UTA NURS 4581 Adults with Complex Needs Exam 1 Meds
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| atorvastatin (Lipitor) classification and use | HMG-CoA Reductase Inhibitor (Statin); used to treat hyperlipidemia by restricting lipoprotein production
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| fluvastatin (Lescol) classification and use | HMG-CoA Reductase Inhibitor (Statin); used to treat hyperlipidemia by restricting lipoprotein production
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| lovastatin (Mevacor) classification and use | HMG-CoA Reductase Inhibitor (Statin); used to treat hyperlipidemia by restricting lipoprotein production
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| pitavastatin (Livalo) classification and use | HMG-CoA Reductase Inhibitor (Statin); used to treat hyperlipidemia by restricting lipoprotein production
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| pravastatin (Pravachol) classification and use | HMG-CoA Reductase Inhibitor (Statin); used to treat hyperlipidemia by restricting lipoprotein production
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| simvastatin (Zocor) classification and use | HMG-CoA Reductase Inhibitor (Statin); used to treat hyperlipidemia by restricting lipoprotein production
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| rosuvastatin (Crestor) classification and use | HMG-CoA Reductase Inhibitor (Statin); used to treat hyperlipidemia by restricting lipoprotein production
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| niacin (Nicobid, Niaspan) classification and use | Niacin; used to treat hyperlipidemia by restricting lipoprotein production
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| nicotinic acid (Slo-Niacin, Novo-Niacin) classification and use | Niacin; used to treat hyperlipidemia by restricting lipoprotein production
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| fenofibrate (TriCor) classification and use | Fibric Acid Derivative; used to treat hyperlipidemia by restricting lipoprotein production
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| gemfibrozil (Lopid) classification and use | Fibric Acid Derivative; used to treat hyperlipidemia by restricting lipoprotein production
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| cholestyramine (Questran) classification and use | Bile-Acid Sequestrant; used to treat hyperlipidemia by increasing lipoprotein removal
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| colesevelam (WelChol) classification and use | Bile-Acid Sequestrant; used to treat hyperlipidemia by increasing lipoprotein removal
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| colestipol (Colestid) classification and use | Bile-Acid Sequestrant; used to treat hyperlipidemia by increasing lipoprotein removal
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| ezetimibe (Zetia) classification and use | Cholesterol Absorption Inhibitor; used to treat hyperlipidemia by decreasing cholesterol absorption
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| HMG-CoA Reductase Inhibitors (Statins) Mechanism of Action and Effects | Block synthesis of cholesterol and increase LDL receptors in liver, ↓ LDL, ↓ Triglycerides, ↑ HDL
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| HMG-CoA Reductase Inhibitors (Statins) Nursing Considerations | Well tolerated with few side effects. Monitor liver enzymes and creatine kinase (if muscle weakness or pain occurs).
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| Niacin Mechanism of Action and Effects | Inhibits synthesis and secretion of VLDL and LDL, ↓ LDL, ↓ Triglycerides, ↑ HDL
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| Niacin Nursing Considerations | Most side effects subside with time; decreased liver function may occur with high doses. Taking aspirin or NSAID 30 min before drug may prevent flushing; take drug with food. Treat elevated homocysteine levels with folic acid.
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| Fibric Acid Derivatives Mechanism of Action and Effects | Decrease hepatic synthesis and secretion of VLDL; ↓ LDL; ↓ Triglycerides; ↑ HDL
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| Fibric Acid Derivatives Nursing Considerations | May ↑ effects of warfarin (Coumadin) and some antihyperglycemic drugs. When used in combination with statins, may increase adverse effects of statins, especially myopathy.
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| Bile-Acid Sequestrants Mechanism of Action and Effects | Bind with bile acids in intestine, forming insoluble complex and excreted in feces, resulting in removal of LDL and cholesterol; ↓ LDL
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| Bile-Acid Sequestrants Nursing Considerations | Effective and safe for long-term use; side effects diminish with time. Interfere with absorption of many drugs (e.g., digoxin, thiazide diuretics, warfarin, some antibiotics [e.g., penicillins]).
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| Cholesterol Absorption Inhibitor Mechanism of Action and Effects | Inhibits the intestinal absorption of cholesterol; ↓ LDL; ↑ HDL
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| Cholesterol Absorption Inhibitor Nursing Considerations | When used with a statin, LDL is further reduced. Should not be used by patients with liver impairment.
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| Simvastatin (Zocor) Drug Alert | Increased risk for rhabdomyolysis when also used with gemfibrozil (Lopid) or niacin. Signs of rhabdomyolysis: ↑ creatine kinase levels, muscle tenderness.
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| Niacin (Niaspan) Drug Alert | Instruct patient that flushing (especially of face and neck) may occur within 20 minutes after taking drug and may last for 30 to 60 minutes. Can premedicate with aspirin or NSAID 30 minutes before to reduce flushing.
