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31 Cards in this Set
- Front
- Back
Calcium channel blocker’s prevent calcium ions from entering cells having greatest effect on |
Heart and vessels |
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calcium channel blocker, is a class IV antidysrhythmic; Adverse effects: constipation, facial flushing, HA, edema, bradycardia, AV block and decreased contractility; Drug interactions: digoxin increase AV block risk, beta-adrenergic blocker same effect, grapefruit juice: verapamil toxicity; use: essential hypertension, cardiac dysrhythmia, and angina pectoris |
Verapamil (calan, isoptin) |
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Calcium channel blocker; use angina pectoris, essential hypertension, and cardiac dysrhythmias; adverse affects same as verapamil, except less constipation |
Diltiazem |
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Calcium channel blocker especially to dilate vessels; Little in heart so no dysrhythmia treatment; use: angina, hypertension (investigational to suppress preterm labor) |
Nifedipine (adalat, procardia) |
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Direct action on vascular smooth muscle to dilate vessels; Use: essential hypertension, hypertensive crisis and heart failure; adverse effects: reflects tachycardia, increased blood volume, systemic lupus erythematosis like syndrome |
Hydralazine (Apresoline) |
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More intense vasodilation van hydralazine, therefore reserved for extreme hypertension because of adverse effects; use: severe hypertension; adverse effects reflex tachycardia, sodium and water retention, hypertrichosis (excessive hair growth), pericardial Effusion |
Minoxidil |
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Use: hypertensive emergencies; adverse effects: hypertension, cyanide poisoning |
NA nitroprusside (nitropress, nipride) |
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Cardiac glycosides; purple Foxclove; views: heart failure and control dysrhythmias, slows and strengthens, increases cardiac output; adverse effects: dysrhythmias (secondary to hypokalemia loss with diuretics); narrow Therapeutic range; toxic symptoms: anorexia, nausea, vomiting, fatigue, visual disturbances; monitor serum drug levels; drug interactions: diuretics, ACE inhibitors, sympathomimetics, quinidine, and verapamil; Be sure to assess apical pulse, must be greater than 60 to administer prior to administration |
Digoxin (lanoxin) |
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Oldest, best studied most widely used class one antidysrhythmic, sodium channel blocker; bark of cinchona tree; Also has antimalarial and antipyretic properties; slows impulse conduction and atria, ventricles and HIS-purkinje system; Delays repolarization; strongly anti-cholinergic; blocks vagal input to heart, increasing SA node automaticity and AV conduction; widens QRS complex and prolongs QT interval; use: SVT, ventricular dysrhythmias, atrial flutter, atrial Fibrillation’s and sustained v tach |
Quinidine |
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Similar to Quinidine, class I antidysrhythmic in action and use; serious side effects limit use though; to use atrial and ventricular dysrhythmias; adverse affects: systemic lupus erythematosis like syndrome, blood dyscrasias |
Procainamide (procan) |
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Class 1B just rhythmic; for ventricle dysrhythmias only use IV; slows conduction and atria, vents and HIS-purkinje System, reduces automaticity, accelerates repolarization |
Lidocaine (xylocaine) |
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Ben’s a pro, and now a pro, lisinopril; decrease levels of angiotensin II and bradykinin to dilate blood vessels and decrease volume; use: hypertension, myocardial infarction; adverse effects: cough, hypotension, hyperkalemia and angioedema; therapeutic action is to lower blood pressure |
ACEI – angiotensin converting enzyme Inhibitors |
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A class II antidysrhythmic; use: treat dysrhythmias; adverse affects: heart failure, AV block, sinus arrest, hypotension and bronchospasm |
Propranolol (Inderal) |
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Class III antidysrhythmic agent, a potassium channel blocker; only approved for life-threatening ventricular dysrhythmias as last resort, because of toxicity; adverse effects: pulmonary toxicity, pneumonitis, pulmonary fibrosis; cardiotoxicity, thyroid toxicity, liver toxicity |
Amiodarone (pacerone) |
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Most effective drugs for lowering cholesterol and LDL, can raise HDL and lower TG in some patients; use: hypercholesterolemia, primary and secondary prevention of CV events, primary prevention and people with normal LDL, post MI therapy and diabetes; Actions: reduce LDL, elevate HDL, reduce GG; adverse effects: myopathy/rhabdomyolysis (muscle injury and weakness) and hepatotoxic; Drug selection: Any Staten to lower LDL by 30 to 40%, greater than 40% use atorvastatin or simvastatin |
Statins |
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Reduce LDL and TG, increases HDL better than others; does little to improve outcomes |
