Test 3 - Cardiovascular Flashcards
What is Cholesterol
Helps maintain Vitamin D levels and hormones
Gemfibrozil teaching
*Class - Fibric Acid Agent
Lowers triglycerides and LDL levels
Combine with Statins for greatest decrease
TEACHING:
—May potentiate warfarin (warfarin prevents blood clots)
—monitor GI effect - TEACH TO TAKE WITH FOOD
—pregnancy B
Non pharmacological cholesterol reduction
Lifestyle changes monitor blood lipid levels maintain weight at optimum level exercise low fat diet and cholesterol increase fiber decrease tobacco use
Statin side effects
*Class - HMG-CoA Reductase Inhibitor first drug of choice to lower cholesterol should be taken in the evening SIDE EFFECTS muscle or Jt pain
RHABDOMYOLISIS
- Muscle fiber breakdown
- rare but serious
- coca cola urine
Statin side effects
*Class - HMG-CoA Reductase Inhibitor
first drug of choice to lower cholesterol
should be taken in the evening
SIDE EFFECTS
headache, fatigue, MUSCLE OR JT PAIN, and heartburn
Types of Lipids
LDL - Bad Cholesterol <100 liver—>tissues
HDL - good cholesterol >40 Tissues—>liver
Triglycerides <150 - stored fat energy
Diuretic adverse effects
Hypokalemia
Hyponatremia
Ototoxicity
SIDE EFFECTS: Dehydration, thirst, dry mouth, weight loss, headache, hypotension, dizziness, fainting
Teach safety with orthostatic hypotension
Loop Diuretic
Most effective
Block reabsorption of Na and Cl in Loop of Henle
Increase UO even when kidney blood flow is diminished
FLUROSEMIDE most frequent
BUMETANIDE 40x more potent, shorter duration
Thiazide Diuretic
Most frequently prescribed class
— less effective than loop but less side effects (does not cause ototoxicity)
Treats mild to moderate HTN
Ineffective in severe renal failure
If allergic to sulfa, may be allergic to Thiazide and Loop
May need K+
Drugs that are Nephrotoxic
NSAIDS ACE inhibitors Radiographic Dyes Aminoglycosides (antibiotics) Amphotericin B (anti fungal) Cancer Drugs Immunodepressants
During renal failure
Dose reduction
Discontinue Nephrotoxic drugs
OSMOTIC DIURETICS (mannitol) - used in acute renal failure —– Administered through a filtered IV
Hyperkalemia Treatment
Hyperkalemia: Kidneys unable to adequately excrete K+
>5 mEq/L
Administer Insulin and Glucose
Ca+ and Sodium Bicarbonate to correct acidosis
Kayexelate po or rectal
Hypokalemia signs and symptoms
Dysrthymias, cardiac arrest
Hyponatremia plan of action
<135 mEq/L
If from fluid overload —> Loop Diuretics
Oral sodium chloride if mild
Parenteral NS or LR if <130
K+ IV administration
NEVER IV PUSH
Solution Tonicity
hypotonic, isotonic, hypertonic
Tonicity: Ability of a solution to cause a cell to lose or gain water
Hypotonic: Treat dehydration with normal B/P (water moves into the cell)
Isotonic: Does not change tonicity of blood - treat dehydration w/ low B/P
Hypertonic: Treat cellular edema - Cell shrinks
Beta blocker contraindications
Asthma or Chronic Bronchitis
HR<60
Beta blocker mechanism of action
Decrease BP and HR (second line drug) Decreases workload (negative inotropic effect)
Antihypertensive Drugs
ABCD Ace inhibitors/Angiotensin II blockers Beta blockers Calcium channel blockers Diuretics
Beta blocker side effects
Bradycardia.. do not give to pt with HR <60
Heart block
HCTZ teaching
Hydrochlorothiazide - Diuretic
Used or Mild to Moderate HTN
Adverse effects: Electrolyte imbalance (esp K+)
—May need potassium
Ineffective in severe renal failure
Allergy to sulfa may have allergy to thiazide and loop diuretics
Loop diuretics lab tests
Lab Test Considerations: Monitor electrolytes (especially potassium), blood glucose, BUN (blood urea nitrogen), and serum uric acid levels before and periodically throughout course of therapy.