CARDIOVASCULAR MEDS

Flashcards
http://quizlet.com/23952741/nclex-pn-cardiac-flash-cards/
http://allnurses.com/nursing-student-
assistance/pharmacology-flashcards-595483.html

DRUG CARDS
Drug Classification
Uses:all uses
Actions:all actions
Names:both generic & trade
Side Effects: life threatening side effects first, define vocab
unknown to student in ()
example of Med name & Dose: Generic (trade), dose range
Example of Nursing considerations: list all, putting important
ones first
Baseline Assessment:
Intervention/Evaluation:
Patient teaching:
Free Apps for Nursing Students
http://findnursingschools.com/blog/12-free-
apps-for-nurses-and-nursing-students/
Epocrates
NCLEX-PN study help app
http://studentnurses3.blogspot.com/p/pharm
-pneumonics.html


Videos
CHF-ABCD part 1:
http://youtu.be/0LkvuZN9TXA
CHF-ABCD part 2:
http://youtu.be/I9eW2aKAE54
RAAS system:
http://youtu.be/M0vpn6YVwiI
ACE inhibitor rap:
http://youtu.be/A53PrkLqZUs



Classes of Cardiovascular Drugs
ACE Inhibitors/Thiazide combos
ACE inhibitors
Alpha Agonists, Central
Alpha Blockers,Peripheral
Antiarrthythmics, Oral
Antiarrthymthmics, Parenteral
Anticoagulants
Antiplatelets
ARB/Thiazide Combos
ARBs
Beta Blocker/Thiazide Combos
Beta Blockers
Calcium Channel Blockers-Dihydropyridine
Calcium Channel Blockers-Non-dihydropyridine
Diuretics 1: Loop
Diuretics 2: Thiazide
Diuretics 3:Potassium-sparing
Diuretics 4: Other
Dyslipidemia: Fibrates
Dyslipidemia: Other
Dyslipidemia:Statins
Inotropes/Pressors
Other Antihypertensives
Other Cardiovascular
Pulmonary Artery HTN
Thrombolytics
Vasodilators/Nitrates

A B C D for HTN and CHF
A=ACE inhibitors
B=Beta Blockers
C=Calcium Channel Blockers
D=Diuretics
A=ACE INHIBITORS
End in pril like lisinopril
Mechanism of action: Inhibits angiotensin converting
enzyme, interfering with conversion of Angio 1 to Angio 2
Used for:
HTN: 10-40mg PO daily
CHF: 5-20mg PO daily-do not exceed 40mg per day
Acute MI: 5-10mg PO daily for six weeks. Start at 5mg for two
days then increase to 10mg.
Nursing Implications: Monitor BUN/Cr at baseline then
periodically more if CHF, electrolytes, BP
Side Effects: Persistent cough, angioedema-DC if these occur
Common Side Effects: dizziness, fatigue, headache, diarrhea,
elevated BUN and Creat. levels
ACE INHIBITOR
Captopril (Capoten)
Used for:
Mechanism of Action:
Standard Dose:
Nursing Implications:
Side Effects:

If patient cant tolerate ACE Inhibitor give:
Talmisartan (Micardis)-ARB
B=BETA BLOCKERS
End in lol like propranolol (Inderal)
Mechanism of Action: Antagonizes Beta-1 and Beta-2
adrenergic receptors
Used for:
HTN: 80-240mg PO bid, incr. dose q3-7 days, start at
80mg. Taper over 1-2 weeks to D/C
Angina: 80-320mg PO divided bid-qd, incr. dose q3-7 days.
Start at 80mg. Taper over 1-2 weeks to D/C.
A-fib: 10-30mg PO tid-qid.
Nursing Implications: Monitor BP and HR
Side Effects: fatigue, dizziness, constipation,
bradycardia, hypotension, BRONCHOSPASM

BETA BLOCKERS
Acebutolol (Sectra)
Used for: reduces ejection fraction
Mechanism of Action:
Standard Dose:
Nursing Implications:
Side Effects:

C=CALCIUM CHANNEL BLOCKERS
End in pine like amlodipine (Norvasc)
Mechanism of Action: inhibits calcium ion influx
into vascular smooth muscle and myocardium
Used for:
HTN: 5-10mg PO daily. Do not give more than
10mg.
Angina: same as above
Nursing implications: Monitor BP
Side Effects: peripheral edema, hypotension,
fatigue, palpitations
CALCIUM CHANNEL BLOCKERS
Diltiazem (Cardizem)
Used for: HTN and angina combo
Mechanism of Action:
Standard Dose:
Nursing Implications:
Side Effects:

