Pharmacology ATI (Cardiac Meds)

Ace Inhibitors “pril” (Action)
Selectively suppresses renin-angiotensin-aldosterone RAAS system. inhibits ACE and prevents conversion of angiotension 1 to angiotension 2=vasodilation

ACE “PRIL” (side effects)
cough
hypotension
blurred vision
hepatic failure
pancreatitis
angioedema
neutropenia
hyperkalemia

ACE “pril” nursing implications and teaching
Hold if SBP under 90
Change position slowly (orthostatic hypotension)
Monitor for decreased WBC, hyperkalmia
monitor LFT
Monitor GFR/creatinine
Not to stop abruptly-taper off
avoid increasing K+ on diet
Report a dry cough

Beta Blockers “lol” Action
lowers BP by blocking Beta-2 adrenergic receptors. Blocks renin first step in RAAS cycle.

Beta Blocker “lol” Side Effects
Fatigue
Weakness
Bradycardia
CHF
Pulmonary Edema
Bronchospasm
AV block
cardiac arrest
thrombocytopenia

Beta Blocker “lol” nursing implications/teaching
Hold if SBP under 90
Hold if HR under 60
Orthostatic Hypotension precautions
Contraindicated in worsening CHF, bradycardia
Use with caution with DM or Liver Disease
Take immediately after meals, and at hs to prevent hypotension
NO OTC nasal decongestants, cold meds, avoid alcohol, smoking, and sodium
Take pulse and BP at home–parameters
Monitor glucose if DM
Report to DR if difficulty breathing, dizziness, fever, SOB, confusion, decreased vision

CCB (norvasc, “pine” ) Action mechanism
Inhibits Ca+ across cell membrane during cardiac depolarization–relaxation of coronary smooth muscle. , increases O2 delivery in pt’s with angina.

CCB (norvasc, “pine”) SE
peripheral edema
cardiac arrhythmias
CHF
HA
Hypotension
N/V/D
Muscle Cramps
Dizziness

CCB (norvasc, “pine”) nursing implicaitions/patient teaching
orthostatic hypotension precautions
Careful I/O and fluid status for edema
Liver and Kidney Function
Hold if SBP under 90 and HR is under 60
Avoid hazardous activity until stable and dizziness has subsided
Avoid OTC medications
Stress Reduction/Exercise/No smoking
Call HCP with irregular heart beat, SOB, Swelling of hands and feet, dizziness
Call doctor if HR less than 50bpm

Nitrates (isordil, nitroglycerin) action mechanism
Decreases preload and afterload, decreases diastolic pressure, systemic vascular resistance, and dilates coronary arteries–improves blood flow

Nitrates(isordil, nitroglyerin) SE
headache
Tachycardia
hypotension
palpitations
collapse/dizziness

Nitrates (isordil, nitroglycerin) Nursing implications/pt teaching
PQRST pain as the nurse
orthostatic hypotension precautions
Vitals before and after
original container, dark, dry, cool spot
expires after 6 months
3 tabs in 15 minutes–fizzy dissolve under tongue
no alcohol or caffiene
should be taken before strenuous exercise or sex
not to be taken with ED medication
call 911 if chest pain after 3 doses

HMG-CoA reductase “Statins” action
inhibits HMG Co-A reductase enzyme which reduces cholesterol synthesis in the liver—high doses lead to plaque regression

HBG-Co-A reductase “Statins” SE
GI disturbance
Rash
Rhabdomyolysis (muscle breakdown)

HBG-Co-A reductase “Statins” Nursing Implications/Teaching
Give with food to avoid GI disturbance
Watch ALT, AST, BIli closely
Watch CPK for muscle damage–
Tell patient frequent bloodwork is necessary
Report blurred vision to dr
If having muscle pain more than 30 days after starting report to doctor
DO NOT take while PG
Avoid sun exposure
Diet/Excercise/No Smoking plan

Antiarrhytmics “Amirodarone” Action Mechanism
prolongs duration fo action potential and effective refractory period. it increases PR and QT intervals, decreases sinus rate, decreases peripheral vascular resistance

Antiarrhythmic “Amirodarone” SE
Dizziness
Fatigue
Malaise
Ataxia
Bradycardia
Sinus Arrest
CHF
AV block
pancreatitis
hepatoxic
pulmonary fibrosis

antiarrhythmic “amirodarone” nursin implications and teaching
Watch for QT prolongation–lead to VT/VF with IV
Hold if HR lower than 60 with IV
Chronic use assess for lung crackles, pleuric chest pain, diminished breath sounds
Assess neurotoxicity: ataxia, tremors, tingling in fingers/toes
Assess S/S of thryroid dysfunction-HYPO and HYPER
Liver Function Tests/T3 and T4
NO GRAPEFRUIT JUICE
Dont stop aburptly
avoid sun exposure
skin discoleration is permanent
do not skip doses

