Week 7 Cardiovascular medications Flashcards
Aspirin
OTC
Bayer,
Ecotrin
Analgesics/Anti-inflammatory
Analgeic/Antiplatelet
salicylate (antiplatelet)
Prevention of CV events
Bleeding, Reye’s Syndrome (do not give to children < 16)
Anticoagulants, NSAIDs, Ginkgo biloba
No Boxed warning, bleeding
Patient counseling Discuss signs of symptoms of bleeding Children less than 16years old avoid all salicylate containing products EC baby aspirin use for heart health Do not use EC for ER
Clopidogrel
Plavix
Cardiovascular
Anticoagulants
antiplatelet
Heart attack; clot prevention
Bleeding
Anticoagulants, NSAIDs, omeprazole, esomeprazole
Did not cover
Dabigatran
Pradaxa
Cardiovascular
Anticoagulants
Direct Thrombin Inhibitor
Prevention and treatment of clots; prevention of stroke in nonvalvular atrial fibrillation
bleeding, stomach irritation/heartburn
antacids, Dual anticoagulant/antiplatelet, NSAIDs
Boxed warning: abrupt d/c inc risk of thrombotic events
Patient counseling
Do not open the capsules
Do not store in another container
Digoxin
Lanoxin
Cardiovascular
Antiarrhythmic
Anti-arrhythmic
Atrial fibrillation, heart failure, supraventricular tachyarrhythmia
GI: anorexia, diarrhea, nausea, vomiting; HA; rash; visual disturbances
beta blockers, diuretics, antacids, bile acid sequestrants, sucralfate
Narrow therapeutic index, digoxin toxicity
Patient counseling
Take at the same time daily - after morning meal
Do not stop abruptly
Enoxaparin
Lovenox
Injection (SQ)
Cardiovascular
Anticoagulants
Low Molecular Weight Heparin (LMWH)
DVT (blood clots)
Bleeding, bruising at injection site
No major; think about things that cause bleeding; Dual anticoagulant/antiplatelet, NSAIDs
Boxed Warning: spinal puncture paralysis risk; dose adjustments in kidney dysfunction, elderly, underweight/overweight
Patient counseling
Do not inject into muscle, should be fatty tissue- bruising
Watch signs of bleeding
Isosorbide Mononitrate
Imdur
Cardiovascular
Antianginal
Anti-anginal (Nitrate)
prophylaxis of angina
HA, dizziness, hypotension
Phosphodiesterase inhibitors (PDE)
CI: PDE
Patient counseling
Take on an empty stomach with at least 4oz of water
DO NOT BREAK CRUSH CHEW
can use APAP to treat headache
Nitroglycerin
Patch-Nitro-Dur; tablets- NitroStat; ointment- Nitro-Bid
PO, patch, topical
Cardiovascular
Antianginal
Nitrate (anti-anginal)
Tab: acute angina, prophylaxis of angina
HA, flushing, light-headedness
Phosphodiesterase inhibitors (PDE)
CI: PDE
Patient counseling
Patch: contain metals, should be removed before MRI
Ointment: use applicator to apply to chest
Tablets: dissolve under tongue
Take at first sign of chest pain
Dissolve one tablet under tongue every 5mins until chest pain resolved
May give up to 3 dose. Call 911 after 3 doses
Rivaroxaban
Xarelto
Cardiovascular
Anticoagulants
Factor Xa Inhibitor
Prevention and treatment of clots; nonvalvular atrial fibrillation
bleeding
Dual anticoagulant/antiplatelet, NSAIDs
BBW; d/c inc risks of thrombotic events, spinal puncture –> paralysis risk
Patient counseling
Once daily dosing should be with evening meals
Clinical pearls
There are two strengths available one is loading dose
Warfarin
Jantoven
Coumadin
Cardiovascular
Anticoagulants
Vitamin K Antagonist
Atrial fibrillation, prevention and treatment of clots
bleeding, purple toe syndrome
Green, leafy veggies, antibiotics (quinolones, bactrim, macrolides), NSAIDs, Dual anticoagulant/antiplatelet
Boxed Warning: major or fatal bleedding, elderly more susceptible to bleeding, monitor INR
Patient counseling
Watch for signs and symptoms of bleeding
Take at the same time daily at evening
Avoid situations where bleeding likely to occur
Maintain a diet consistent in vitamins K content
Clinical pearls
Target of pharmaceuticals: require frequency monitoring and dose adjustment INR
Which of the following medications is an
anti-arrhythmia medication?
A. Digoxin
B. Clopidogrel
C. Warfarin
D. Dabigatran
A. Digoxin
How should patients be counseled to take
Digoxin?
A. With an antacid to prevent GI irritation
B. First thing in the morning on an empty stomach
C. With food in the morning— IMMEDIATELY AFTER MEAL
D. With food in the evening
C. With food in the morning—
IMMEDIATELY AFTERMEAL
What anticoagulation medicine is
commonly referred to as “rat poison”?
A. Aspirin
B. Dabigatran
C. Rivaroxaban
D. Warfarin
D. Warfarin
Which medication is an injectable dosage
form?
A. Dabigatran
B. Rivaroxaban
C. Enoxaparin
D. Warfarin
C. Enoxaparin
Patients on warfarin CANNOT eat green
leafy veggies
A. True
B. False
B. False—Can have, just needa consistent amount so that
their warfarin dose is appropriate to reflect vitamin K from their diet (warfarin is a VitaminK antagonist)
Patients using aspirin during a heart attack should use which type? A. Chewable B. Regular Release Tablet C. Enteric Coated
B. Regular Release Tablet—EC won’t degrade fast enough to provide benefit. Chewable is widely used by patients, but wouldn’t be wrong. Test would expect you to know that you can’t use EC in an emergency
