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318 topics 6-8 > topic 7 cardiac drugs > Flashcards

topic 7 cardiac drugs Flashcards

1
Q

nonpharmalogical ways to treat HF

A

limit salt and saturated fat
limit/stop alc intake, no smoking
mild exercise

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2
Q

class of digoxin

A

cardiac glycoside

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3
Q

MOA of digoxin

A

inhibits sodium potassium pump, slowing down the heart, allowing it to contract more easily
- results in increased cardiac output and increased tissue perfusion

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4
Q

what assessment do you do before giving digoxin

A

take apical pulse for 1 min

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5
Q

lab considerations for digoxin

A

check potassium

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6
Q

why is digoxin given

A

for dysrythmias

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7
Q

what effect does digoxin have on heart muscle

A

Increases myocardial contractility

Decreases heart rate

Decreases conduction

Increases cardiac output

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8
Q

digoxin contraindications

A

renal and hepatic dysfunction, bradycardia, electrolyte imbalance, older adults

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9
Q

signs of digoxin toxicity

A

nausea, weakness, diarrhea, vomiting, HR below 60, green/yellow halos, confusion

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10
Q

digoxin range for HF

A

0.5-1 ng

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11
Q

patient teaching for digoxin

A

take apical pulse, eat dried fruits and potatoes, ensure you have enough medication

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12
Q

what class is nitroglycerin

A

antianginal

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13
Q

CAM interactions with digoxin

A

st johns wort decreases absorption
licorice, aloe, ephedra increases risk of toxicity

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14
Q

uses for nitroglycerin

A

angina, heart attack

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15
Q

MOA of nitroglycerin

A

decreases myocardial demand for O2, vasodilates

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16
Q

normal side effects of nitroglycerin

A

dizziness and headache, blurred vision, GI distress

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17
Q

how long do you leave the nitroglycerin patch on for?

A

leave on for 12, take off for 12

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18
Q

what should you do if angina doesn’t go away after one sublingual tab of nitroglycerin

A

after 5 min call 911, do 2 more doses (3 in total)

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19
Q

drug interactions with nitroglycerin

A

don’t give with other drugs that impact BP

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20
Q

priority assessment with nitroglycerin

A

BP first then HR

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21
Q

caution with nitroglycerin

A

renal or hepatic disease
acute MI
head trauma
pregnancy, breastfeeding

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22
Q

normal BUN range

A

10-20 mg

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23
Q

normal creatinine range

A

.5-1.3mg (over 2 bad)

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24
Q

classification of atenolol

A

beta 1 blocker

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25
Q

uses of atenolol

A

hypertension, angina, prophylaxis is treatment of acute MI

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26
Q

what does atenolol do?

A

lowers HR
lowers contractility
lowers O2 demand to heart

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27
Q

atenolol nursing considerations

A

don’t stop abruptly, will cause rebound hypertension,
monitor BP and HR

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28
Q

contraindications for atenolol

A

Sinus bradycardia, heart block
Pulmonary edema (decreases contractility so it would cause even more edema) , acute bronchospasm

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29
Q

caution for atenolol

A

renal dys, diabetes

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30
Q

interactions with atenolol

A

atropine and anticholinergic drugs (increases)
decreased effects w/ NSAIDs
risk of hypoglycemia with insulin

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31
Q

side effects of atenolol

A

CNS effects, depression, erectile dysfunction, GI distress, cool extremities

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32
Q

what does a pt taking atenolol need to report if they feel?

A

report complaints of excessive dizziness, lightheadedness, early morning insomnia, mental depression, or chest pain

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33
Q

what class is diltiazem?

A

calcium channel blocker

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34
Q

what is the action of calcium channel blockers

A

blocks calcium access to cells, relaxing coronary artery spasms
- decreases contractility and O2 demand (less cardiac workload, relaxes heart)

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35
Q

side effects of diltiazem

A

low BP, bradycardia, headache, edema, nausea

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36
Q

pt education for diltiazem

A

stand up slowly, do not stop abuptly can cause angina episode, monitor BP

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37
Q

what is the most effective anginal for African Americans

A

calcium channel blockers (diltiazem)

38
Q

CAMs with diltiazem

A

no st johns or ginsing – decreased effectiveness
garlic and hawthorn – inc. hypotensive effect

39
Q

what class is hydrochlorothiazide

A

thiazide diuretic

40
Q

what does hydrochlorothiazide hold onto

A

calcium

41
Q

use of hydrochlorothiazide

A

lowers BP by excreting potassium, sodium, water
- increase urine output
- treats hypertension, edema, heart failure

42
Q

MOA of hydrochlorothiazide

A

acts of renal distal tubules, excretion of electrolytes decreases preload and cardiac output, causes vasodilation, lowers BP

43
Q

is hydrochlorothiazide fast acting or intermediate

A

intermediate, not used for pt with renal impairment

44
Q

labs for hydrochlorothiazide

A

electrolytes: Na, K, Mg

45
Q

side effects of hydrochlorothiazide

A

electrolyte imbalance, hyperlipidemia, hyperglycemia, PHOTOSENSITIVITY, muscle cramps, ORTHO HTN
life-threatening: hypokalemia

46
Q

CAMs for hydrochlorothiazide

A

no licorice root or aloe (decrease potassium)
no gingko (increase BP) no hawthorn (decrease BP)

47
Q

what class is furosemide

A

loop diuretic - heavy hitter, used in emergent situations

48
Q

can furosemide cause ototoxicity?

