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12 Cards in this Set
- Front
- Back
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Statins |
ex. Atorvastatin - HMG-CoA reductase inhibitor, antihypertensive - An important enzyme for cholesterol synthesis, therefore it decreases - Liver responds by increasing # LDL receptors on it's surface, so it removes LDL from serum - PO, 98% protein bound, hepatic metbolism, biliary excretion, 2 weeks onset - Rhabdo is dangerous side effect |
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Bile resins/sequestrants |
ex. Questron - binds to bile acids, forming a large complex that can't be reabsorbed in small intestine (interrupts enterohepatic circ.) so they're excreted in feces. - Liver responds by increasing # LDL receptors on it's surface, so it removes LDL from serum - PO, acts locally, more frequent side fx than statins (& less effective), though they're limited to GI tract (bloating, steatorrhea, constipation) - May interfere with absorption of vit & min so take 1 hour before - Doesn't lower triglycerides - Decreases fx of digoxin, thyroid hormone, thiazides, increases warfarin by bind vit K |
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Fibric acid drugs ex. Lopid |
Used for high triglyceride levels, little effect on LDL - Activates enzyme: lipoprotein lipase, which increases breakdown and elimination of triglyceride from plasma. - Used adjunct to statins - GI related side fx |
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Cholesterol absorption inhibitor ex. Ezetimibe |
Blocks absorption of cholesterol in intestinal lumen by as much as 50% - used as adjunct, since this only accounts for 25% of cholesterol |
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Thiazides |
Safe, most potent. Hypokalemia may be adverse fx. Use cautiously with hyperlipidemia. |
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Potassium sparing diuretics ex. spirolatone |
Don't cause hypokalemia, but risk of hyperkalemia. |
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Loop diuretics ex. Lasix |
Very effective for reducing BP, but not maintenance therapy. |
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Calcium channel blockers - dihydropyridines |
ex. Amiodine
- Highly selective for Ca channels in vascular smooth muscle and coronary arteries to cause decrease in intracellular Ca available for muscle contraction. -Can be used to dilate coronary arteries to tx angina (administered with Beta blockers) - PO, 90% absorbed, highly protein bound, onset 30-60 min - Nursing responsibilities: compliance, hypotension, dizziness, headache, peripheral edema, monitor for reflex tachycardia, HF |
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Calcium channel blockers - nondihydropyridines |
ex. Verapamil. Antihypertensive, antianginal, antidysrhytmic - Blocks Ca channels on myocardium, -ve inotropic fx, can suppress abnormal cardiac rhythms, atrial fib. - Difference is that this also effects myocardial smooth muscle, not just vascular? - Nursing responsibilities: compliance, hypotension, dizziness, headache, peripheral edema, monitor for reflex tachycardia, HF |
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ACE Inhibitor |
ex. Catopril. - Renin-angiotensin converting enyzme inhibitors, antihypertensive. - binds to and inhibits ACE so angiotensin I not converted to angiotensin II. This means no aldosterone, so H2O & Na not retained, so blood volume and consequently BP are decreased. Also decreases peripheral resistance. - PO, not metabolized, renal excretion - Can cause build up of bradykinin causing cough, can cause hyperkalemia due to decrease aldosterone, angioedema - Nursing responsibilities: compliance, hypotension, monitor for hyperkalemia, use cautiously with hypovolemia & hyponatremia, liver & renal impairment |
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Angiotensin II receptor blocker |
ex. Losartan For HTN, stroke prophylaxis with left ventricular hypertrophy, prevent DMII nephropathy. - Blocks angiotensin receptors = decreased BP - PO, 99% protein bound - Nursing responsibilities: compliance, hypotension, monitor for hyperkalemia, use cautiously with hypovolemia & hyponatremia, liver & renal impairment |
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Beta-Adrenergic Antagonists |
ex. Propanolol (nonselective), blocks beta 1 & 2 (opposed to just beta1) - Antagonizes fx of catecholamines by competing for adrenergic receptors (decrease HR, -ve inotropic), also blocks receptors to relax vascular smooth muscle - decreased cardial contraction = decreased CO - Nursing responsibilites: decreased activity tolerance, fatigue, decreased gluconeogenesis, hypotension, bradycardia. Monitor blood glucose, hold if systolic <90mmHg or symptomatic, monitor HR. |
