 
•	Hypovolemia 
•	Conditions that limit cardiac output
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5
Q

Nitrates DDI

A

DDI:
• Ergot derivatives
• Heparin
• Sildenafil, talafil, vardenafil (erectile dysfunction medication)

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6
Q

Nitrates Adverse Effects

A
  • CNS: (terrible) headache, dizziness, and weakness
  • GI: nausea, vomiting
  • CV: Hypotension
  • Flushing, pallor increased perspiration
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7
Q

Nitrates:

Assessments

A

Assess:
Hx: allergy, early MI, head trauma, cerebral hemorrhage, hypotension, hypovolemia, anemia, or low cardiac output, pregnancy or lactation
Physical: vital signs, weight, heart & lung sounds, skin, perfusion(pulses), skin condition (baseline)
Labs: CBC, hemoglobin & hematocrit, renal and hepatic functions

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8
Q

Nitrates:

Diagnosis

A

Dx:

  • Decreased cardiac output related to vasodilation and hypotensive effects
  • Risk for injury related to CNS or CV effects
  • Ineffective tissue perfusion related to hypotension or changes in cardiac output
  • Deficient knowledge
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9
Q

Nitrates:

Implementation

A

Implementation:
• Have the patient lay down or sit down prior to administration
• Give sublingual preparations under the tongue or in the buccal pouch
• SL does may be repeated 3 times, five minutes apart, if no relief they need to go to emergency room
• Give SR with water and don’t chew
• Have life-support equipment ready
• Provide thorough patient teaching

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10
Q

Nitrates:

Evaluation

A
Eval:
Response to the drug
Adverse effects 
Effectiveness of comfort measures Compliance with the regimen
Effectiveness of the teaching plan
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