VASODIALTOR CHAPTER 41 Flashcards
Which of the following drugs is a Vasodilator?
A. Benztopine
B. Atropine
C. Cilstazol
D. Sumatriptan
C. Cilstazol
What is Cilstazol used to treat?
PVD (PERIPHERAL VASUCLAR DISEASE)
Patient reports of…
Intermittent claudication(pain when walking and or moving , then the pain stops at rest))
Treatment
Peripheral vasodilators increase blood flow such as
cilostazol
To treat peripheral vascular disease and claudicationMechanism of Action: Acts directly to inhibit platelet aggregation and cause vasodilation, especially in femoral vasculature.
What’s is the action of Cilstazol?
Cilostazol
Action
* Causes peripheral vasodilation
* Inhibits platelet aggregation - weak
Use
* Intermittent claudication, other peripheral vascular diseases
Side effects/Adverse reactions
* Dizziness, headache, GI distress, peripheral edema
* Tachycardia, palpitations
* Possible bleeding
* Orthostatic hypotension
What is the side effect of Cilostazol?
Dizziness, headache, nasopharyngitis, rhinitis, cough, dyspepsia, myalgia, flushing, nausea, vomiting, flatulence, diarrhea, melena, back and abdominal pain, peripheral edema, infection, influenza, cholelithiasis
What is the verse effect of Cilostazol?
Tachycardia, palpitations, angina, HF, MI, hypo/hypertension, peptic ulcer, gout, diabetes mellitus, elevated hepatic enzymesLife-threatening: Thrombocytopenia, leukopenia, aplastic anemia, agranulocytosis, dysrhythmias, Stevens-Johnson syndrome
Contraindications of Cilostazol
Heart failure, hypersensitivity, bleeding disordersCaution: Hepatic and renal disease, tobacco smokers, cardiovascular disease, dysrhythmias, pregnancy, breastfeeding, older adults
nteractions
Other drugs that cause vasodilation or bleeding
Grapefruit juice
Does cilostazol cause the blood to be thin?
A. No
B. Yes
B. Yes
Cilostazol Inhibits platelet aggregation
Nursing interventions and teaching for Cilostazol
Nursing interventions
Monitor vital signs, especially blood pressure and
heart rate.
Inform patient that a desired therapeutic response
may take 1.5 to 3 months.
Advise patient not to smoke or ingest alcohol.
Encourage patient to change position slowly but
frequently to avoid orthostatic hypotension.
Take with food – no grapefruit juice
Evaluation
- A patient has been prescribed cilostazol. Which statement by the client indicates the need for further teaching?
A. “I can take the medication with food if it causes nausea.”
B.”This medication is used to improve blood flow.”
C.”I can continue to take ginkgo biloba to improve my memory.”
D.”I should be cautious when standing.”
ANS: C
Cilostazol should not be taken with ginkgo biloba because bleeding time can be prolonged. It can cause nausea so the nurse should recommend taking the medication with food. Cilostazol does cause vasodilation and improves blood flow which can also cause peripheral edema.
Caution should be taken when standing for long periods
- A patient, who has intermittent claudication, has been taking 100 mg of cilostazol (Pletal) twice times daily with meals for 2 weeks. The patient calls the clinic and reports continued pain in both legs during exercise. How will the nurse advise the patient?
A.”It can take from 2-12 weeks for the medication to help with your claudication symptoms.”
B. “Notify the provider of the continued pain and request increasing the dose,”
C. “You should stop the medication immediately since it is not working.”
D. “Take the medication right before you exercise for best effects.”
ANS: A
Patients should be counseled that the desired therapeutic effects may take to 3 months. The patient is currently taking the maximum recommended daily dose of cilostazol, so an increase in dose would not be recommended. The medication should be taken 30 minutes before or 2 hours after the morning and evening meals. Taking it immediately before bouts of exercise will not increase effectiveness.
