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Cardiac Meds 2011
Medication Tutorial
Question | Answer |
---|---|
Four main groups of dysrhythmias | Atropine, Amiodarone, Lidocaine, Cardizem |
It's action is to block the parasympathetic effect on the heart and therefore increase heart rate. Bronchodilation occurs with this drug as well. | ATROPINE |
Blocks the movement of K+ ions across the myocardial cell walls. Therefore decreases repolarization. | AMIODARONE |
Na+ channel blocker | LIDOCAINE |
Anticholinergic | ATROPINE |
Decreases the automaticity of the myocardial cells. | LIDOCAINE |
One of the Ca+ channel blockers | CARDIZEM |
Used to slow the heart rate by a blockate at the sinus node and by slowing conduction through the AV node. | CARDIZEM |
4 Types of Drugs used to treat CAD | VASODILATORS (Nitrates), ANTIPLATELETS, BETA BLOCKERS (lol), ACE INHIBITORS (pril) |
Used to decrease angina | VASODILATOR (e.g. nitrates) |
Used to prevent clot build up | ANTIPLATELETS |
These medications will decrease preload and afterload due to their affect on arteries and veins | VASODILATORS |
This class decreases platelet aggregation | ANTIPLATELETS |
This class has multiple uses including: Angina, Hypertension, Dysrhythmia, MI, heart failure, and migraines. | BETA BLOCKERS |
Used in CAD, Hypertension, and Heart Failure | ACE INHIBITORS |
Decreases Angiotension II and thereby promotes vasodilation. Also prevents structural changes in cardiac, vascular beds (remodeling) | ACE INHIBITORS |
K+ Channel Blocker | AMIODARONE |
Used with symptomatic bradycardia | ATROPINE |
Side effects are dry mouth, blurred vision, constipation, urinary retention | ATROPINE |
List (3) Nursing Implications of Atropine | 1. Considered emergency drug and part of ACLS protocol. 2. Only given I.V. 3. Desire to have patient on telemonitor |
Used for PVC's and ventricular tachycardia. It has also been helpful in atrial fib. | AMIODARONE |
Side effects can be severe. Toxic to lung tissue and vision. | AMIODARONE |
Given only IV | LIDOCAINE |
Side effects are CNS depression, convulsions, and can have increase in dysrhythmias. Monitor for mental status changes | LIDOCAINE |
Has effect on the electrical pathways above the ventricle, therefore used to slow down dysrhythmias originating in atria | CARDIZEM |
Side effects are flushing and peripheral edema | CARDIZEM |
List 2 nursing implications with Cardizem | Monitor BP and HR |
This drug is given IV and PO | AMIODARONE |
Patient's often do not feel well when first placed on the drug.. they complain of fatigue and anorexia | AMIODARONE |
List 2 drugs that you specifically need to watch HR and BP | CARDIZEM & AMIODARONE |
Drug has very long half life of 25-110 days | AMIODARONE |
This helps dilate coronary arteries thus decreasing angina | NITRATES |
ASA is the most widely used for prevention and least expensive. Plavix is used post stent, maybe post CABG and post MI | ANTIPLATELETS |
B1(heart) and B2(lungs). This group can be nonselective or selective of one receptor. Coreg has an alpha (vascular) component as well. All of these receptors are part of the Sympathetic Nervous System. | BETA BLOCKERS |
It is important to monitor for hypotension, especially with the first dose of this medication | ACE INHIBITORS |
These are given PO(isordil), SL, IV and paste | NITRATES |
ASA helps to decrease inflammation as well (Plavix does at a lower level) | ANTIPLATELETS |
With CAD patients, these meds are used to decrease the oxygen consumption of the heart and decreases SNS stimulation (decrease HR) | BETA BLOCKERS |
Severe reaction of angioedema can result. Other side effects are cough and hyperkalemia. | ACE INHIBITORS |
Due to the arterial dilation, hypotension can occur. Always give SL with the patient seated or prone. Headaches can occur due to dilation of arteries to the head | NITRATES |
IV class (glcoprotein IIbIIIa inhibitors) are also antiplatelet. These are infused right after a stent is placed. What are 2 of their names? | INTREGRELLIN & REOPRO |
Meds are usually well tolerated. Can cause some adverse hemotologic events, but common side effects are abdominal pain and increased risk of GI bleed | ANTIPLATELETS |
Side effects are bradycardia, decreased CO, bronchoconstriction, decreased glycogenolysis, and can increase incidents of impotence | BETA BLOCKERS |
Reflex tachycardia can occur | NITRATES |
Use with caution in respiratory patient, and warn DM patient about reduced warning of hypoglycemia | BETA BLOCKERS |
Monitor heart rate and blood pressure when giving doses | BETA BLOCKERS |
Why are patients with Congestive Heart Failure (CHF) usually prescribed many medications? | Many compensatory responses occur with CHF. The meds are prescribed to suppress these responses. |
What med suppresses the increases of SNS in CHF patients? | BETA BLOCKERS |
What med suppresses the increase of renal vasoconstriction in CHF patients? | ACE INHIBITORS |
What med suppresses Ventricular Remodeling in CHF patients? | ACE INHIBITORS |
These medications are also important in treating CHF | Diuretics |
Purpose of this drug is to increase the strength of the heart's contraction | INOTROPES |
This drug is a combination of a positive Inotrope and a negative Chronotrope | DIGOXIN |
3 common classes of drugs used alone and in combination to reduce blood pressure: | BETA BLOCKERS, ACE INHIBITORS, and DIURETICS |
Most common used Diuretic to assist in blood pressure control | THIAZIDES |
Calcium Channel Blocker | NORVASC |
Causes vasodilation at arterioles | NORVASC |
Central acting causes a decrease in sympathetic neuro firing (clonidine) | ALPHA BLOCKERS |
What competes with Digoxin and requires monitoring for proper levels? | POTASSIUM (K+) |
Given IV push or more common PO | DIGOXIN |
Side effects are flushing and peripheral edema | NORVASC |
Side effects are rebound hypertension and drowsiness | Central Acting ALPHA BLOCKERS |
Narrow therapeutic window - need to monitor drug levels | DIGOXIN |
Nuring Implications of Norvasc | Monitor BP and HR |
Peripheral acting causes a vasodilation of arterioles and veins (prazosin) | ALPHA BLOCKERS |
Symptoms of toxicity are nausea and visual changes | DIGOXIN |
Side effects are orthostatic hypotension and rebound tachycardia | Peripheral Acting ALPHA BLOCKERS |
Side effects are bradycardia and fatigue | DIGOXIN |