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Cardio Drug Part III
Diruetics, Vasodilators, Blood Condition, Cholesterol/Lipid
| Question | Answer |
|---|---|
| Decrease the plasma and extracellular fluid volumes | Diuretics |
| Decreased preload Decreased cardiac output Decreased total peripheral resistance are the results for: | Diuretics |
| Decreased workload of the heart, and decreased blood pressure are the Overall effect of: | Diuretics |
| are the most commonly used diuretics for hypertension | Thiazide Diuretics |
| Listed as first-line antihypertensives in the JNC-7 guidelines | Thiazide Diuretics |
| Directly relax arteriolar and/or venous smooth muscle, Result: decreased systemic vascular response, decreased afterload, and peripheral vasodilation are the mechanism of action of: | Vasodilators: Mechanism of Action |
| diazoxide (Hyperstat), hydralazine HCl (Apresoline), minoxidil (Loniten), sodium nitroprusside (Nipride, Nitropress) are | Antihypertensive Drugs Vasodilators |
| Treatment of hypertension, May be used in combination with other drugs, Oral diazoxide may be used as an antihypoglycemic, Sodium nitroprusside and intravenous diazoxide are reserved for the management of hypertensive emergencies are indications for: | Vasodilators: Indications |
| A vasodilator that causes Dizziness, headache, anxiety, tachycardia, nausea and vomiting, diarrhea, anemia, dyspnea, edema, nasal congestion, others as adverse effects | Hydralazine (Vasodilators) |
| A vasodilator that causes Bradycardia, hypotension, possible cyanide toxicity (rare) as adverse effects | Sodium nitroprusside |
| A vasodilator that causes Dizziness, headache, anxiety, orthostatic hypotension, dysrhythmias, sodium and water retention, nausea, vomiting, hyperglycemia in diabetic patients, others as adverse effects | Diazoxide |
| Before beginning therapy, obtain a thorough health history and head-to-toe physical examination, Assess for contraindications to specific antihypertensive drugs, Assess for conditions that require cautious use of these drugs are nursing implications for | Vasodilators: Nursing Implications |
| Educate patients about the importance of not missing a dose and taking the medications exactly as prescribed, Patients should never double up on doses if a dose is missed; check with physician for instructions on what to do if a dose is missed, Monitor BP | Vasodilators: Nursing Implications |
| Instruct patients that these drugs should not be stopped abruptly because this may cause a rebound hypertensive crisis, and perhaps lead to stroke, Oral forms should be given with meals so that absorption is more gradual and effective, IV forms use pump | Vasodilators: Nursing Implications |
| Remind patients that medication is only part of therapy. Encourage patients to watch their diet, stress level, weight, and alcohol intake, Patients should avoid smoking and eating foods high in sodium, Encourage supervised exercise with | Vasodilators: Nursing Implications |
| Instruct patients to change positions slowly to avoid syncope from postural hypotension, Patients should report unusual shortness of breath; difficulty breathing; swelling of the feet, ankles, face, or around the eyes; weight gain or loss; chest pain; pal | Vasodilators: Nursing Implications |
| Men taking these drugs may not be aware that impotence is an expected effect. This may influence compliance with drug therapy, If patients are experiencing serious adverse effects, or believe that the dose or medication needs to be changed, call physician | Vasodilators: Nursing Implications |
| Hot tubs, showers, or baths; hot weather; prolonged sitting or standing; physical exercise; and alcohol ingestion may aggravate low blood pressure, leading to fainting and injury. Patients should sit or lie down until symptoms subside with | Vasodilators: Nursing Implications |
| Patients should not take any other medications, including OTC drugs, without first getting the approval of their physician while taking | Vasodilators (Antihypersensives) |
| Educate about lifestyle changes that may be needed: Weight loss, Stress Management, Supervised exercise, Dietary measures | Vasodilators (Antihypersensives) |
| Monitor for adverse effects (dizziness, orthostatic hypotension, fatigue) and for toxic effects With | Vasodilators (Antihypersensives) |
| Monitor for therapeutic effects: Blood pressure should be maintained at less than 130/90 mm Hg, If a patient with hypertension also has diabetes or renal disease, the BP goal is less than130/80 mm Hg (JNC-7) with | Vasodilators (Antihypersensives) |
