Nitrates Flashcards
Nitrates Drug Names
Isosorbide dinitrate
Isosorbide mononitrate
Nitroglycerin
Nitrates Therapeutic Actions
• Acts directly on smooth muscle to cause relaxation and depress muscle tone of blood vessels (major vasodilation)
Nitrates Indications
- Prevention and treatment of attacks of angina pectoris
Nitrates Contraindications and Cautions
Contraindication: • Allergy • Severe anemia • Head trauma or cerebral hemorrhage • Pregnancy and lactation
Caution: • Hepatic or renal disease • Hypotension • Hypovolemia • Conditions that limit cardiac output
Nitrates DDI
DDI:
• Ergot derivatives
• Heparin
• Sildenafil, talafil, vardenafil (erectile dysfunction medication)
Nitrates Adverse Effects
- CNS: (terrible) headache, dizziness, and weakness
- GI: nausea, vomiting
- CV: Hypotension
- Flushing, pallor increased perspiration
Nitrates:
Assessments
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
Nitrates:
Diagnosis
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
Nitrates:
Implementation
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
Nitrates:
Evaluation
Eval: Response to the drug Adverse effects Effectiveness of comfort measures Compliance with the regimen Effectiveness of the teaching plan