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.
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
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")
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.
inhibit Na and H2O retention at distal tubules, less potent diuretic. Milder than Lasiz but will affect BP stronger than Lasix.
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
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) 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
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.