What are the classifications of cardiac medications? - correct answer Cardiac Glycosides
Phosphodiesterase Inhibitors
Direct Vasodilators
Organic
... [Show More] Nitrate/Vasodilator
Beta-adrenergic Antagonists (Beta-Blockers)
Calcium Channel Blockers
Alpha Adrenergic Agonists
Angiotensin-converting enzymes (ACE) inhibitiors
Angiotensin II Receptor Blockers (ARBS)
Direct Acing Vasodilators
What are the names of the cardiac Glycosides? - correct answer Digoxin (Lanoxin, Digitek)
What is Digoxin used for? - correct answer HF
dysrhythmias
What are the therapeutic digoxin levels? - correct answer Between 0.5 and 2 ng/ml
What electrolyte should be monitored with digoxin? - correct answer K+
HYPOkalemia can increase potential for toxicity
What vital sign should be assessed before administering digoxin? - correct answer Apical pulse
Hold med if HR <60
Why may a pt receive a loading dose of digoxin? - correct answer Digitalizing dose may be given to get serum levels w/in therapeutic range.
Common adverse effects of Digoxin? - correct answer fatigue
anorexia
bradycardia
What are signs of digoxin toxicity? - correct answer HA
vertigo
photophobia
yellow-green halos
tachycardia
AV heart block
What is the Antidote for Digoxin? - correct answer Digibind
What are the names of Phosphodiesterase Inhibitors? - correct answer Milrinone (Primacor)
Inamirnone (Inocor)
What is the indication for phosphodiesterase inhibitors?
Milrinone (primacor)
inamirnone (Inocor) - correct answer Short term management of HF
What are the adverse effects of phosphodiesterase inhibitors
milrinone (Primacor)
inamirnone (Inocor) - correct answer ventricular arrhythmias
hypotension
chest pain
HA
hypokalemia
tremors
throbocytopenia
Who are the phosphodieasterase inhibitors reserved for? - correct answer Those that do not respond to cardiac glycosides (digoxin) or ACE inhibitors
What the name of a direct vasodilator? - correct answer Nesiritide (Natrecor)
What are direct vasodilators indicated for?
nesiritide (Natrecor) - correct answer Acute treatment of HF in pts with dyspnea at rest and/or minimal activity.
What are the common adverse effects of nesiritide (Natrecor)? - correct answer cardiac arrhythmias
hypotension
HA
fainting
anxiety
What should the nurse do if a patient taking nesiritide (Natrecor) has hypotension? - correct answer reduce or stop administration
What labs are important with nesiritide (Natrecor)? - correct answer BASELINE creatinine and continued monitoring b/c natrecor can be nephrotoxic with acutely decompensated heart failure
What are common organic nitrate/vasodilators? - correct answer Nitroglycerin (Nitro-Bid)
Isosorbide (Isordi)
What are organic nitrates indicated for?
Nitroglycerin (Nitro-Bid)
Isosorbide (Isordi) - correct answer stable and unstable angina
rapid acting for acute angina
long acting prevention of angina attacks
What are the adverse effects of organic nitrate/vasodilators?
Nitroglycerin (Nitrobid)
Isosorbide (Isordi) - correct answer HA
hypotension
tachycardia
contact dermatitis w/topical
What are the contraindications for Nitroglycerin and Isosorbide use? - correct answer preexisting hypotension
head trauma
increased ICP
pericardial tamponade
What is required for Nitroglycerin and isosorbide administration? - correct answer Adequate hydration
What should be assessed for IV organic nitrate/vasodilator administration?
nitroglycerin (nitrobid)
isosorbide (isordi) - correct answer MUST USE IV PUMP
CHECK BP
HOLD IF systolic BP <100
What should the nurse know about sublingual administration of nitroglycerin administration? - correct answer For sublingual: may administer up to 3 SL tabs. Store in dark, light resistant container and replace every 6 months.
For topical administration: apply with gloves, non hairy routs, rotate sites, avoid lower extremities
What are examples of Beta Blockers? - correct answer propranolol (Inderal)
atenolol (Tenormin)
metoprolol (Lopressor)
Carvedilol (Coreg)
What is the mechanism of action of Beta Adrenergic Blockers? - correct answer Block adverse effects from sympathetic nervous system.
Blocks the receptor sidtes for epi and norepi so they will DECREASE AFTERLOAD AND CONTRACTILITY resulting in DECREASED BP and DECREASED HR.
