Week 1 Kach & Medications Flashcards
Aldosterone
Affect on BP
Hormone released by adrenal cortex increase retention of sodium & water
Increased BP
Hormone released by adrenal cortex increase retention of sodium & water
Increased BP
Aldosterone
Peptide hormone that caused Vasoconstriction & stimulates aldosterone & ADH
Angiotensin
ACE Inhibitors (e.g., Lisinopril, Enalapril)
Uses: Hypertension, heart failure, post-MI.
Major Side Effects: (5)
Dry cough (due to bradykinin buildup).
Hyperkalemia (high potassium).
Angioedema (swelling of face, tongue, and throat; rare but serious).
Hypotension (especially after the first dose).
Renal impairment (in patients with pre-existing kidney disease).
Major Side Effects:
Dry cough (due to bradykinin buildup).
Hyperkalemia (high potassium).
Angioedema (swelling of face, tongue, and throat; rare but serious).
Hypotension (especially after the first dose).
Renal impairment (in patients with pre-existing kidney disease).
Name class of meds…
Give examples…
Major uses…
ACE Inhibitors (e.g., Lisinopril, Enalapril)
Uses: Hypertension, heart failure, post-MI.
Beta-Blockers (e.g., Metoprolol, Atenolol)
Uses: Hypertension, angina, heart failure, arrhythmias.
Major side effects…(6)
Major Side Effects:
Bradycardia (slow heart rate).
Hypotension.
Fatigue.
Depression or mood changes.
Bronchospasm (in non-selective beta-blockers like propranolol, especially in asthma).
Impotence.
Major Side Effects:
Bradycardia (slow heart rate).
Hypotension.
Fatigue.
Depression or mood changes.
Bronchospasm (in non-selective beta-blockers like propranolol, especially in asthma).
Impotence.
Name class of medication
Give examples
Major uses
Beta-Blockers (e.g., Metoprolol, Atenolol)
Uses: Hypertension, angina, heart failure, arrhythmias.
Calcium Channel Blockers (e.g., Amlodipine, Verapamil)
Uses: Hypertension, angina, arrhythmias.
Major Side Effects: (6)
Peripheral edema (swelling in legs/ankles).
Headache.
Dizziness.
Constipation (especially with verapamil).
Bradycardia or heart block (non-dihydropyridines like verapamil and diltiazem).
Major Side Effects:
Peripheral edema (swelling in legs/ankles).
Headache.
Dizziness.
Constipation (especially with verapamil).
Bradycardia or heart block (non-dihydropyridines like verapamil and diltiazem).
Calcium Channel Blockers (e.g., Amlodipine, Verapamil, diltiazem)
Uses: Hypertension, angina, arrhythmias.
Diuretics (e.g., Furosemide, Hydrochlorothiazide)
Uses: Hypertension, heart failure, fluid retention.
Major Side Effects: (5)
Electrolyte imbalances (e.g., hypokalemia, hyponatremia).
Dehydration.
Hypotension.
Hyperuricemia (can worsen gout).
Ototoxicity (with high doses of furosemide).
Major Side Effects:
Electrolyte imbalances (e.g., hypokalemia, hyponatremia).
Dehydration.
Hypotension.
Hyperuricemia (can worsen gout).
Ototoxicity (with high doses of furosemide).
Name class of medication
Give examples
Major uses
Diuretics (e.g., Furosemide, Hydrochlorothiazide)
Uses: Hypertension, heart failure, fluid retention.
Anticoagulants (e.g., Warfarin, Heparin)
Uses: Prevent blood clots (DVT, PE, stroke).
Major Side Effects: (4)
Bleeding (e.g., gastrointestinal or intracranial).
Bruising.
Heparin-induced thrombocytopenia (HIT) (rare but serious).
Osteoporosis (long-term heparin use).
Major Side Effects:
Bleeding (e.g., gastrointestinal or intracranial).
Bruising.
Heparin-induced thrombocytopenia (HIT) (rare but serious).
Osteoporosis (long-term heparin use).
Class of medication
Examples
Major uses
Anticoagulants (e.g., Warfarin, Heparin)
Uses: Prevent blood clots (DVT, PE, stroke).
Antiplatelets (e.g., Aspirin, Clopidogrel)
Uses: Prevent arterial clots (MI, stroke).
Major Side Effects (3)
Major Side Effects:
Bleeding (e.g., gastrointestinal, easy bruising).
Gastric ulcers (with aspirin).
