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Science
Medicine
Drug Chart: Exam #2 (Cardio/Resp.)
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Abbreviations: DVT= Deep vein thrombosis PE= Pulmonary embolism HTN= Hypertension HF= Heart failure aPTT= Arterial Prothrombin Time PTT= Prothrombin Time BP= Blood pressure BV= Blood vessels VSM= Vascular Smooth Muscle A-Fib= Atrial Fibrillation MI= Myocardial Infarction CO= Cardiac Output
Terms in this set (85)
What kind of diuretic is furosemide?
loop diuretic
What is the function of Furosemide (lasix)?
Reduces venous return which results in a decrease in PREload
What is the function of IV Nitroglycerin?
-Decreases venous return which results in a decrease in PREload
-Dilates Veins AND Arteries
What is the function of Nesirtide (natrecor)?
-Decreases PREload
-Improves Cardiac Output (CO) and decreases pulmonary congestion
-Dilates veins AND arteries
What is the function of Milrinone?
-Inotropic therapy medication
-Phosphodiesterase inhibitor
If a patient can tolerate their HF, what drugs can you send the pt home with?
ACE-1 PLUS a Beta-Blocker and diuretic
What is BiDil a combination of?
Isosribride dinitrate and hydralazine
What population is approved to be given BiDil?
African Americans
What two drugs, if given together, can cause toxicity?
Digoxin + Diuretic (LOW vit. K)
What category of drugs are your -LOLs?
Beta-Blockers
What category of drugs are your -PRILs?
ACE inhibitors
What category of drugs are your -SARTANs?
Angiotensin receptor blockers (ARBs)
When hospitalized and given Labetalol (Trandate), what four things should the nurse do?
-Renal and cardiac checks
-Neurological checks
-Determine cause
-Educate pt. to avoid further crisis
What type of drug is Sodium nitroprusside (Nipride)?
Vasodialator
What is the mechanism of Nipride?
Venous AND arterial dilation
How is Nipride administered? Why?
-IV infection
-Because it's an immediate action
What is the therapeutic uses of Nipride?
Hypertensive emergencies
What are the adverse effects of Nipride?
Excessive hypotension
Cyanide poisoning with excessive dosing
What drug type is Captoprl and Moexipril?
ACE Inhibitor
What is the mechanism of action of Captopril?
-Reduces levels of angiotensin II
-Reduces levels of bradykinin (vasodilation)
What are the therapeutic uses of Captopril?
-HTN
-Diabetic and non diabetic neuropathy
What are the adverse effects of Captopril?
-First dose hypotension
-Cough
-Hyperkalemia
-Renal failure
What are the drug interactions of Captopril and Moexipril?
CANNOT be given with food
What drug classification is Spironolactone?
Aldosterone antagonist
What is the mechanism of action for Spironolactone?
-Blocks aldosterone receptors which blocks the action of aldosterone
-Binds with receptors for other steroid hormones
What are the therapeutic uses of Spironolactone?
-HTN
-HF
What is the adverse effect of Spironolactone?
Hyperkalemia
What drug classification is Losartan?
Angiotensin receptor blockers (ARBs)
What is the mechanism of action of Losartan?
-Blocks access of Angiotensin II
-Causes dilation of arteries AND veins
-Reduces excretion of K+
-Increases renal excretion of diabetic retinopathy
What are the therapeutic uses of Losartan?
-Diabetic neuropathy
-May prevent development of diabetic retinopathy
What are the adverse effects of Losartan?
-Angioedema
-Fetal harm
-Renal failure
-Additive effects with antihypertensives
What drug classification is Hydralazine?
Vasodilator
What is the mechanism of action of Hydralazine?
Arterial dilation results in peripheral resistance and arterial BP falls
What is the therapeutic uses of Hydralazine?
-Essential HTN
-Hypertensive crisis
-HF
What is the adverse effect of Hydralazine?
Reflex tachycardia
What are some drug interactions with Hydralazine?
-Avoid excessive antihypertensive agents
-Combined with diuretic to prevent Na+ and H2O retention and expansion of blood vessels
What drug classification is Verapamil? Diltiazem? Nifedipine?
Calcium Channel Blockers
What is the mechanism of action of Verapamil?
Blocks CC in the heart muscles AND blood vessels
What are some therapeutic uses of Verapamil?
-Angina pectoris
-Essential HTN
-Cardiac dysrhymias
What are some adverse effects of Verapamil?
-Constipation
-Dizziness
-Flushing
-Headache
-Edema (ankles and feet)
What are some drug interactions of Verapamil?
Digoxin+Verapamil= TOXICITY
Grapefruit Juice+Verapamil= TOXICITY
What is the mechanism of action of Diltiazem?