| Monitor for therapeutic effects:Reduction in edema, fluid volume overload, HF; Reduction of hypertension; Return to normal intraocular pressures | Vasodilators (Antihypersensives) |
| Antithrombotic effects: Reduce risk of fatal and nonfatal strokes; | Antiplatelet Drugs |
| Adverse effects: Vary according to drug | Antiplatelet Drugs |
| Prevent the lysis of fibrin, Results: promote clot formation | Antifibrinolytic Drugs |
| Used for prevention and treatment of excessive bleeding resulting from hyperfibrinolysis or surgical complications | Antifibrinolytic Drugs |
| aminocaproic acid (Amicar) is a | Antifibrinolytic Drugs |
| desmopressin (DDAVP), Similar to ADH, Also used in the treatment of diabetes insipidus is what type of drug? | Antifibrinolytic Drugs |
| Prevention and treatment of excessive bleeding: Hyperfibrinolysis, Surgical complications, Excessive oozing from surgical sites such as chest tubes, Reducing total blood loss and duration of bleeding in the postoperative period are the indications to use | Antifibrinolytic Drugs: Indications |
| Uncommon and mild, Rare reports of thrombotic events, Others include: Dysrhythmia, orthostatic hypotension, bradycardia, headache, dizziness, fatigue, nausea, vomiting, abdominal cramps, diarrhea, others are the adverse effects of what drugs? | Antifibrinolytic Drugs: Adverse Effects |
| Drugs that break down, or lyse, preformed clots are what type of drug? | Thrombolytic Drugs |
| Older drugs: streptokinase and urokinase are what type of drug? | Thrombolytic Drugs |
| Newer drugs: Tissue plasminogen activator, Anisoylated plasminogen-streptokinase activator complex (APSAC) are what type of drug? | Thrombolytic Drugs |
| streptokinase (Streptase), anistreplase (Eminase), alteplase (t-PA, Activase), reteplase (Retavase), tenecteplase (TNKase), drotrecogin alfa (Xigris) are what type of drugs? | Thrombolytic Drugs (note generic end in -ASE) |
| Activate the fibrinolytic system to break down the clot in the blood vessel quickly, Activate plasminogen and convert it to plasmin, which can digest fibrin, Reestablish blood flow to the heart muscle via coronary arteries, preventing tissue destruction | Thrombolytic Drugs: Mechanism of Action |
| Acute MI, Arterial thrombolysis, DVT, Occlusion of shunts or catheters, Pulmonary embolus, Acute ischemic stroke indicate that you need what drugs? | Thrombolytic Drugs: Indications |
| BLEEDING: Internal, Intracranial, Superficial; and Other effects: Nausea, vomiting, hypotension, anaphylactoid reactions, Cardiac dysrhythmias are side effects of what drugs? | Thrombolytic Drugs: Adverse Effects |
| Assess: Patient history, medication history, allergies, Contraindications, Baseline vital signs, laboratory values, Potential drug interactions—there are MANY!, History of abnormal bleeding conditions for what drugs? | Thrombolytic Drugs: Nursing Implications |
| Intravenous doses are usually double checked with another nurse, Ensure that SC doses are given SC, not IM, SC doses should be given in areas of deep subcutaneous fat, and sites rotated with what specific drug? | Heparin (Anticoagulants) |
| Do not give SC doses within 2 inches of: The umbilicus, abdominal incisions, or open wounds, scars, drainage tubes, stomas; Do not aspirate SC injections or massage injection site May cause hematoma formation with what specific drug? | Heparin (Anticoagulants) |
| IV doses may be given by bolus or IV infusions, Anticoagulant effects seen immediately, Laboratory values are done daily to monitor coagulation effects (aPTT)with what specific drug? | Heparin (Anticoagulants) |
| Protamine sulfate can be given as an antidote in case of excessive anticoagulation what specific drug? | Heparin (Anticoagulants) |
| Given subcutaneously in the abdomen, Rotate injection sites, Protamine sulfate can be given as an antidote in case of excessive anticoagulation with Enoxaparin (Lovenox) and Dalteparin (Fragmin) what drug class do they belong to? | Anticoagulants LWMHs (low molecular weight heparin) (related to heparin) |
| May be started while the patient is still on heparin until PT-INR levels indicate adequate anticoagulation what specific drug is this? | Warfarin Sodium (Coumadin Sodium or Warfilone) (Oral Anticoagulant) |
| Full therapeutic effect takes several days what specific drug is this? | Warfarin Sodium (Coumadin Sodium or Warfilone) (Oral Anticoagulant) |
| Monitor PT-INR regularly—keep follow-up appointments what specific drug is this? | Warfarin Sodium (Coumadin Sodium or Warfilone) (Oral Anticoagulant) |