Thrombocytopenia (rare).
Major Side Effects:
Bleeding (e.g., gastrointestinal, easy bruising).
Gastric ulcers (with aspirin).
Thrombocytopenia (rare).
Class of meds
Examples
Major uses
Antiplatelets (e.g., Aspirin, Clopidogrel)
Uses: Prevent arterial clots (MI, stroke).
Statins (e.g., Atorvastatin, Simvastatin)
Uses: Lower cholesterol, prevent cardiovascular events.
Major Side Effects: (4)
Myopathy (muscle pain or weakness).
Rhabdomyolysis (rare but serious muscle breakdown).
Hepatotoxicity (elevated liver enzymes).
Hyperglycemia (may worsen diabetes risk).
Major Side Effects:
Myopathy (muscle pain or weakness).
Rhabdomyolysis (rare but serious muscle breakdown).
Hepatotoxicity (elevated liver enzymes).
Hyperglycemia (may worsen diabetes risk).
Class of medication
Examples
Major uses
Statins (e.g., Atorvastatin, Simvastatin)
Uses: Lower cholesterol, prevent cardiovascular events.
Nitrates (e.g., Nitroglycerin, Isosorbide Mononitrate)
Uses: Angina relief.
Major Side Effects: (4)
Major Side Effects:
Headache.
Hypotension (can lead to dizziness or syncope).
Reflex tachycardia.
Flushing.
Major Side Effects:
Headache.
Hypotension (can lead to dizziness or syncope).
Reflex tachycardia.
Flushing.
Name class of medication
Examples
Major uses
Nitrates (e.g., Nitroglycerin, Isosorbide Mononitrate)
Uses: Angina relief.
Antiarrhythmics (e.g., Amiodarone, Digoxin)
Uses: Treat arrhythmias (AFib, VT).
Amiodarone Side Effects:
Digoxin Side Effects:
Amiodarone Side Effects:
Pulmonary toxicity (lung fibrosis).
Thyroid dysfunction (hypo- or hyperthyroidism).
Photosensitivity.
Hepatotoxicity.
Digoxin Side Effects:
Nausea/vomiting.
Visual disturbances (yellow-green halos).
Bradycardia or AV block.
Amiodarone Side Effects:
Pulmonary toxicity (lung fibrosis).
Thyroid dysfunction (hypo- or hyperthyroidism).
Photosensitivity.
Hepatotoxicity.
Digoxin Side Effects:
Nausea/vomiting.
Visual disturbances (yellow-green halos).
Bradycardia or AV block.
Class of medication
Examples
Major use
Antiarrhythmics (e.g., Amiodarone, Digoxin)
Uses: Treat arrhythmias (AFib, VT).
Vasodilators (e.g., Hydralazine)
Uses: Severe hypertension, heart failure.
Major Side Effects: (4)
Reflex tachycardia.
Fluid retention.
Lupus-like syndrome (rare, with hydralazine).
Major Side Effects:
Reflex tachycardia.
Fluid retention.
Lupus-like syndrome (rare, with hydralazine).
Classification
Examples
Major uses
Vasodilators (e.g., Hydralazine)
Uses: Severe hypertension, heart failure.
Monitor Blood Pressure: Watch for hypotension, especially after the first dose.
Check Potassium Levels: Risk of hyperkalemia; avoid potassium supplements or potassium-sparing diuretics.
Assess Renal Function: Monitor creatinine and kidney function, especially in patients with renal impairment.
Monitor for Angioedema: Swelling of the face, tongue, or throat is a medical emergency.
Educate About Dry Cough: Reassure patients it is a common side effect and consult the provider if severe.
ACE Inhibitors (e.g., Lisinopril, Enalapril)
ACE Inhibitors (e.g., Lisinopril, Enalapril)
ACE Inhibitors (e.g., Lisinopril, Enalapril)
Monitor Blood Pressure: Watch for hypotension, especially after the first dose.
Check Potassium Levels: Risk of hyperkalemia; avoid potassium supplements or potassium-sparing diuretics.
Assess Renal Function: Monitor creatinine and kidney function, especially in patients with renal impairment.
Monitor for Angioedema: Swelling of the face, tongue, or throat is a medical emergency.
Educate About Dry Cough: Reassure patients it is a common side effect and consult the provider if severe.
Beta-Blockers (e.g., Metoprolol, Atenolol)
Nursing considerations (5)
Monitor Heart Rate and Blood Pressure: Hold the medication if HR < 60 bpm or SBP < 90 mmHg unless otherwise directed.
