Cardiac Drug

Front 1

What is peripheral vasodilators used for

Back 1

Treatment of leg pain caused by intermittent claudication, arteriosclerosis obliterans, raynauds disease, noc leg cramps, vasospasm because of blood clots

Front 2

S/E of Vasodilators

Back 2

HA, weakness, tachy, rash, flushing, postural hypotension, dsyrhythmias, confusion, tingling, sweating

Front 3

ischemia

Back 3

poor blood supply to an organ

Front 4

Ischemic heart disease

Back 4

Poor blood supply to the heart muscle

CAD, atherosclerosis

Front 5

Myocardial infarction (MI)

Back 5

Heart attack, necrosis or death of cardiac tissue

Front 6

Therapeutic objectives for cardiac meds

Back 6

-increase blood flow to ischemic heart muscle
-decrease myocardial o2 demands
-minimize the frequency of attack and decrease the duration and intensity of anginal pain
Improv the pts functionnal capacity with as few adverse effects as possible
-prevent or delay the worst possibel outcome

Front 7

Causes of Dysrhythmias

Back 7

-irritation to the heart tissue after an MI/cardiac surgery
-CAD, Fluid/lytes imbalances, hypoxia, drug reactions

Front 8

Class I-antidysrhythmics

Back 8

-disopyramide, quinidine
-lengthen the effective refractory period of atrial/ventricular myocardium by slowing the fast inward current cause by sodium
-make the heart less excitable
-treat rapid/irregular dysrhythmias

Front 9

Class II-antidysrhythmics

Back 9

-acebutolol,propranolol
-reduce sympathetic excitation to the heart affect loading of the cells

Front 10

Class III-antidysrhythmics

Back 10

-amiodarone
-lenthen the action potential duration or the length of time it take for 1 cell to fire and recover

Front 11

Class IV- antidysrhythmics

Back 11

-CCB, verapamil,dilitazem
-Selectively blocks the ability of CA to enter the myocardium and prolong the effect reflractory period in the AV node

Front 12

Antidysrhythmics uses

Back 12

-decrease BP in hypertensive pt
-decrease edema and fatigue
-reg hr
-improve cardiac out

Front 13

S/E: antidysrhythmics

Back 13

SOB, edema, Dizziness, syncope, CP, blurred vision,

Front 14

Antianginals

Back 14

-Nitrates: universal vasodilators
-Directly cause vascular smooth muscle to relax (arterial & venous)
-Decrease myocardial oxygen use
-Increase collateral-vessel circulation to the heart

Calcium channel blockers
-Dilate coronary arteries & arterioles
-Reduce response of electrical conduction system.

Front 15

Action and uses
Nitrates

Back 15

-Acute & chronic anginal attacks
-Reduce the workload of the heart

Front 16

Uses of Peripheral Vasodilators

Back 16

-Relax the smooth muscles of peripheral arterial vessels to increase peripheral circulation
-Used to treat leg pain caused by vasoconstriction

Front 17

Nitrates

Back 17

-Rapid-acting nitrates: relieve pain in acute angina
-Long-acting nitrates: prevent or treat anginal attacks and reduce severity & frequency of anginal attacks

Front 18

Form of nitrates

Back 18

Ointments*
Transdermal patches*
Translingual sprays*
Sublingual*
Buccal*
Chewable tablets
Oral capsules/tablets
Intravenous solutions*

Front 19

storage of nitrates

Back 19

-Sunlight speed up
-lose strength -3 mths
-kept in original drk bottle
-all cotton removed
-tightly capped
-regrigerator

Front 20

If anginal pain occurs:

Back 20

Stop activity and sit or lie down
Take a SL tablet, and wait 5 minutes
If no relief in 5 minutes, take a second SL tablet
If no relief in 5 minutes, take a third SL tablet
After three tablets/15 minutes, if no relief of chest pain, call Emergency Services/911 immediately
Do not try to drive to the hospital

Front 21

A/E: Nitrates

Back 21

Headaches
Usually diminish in intensity and frequency with continued use
Tachycardia, postural hypotension
Tolerance may develop. Occurs in patients taking nitrates around the clock or with long-acting forms
Prevented by allowing a regular nitrate-free period
Transdermal forms: remove patch at bedtime for 8 hours, then apply a new patch in the morning

Front 22

S/E: Vasodilators

Back 22

headache, weakness, tachycardia, flushing, postural hypotension, dysrhythmias, confusion, severe rash, nervousness, tingling, and sweating.

