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51 Cards in this Set
- Front
- Back
Alpha Adrenergic Blockers
(examples/uses) |
Hypertension
prazosin (Minipress) doxazosin mesylate (Cardura) |
|
Alpha Adrenergic Blockers
(SE and contraindications) |
orthostatic hypotension, reflex tachycardia, nasal congestion, impotence
|
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Alpha Adrenergic Blockers
(Nursing considerations) |
*Administer first dose at bedtime to avoid fainting
*Change positions slowly *Monitor BP, weight, BUN/Creatinine, edema |
|
Centrally Acting Alpha-Adrenergics
(examples/uses) |
Hypertension (decreases rate and force of contraction)
clonidine (Catapres) methyldopa (Aldomet) |
|
Centrally Acting Alpha-Adrenergics
(SE and contraindications) |
drowsiness, dry mouth, rebound hypertension, orthostatic hypotension, CHF
Medication interactions: Prazosin, MAOIs and TCAs can counteract the antihypertensive effect of clonidine. Additive CNS depression can occur if used with other CNS depressants. |
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Centrally Acting Alpha-Adrenergics
(Nursing considerations) |
*Don't discontinue abruptly
*Monitor for fluid retention |
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Beta Adrenergic Blockers
(examples/uses) |
Hypertension (decreases excitability of the heart)
atenolol (Tenormin) metoprolol (Toprol) nadolol (Corgard) metoprolol (Lopressor) carvedilol (Coreg) |
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Beta Adrenergic Blockers
(SE and contraindications) |
Beta1 Blockers - bradycardia, decreased cardiac output, AV block, orthostatic hypotension, gastric pain, tachycardia, impotence, nightmares, depression, dizziness
Beta 2- bronchospasm |
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Beta Adrenergic Blockers
(nursing considerations) |
*Do not discontinue abruptly
*Take with meals *Provide rest periods *For diabetic patients, blocks normal signs of hypoglycemia (sweating, tachycardia); monitor blood glucose *Medications have antianginal and antiarrhythmic actions |
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Angiotensin-Converting Enzyme (ACE) Inhibitors
(examples/uses) |
Hypertension (blocks vasocontriction)
captopril (Capoten) enalapril (Vasotec) lisinopril (Prinivil) |
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Angiotensin-Converting Enzyme (ACE) Inhibitors
(SE and contraindications) |
orthostatic hypotension, persistent non-productive cough, hyperkalemia, rash, angioedema, neutropenia, gastric irritation, tachycardia, MI, proteinuria, peripheral edema
Contraindications: Pregnancy category D, renal stenosis, hypersensitivity, use cautiously in clients with renal impairment and disorders Medication Interactions: diuretics, antihypertensives (additive effect), potassium supplements and potassium sparing diuretics, lithium, NSAIDs |
|
Angiotensin-Converting Enzyme (ACE) Inhibitors
(Nursing considerations) |
*Decreased absorption if taken with food - give 1 hr before or after
*Small frequent meals *Frequent mouth care *Change position slowly *Can be used with thiazide diuretics |
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Angiotensin II Receptor Blockers (ARBs)
(examples/uses) |
Hypertension (vasodilation; decrease Na and K+ retention)
losartan (Cozaar) valsartan (Diovan) candesartan (Atacand) |
|
Angiotensin II Receptor Blockers (ARBs)
(SE and contraindications) |
angioedema, hypertension, HF, diabetic nephropathy, myocardial infarction, stroke prevention
Contraindications: Pregnancy category D, renal stenosis |
|
Angiotensin II Receptor Blockers (ARBs)
(nursing considerations) |
*Change positions slowly
*Monitor for edema *Instruct client to notify provider in edema occurs |
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Calcium Channel Blocker
(examples/uses) |
Hypertension, angina, dysrhythmias (slows impulse conduction)
nifedipine (Procardia) amlodipine (Norvasc) verapamil (Calan) diltiazem (Cardizem) |
|
Calcium Channel Blocker
(SE and contraindications) |
nifedipine (reflex tachycardia, edema, toxicity)
verapamil and diltizem (orthostatic hypotension, edema, constipation, bradycardia, heart failure, dysrhythmias) Medication/Food Interactions: grapefruit juice can lead to toxicity, beta-blockers, digoxin |
|
Calcium Channel Blocker
(nursing considerations) |
*Monitor vital signs