Verapamil (Calan)
Used for: HTN and angina combo
Mechanism of Action:
Standard Dose:
Nursing Implications:
Side Effects:

Nifedipine (procardia)
Used for:
Mechanism of Action:
Standard Dose:
Nursing Implications:
Side Effects
D=DIURETICS
End in ide like furosemide (Lasix) (loop diuretic)
Mechanism of Action: inhibits Loop of Henle and proximal
and distal convoluted tubule sodium and chloride
reabsorption
Used for:
Edema: 40-120mg per day, PO divided, qd-bid
Start 20-80mg, POx1, inc. 40mg q6-8h. Max 600mg per day.
HTN: 10-40mg PO bid. Start with 40mg bid, alt. start is 10-
20mg PO bid. Max 600mg per day.
Nursing Implications: Monitor daily weight, BP, electrolytes,
blood glucose (may cause increased BG levels in diabetics),
fall risk
Side Effects: urinary frequency, dizziness, nausea/vomiting,
weakness, orthostatic hypotension, RASH
HYDROCHLOROTHIAZIDE (HCTZ)
AKA: HydroDIURIL
Used for:
Mechanism of Action:
Standard Dose:
Nursing Implications:
Side Effects: SULFA-ALLERGY
CONTRAINDICATED, sulfa-based diuretic
OTHERS:
ANTI-COAGULANTS:
Coumadin (warfarin)-used for anticoagulant
Inhibits Vitamin K dependent coagulation
factor synthesis. If OD give Vitamin K
Heparin & Lovenox(enoxoparin) (low-
molecular weight heparin)-anticoagulants, if
OD give protamine sulfate
Clopidogrel (Plavix)-inhibits platelets
aggregation

Digoxin (Lanoxin)-inhibits sodium-potassium
ATPase, cardiac glycoside
Sx of toxicity: nausea, loss of appetite,
bradycardia, confusion, seeing spots,
vomiting, diarrhea
Must take serum drug levels due to narrow
therapeutic range.
If OD or toxicity: Give Digoxin Immune Fab
(digibind)

ALPHA BLOCKERS:
Methyldopa (Aldomet)
Used for:
Mechanism of Action:
Standard Dose:
Nursing Implications:
Side Effects:

Prazosin (Minipress)
Used for:
Mechanism of Action:
Standard Dose:
Nursing Implications:
Side Effects:

OTHER:
Acetylcysteine (Mucomyst)-used for acetaminophen (Tylenol) overdose


PRACTICE QUESTIONS
1. A client receiving hydrochlorothiazide is
instructed to increase her dietary intake of
potassium. The best snack for the client
requiring increased potassium is:
Pear
Apple
Orange
Banana

1. Which of the following medication orders needs
further clarification?
Darvocet 65mg PO q 46 hrs. PRN
Nembutal 100mg PO at bedtime
Coumadin 10mg PO
Estrace 2mg PO q day

2. Which of the following findings is associated
with right-sided heart failure?
Shortness of breath
Nocturnal polyuria
Daytime oliguria
Crackles in the lungs


3. A client with congestive heart failure has been
receiving Digoxin (lanoxin). Which finding indicates
that the medication is having a desired effect?
Increased urinary output
Stabilized weight
Improved appetite
Increased pedal edema

4. Before administering a client's morning dose of Lanoxin
(digoxin), the nurse checks the apical pulse rate and
finds a rate of 54. The appropriate nursing intervention
is to:
Record the pulse rate and administer the medication
Administer the medication and monitor the heart rate
Withhold the medication and notify the doctor
Withhold the medication until the heart rate increases


5. The doctor has prescribed aspirin 325mg daily for a
client with transient ischemic attacks. The nurse knows
that aspirin was prescribed to:
Prevent headaches
Boost coagulation
Prevent cerebral anoxia
Keep platelets from clumping together

6. A client who was admitted with chest pain and
shortness of breath has a standing order for oxygen via
mask. Standing orders for oxygen mean that the nurse
can apply oxygen at:
2L per minute
6L per minute
10L per minute
12L per minute


7. A client with a history of emboli is receiving Lovenox
(enoxaparin). Which drug is given to counteract the
effects of enoxaparin?
Calcium gluconate
Aquamephyton
Methergine
Protamine sulfate

8. Which statement best describes the difference between
the pain of angina and the pain of myocardial
infarction?
Pain associated with angina is relieved by rest.
Pain associated with myocardial infarction is always more
severe.
Pain associated with angina is confined to the chest area.
Pain associated with myocardial infarction is referred to the
left arm.