Blocks CC in the heart muscle ONLY
What are some therapeutic uses of Diltiazem?
-Angina pectoris
-HTN
-Cardiac dysrhythmias
What are the adverse effects of Diltiazem?
-Exacerbates bradycardia
-Sick sinus syndrome
-HF
What is the drug interaction with Diltiazem?
Beta-blockers+Digoxin=TOXICITY
What is the mechanism of action of Nifedipine?
-Blocks calcium channels in vascular smooth muscle
-DOES NOT affect HR
What is the DIRECT mechanism of action for Nifedipine?
-Limited to blockade of CC in VSM
What is the INDIRECT mechanism of action for Nifedipine?
-Lowers BP
-Activated baroreceptor reflex
-Primary with fast acting and sustained release
What are the therapeutic uses for Nifedipine?
-Angina pectoris
-HTN
-Can relieve migraine headache and suppress preterm labor
What are some adverse effects of Nifedipine?
-Relfex tachycardia
-Anginal pain
-Peripheral edema
What are some interactions with Nifedipine?
DO NOT give grapefruit juice!
What does Propranolol, Metoprolol, and Carvedilol do?
Block fight or flight response
What drug class is Propranolol, Metoprolol, and Carvedilol?
Beta blockers
What are the therapeutic uses for Propranolol?
-HTN
-MI
-HF
What are the adverse effects of Beta 1 blockers?
-Bradycardia
-Rebound cardiac excitation
What are the adverse effects of Beta 2 blockers?
-Bronchoconstriction -Hypoglycemia
What are the contraindications for Propanolol?
-Uncompensated HF
-Pulmonary edema
-Cardiogenic shock
-NEVER stop abruptly
What are some drug interaction of Propranolol?
-Diltiazem/Verapamil+Propranolol=Slows conductivity of the heart
-Digoxin+Propanolol= Slow HR
How is Heparin (Unfactionated) administered?
IV
What is the mechanism of action for Heparin (Unfactionated)?
-Inhibits the synthesis of clotting factors
-Inhibits the activity of clotting factors
What are the therapeutic uses of Heparin (Unfactionated)?
-Stroke evolving
-Massive Deep-Vein Thrombosis
What are the adverse effects ofHeparin (Unfactionated)?
-Hemorrhage
-Heparin-induced thrombocytopenia (allergic response)
What is the antidote for an overdose of heparin?
Protamine sulfate
What are the therapeutic uses of Low-Molecular Wright Herapins?
-Prevention of DVT after surgery
What are the adverse effects of Low-Molecular Wright Herapins?
-Bleeding
-Severe neurological injury for pts undergoing spinal puncture OR spinal epidural anesthesia
How is Low-Molecular Wright Herapins administered?
Subcutaneously
What is Warfarin?
An oral anticoagulant
What is the mechanism of action of Warfarin?
-Inhibits the synthesis of clotting factors
-Inhibits the activity of clotting factors
What is the clinical use of Warfarin?
Vitamin K suppressant
What are the therapeutic uses of Warfarin?
NOT useful in an emergency
What is the therapeutic uses of Warfarin with Long-term prophylaxis of thrombosis?
-Prevention of venous thrombosis
-Prevention of thromboembolism
-Prevention of thrombosis during A-Fib
What are some adverse effects of Warfarin?
Hemorrhage
What is the normal Prothrombin Time (PTT)?
11-12.5 seconds
What are the drug interaction with Warfarin?
Heparin and Aspirin
What drug class is Dabigartran etexilate?
Direct thrombin inhibitors
What is Dabigartran etexilate?
Oral PRODRUG that undergoes conversion to Dabigartran
What are the therapeutic uses of Dabigartran etexilate?
A-Fib
What are the adverse effects of Dabigartran etexilate?
-Bleeding
-GI disturbances
What is the antidote for Dabigartran etexilate?
idarucizumab (praxbind)
What drug class is Rivaroxaban?
Direct Factor XA inhibitor
What is the mechanism of action of Rivaroxaban?
Binds directly with factor Xa to cause inactivation
What are the therapeutic uses ofRivaroxaban?
-Prevention of DVT and PE after total hip/knee replacement
-Prevention of shock in patients with A-Fib
-Treatment of DVT and PE unrelated to orthopedic surgery
What is the mechanism of action of Fibrinolytic-tPA?
-Dissolves fibrin
What are the therapeutic uses of Fibrinolytic-tPA?
-<3 hours from signs and symptoms of stroke
-<12 hours of signs and symptoms of MI
What is the adverse reaction of Fibrinolytic-tPA?
Highest risk for bleeding
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