Admin Dopamine for circulatory depression, O2, diazepam for seizures

Cardiac Glycoside/Positive Inotrope “Digoxin” Action mechansim
inhibits the Na/K ATPase pump so more CA is available increases contractions. Increases cardiac output

Cardiac Glycoside/Positive Inotrope “Digoxin” SE
fatigue,
bradycardia,
anorexia,
N/V,
hypotension,
arrhythmias

Cardiac Glycoside/Positive Inotrope “Digoxin” Nursing implications/teaching
60 second apical pulse over 60
increases elderly fall risk
low K, Mg, Ca will cause more likely dig toxicity
0.5-2.0ng/ml WNL
Dig Tox:
abd pain
N/V
bradycardia
visual changes
No stop abruptly
no antacids at same time as medication
avoid OTC
Low sodium diet

Loop Diuertics “Furosemide/Lasix” Action Mechanism
inhibits Na and Cl at proximal and distal tubule in loop of henly

Loop Diuertics “Furosemide/Lasix” SE
dehydration
hypovolemia
hypokalemia
hyponatremia
hypomagnesiumia
hypotension
chest pain
muscle cramps
tinnitus
blurred vision

Loop Diuertics “Furosemide/Lasix” Implications/Teaching
change position slowly
Hold if SBP under 90
Monitor Electrolytes
monitor GFR
S/S hypokalemia: tachycardia, muscle weakness, constipation
Need for high potassium diet, or potassium supplement
exercise/diet/stress relief
Take early in day to avoid sleepiness
avoid OTC
use suncreen and avoid sun exposure

Potassium Sparing Diuretic “actone” action mechanism
competes with aldosterone at distal tubule, excretes Na and Cl but not K and Phosphate

Potassium Sparing Diuretic “actone” SE
hyperkalemia
HA
confusion
Metabolic Acidosis
Hyponatremia
Diarrhea
Hepatocellular Toxicity

Potassium Sparing Diuretic “actone” implications/teaching
With ACE can cause hyperkalemia
Do not use K+ based salt substitutes, watch K+ rich foods (oranges, bananas,dates)
Electrolyte monitoring
BUN/ABG
Weight and I/O monitoring
Metabolic Acidosis S/S:
drownsiness
restlessness
Take in AM to avoid restlessness
Notify HCP if PG is planned

Thiazide diuretics “hydrocholorothiazide” action mechanism
Acts on distal and ascending tube of henle by increasing excretion of water, Na, Cl, and K

Thiazide diuretics “hydrocholorothiazide” SE
Hypokalemia
Dizziness
Irregular pulse
Orthostatic hypotension
blurred vision
hypercalcemia
hyponatremia
N/V
anorexia
Renal Failure
Hepatitis

Thiazide diuretics “hydrocholorothiazide” nursing implications/teaching
Monitor BB
Daily Weights/I&O for edema
If on Digoxin assess carefully for Dig Toxicity–R/T depleting K
Electrolyte Monitoring
Orthostatic Hypotension precautions
S/S hypokalemia:
muscle weakness, muscle cramps, dizziness, constipation
Take early in day to avoid nocturia
Avoid Alcohol
Avoid OTC

Anticoagulant “Warfarin” Action Mechanism
Interferes with blood clotting by depressing liver synthesis of vitamin K dependent coagulation factors

Anticoagulant “Warfarin” SE
GI Bleeding
Angina
Hypotension
Hemorrhage
N/V/D
Anorexia
Hepatitis
Jaundice
leukopenia

Anticoagulant “Warfarin” Nursing implications/patient teaching
Tarry stools
Nose Bleeds
Hematuria
Bleeding gums
Hemoglobin monitoring
INR 2-3
LFT
Carry ID stating on warfarin
Need frequent bloodwork
Avoid hazardous activities
Tell all HCP about anticoagulant usage
S/S of

Antedocte=Vit K

Anticoagulant Lovenox/Heparin Mechanism of action
Prevents conversion of fibrinogen to fibrin and prothrombin to thrombin

Anticoagulant Lovenox/Heparin SE
Anemia
Thrombocytopenia
Bleeding/hemorrhage
Fever
HA
Hyperkalemia

Anticoagulant Lovenox/Heparin Nursing implications/patient teaching
Prothrombin=antedocte
assess for signs of bleeding
Sub Q in abdomen or IV (heparin only in IV or sub q)
assess for heparin induced thrombocytopenia
Avoid OTC meds
Use soft toothbrush/electric razor
Carry ID stating on Lovenox
Report bruising or bleeding to HCP

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thiazide diuretics nursing implications monitor: vitals, electrolytes, weight, input and output loop diuretics nursing implications monitor: vitals, electrolytes, weight, I&O, orthostatics WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY FOR YOU FOR ONLY $13.90/PAGE Write my sample …

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