Part 1 (anticoagulants, antihyperlipidemic, pain and inflammation Flashcards by Kaitlyn Hoover

What is the action of Heparin?

Combines with antithrombin III to inactivate clotting factors 9, 10, 11, and 12

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What is the therapeutic use of Heparin?

prophylaxis of DVT, PE, MI, management of acute thromboembolic disorders

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What are the adverse effects of Heparin?

Hemorrhage (blood in stool, hematuria, hematemesis, brain hemorrhage) HIT

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What are the contraindication of Heparin?

Active bleeding, intracranial bleed, Hx of gastric ulcers

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What are the nursing actions of Heparin?

Monitor aPPT, protamine sulfate is the antidote, narrow therapeutic range, assess for bleeding

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What are the patient teachings with Heparin?

If bleeding, apply pressure until it stops (up to 10 mins), fall/bleeding precautions

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What drug class is warfarin in?

Vitamin K Antagonist

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What is the action of Warfarin?

Prevents synthesis of Vitamin K clotting factors 2, 7, 9, and 10

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What is the therapeutic use of Warfarin?

Long -term prevention or management of thromboembolic disorders

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What are the adverse effects of Warfarin?

Hemorrhage, N/V, abdominal pain, dizziness, joint/muscle pain, urticaria, alopecia,

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What is Warfarin’s BBW for?

Risk of major hemorrhaging

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what are the contraindications for taking Warfarin?

GI ulcerations, blood disorders, recent surgery of the eye, spinal cord, or brain

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What the nursing actions for Warfarin?

Monitor INR, narrow therapeutic range, assess for s/sx of thrombotic disorders, Vitamin K is the antidote

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What are the patient teachings for Warfarin?

Reduce cardiovascular risk factors, take as prescribed, use an electric razor, fall/bleed precautions, don’t walk barefoot.

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What is the action of Alteplase?

Catalyzes conversion of plasminogen to plasmin, breaking down blood clots

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what is the therapeutic use of Alteplase?

acute coronary arterial thromboembolism

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What are the adverse effects of Alteplase?

Bleeding, symptomatic brain hemorrhage

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What are the contraindications for taking Alteplase?

uncontrolled severe HTN, aneurysm, intracranial or intraspinal surgery or trauma; no recommended for those over 80 yrs

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What are the nursing actions for Alteplase?

only experienced personnel can give Alteplase, assess for cardiac dysrhythmias, check INR, aPPT, platelet count, and fibrinogen; IV only

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What drug class is Atorvastatin (statins) in?

Antihyperlipidemic

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What is the action of Atorvastatin?

inhibits an enzyme needed for synthesis of cholesterol; CYP450 enzyme is needed for the metabolism in the liver

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What is the therapeutic use for Atrovastatin?

primary prevention of CAD, CVD, and tx of hypercholesterolemia

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what are the adverse effects of Atorvastatin?

generally well tolerated – N/D, constipation, HA, rash, hepatic dysfunction, myopathies

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what are the contraindication of taking Atorvastatin?

Pregnancy, lactation, active liver disease

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What are the nursing actions of Atorvastatin

Monitor lipid response

What is the patient teaching for Atorvastatin?

Best taken with evening meal, don't drink grapefruit juice, exercises and low-fat diet helps improve cholesterol levels

what is the action of Niacin?

increases HDL cholesterol

What is the therapeutic use of Niacin

no longer used as a dyslipidemia agent

what are the adverse effects of Niacin?

potential risk of hepatotoxicity, potential for hyperglycemia, skin flushing, pruritis, GI irritation, hepatitis

what are the nursing actions for Niacin?

Niacin- statin combination increases risk of hepatotoxicity.

What drug class is Fenofibrate in?

Fibrates (antihyperlipidemic)

what is the action of Fenofibrate?

increase oxidation in fatty acids, decreasing hepatic production of triglycerides, decreases VLDL and increases HDL

what is the therapeutic use of Fenofibrate?

reduction of triglyceride values, tx of hypertriglyceridemia.

what are the adverse effects of Fenofibrate?

GI discomfort, diarrhea, increased risk of gallstone formation

what are the contraindication of Fenofibrate?

hepatic or severe renal disease; preexisting gallbladder disease, primary biliary cirrhosis, or persistent liver function abnormalities of unknown origin

what are the nursing actions for Fenofibrate?

may enhance warfarin; give w/ food to increase absorption, therapeutic effects occur in 1 month

what drug class is Aspirin in?

salicylate

what is the action of Aspirin?

inhibits prostaglandin synthesis, prevents platelet aggression; blocks pain receptors, anti-inflammatory, antipyretic

what is the therapeutic use of Aspirin?

relieves mild to moderate pain; decreases inflammation in those with arthritis, reduces fever in adults

what are the adverse effects of Aspirin?