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| Gemfibrozil (Lopid) Drug Alert | May increase the risk of bleeding in patients taking warfarin (Coumadin). May increase the effects of antihyperglycemic drugs (e.g., repaglinide [Prandin]).
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| Nitrates mechanism of action | Promote peripheral vasodilation, decreasing preload and afterload. Coronary artery vasodilation.
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| β-Adrenergic blocker mechanism of action | Inhibit sympathetic nervous stimulation of the heart. Reduce heart rate, contractility, and blood pressure. Decrease afterload.
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| Calcium channel blockers | Prevent calcium entry into vascular smooth muscle cells and myocytes (cardiac cells). Coronary and peripheral vasodilation. Reduce heart rate, contractility, and blood pressure.
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| ACE Inhibitor mechanism of action | Prevent conversion of angiotensin I to angiotensin II resulting in vasodilation. Decrease endothelial dysfunction. Useful with heart failure, tachycardia, MI, hypertension, diabetes, and chronic kidney disease
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| Sublingual nitroglycerin (Nitrostat, NitroQuick) classification and use | Nitrate; used to treat chronic stable angina and acute coronary syndrome
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| Translingual spray nitroglycerin (Nitrolingual) classification and use | Nitrate; used to treat chronic stable angina and acute coronary syndrome
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| Nitroglycerin ointment (Nitro-Bid, Nitrol) classification and use | Nitrate; used to treat chronic stable angina and acute coronary syndrome
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| Transdermal nitroglycerin (Transderm-Nitro, Minitran) classification and use | Nitrate; used to treat chronic stable angina and acute coronary syndrome
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| Extended-release buccal tablets (Nitrogard) classification and use | Nitrate; used to treat chronic stable angina and acute coronary syndrome
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| Isosorbide dinitrate (Isordil, Sorbitrate) classification and use | Nitrate; used to treat chronic stable angina and acute coronary syndrome
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| IV nitroglycerin (Nitro-Bid IV, Tridil) classification and use | Nitrate; used to treat chronic stable angina and acute coronary syndrome
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| atenolol (Tenormin) classification and use | β-Adrenergic Blockers; used to treat chronic stable angina and acute coronary syndrome
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| carvedilol (Coreg) classification and use | β-Adrenergic Blockers; used to treat chronic stable angina and acute coronary syndrome
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| esmolol (Brevibloc) classification and use | β-Adrenergic Blockers; used to treat chronic stable angina and acute coronary syndrome
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| metoprolol (Lopressor) classification and use | β-Adrenergic Blockers; used to treat chronic stable angina and acute coronary syndrome
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| nadolol (Corgard) classification and use | β-Adrenergic Blockers; used to treat chronic stable angina and acute coronary syndrome
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| propranolol (Inderal) classification and use | β-Adrenergic Blockers; used to treat chronic stable angina and acute coronary syndrome
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| amlodipine (Norvasc) classification and use | Calcium Channel Blocker; used to treat chronic stable angina and acute coronary syndrome
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| diltiazem (Cardizem) classification and use | Calcium Channel Blocker; used to treat chronic stable angina and acute coronary syndrome
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| felodipine (Plendil) classification and use | Calcium Channel Blocker; used to treat chronic stable angina and acute coronary syndrome
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| nifedipine (Procardia) classification and use | Calcium Channel Blocker; used to treat chronic stable angina and acute coronary syndrome
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| nicardipine (Cardene) classification and use | Calcium Channel Blocker; used to treat chronic stable angina and acute coronary syndrome
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| verapamil (Calan, Isoptin) classification and use | Calcium Channel Blocker; used to treat chronic stable angina and acute coronary syndrome
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| captopril (Capoten) classification and use | ACE Inhibitor; used to treat chronic stable angina and acute coronary syndrome
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| enalapril (Vasotec) classification and use | ACE Inhibitor; used to treat chronic stable angina and acute coronary syndrome
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| Nitroglycerin Drug Alert | Tablet or spray needs to be administered under the tongue. Instruct patient not to combine with drugs used for erectile dysfunction (e.g., sildenafil [Viagra]). Monitor for orthostatic hypotension because it may occur after administration.
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| recombinant plasminogen activator (rPA; reteplase [Retavase]) classification and use | fibrinolytic therapy; used in ST-segement-elevation MI (STEMI) to break up fibrin meshwork in clots
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| tissue plasminogen activator (tPA; alteplase [Activase]) classification and use | fibrinolytic therapy; used in ST-segement-elevation MI (STEMI) to break up fibrin meshwork in clots
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| TNK-tPA (tenecteplase [TNKase]) classification and use | fibrinolytic therapy; used in ST-segement-elevation MI (STEMI) to break up fibrin meshwork in clots
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| Fibrinolytic Drug Alert | If signs and symptoms of major bleeding occur (e.g., drop in BP, an increase in HR, a sudden change in the patient's level of consciousness, blood in the urine or stool), stop the therapy and notify the physician.
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