*Do not chew or divide sustained release tablets *Contraindicated in heart block *Contact health provider if blood pressure <90/60 *Instruct client to avoid grapefruit (verapamil) *Monitor for signs of heart failure *If giving IV push, administer slowly over 2 – 3 minutes |
|
Nitrates
(examples/uses) |
Angina, HF, perioperative BP control (decreases cardiac o2 demand)
IV nitroglycerin SL nitroglycerin (Nitrostat), isosorbide dinitrate (Imdur) |
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Nitrates
(SE and contraindications) |
Side/Adverse Effects: Headache, orthostatic hypotension, reflex tachycardia, tolerance, dizziness
Medication Interactions: antihypertensives can contribute to hypotensive effect, sildenafil (Viagra) |
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Nitrates
(nursing considerations) |
*Take sublingual tablets under tongue or in buccal pouch; tablet should "fizzle" or burn
*Check expiration date *Discard unused med after 6 months *Take sustained-release tablets with water, don't chew them *Administer topically over 6 X 6 inch area using applicator, cover with plastic wrap, rotate sites *Administer transdermal to skin free of hair, do not apply to distal extrem, remove before defibrillation or cardioversion *Administer transmucosal tablets between lip and gum above the incisors or between the cheek and gum, do not chew *Administer translingual spray into oral mucosa; do not inhale *Withdraw medication gradually over 4-6 weeks *Provide rest periods *Teach to take medication when chest pain anticipated *May take q 5 min X 3 doses *Beta-adrenergic blockers and calcium-channel blockers also used for angina |
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Cardiac Glycosides
(examples/uses) |
HF, dysrhythmias (increases cardiac output and blood flow to the kidneys)
Digoxin (Lanoxin, Digitek) |
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Cardiac Glycosides
(SE and contraindications) |
dysrhythmias, cardiotoxicity leading to bradycardia, anorexia, N/V, abdominal pain, vision changes, confusion
Herbal interactions: licorice, hawthorn, ginseng, ma-huang (ephedra) |
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Cardiac Glycosides
(nursing considerations) |
*Administer with caution to elderly or clients with renal insufficiency
*Monitor renal function and electrolytes *Instruct clients to eat high-potassium foods (low K+ increases risk of digitalis toxicity) *Take apical pulse for 1 full min before admin; notify physician if AP less than 60 *Maintenance dose 0.125-0.5 mg *Therapeutic blood levels 0.5-2 nanograms per mL *Toxic blood levels greater than 2 nanograms pr mL *Digibind - antidote |
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Antidysrhythmics
(examples) |
procainamide (Pronestyl)
lidocaine amiodarone (Cordarone) adenosine (Adenocard) ibutilide (Corvert) |
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Antidysrhythmics
(SE and contraindications) |
*Procainamide – systemic lupus syndrome, blood dyscrasias, cardiotoxicity
*lidocaine – CNS effects, respiratory arrest *amiodarone – pulmonary toxicity, sinus bradycardia, hypotension, liver and thyroid dysfunction |
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Bile Acid Sequestrants
(examples) |
antilipemic agent (increases loss of bile acid in feces; decreases cholesterol)
cholestyramine (Questran) colestipol (Colestid) |
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Bile Acid Sequestrants
(SE and contraindications) |
constipation, rash, fat-soluble vitamin deficiency, abdominal pain and bloating
|
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Bile Acid Sequestrants
(nursing considerations) |
*Sprinkle powder on noncarbonated beverage or wet food; let stand 2 min; stir slowly
*Administer 1 hr before or 4-6 hrs after meals to avoid blocking absorption *Instruct patient to report constipation immediately *Avoid taking Digoxin, warfarin, thiazides or tetracyclines 1 hr before or 4 hrs after taking Bile sequestrants. |
|
HMG-CoA reductase inhibitors (Statins)
(example) |
Decreases LDL cholesterol levels
lovastatin (Mevacor) pravastatin (Pravachol) Simvastatin (Zocor) Atorvastatin (Lipitor) Fluvastatin (Lescol) Rosuvastatin (Crestor) |
|
HMG-CoA reductase inhibitors (Statins)
(SE and contraindications) |
myopathy, increased liver enzymes
causes vasodilation |
|
HMG-CoA reductase inhibitors (Statins)
(nursing considerations) |