N/V, GI discomfort, potential risk for GI bleeds, ASA toxicity, bruising

what is the BBW for Aspirin?

Children and teens with viral illness at increased risk for Reyes syndrome; potentially fetal encephalopathy and fatty liver

what are the contraindication for Aspirin?

children and teens with viral illnesses, pregnancy

what is the nursing actions for Aspirin?

do not give with other NSAID's, assess for ASA toxicity (tinnitus)

what is the patient teaching for Aspirin?

take w/ food and full glass of water; avoid or minimize alcohol intake, do not take concurrently w/ other NSAID's

is acetaminophen (Tylenol) an NSAID?

what is the action of acetaminophen?

act directly on hypothalamus to increase vasodilation and sweating to reduce fever; analgesic

what is the therapeutic use for acetaminophen?

reduces fever and decreases minor pain

what are the adverse effects of acetaminophen?

hepatotoxicity, renal failure, myocardial damage

what are the contraindications for acetaminophen?

cation in pregnany and lactation

what is the nursing actions with acetaminophen?

give with food

what is the patient teaching for acetaminophen?

do not exceed recommended dosage, inform HCP in fever or rash develops

is Ibuprofen a NSAID

YES

what is the action of Ibuprofen?

blocks prostaglandin synthesis; inhibits inflammatory cells

what is the therapeutic use for Ibuprofen?

Tx of mild to moderate pain, tx of inflammation, antipyretic

what are the adverse effects of Ibuprofen?

dry mouth, GI bleed, nauseam epigastric pain, constipation, nephrotoxicity, dyspnea, pharyngitis,

what does Ibuprofen have a BBW for?

increase risk of CV thrombotic event

what are the contraindications for Ibuprofen?

allergy to NSAID's, and salicylates

what is the nursing actions for Ibuprofen?

assess pain, monitor BUN and CR levels, monitor fot bleeding

what is the patient teaching for Ibuprofen?

take w/ food, drink plenty of water, report any signs of bleeding

what drug class is Meloxicam in?

oxicam derivatives (NSAID)

what is the action of Meloxicam?

cox1 and cox2 inhibitor

what is the therapeutic use for Meloxicam?

anti-inflammatory, antipyretic, analgesic, longer lasting and stronger that Ibuprofen.

what are the adverse effects of Meloxicam?

dyspnea, bronchospasm (not good for asthmatic patients), bleeding, anemia

what is Meloxicam BBW for?

Cv events and GI bleeds

what is the contraindications for Meloxicam?

asthmatic patients, those who have aspirin allergy

what are the nursing actions for Meloxicam?

salicylates can increase effects of Meloxicam

what is the patient teachings for Meloxicam?

take w/ food, s/sx of bleeding

what drug class is Celebrex in?

COX 2 inhibitor

what is the action of Celebrex?

inhibits COX 2 enzyme

what is the therapeutic use for Celebrex?

selectively blocks pain and inflammation, RA, osteoarthritis, dysmenorrhea, long-term reducation of colon polyps; medication bypasses stomach

what are the adverse effects of Celebrex?

HA, dizziness, insomnia, MI, renal impairment

what are the contraindications of Celebrex?

known allergies to sulfa, NSAID's, and ASA

what are the nursing actions for Celebrex?

assess for anaphylactic reaction, assess for chest pain, SOB, confusion

what is the patient teaching for Celebrex?

S/sx of MI and anaphylactic reaction

what is the action of Prednisone?

powerful anti-inflammatory; suppresses immune response

what is the therapeutic effect of Prednisone?

allergies, asthma, cancer, COPD, adrenocortical insufficiency

what are the adverse effects of Prednisone?

adrenocortical insufficiency, hypotension, heart failure, hyperglycemia, increased risk of osteoarthritis, decreased immunity

what are the contraindication of Prednisone?

systematic fungal infection, immune suppressant

what are the nursing actions for Prednisone?

must tamper usage; increase dose at times of stress

what is the patient teaching for Predisone?

do not stop abruptly, avoid exposure to infections. report any signs of infection, increase dosage in times of stress.