Assess for Fatigue: Common initially but often improves over time.
Watch for Bronchospasm: Be cautious with non-selective beta-blockers in patients with asthma or COPD.
Do Not Stop Abruptly: Educate patients to taper off the medication to avoid rebound hypertension or tachycardia.
Monitor Blood Glucose in Diabetics: Can mask symptoms of hypoglycemia.
Monitor Heart Rate and Blood Pressure: Hold the medication if HR < 60 bpm or SBP < 90 mmHg unless otherwise directed.
Assess for Fatigue: Common initially but often improves over time.
Watch for Bronchospasm: Be cautious with non-selective beta-blockers in patients with asthma or COPD.
Do Not Stop Abruptly: Educate patients to taper off the medication to avoid rebound hypertension or tachycardia.
Monitor Blood Glucose in Diabetics: Can mask symptoms of hypoglycemia.
Name class of medication
Examples
Beta-Blockers (e.g., Metoprolol, Atenolol)
Monitor for Edema: Encourage patients to elevate legs or reduce sodium intake if swelling occurs.
Check Heart Rate: Especially with non-dihydropyridines like verapamil or diltiazem; risk of bradycardia.
Assess for Constipation: Encourage fiber-rich foods and adequate hydration.
Monitor Blood Pressure: Watch for hypotension.
Avoid Grapefruit Juice: Can increase drug levels and lead to toxicity.
Class of medication
Examples
Calcium Channel Blockers (e.g., Amlodipine, Verapamil)
Calcium Channel Blockers (e.g., Amlodipine, Verapamil)
Nursing considerations (5)
Monitor for Edema: Encourage patients to elevate legs or reduce sodium intake if swelling occurs.
Check Heart Rate: Especially with non-dihydropyridines like verapamil or diltiazem; risk of bradycardia.
Assess for Constipation: Encourage fiber-rich foods and adequate hydration.
Monitor Blood Pressure: Watch for hypotension.
Avoid Grapefruit Juice: Can increase drug levels and lead to toxicity.
Monitor Electrolytes: Check for hypokalemia (loop/thiazide diuretics) or hyperkalemia (potassium-sparing diuretics).
Assess for Dehydration: Monitor for signs such as dry mouth, low urine output, and dizziness.
Monitor Blood Pressure: Hypotension is common, especially orthostatic hypotension.
Encourage Potassium-Rich Foods: For potassium-depleting diuretics (e.g., furosemide).
Educate About Timing: Administer in the morning to avoid nocturia.
Name class of medication
Examples
Diuretics (e.g., Furosemide, Hydrochlorothiazide)
Diuretics (e.g., Furosemide, Hydrochlorothiazide)
Nursing considerations (5)
Monitor Electrolytes: Check for hypokalemia (loop/thiazide diuretics) or hyperkalemia (potassium-sparing diuretics).
Assess for Dehydration: Monitor for signs such as dry mouth, low urine output, and dizziness.
Monitor Blood Pressure: Hypotension is common, especially orthostatic hypotension.
Encourage Potassium-Rich Foods: For potassium-depleting diuretics (e.g., furosemide).
Educate About Timing: Administer in the morning to avoid nocturia.
Monitor for Bleeding: Check for signs of bruising, blood in stool/urine, or prolonged bleeding.
Assess Lab Values:
PT/INR for warfarin.0.8–1.2
Therapeutic range (for patients on warfarin): 2.0–3.0: For most indications, including atrial fibrillation, deep vein thrombosis (DVT), or pulmonary embolism (PE).
aPTT for heparin.
PTT (Partial Thromboplastin Time):
Normal range (for individuals not on anticoagulants): 25–35 seconds
Therapeutic range (for patients on heparin): 1.5–2.5 times the normal range (approximately 60–100 seconds)
Educate About Diet: Warfarin patients should maintain consistent vitamin K intake.
Avoid IM Injections: To reduce the risk of hematoma.
Heparin Protocol: Double-check dosages; use infusion pumps for continuous IV heparin.
Anticoagulants (e.g., Warfarin, Heparin)
Anticoagulants (Warfarin/ Heparin)
Nursing considerations (5)
Monitor for Bleeding: Check for signs of bruising, blood in stool/urine, or prolonged bleeding.