*Take with food; avoid alcohol
*Grapefruit juice must be avoided *Contact physician if unexplained muscle pain occurs; esp with fever or malaise *Take at night *Give with caution to clients with decreased liver function |
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Nicotinic Acid
(example) |
Decreases total cholesterol, LDL & triglycerides; increases HDL
Niacin |
|
Nicotinic Acid
(SE and contraindications) |
flushing, hyperglycemia, gout, upper GI distress, liver damage
|
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Nicotinic Acid
(nursing considerations) |
*Flushing occurs several hours after med is taken, will decrease over 2 weeks
*Also used for pellagra and peripheral vascular disease *Avoid alcohol |
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Folic Acid Derivatives
(example) |
Decreases total cholesterol, VLDL and triglycerides
fenofibrate (Tricor) Gemfibrozil (Lopid) |
|
Folic Acid Derivatives
(SE and contraindications) |
abdominal pain, myalgia and swollen joints
increased risk of gallbladder disease |
|
Folic Acid Derivatives
(nursing considerations) |
*Administer before meals
*Instruct clients to notify health care provider if muscle pain occurs |
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Heparin
(uses) |
anticoagulant
thrombotic strokes, pulmonary embolism, deep vein thrombosis (DVT) and DVT prophylaxis, DIC, MI |
|
Heparin
(SE and contraindications) |
hemorrhage/bleeding, heparin induced thrombocytopenia (HIT), hypersensitivity reactions, anemia, fever
Contraindicated in clients with thrombocytopenia, uncontrolled bleeding, use cautiously in clients with hemophilia, peptic ulcer disease, severe hypertension. |
|
Heparin
(nursing considerations) |
*Monitor for signs of bleeding. Stop heparin if platelet count is less than 100,00/mm3
*Monitor therapeutic PTT at 1.5-2.5 times the normal (68-80 sec) *Use IV pump; deep SQ (never IM) *Antidote (protamine sulfate) |
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warfarin (Coumadin)
(uses) |
Antagonizes vitamin K, preventing the synthesis of four coagulation factors: VII, IX, X and prothrombin (PT)
Uses: prevention of thrombosis in clients with atrial fibrillation and prosthetic heart valves |
|
warfarin (Coumadin)
(SE and contraindications) |
Hemorrhage/Bleeding, diarrhea, rash, fever
Contraindications: Pregnancy category X, low platelet count, uncontrolled bleeding, liver disorders, use cautiously in clients with hemophilia, peptic ulcer disease, severe hypertension Medication/Food Interactions: heparin, aspirin, glucocorticoids, acetaminophen, sulfonamides, cephalosporin, phenobarbital, carbamazepine, phenytoin, vitamin K and foods high in vitamin K |
|
warfarin (Coumadin)
(nursing considerations) |
*Monitor PT at 1.5-2.5 times normal (18-24 seconds)
*Monitor INR at 2.0-3.0 *Antidote: Vitamin K, whole blood, plasma *Teach measures to avoid venous stasis *Emphasize importance of regular lab testing *Patient should avoid foods high in Vitamin K |
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Adenosine diphosphate (ADP) receptor antagonists
|
Antiplatelet agent (prevent platelets from clumping together (aggregating) by inhibiting enzymes and factors that normally lead to clotting)
clopidogrel (Plavix) ticlodipine (Ticlid) |
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Adenosine diphosphate (ADP) receptor antagonists
(SE and contraindications) |
thrombocytopenic purpura, GI upset, bleeding
|
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Salicylates
|
Antiplatelet agent
Asprin |
|
Salicylates
(SE and contraindications) |
Short term use - GI bleed, heartburn, occasional nausea
Prolonged high dosage - salicylism: metabolic acidosis, respiratory alkalosis, dehydration, fluid and electrolyte imbalance, tinnitus Contraindications: GI disorders, severe anemia, vitamin K def |
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Salicylates
(Nursing considerations) |
*Observe for bleeding gums, bloody or black stools, bruises
*Give with milk, water or food |
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Thrombolytics
(examples/uses) |
Dissolve clots that have already formed
tenecteplase (TNKase) tissue plasminogen activator (t-PA) streptokinase (Streptase) |
|
Thrombolytics
(SE and contraindications) |
bleeding, allergic reaction
contraindications: active bleeding, recent stroke, surgery or trauma, severe hypertension, pregnancy |