B1 = Heart & B2 = Lungs
(You have 1 heart and 2 lungs)
ACE inhibitors, Beta Blockers, Calcium Channel Blockers, Diuretics (ABCD)
block norepinephrine and epinephrine (adrenaline) from binding to beta receptors; reduce heart rate; reduce blood pressure by dilating blood vessels; and may constrict air passages by stimulating the muscles that surround the air passages to contract.
could be selective or non selective, It could work for either a Beta 1 or Beta 2 or Both a Beta 1 & Beta 2.
Beta 1 sites
in the heart are responsible for increasing HR, Contractility (the force of heart beat), and AV conduction
Non-Selective Beta Blockers
They will block both beta 1 and beta 2 receptors. They can slow not only cardiac output, but also the renal and other systems.
Selective Beta Blockers
They block beta 1 receptors and are very useful in hypertension and certain cardiac diseases. They relax the heart and slow its pumping, thus lowering blood pressure and heart rate. This allows the mechanism of the heart to improve over time.
Beta 2 sites
are found in bronchial and vascular smooth muscles which cause relaxation and dilation
Hold med if HR is < 50 BPM via APICAL pulse only.
end in "OLOL" (Generic only), i.e. Metoprolol (Lopressor) Generic (Trade)
Known as a Lazy drug b/c side effects /adverse reactions are fatique, weakness, impotence, hypotension, depression, bradycardia, ↓ myocardial contraction
Selective Beta 1 Site, does not effect Beta 2 receptors, Blocks stimulation of Beta 1 receptors
↓ intravascular volume by ↑ urine production
What is the formula for mean arterial pressure?
Systolic + 2(Diastolic) / 3
end in "IDE" (Generic only), i.e. Furosemide (Lasix) Generic (Trade)
Loop diuretic, it inhibits the reabsorption of Na and Ch from the loop of Henle and distal renal tubule. It increases renal excretion of H2o, Na, Cl, Mg, K+, Ca. A diuresis, decreases BP, and mobilization of excessive fluid.
Administering Furosemide (Lasix) to quickly
Can cause damage to the 8th cranial nerve, resulting in loss of hearing. ("Ototoxic")
Permanent hearing problem
Adverse Reaction to Furosemide (Lasix)
Dehydration, Hypochloremia, Hypokalemia, Hypomagnesemia, Hyponatremia, Hypovolemia, Metabolic acidosis
Furosemide (Lasix) and potassium levels and digoxin toxicity
Hypokalemia precipitates digoxin toxicity. Be careful when giving diuretics, which can cause hypokalemia and increase risk of dig. toxicity.
Furosemide (Lasix) Implementation
Assess fluid status prior to therapy, Monitor BP and pulse prior to administration, Monitor electrolytes, renal and hepatic function, and glucose levels.
1 K of weight loss
equals 1 L of fluid loss
inhibit Na and H2O retention at distal tubules, less potent diuretic. Milder than Lasiz but will affect BP stronger than Lasix.
Slower acting diuretic
Adverse Reaction to Hydrochlorothiazide (HCTZ)
Hypokalemia, Hyperuricemia, May cause increase serum cholesterol, LDL, and triglycerides
Calcium Channel Blockers
blocks calcium entry into cells of vascular smooth muscle and myocardium, dilates coronary arteries, inhibits coronary artery spasms thus decreases angina, decreases AV conduction, systemic vasodilation resulting in decreased BP
Adverse Reaction to Diltiazem (Cardizem)
Arrhythmias, CHF, Stevens-Johnson Syndrome, Peripheral Edema
Burn from inside out
Diltiazem (Cardizem) Implementation
Assess for S/S of digoxin Toxicity, Do NOT crush time released medication, Change Position slowly, Monitor BP, pulse, I&O's, daily weights, ECG, and K+ levels.
Slows AV node conduction, decreases conduction thrus SA & AV node, strengthens force of contraction, increases CO. Strengthens heart muscle & slows heart better pump.
Digoxin (Lanoxin) Loading Dose
Large Dose administered to get to therepeautic range
Hold Med if HR < 60 BPM via APICAL pulse for 1 full minute.
Digoxin (Lanoxin) Therapeutic Level
0.5 - 2 ng/mL
Digoxin (Lanoxin) Implementation
Loading dose administered over 12 - 24 hours, Monitor apical pulse for 1 full minute before administration, Monitor K, Mg, Ca, Monitor renal & hepatic function
Digoxin (Lanoxin) K levels
If K is low it can potentiate Digoxin medication
Blood thinner, prevents clot formation and extenstion, does not dissolve existing clots, prevention of DVT, PE, Embolism 2° A-Fib, Stroke and MI.
Anticoagulants are contradicated in clients with
coagulation disorders, ulcer disease, malignancy, recent surgery, trauma, or active bleeding.
Prevents the conversion of thrombin to prothrombim
Reason why Lose Dose Heparin is given
To prevent DVT in patients on prolonge bed rest.
Needs to be verified by another RN or LPN
Heparin usual dose
5000 u SQ q8 - 12 h
Adverse Reaction in Heparin
Bleeding, Anemia, Thrombocytopenia (low platelet count)
Heparin Half Life
2 - 6 hours
interferes with hepatic synthesis of Vitamin K dependent clotting factor
Warfarin Half Life
0.5 - 3 days
Adverse Reaction in Warfarin
Vitamin K, aquamephyton, whole blood