| Antidote is vitamin K what specific drug is this? | Warfarin Sodium (Coumadin Sodium or Warfilone) (Oral Anticoagulant) |
| Many herbal products have potential interactions—increased bleeding may occur: Capsicum pepper, Garlic, Ginger, Gingko, Ginseng, Feverfew with what specifc drug? | Warfarin Sodium (Coumadin Sodium or Warfilone) (Oral Anticoagulant) |
| Education should include: Importance of regular lab testing, Signs of abnormal bleeding, Measures to prevent bruising, bleeding, or tissue injury with what type of drugs? | Anticoagulants: Patient Education |
| Education should include: Wearing a medical alert bracelet, Avoiding foods high in vitamin K (tomatoes, dark leafy green vegetables), Consulting physician before taking other meds or OTC products, including herbals with what drugs? | Anticoagulants: Patient Education |
| Concerns and teaching tips same as for anticoagulants: Dipyridamole should be taken on an empty stomach, Drug-drug interactions, Adverse reactions to report, Monitoring for abnormal bleeding with what drugs? | Antiplatelet Drugs: Nursing Implications |
| Drugs used to inhibit the aggregation of plateles to treat clients that have experienced CVAs or MI | Antiplatelet Drugs: |
| Aspirin, dipyridamole (Persantine, and sulfinpyrazone (Anturane) are examples of what type of drugs? | Antiplatelet Drugs |
| This drug enzymes act to convert the substance known as plasminogen to the enzyme fibrinolysin. This dissolves fibrin clots, as well as other plasma proteins. | Thrombolytic Agents |
| urokinase (Abbokinase) and streptokinase (Streptase) are examples of what drugs? | Thrombolytic |
| Indicated for the lysis of acute massive pulmonary emboli and for treatment of central venous line sespis cause by fibrin formation. Urokinase is becoming choice for clearing fibrin from the catheters of central venous access | Thrombolytic |
| Follow strict manufacturer’s guidelines for preparation and administration, Monitor IV sites for bleeding, redness, pain, Monitor for bleeding from gums, mucous membranes, nose, injection sites with what drugs? | Thrombolytic |
| Observe for signs of internal bleeding (decreased BP, restlessness, increased pulse) with what drugs? | Thrombolytic |
| Monitor for signs of excessive bleeding: Bleeding of gums while brushing teeth, unexplained nosebleeds, heavier menstrual bleeding, bloody or tarry stools, bloody urine or sputum, abdominal pain, vomiting blood with what drugs? | Coagulation Modifier Drugs Nursing Implications |
| Monitor for adverse effects: Increased BP, headache, hematoma formation, hemorrhage, shortness of breath, chills, fever | Coagulation Modifier Drugs Nursing Implications |
| Substances used to treat HYPERLIPIDEMIA. | Antilipemics |
| Atorvastatin Ca (Lipitor) | Antilipemics |
| HMG-CoA reductase inhibitors (HMGs, or statins), Bile acid sequestrants, Niacin (nicotinic acid), Fibric acid derivatives, Cholesterol absorption inhibitor, Combination drugs are all what type of drugs? | Antilipemics |
| lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor), atorvastatin (Lipitor), fluvastatin (Lescol) are all what type of drugs? | Antilipemics: HMG-CoA Reductase Inhibitors (HMGs, or statins) (NOTE: generic end in -STATIN) |
| is an enzyme required for the production of cholesterol in the body. This new class of drugs inhibits the action of this enzyme, thereby resulting in and increase in HDL and reduction in LDL and VLDL and triglyceride levels | HMG-Co Reducatse inhibitors |
| Inhibit HMG-CoA reductase, which is used by the liver to produce cholesterol, Lower the rate of cholesterol production this mechanism is used by what drug? | HMG-CoA Reductase Inhibitors |
| First-line drug therapy for hypercholesterolemia what drug is this? | HMG-CoA Reductase Inhibitors |
| Treatment of types IIa and IIb hyperlipidemias, Reduce LDL levels by 30% to 40%, Increase HDL levels by 2% to 15%, Reduce triglycerides by 10% to 30% when using what drug? | HMG-CoA Reductase Inhibitors |
| Mild, transient GI disturbances, Rash, Headache, Myopathy (muscle pain), possible leading to the serious condition rhabdomyloysis, Elevations in liver enzymes or liver disease are the side effects of what drugs? | HMG-CoA Reductase Inhibitors |
| cholestyramine (Questran), colestipol hydrochloride (Colestid), colesevelam (tablet form) are examples of what drugs? | Bile Acid Sequestrants (Antilipemics) |
| Also called bile acid-binding resins and ion-exchange resins | Bile Acid Sequestrants (Antilipemics) |
| These drugs mechanism of action is to prevent resorption of bile acids from small intestine (Bile acids are necessary for absorption of cholesterol) | Bile Acid Sequestrants (Antilipemics) |