Assess Lab Values:
PT/INR for warfarin.0.8–1.2
Therapeutic range (for patients on warfarin): 2.0–3.0: For most indications, including atrial fibrillation, deep vein thrombosis (DVT), or pulmonary embolism (PE).
aPTT for heparin.
PTT (Partial Thromboplastin Time):
Normal range (for individuals not on anticoagulants): 25–35 seconds
Therapeutic range (for patients on heparin): 1.5–2.5 times the normal range (approximately 60–100 seconds)
Educate About Diet: Warfarin patients should maintain consistent vitamin K intake.
Avoid IM Injections: To reduce the risk of hematoma.
Heparin Protocol: Double-check dosages; use infusion pumps for continuous IV heparin.
Monitor for Bleeding: Educate patients to report unusual bruising, nosebleeds, or black/tarry stools.
Assess for GI Symptoms: May cause gastric irritation; take with food or a proton pump inhibitor if needed.
Check Platelet Levels: Monitor CBC periodically.
Educate About Dual Therapy: Often combined with anticoagulants; emphasize adherence to reduce clot risk.
Classification of medication
Examples
Antiplatelets (e.g., Aspirin, Clopidogrel)
Antiplatelets (e.g., Aspirin, Clopidogrel)
Nursing considerations (5)
Monitor for Bleeding: Educate patients to report unusual bruising, nosebleeds, or black/tarry stools.
Assess for GI Symptoms: Aspirin may cause gastric irritation; take with food or a proton pump inhibitor if needed.
Check Platelet Levels: Monitor CBC periodically.
Educate About Dual Therapy: Often combined with anticoagulants; emphasize adherence to reduce clot risk.
Monitor Liver Function: Check liver enzymes (AST/ALT) before starting and periodically during therapy.
Assess for Myopathy: Educate patients to report muscle pain, weakness, or dark urine (signs of rhabdomyolysis).
Administer in the Evening: Most cholesterol synthesis occurs at night.
Avoid Grapefruit Juice: Increases risk of drug toxicity.
Monitor Blood Glucose: Can slightly elevate glucose levels in diabetic patients.
Class of medication
Examples
Statins (e.g., Atorvastatin, Simvastatin)
Statins (e.g., Atorvastatin, Simvastatin)
Nursing considerations (5)
Monitor Liver Function: Check liver enzymes (AST/ALT) before starting and periodically during therapy.
Assess for Myopathy: Educate patients to report muscle pain, weakness, or dark urine (signs of rhabdomyolysis).
Administer in the Evening: Most cholesterol synthesis occurs at night.
Avoid Grapefruit Juice: Increases risk of drug toxicity.
Monitor Blood Glucose: Can slightly elevate glucose levels in diabetic patients.
Monitor Blood Pressure: Watch for hypotension; avoid in patients with systolic BP < 90 mmHg.
Educate About Headaches: Common side effect; treat with acetaminophen if needed.
Avoid Concurrent Use with PDE5 Inhibitors: (e.g., sildenafil) due to severe hypotension risk.
Provide Instructions for Sublingual Nitroglycerin: Take at first sign of angina, repeat every 5 minutes for up to 3 doses; seek help if no relief.
Monitor for Reflex Tachycardia: May require beta-blocker co-administration.
Name classification
Examples
Nitrates (e.g., Nitroglycerin, Isosorbide Mononitrate)
Nitrates (e.g., Nitroglycerin, Isosorbide Mononitrate)
Nursing considerations (5)
Monitor Blood Pressure: Watch for hypotension; avoid in patients with systolic BP < 90 mmHg.
Educate About Headaches: Common side effect; treat with acetaminophen if needed.
Avoid Concurrent Use with PDE5 Inhibitors: (e.g., sildenafil) due to severe hypotension risk.
Provide Instructions for Sublingual Nitroglycerin: Take at first sign of angina, repeat every 5 minutes for up to 3 doses; seek help if no relief.
Monitor for Reflex Tachycardia: May require beta-blocker co-administration.
Monitor lung function for pulmonary toxicity.
Check thyroid function (T3, T4, TSH).
Watch for photosensitivity; educate about sun protection.
Class of meds
Examples
Antiarrhythmics (e.g., Amiodarone, Digoxin)
Amiodarone
Digoxin:
Monitor levels to prevent toxicity (therapeutic range: 0.5–2.0 ng/mL).
Assess for signs of toxicity (nausea, visual changes, bradycardia).
Check apical pulse for 1 full minute before administration; hold if HR < 60 bpm.