A

if IV pushed too fast

49
Q

patho of furosemide

A

acts on loop of henle, inhibits chloride transport of sodium and passive reabsorption of sodium

50
Q

what does furosemide excrete

A

sodium
water
potassium
calcium
magnesium

51
Q

what can furosemide increase

A

blood glucose and uric acid levels

52
Q

indications for furosemide

A

ascites, edema, hypertension

53
Q

side effects of furosemide

A

electrolyte imbalance, hypotension, skin disturbances, photosensitivity, GI upset

54
Q

interactions with furosemide

A

no alcohol, no anticoagulants, increase dig toxicity

55
Q

adverse reactions of furosemide

A

Hypokalemia, hyponatremia, hypomagnesemia
ORTHO HTN, tinitis

56
Q

CAM interactions furosemide

A

licorice decrease potassium
no ginsing or hawthorn

57
Q

pt education furosemide

A

take first thing in morning, take w food, monitor I/O, watch for signs of hypokalemia, notify provider if weight gain over 2 lbs

58
Q

what class is spironolactone

A

potassium sparing diuretic

59
Q

uses of spironolactone

A

edema, circulatory overload, HTN, HF hypokalemia

60
Q

MOA of spironolactone

A

acts of distal renal tubules to promote sodium and water excretion and K retention

61
Q

side effects spironolactone

A

hyperkalemia, headache, GI upset, electrolyte imbalance

62
Q

labs for spironolactone

A

monitor potassium, do EKG

63
Q

education for spironolactone

A

avoid potassium rich foods, monitor potassium, take with food, monitor BP, take daily weight, I/O, avoid ACE inhibitors (increase RAAS system)

64
Q

Nonpharmacological ways to lower HTN

A

Stress-reduction techniques
Exercise
Salt restriction
Decrease alcohol ingestion
Smoking cessation

65
Q

what effect does hydrochlorothiazide have with potassium sparing diuretic (spironlactone)

A

antihypertensive

66
Q

what class do ACE inhibitors, beta blockers, ARBs fall under

A

antihypertensive

67
Q

what class is metoprolol

A

antihypertensive

68
Q

uses of metoprolol

A

controls HTN, acute MI, angina, HF

69
Q

contraindications of metoprolol

A

heart block, cardio shock, hypotension, acute HF, bradycardia

70
Q

MOA of metoprolol

A

decreases cardiac output by diminishing SNS, lowers contractility, blocks renin release

71
Q

labs to run for metoprolol

A

liver enzymes (metoprolol increases hepatic enzymes)

72
Q

pt education for metoprolol

A

log BP and HR, don’t stop abruptly, report HR under 60 and dizziness, slow pulse, GI upset

73
Q

side effects of metoprolol

A

bradycardia, lethargy, tinnitus, erectile dysfunction, HYPOTENSION

74
Q

CAMs for metoprolol

A

no ephedra, no black licorice, no parsley, ginsing, milk thistle

75
Q

class of prazosin hydrochloride

A

alpha adrenergic blocker antihypertensive

76
Q

use of prazosin hydrochloride

A

to control hypertension

77
Q

MOA of prazosin hydrochloride

A

dialates blood vessels, lowers BP

78
Q

caution for prazosin hydrochloride

A

angina, pregnancy, breastfeeding, ortho hypertension

79
Q

pt considerations for prazosin hydrochloride

A

good for pt with diabetes, and lipid abnormalities.. it raises HDL and lowers HDL, does not impact respiratory at all

80
Q

is prazosin hydrochloride highly protein bound

A

yes

81
Q

client education for prazosin hydrochloride

A

change position slow, monitor BP, takes 4 weeks to work, call provider if you see sudden change in HR or BP
** can cause sodium + water retention, monitor weight

82
Q

side effects of prazosin hydrochloride

A

tinnitus, CNS effects, GI effects, erectile dysfunction, ORTHO HTN

83
Q

drug interactions with antihypertensives

A

NSAIDs decrease the antihypertensive effect

84
Q

what class is lisinopril

A

angiotensin antagonist ACE inhibitor

85
Q

use for lisinopril

A

hypertension

86
Q

MOA of lisinopril

A

blocks angiotensin 2, excretes sodium, holds onto potassium

87
Q

pt considerations for lisinopril

A

african americans will need diuretic w this drug to lower BP, safe for increased renin, no pregnant women, renal insufficient pt need lower dose

88
Q

pt education lisinopril

A

take BP, avoid K rich foods, can cause Angioedema, Cough, Elevated K.. call provider
follow safety for ortho htn

89
Q

what class is valsartan

A

angiotensin 2 receptor blocker (ARB)

90
Q

MOA of valsartan

A

blocks angio. receptors which causes vasodilation, blocks release of aldosterone

91
Q

indication for valsartan

A

hypertension

92
Q

pt considerations valsartan

A

not ideal with renal or hepatic insufficiency, less effect in African Americans, may increase liver and kidney labs, no pregnant/breastfeeding

318 topics 6-8 (3 decks)

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