| This drug is indicated when a person has Type II hyperlipoproteinemia, Relief of pruitus associated with partial bilary obstruction (cholestyamine), may be used along with statins | Bile Acid Sequestrants (Antilipemics) |
| The adverse effects: Constipation, Heartburn, nausea, belching, bloating (they tend to disappear over time) | Bile Acid Sequestrants (Antilipemics) |
| This Antilipemic drug when taken in large doses has Lipid-lowering properties by decreasing fatty acids in the blood... Also called vitamin B3 | Niacin (Nicotinic Acid) (Antilipemic) |
| This effective, inexpensive, drug is often used in combination with other lipid-lowering drugs | Niacin (Nicotinic Acid) (Antilipemic) |
| The mechanism of action of this drug: Thought to increase activity of lipase, which breaks down lipids; Reduces the metabolism or catabolism of cholesterol and triglycerides what drug is this? | Niacin (Nicotinic Acid) (Antilipemic) |
| This drug is effective in lowering triglyceride, total serum cholesterol, and LDL levels; Increases HDL levels | Niacin (Nicotinic Acid) (Antilipemic) |
| Effective in the treatment of types IIa, IIb, III, IV and V hyperlipidemias | Niacin (Nicotinic Acid) (Antilepemic) |
| The adverse effects of this drug is flushing (due to histamine release), Pruitus, and GI distress | Niacin (Nicotinic Acid) (Antilipemic) |
| Also known as fibrates | Fibric Acid Derivatives |
| gemfibrozil (Lopid) fenofibrate (Tricor) | Fibric Acid Derivatives (Antilipemics) |
| The mechanism of action of these drugs work by activating lipase, which breaks down cholesterol | Fibric Acid Deratives (Antilipemics) |
| Suppresses the release of fatty acid from the adipose tissue, inhibit synthesis of triglycerides in the liver, and increases the secretion of cholesterol in the bile | Fibric Acid Derivatives (Antilipemics) |
| These drugs treat types III, IV, and V hyperlipidemias | Fibric Acid Derivatives (Antilipemics) |
| The drug effects are decreases in triglyceride levels, Increases in HDL by as much as 25% | Fibric Acid Derivatives (Antilipemics) |
| The adverse effects of these drugs is: Abdominal discomfort, diarrhea, nausea, Blurred vision, headache, increased risk of gallstones, prolonged prothrombin time, Liver studies may show increased function | Fibric Acid Derivatives (Antilipemics) |
| ezetimibe (Zetia) is an example of what drug? | Cholesterol Absorption Inhibitor (Antilipemics) |
| This drug inhibits absorption of cholesterol and related sterols from the small intestine = reduced total cholesterol LDL, triglyceride levels, increases HDL, works well when taken with a stantin drug | Cholesterol Absorption Inhibitor (Antilipemics) |
| Before begining therapy, obtain a thorough health and med. history, Assess dietary patterns, exercise level, weight, height, VS, tobacco and alcohol use, family history and contraindications, drug interactions | (Antilipemics) |
| Contraindications of these drugs are bilary obstruction, liver dysfunction, active liver disease | (Anitlipemics) |
| Obtain baseline liver function studies | Antilipemics |
| Patients on long-term therapy may need supplemental fat-soluble vitammins (A, D, K); Take with meals to decrease GI upset | Antilipemics |
| Patient must be counseled concerning diet and nutrition on an ongoing basis. Instruct proper procedure for taking meds. | Antilipemics |
| Powder forms must be taken with a liquid, mixed thoroughly but not stirred. Never taken dry | Antilipemics |
| Other meds. should be taken 1 hour before or 4-6 hours after meals to avoid interference with absorption | Antilipemics |
| Clofibrate often causes constipation; instruct patients to increase fiber and fluid intake to offset this effect | Antilipemics |
| To minimize the effects of this drug, start on low initial dose and gradually increase it, and take with meals | Niacin (Antilipemics) |
| Small doses of aspirin or NSAIDs may be taken 30 minutes before what drug to minimize cutaneous flushing | Niacin (Antilipemics) |
| Inform patients that these drugs may take several weeks to show effectiveness | Antilipemics |
| Instruct patients to report persistent GI upset, constipation, abnormal or unusual bleeding, and yellow discoloration of the skin | Antilipemics |
| Monitor for adverse effecs, including increased liver enzyme studies | Antilipemics |
| Monitor these drugs for therapeutic effects: Reduced cholesterol and triglyceride levels | Antilipemics |
Created by:
Cinderelle
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