What are beta blockers used for? - correct answer angina
particularly exercise induced angina
chest pain
HTN
ventricular dysrhythmias
THYROID STORM
MI
Off label uses:
migranes
tachycardia associated w/ stage fright
How are beta blockers tolerated? - correct answer tolerated well at low doses
withdraw GRADUALLY to avoid rebound HTN angina and MI
What are the adverse effects of beta blockers? - correct answer bradycardia
hypotension
2nd and 3rd degree heart block
fatigue
lethargy
depression
wheezing
dyspnea
impotence and decreased libido
altered glucose and lipid metabolism
What should be assessed before administration of beta blockers? - correct answer Hold if HR <60
What should be monitored with beta blockers? - correct answer blood sugar
cholesterol and triglicerides
Who should not receive beta blockers? - correct answer asthmatics (some beta blockers also constrict the smooth muscle of the bronchioles.)
diabetics (beta blockers block the sympathetic responses seen in hypoglycemia.)
What are some examples of Angiotensin converting enzyme (ACE) inhibitors? - correct answer Enalapril (Vasotec)
Fosinopril (Monopril)
Catopril (Capoten)
Lisinopril (Zestril, Prinvil)
Moexpril (Univasc)
Ramipril (Altace)
What are the actions of ACE inhibitors?
enalapril-Vasotec
fosinopril-Monopril
captopril-Capoten - correct answer Blocks conversion of angiotensin I to angiotensin II.
Promote VASODILATION and DIURESES, DECREASES ALDOSTERONE secretion--- kidneys will get rid of Na+ and water and retain K+.
What are ACE inhibitors used for?
enalapril- Vasotec
captopril- Capotin
lisinopril- Zestril, Prinivil
fosinopril- Monopril
moexpril- Univasc
ramipril- Altace - correct answer HTN
HF
MI
What are the adverse effects of ACE inhibitors?
lisinopril
ramipril
captopril
enalapril - correct answer generally mild
dizziness
fatigue
DRY NONPRODUCTIVE COUGH
chest pain
tachycardia
Hyperkalemia
HYPERmagnesemia
What is a rare but serious side effect of ACE inhibitors?
captopril
lisinopril
enalaprol
captopril - correct answer angioedema- laryngeal swelling
can be fatal
What electrolytes should be monitored with ACE inhibitors? - correct answer Mg+ and K+
What effect does ACE inhibitors have on diuretics? - correct answer ENHANCES the effect of thiazide diuretics
What should the nurse watch for with ACE inhibitors? - correct answer Hyperkalemia
hypermagnesemia
othostatic syncope
hypotension
orthostatic syncope
What are the names of the Angiotensin II Receptor Blockers (ARBs)? - correct answer losartan - Cozaar
olmesartan - Benicar
valsartan - Diovan
Irbesartan - Avapro
What is the action of ARBs?
losartan - Cozaar
olmesartan - Benicar
valsartan - Diovan
Irbesartan - Avapro - correct answer Blocks effects of angiotensin II (a potent vasoconstrictor) at the receptor site (used as an alternative to ACE inhibitors), ACE inhibitors block he conversion of AI to AII but AII can also be formed by other enzymes not blocked by ACE inhibitors.
What do ARBs do?
losartan - Cozaar
olmesartan - Benicar
valsartan - Diovan
Irbesartan - Avapro - correct answer DECREASE BP
INCREASE CO
POTENT VASODILATOR
What are ARBs used for?
losartan - Cozaar
olmesartan - Benicar
valsartan - Diovan
Irbesartan - Avapro - correct answer HTN
HF adjunctive therapy
What are the adverse effects of ARBs?
losartan - Cozaar
olmesartan - Benicar
valsartan - Diovan
Irbesartan - Avapro - correct answer ARBs are a POTENT VASODILATOR
effects are generally mild:
HA
upper respiratory infections
dizziness
GI complaints
fatigue
What are ARBs most commonly used for? - correct answer Often used in combination therapy for management of HTN
What should the nurse watch for with ARBs?
losartan - Cozaar
olmesartan - Benicar
valsartan - Diovan
Irbesartan - Avapro - correct answer hyperkalemia
hypotension
renal dysfunction
What are the names of some Calcium Channel Blockers? - correct answer Amlodipine - Norvasc
Diltiazem - Cardizem
Ranolazine - Ranexa
What are Calcium Channel blockers indicated for?
amlodipine - Norvasc
diltiazem - Cardizem
ranolazine - Ranexa - correct answer angina
HTN
dysrhythmias
migraines
Raynauds
What are the adverse effects of calcium channel blockers?
amlodipine -Norvasc
diltiazem - Cardizem
ranolazine - Ranexa - correct answer bradycardia or tachycardia
heart block
hypotension
dyspnea
wheezing
GI complaints
dermatitis
When should the dose of Calcium channel blockers be reduced?
amlodipine -Norvasc
diltiazem - Cardizem
ranolazine - Ranexa - correct answer Reduce with liver disease and use with caution
Taper dose [Show Less]