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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
uses of atenolol
hypertension, angina, prophylaxis is treatment of acute MI
26
what does atenolol do?
lowers HR lowers contractility lowers O2 demand to heart
27
atenolol nursing considerations
don't stop abruptly, will cause rebound hypertension, monitor BP and HR
28
contraindications for atenolol
Sinus bradycardia, heart block Pulmonary edema (decreases contractility so it would cause even more edema) , acute bronchospasm
29
caution for atenolol
renal dys, diabetes
30
interactions with atenolol
atropine and anticholinergic drugs (increases) decreased effects w/ NSAIDs risk of hypoglycemia with insulin
31
side effects of atenolol
CNS effects, depression, erectile dysfunction, GI distress, cool extremities
32
what does a pt taking atenolol need to report if they feel?
report complaints of excessive dizziness, lightheadedness, early morning insomnia, mental depression, or chest pain
33
what class is diltiazem?
calcium channel blocker
34
what is the action of calcium channel blockers
blocks calcium access to cells, relaxing coronary artery spasms - decreases contractility and O2 demand (less cardiac workload, relaxes heart)
35
side effects of diltiazem
low BP, bradycardia, headache, edema, nausea
36
pt education for diltiazem
stand up slowly, do not stop abuptly can cause angina episode, monitor BP
37
what is the most effective anginal for African Americans
calcium channel blockers (diltiazem)
38
CAMs with diltiazem
no st johns or ginsing -- decreased effectiveness garlic and hawthorn -- inc. hypotensive effect
39
what class is hydrochlorothiazide
thiazide diuretic
40
what does hydrochlorothiazide hold onto
calcium
41
use of hydrochlorothiazide
lowers BP by excreting potassium, sodium, water - increase urine output - treats hypertension, edema, heart failure
42
MOA of hydrochlorothiazide
acts of renal distal tubules, excretion of electrolytes decreases preload and cardiac output, causes vasodilation, lowers BP
43
is hydrochlorothiazide fast acting or intermediate
intermediate, not used for pt with renal impairment
44
labs for hydrochlorothiazide
electrolytes: Na, K, Mg
45
side effects of hydrochlorothiazide
electrolyte imbalance, hyperlipidemia, hyperglycemia, PHOTOSENSITIVITY, muscle cramps, ORTHO HTN life-threatening: hypokalemia
46
CAMs for hydrochlorothiazide
no licorice root or aloe (decrease potassium) no gingko (increase BP) no hawthorn (decrease BP)
47
what class is furosemide
loop diuretic - heavy hitter, used in emergent situations
48
can furosemide cause ototoxicity?
if IV pushed too fast
49
patho of furosemide
acts on loop of henle, inhibits chloride transport of sodium and passive reabsorption of sodium
50
what does furosemide excrete
sodium water potassium calcium magnesium
51
what can furosemide increase
blood glucose and uric acid levels
52
indications for furosemide
ascites, edema, hypertension
53
side effects of furosemide
electrolyte imbalance, hypotension, skin disturbances, photosensitivity, GI upset
54
interactions with furosemide
no alcohol, no anticoagulants, increase dig toxicity
55
adverse reactions of furosemide
Hypokalemia, hyponatremia, hypomagnesemia ORTHO HTN, tinitis
56
CAM interactions furosemide
licorice decrease potassium no ginsing or hawthorn
57
pt education furosemide
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
what class is spironolactone
potassium sparing diuretic
59
uses of spironolactone
edema, circulatory overload, HTN, HF hypokalemia
60
MOA of spironolactone
acts of distal renal tubules to promote sodium and water excretion and K retention
61
side effects spironolactone
hyperkalemia, headache, GI upset, electrolyte imbalance
62
labs for spironolactone
monitor potassium, do EKG
63
education for spironolactone
avoid potassium rich foods, monitor potassium, take with food, monitor BP, take daily weight, I/O, avoid ACE inhibitors (increase RAAS system)
64
Nonpharmacological ways to lower HTN
Stress-reduction techniques Exercise Salt restriction Decrease alcohol ingestion Smoking cessation
65
what effect does hydrochlorothiazide have with potassium sparing diuretic (spironlactone)
antihypertensive
66
what class do ACE inhibitors, beta blockers, ARBs fall under
antihypertensive
67
what class is metoprolol
antihypertensive
68
uses of metoprolol
controls HTN, acute MI, angina, HF
69
contraindications of metoprolol
heart block, cardio shock, hypotension, acute HF, bradycardia
70
MOA of metoprolol
decreases cardiac output by diminishing SNS, lowers contractility, blocks renin release
71
labs to run for metoprolol
liver enzymes (metoprolol increases hepatic enzymes)
72
pt education for metoprolol
log BP and HR, don't stop abruptly, report HR under 60 and dizziness, slow pulse, GI upset
73
side effects of metoprolol
bradycardia, lethargy, tinnitus, erectile dysfunction, HYPOTENSION
74
CAMs for metoprolol
no ephedra, no black licorice, no parsley, ginsing, milk thistle
75
class of prazosin hydrochloride
alpha adrenergic blocker antihypertensive
76
use of prazosin hydrochloride
to control hypertension
77
MOA of prazosin hydrochloride
dialates blood vessels, lowers BP
78
caution for prazosin hydrochloride
angina, pregnancy, breastfeeding, ortho hypertension
79
pt considerations for prazosin hydrochloride
good for pt with diabetes, and lipid abnormalities.. it raises HDL and lowers HDL, does not impact respiratory at all
80
is prazosin hydrochloride highly protein bound
yes
81
client education for prazosin hydrochloride
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
side effects of prazosin hydrochloride
tinnitus, CNS effects, GI effects, erectile dysfunction, ORTHO HTN
83
drug interactions with antihypertensives
NSAIDs decrease the antihypertensive effect
84
what class is lisinopril
angiotensin antagonist ACE inhibitor
85
use for lisinopril
hypertension
86
MOA of lisinopril
blocks angiotensin 2, excretes sodium, holds onto potassium
87
pt considerations for lisinopril
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
pt education lisinopril
take BP, avoid K rich foods, can cause Angioedema, Cough, Elevated K.. call provider follow safety for ortho htn
89
what class is valsartan
angiotensin 2 receptor blocker (ARB)
90
MOA of valsartan
blocks angio. receptors which causes vasodilation, blocks release of aldosterone
91
indication for valsartan
hypertension
92
pt considerations valsartan
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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