Week 7 Cardiovascular System - Medications for Coronary Artery Disease and Dysrhythmias & Hematological System Flashcards
Atorvastatin (Lipitor) class
HMG-CoA Reductase Inhibitors
Atorvastatin (Lipitor) other drugs
simvastatin (Zocor)
lovastatin (Mevacor)
rosuvastatin (Crestor)
Atorvastatin (Lipitor) EPA
↑ HDL and ↓ LDL and total cholesterol by:
Inhibiting HMG CoA reductase, an enzyme that synthesizes cholesterol in the liver
Atorvastatin (Lipitor) Therapeutic use
treat high cholesterol and prevent vascular disease
Atorvastatin (Lipitor) ADRs
myopathy - muscle weakness
hepatotoxicity
Atorvastatin (Lipitor) contraindications and interactions
teratogenic
liver disease
alcohol use disorder
grapefruit juice increases risk of ADRs
increased risk of bleeding with warfarin
Atorvastatin (Lipitor) interventions and education
report muscle pain
report abdominal pain, jaundice, fatigue
periodic liver function testing
gemfibrozil (Lopid) class and other drug
fibrates
fenofibrate (TriCor)
gemfibrozil (Lopid) EPA
increases oxidation of fatty acids in the liver and tissues, decreases production of triglycerides
gemfibrozil (Lopid) therapeutic use
reduce serum triglycerides and increase HDLs
gemfibrozil (Lopid) ADRs
GI - nausea, diarrhea, pain
hepatotoxicity
gallstones
myopathy
gemfibrozil (Lopid) contraindications and interactions
gall bladder disease
liver disease
renal impairment
warfarin increases risk of bleeding
use with statins increases risk of myopathy
gemfibrozil (Lopid) interventions and education
take with food
report muscle pain
report abdominal pain, jaundice, fatigue
periodic liver function testing
nitroglycerin class
nitrate anginal
nitroglycerin EPA
Converts to nitric oxide, potent vasodilator
relaxes smooth muscle in blood vessel walls
Relieve angina pain by venous dilation, coronary artery dilation, and arteriole dilation
nitroglycerin therapeutic use
management/treatment of acute chest pain caused by myocardial ischemia
nitroglycerin ADRs
headache, hypotension, dizziness, bradycardia, syncope
nitroglycerin contraindications and interactions
anemia
hypotension
hypovolemia
renal impairment
slidenafil (Viagra) can cause life threatening hypotension
nitroglycerin interventions and education
- stop activity before taking, let one tablet dissolve under tongue, rest for five minutes
- if pain is not relieved, use a second tablet, wait five minutes and repeat with 3rd tablet if needed
- if pain is not resolved after 3, seek medical attention
lidocaine class
Class IB Sodium Channel Blockers
lidocaine EPA
- Blocks Na+ channels thereby shortening the repolarization phase of the cardiac cycle
- decreases the rate of contractions of the heart.
lidocaine therapeutic use
Treats serious ventricular dysrhythmias associated with MI, cardiac cath, & cardiac surgery
lidocaine ADRs
hypotension, bradycardia, dysrhythmias, anxiety
lidocaine administration for dysrhythmias
only given IV in hospital setting
lidocaine contraindications and interactions
untreated bradycardia or heart block
teratogenic
lidocaine interventions and educations
continuously monitor VS and cardiac rhythm
avoid OTC cold meds, asthma meds, and appetite suppressants that could aggravate irregular heartbeats
flecainide (Tambocor) class
Class IC sodium channel blockers
flecanide (Tambocor) EPA
blocks Na+ channels to slow conduction velocity and the refractory period
flecanide (Tambocor) therapeutic use
treat atrial flutter or atrial fibrillation
flecainide (Tambocor) ADRs
worsening of heart failure
widens QRS complex
potential for other dysrhythmias to occur
flecainide (Tambocor) black box warning
fatal arrhythmias and death in patients with recent MI
flecainide (Tambocor) contraindications and interactions
heart block or heart failure
flecainide (Tambocor) interventions and education
must be in hospital setting at start of therapy to monitor heart continuously
cardiac monitoring and vital signs before and after each dose
avoid OTC cold meds, asthma meds, appetite suppressants
Amiodarone class and other med
Class III Potassium Channel Blockers
doefetilide (Tikosyn)
Amiodarone EPA
Blocks K+ channels in turn slowing repolarization and prolonging the refractory period to slow down the heart rate.
Amiodarone therapeutic use
Treats various life-threatening ventricular and/or atrial tachy-dysrhythmias
amiodarone ADRs
fatal dysrhythmias and hypotension
amiodarone black box warning
Long term use of amiodarone can cause fatal pulmonary toxicity
amiodarone Contraindications and Interactions
Heart block
Heart failure
Teratogenic
amiodarone interventions and education
cardiac rhythm monitoring and vital signs before dose
take with food
no grapefruit juice
avoid OTC cold med, appetite suppressants, asthma meds
increases effects of digoxin and phenytoin
diltiazem (Cardizem) class and other
Class IV calcium channel blocker
verapamil (Calan)
diltiazem (Cardizem) therapeutic use
atrial tachycardia
diltiazem (Cardizem) ADRs
dizziness, bradycardia, heart block
diltiazem (Cardizem) contraindications
heart block
heart failure
diltiazem (Cardizem) interventions and education
cardiac rhythm monitoring and vital signs before dose
avoid OTC cold meds, asthma meds, appetite suppressants
diltiazem (Cardizem) EPA
blocks calcium channels, causing slower conduction through SA and AV nodes, slowing down heart rate
adenosine
Unclassified Antidysrhythmic Drug
adenosine therapeutic use
treats supraventricular tachycardia
adenosine EPA
acts like a calcium channel blocker
adenosine considerations
only given IV and must be given quickly due to short half life
magnesium
unclassified antidysrhythmic drug
magnesium therapeutic use
treats torsades de pointe
magnesium EPA
gatekeeps calcium from the cells to prevent contractions and irritable cardiac cells that lead to dysrhythmias