Front 23

Types of lipoproteins

Back 23

Chylomicrons
Very Low Density Lipoproteins (VLDLs)
Low Density Lipoproteins (LDLs)
High Density Lipoproteins (HDLs)

Front 24

CAD risk factors

Back 24

Male 45 years or older
Female over 55 years or women with premature menopause not on estrogen replacement therapy
Family history: history of premature CHD
Current cigarette smoker

Front 25

Antihperlipidemics

Back 25

HMG-CoA Reductase Inhibitors: atorvastatin
Fibric Acid Derivatives: gemfibrozil
Bile Acid Sequestrants: cholestyramine
Niacin

Front 26

Antihperlipidemics-nursing interventions

Back 26

Pay attention to drug interactions
Bile acid sequestrants come as a powder.
Administer meds before or with meals.
Take other meds 1 hour before or 4-6 hours after antihyperlipidemics
Monitor for constipation/hemorrhoids: may need high-bulk diet or laxatives

Front 27

Cardiotonics

Back 27

Drugs that increase the force of myocardial contraction
Used to treat heart muscle failure
Cardiac glycosides
digoxin

Front 28

Action of cardiotonics

Back 28

Increase contraction strength or force (positive inotropic action)
Slow the heart rate

Front 29

Uses of dig

Back 29

Treatment of CHF and rapid or irregular heartbeats

Front 30

A/E: of dig

Back 30

Dig toxicity: verified by serum dig levels
The amount of medication that is therapeutic and the amount that is toxic are not very different.
Dig toxicity s/s: bradycardia/tachycardia, dysrhythmia, delirium, headache, visual changes (blurred vision, yellow/green vision, halo around dark objects), n/v.

Front 31

Nursing interventions of DIG

Back 31

Take an apical pulse for a full minute prior to administering digoxin. If pulse <60, hold the med and notify physician.
Drug levels must be monitored: 0.5 – 2 ng/mL. Toxic level = 2.5 ng/mL.
Monitor ‘lytes: low potassium levels increase toxicity
Drug interactions
Initial and maintenance doses

Front 32

Diuretics

Back 32

Indirectly reduce blood pressure by producing sodium & water loss and lowering the tone or rigidity of the arteries

Front 33

Type of diurectics

Back 33

Thiazides and sulfonamides
Loop
Potassium-sparing

Front 34

Adrenergic Inhibitors

Back 34

Beta-adrenergic blockers
Non-selective: reduce heart rate and force of contraction; prevent renin release; dilated blood vessels
Central adrenergic inhibitors
Vascular relaxation & lower blood pressure
Peripheral adrenergic antagonists
Decreased peripheral resistance

Front 35

Alpha-adrenergic inhibitors

Back 35

Arterial and venous dilation

Front 36

Angiotensin-related agents

Back 36

Inhibit angiotensin, which is a powerful vasoconstrictor

Front 37

Vasodilators

Back 37

Decreased vascular resistance

Front 38

Calcium channel blocking agents

Back 38

Decreased vascular resistance

Front 39

Nursing intervetnions-HTTN

Back 39

Instruct patients to change positions slowly to avoid syncope from postural hypotension
Patients should report unusual shortness of breath; difficulty breathing; swelling of the feet, ankles, face, or around the eyes; weight gain or loss; chest pain; palpitations; or excessive fatigue

Front 40

High BP

Back 40

Stage I: Lifestyle changes
Stage II: Drug therapy
Adverse reactions
Potassium-rich foods: bananas, citrus fruits, dried fruits, apricots, cantaloupe, watermelon, nuts, dried beans, beef, and fowl.
Drug interactions

Front 41

Urinary incontinence

Back 41

Atropine, tolterodine

Front 42

Benign prostatic hyperplasia

Back 42

Tamsulosin (Flomax), an alpha receptor blocker

Front 43

Analgesia

Back 43

phenazopyridine

Front 44

Causes of dehydration:

Back 44

Diarrhea
Vomiting
Bowel obstruction
Fever

Front 45

S/S of dehydration

Back 45

Weight loss
Dry skin, poor skin turgor
Lack of sweat
Dry mucous membranes
Decreased urinary output
Hypotension
Tachycardia and increased respirations