Niacin (nicotinic acid) |
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Use: acute angina attack, vasodilator; adverse effects: HA, orthostatic hypotension, reflex tachycardia; tolerance develops rapidly, used in lowest effective dosages; patches and sustained release should be intermittent; SL for acute angina: give as soon as pain begins, do not delay, call 911, Take another at 5 minutes and a third at another 5 minutes if not relieved |
Nitroglycerin |
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Anticoagulant (does not dissolve clots); Rapid acting; injection only; IV Subcutaneous; suppresses coagulation, can prevent clots and prevent extension of clot; does not break down a current clot; short half-life 1.5 hours; use: pregnancy if needed, pulmonary embolism, evolving stroke, DVT, open heart surgery, renal dialysis, prevent postop venous thrombosis, adjust to thrombolytic for AMI; Adverse effects: hemorrhage, spinal/epidural hematoma, heparin induced thrombocytopenia; For overdose use protamine sulfate; Measured in units not milligrams so I: measured by blood activated partial thromboplastin time; therapeutic levels of heparin increases by 1.5 to 2 times |
Unfractionated heparin |
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Low molecular weight heparin; adverse effects: bleeding, thrombocytopenia, OD treat with protamine sulfate also; very expensive; Lovenox first available in USA, more money in USA on this than any other drunk |
Enoxaparin (lovenox) |
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Oldest oral anticoagulant, does not dissolve clots; prevent thrombosis; delayed onset so not an emergency, given with parenteral heparin and continued or early after heparin discontinued; uses: prophylaxis, suppresses coagulation by decreasing factors VII, IX, X And prothrombin, vitamin K is antedote; Monitor treatment with prothrombin time; results not reported an international normalized ration; adverse effects: hemorrhage; vitamin K treat severe OD; dietary vitamin K can reduce anticoagulant effects; Mayonnaise, canola oil, soy bean and green leafy vegetables; Patients should keep intake of these foods constant; patient also monitor for bleeding and do not use sharp objects such as razors electric razors are better |
Warfarin (Coumadin) |
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Oral prodrug, rapid onset; No need to monitor coagulation; few drug/food interactions; Lower risk of bleeding; use: atrial fibrillation, knee/hip replacement; Adverse effects: bleeding, G.I. disturbance |
Dabigatran etexilate (Pradaxa) |
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Oral anticoagulant inhibitor factor XA; use: knee and hip replacement, nonvalvular atrial fibrillation; Adverse effects: bleeding, spinal epidural hematoma |
Rivaroxaban (xarelto) |
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Not for patients with peptic ulcer history; monitor for bleeding; take in definitely after myocardial infarction |
ASA antiplatelet |
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Tissue plasminogen activator manufactured via recombinant therapy, thrombolytic; use: acute myocardial infarction, stroke from clot, not from ruptured aneurysm or other bleed, acute massive PE; treat within two hours of symptom onset; adverse effects: bleeding, reperfusion dysrhythmias after restoring blood flow |
Alteplase (Activase) |
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Factor VIII concentrates for hemophilia A; recombinant factor VIII are agents of choice; Adverse effects: allergic reactions; does: on demand/prophylactic |
Given IV route |
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Factor I X concentrates for him aphelia be given on demand; dose determined by sight and severity of bleeding |
Push at earliest sign of bleeding |
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Analog of antidiuretic hormone can’t stop/prevent bleeding in patients with mild hemophilia A; and releases stored factor VIII; given nasal spray/IV infusion |
Desmopressin (stimate) |
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Mostly receive through dietary: Fish meat and dairy products; necessary for cell growth and division; replacement is parenteral, it could be given orally, but for several neurologic deficit’s Parenteral administration is indicated |
Vitamin B 12 |
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Take with vitamin C, between meals, use straw |
Ferrous sulfate |
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Produced by recombinant DNA technology; use: to treat anemia of chronic renal failure, chemotherapy induced anemia, HIV patients taking Zidovudine, Occasionally anemic patients scheduled for elective surgery; check hematocrit/hemoglobin for therapeutic effect; requires vitamin B 12, folic acid and iron to be effective so educate on increase intake of food to high in iron and vitamin C; stimulates production of RBCs |
Erythropoietin (Epogen) |
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White cell growth factor produced by recombinant DNA technology; used for patient undergoing myelosuppressive chemotherapy |
Filgrastim (Neupogen) |