Antiarrhythmics Digoxin
Monitor Blood Pressure: Watch for hypotension or reflex tachycardia.
Assess for Fluid Retention: May require diuretics to counteract.
Watch for Lupus-Like Syndrome:
Educate patients about symptoms like joint pain or rash.
Administer with Food: Reduces risk of GI upset.
Classification of medication
Examples
Vasodilators (e.g., Hydralazine)
Vasodilators (e.g., Hydralazine)
Monitor Blood Pressure: Watch for hypotension or reflex tachycardia.
Assess for Fluid Retention: May require diuretics to counteract.
Watch for Lupus-Like Syndrome:
Educate patients about symptoms like joint pain or rash.
Administer with Food: Reduces risk of GI upset.
Assessing a patient taking Metoprolol for sgins of hypoglycemia. Which manifestación will you see
Difficult thinking
Tachycardia
Weakness
Tremors
Restlessness
Difficult thinking
Tachycardia
Weakness
Tremors
Patient taking valsartan for HTN. Which is most important teaching before taking first dose.
Instruct patient to ask for help when getting out of bed
Give medication with milk to prevent GI upset
Save all urine for measurement
Monitor cardiac rhythm disturbances
Instruct patient to ask for help when getting out of bed
Valsartan is an ARB - which lower BP
Orthostatic hypotension may occur
Which of the following are SE of Lisinopril
Hypokalemia
Hypernatremia
Cough
Dizzy
Bradyca
Cough
Dizzy
Which medication class do you avoid with Grapefruit
CCB & Statins
Pulse pressure = Systolic- Diastolic
Reflects the filling pressure of…
Coronary Arteries
Period of cardiac muscle relaxation (Diastolic) followed by muscle contraction (Systolic) in the heart…
Cardiac cycle
Ectopic focus…
Shift in pacemaker of the heart from SA node to other site
Where do the impulses for the heart to contract come from.
The Heart itself.
Not the brain
Where are baroreceptors located…
Function…
Arch of aorta & Carotid Artery
Senses changes in blood pressure & sends signals to NS to change BP according
Mean Arterial Pressure MAP
(Average pressure in the arteries during Ventriclar Contractions & Relaxation.)
3 Elements
Formula
Normal MAP: What low & High values indicate…
HR
SV
PVR Peripheral vascular resistance.
CO × PVR
70–100 mmHg
Key Points:
MAP below 60 mmHg: Indicates inadequate perfusion to vital organs, which can lead to organ dysfunction.
MAP above 100 mmHg: Can indicate increased cardiovascular strain, often associated with hypertension or other conditions.
Low BP detected by baroreceptors will increase sympathetic NS to constrict blood vessels and (Decrease / Increase) Peripheral vascular resistance.
Increase. This is according to the book
What specific action activities the RAAS…
Lack of blood flow to the kidney
HTN can lead to…
Hypo…..
HTN:
Blood vessel damage
Atherosclerosis
MI
Stroke
Kidney issues
Hypo: Poor perfusion to organs
Take ACE on a full stomahx to avoid GI upset
False
Take on empty to absorb better
Contractions to CCB
Heart block
Sick sinus syndrome
HF
MI W/ Pulmonary edema
Renal / Hepatix dysfunction
This medication can mask Hypoglycemia
This medication can give hyperglycemia
BB Can mask hypoglycemia
Statins can give hyperglycemia
Treatment of Low BP
Sympathetic Drugs
Othrostatic drug…
Neurogenix…
Midodrine ortho
Droxidopa neurogenix
Drugs to treat shock. Low BP
Dobutamine
Dopamine
Ephedrine
Epinephrine
Cause of essential HTN..
Unknown.
Type of problems Digoxin is used for..
Not first line treatment
Describe basically what Cardiac Glycoside Digoxin does
Digoxin helps the heart by (decreasing / increasing) its pumping strength (positive inotropy) and (slowing / speeding up) the heart rate (negative chronotropy), improving efficiency and control in conditions like heart failure and atrial fibrillation.
HF, A fib / Flutter Only
Digoxin helps the heart by increasing its pumping strength (positive inotropy) and slowing the heart rate (negative chronotropy), improving efficiency and control in conditions like heart failure and atrial fibrillation.
Digoxin antidote..
Digoxin immune fab
How do Cardiac Glycoside (Digoxin) work… Simply put
Increase movement of calcium into heart and Increase Force Contraction , Increase blood flow to Kidney (Diuretic effect), Slow AV node conduction
