Drugs Affecting The Cardiac System

Front 1

Hypokalemia

Back 1

not enough potassium
<3.5 meq/l
Uncommon in clients who can eat

Front 2

Hyperkalemia

Back 2

to much potassium
>5 meq
muscle weakness, respiratory inefficiency
Cardio toxcisity

Front 3

atrial defibrillation

Back 3

Most common dysrhythmia
most significant in presence of underlining heart disease.
it is disorganised, tremorlike movement of the atria

Front 4

what is chf

Back 4

Complex condition characterized by a weakened heart.
Systolic dysfunction: cardiac contraction is impaired or weak.
Diastolic dysfunction: relaxation of the heart is impaired and abnormal filling of the heart.
Failure of the heart to pump enough blood to the peripheral organs.

Hint 4

Peripheral organs receive low blood flow, reduced oxygen and nutrients which may lead to organ damage.
In some individuals, fluid backs up in the lung, resulting in pulmonary congestion; fluid congestion may also develop in peripheral organs.

Front 5

4 classes of Diuretics

Back 5

-loop
-Thiazides
-potassium sparing diuretics
-osmotic agents

Front 6

How do Diuretics work ?

Back 6

-They work in the kidneys to increase the amount of fluid excreted. Which loweres the circulation volume

Front 7

Uses of diuretics

Back 7

Hypertension
Chf
fluid overload

Front 8

What is expected outcome
of diuretics ?

Back 8

Incerased output
decreased BP

Front 9

NI of dieurtics

Back 9

Monitor intake and out put
Mon. serum electrolytes levels

Front 10

Loop Diuretic

Back 10

Prototype: furosemide (Lasix)

Front 11

furosemide (Lasix

Back 11

Strongest and fasting acting
acts in the loopof Henleto inhibit sodium and chloride reabsorbtion

Cause electrolyte loss (esp potassium; recommend a potassium supplement while on lasix; also patient should consume foods high in potassium, ie fruits, deep green leafy veggies and legumes)
Dehydration

Front 12

Thiazide Diuretics

Back 12

Prototype: hydrochlorothiazide (Hydrodiuril; HCTZ)

Front 13

Prototype: hydrochlorothiazide (Hydrodiuril; HCTZ)

Back 13

Less potent than loop
slightly stops sodium & water reabsoption
Adverse affects :Hypotension'Orthostatic hypotension , hypoglycemia

Front 14

Potassium Sparing Diuretics

Back 14

Prototype: spironolactone (Aldactone)
Spir=spare!!

Front 15

Prototype: spironolactone (Aldactone

Back 15

Works in the distal tubules to inhibit sodium and water reabsorption and also acts to increase potassium retention (Hyperkalemia).
This spares potassium. You will have more left.
Sometimes used with loop diuretics to counteract Hyperkalemia

Front 16

Precautions for Patients on a Spironolactone Diuretic

Back 16

Patients should avoid foods that may increase potassium levels and create hyperkalemia while on potassium sparing diuretics, such as:
salt substitutes= potassium chloride
low salt foods
many soft drinks=have lots of sodium
Poor renal function also increases the risk of Hyperkalemia

Front 17

Osmotic Agent Diuretics

Back 17

Prototype: mannitol (Osmitrol)

Front 18

Prototype: mannitol (Osmitrol)
How it works?

Back 18

produce rapid diuresis by increasing the solute load (osmotic pressure) of the glomerular filtrate. Water is pulled from the extravascular sites into the bloodstream and excreted via the kidneys.

Front 19

Prototype: mannitol (Osmitrol)
What is it used for?

Back 19

Used to reduce intracranial pressure before and after neurosurgery, and reduces intraocular pressure before certain types of eye surgery

Front 20

"Dig"Digoxin
Mech of action?

Back 20

Inotrope: Stimulates heart contraction by promoting an increase in intracellular calcium; improves the pumping action of the heart. The workload on heart increases (may cause a problem for someone who already suffers from angina)
Dig decreases heart rate by slowing the conduction speed of the heart.

Front 21

Prototype: Digoxin (Lanoxin) Wha is it used for

Back 21

It is used for CHF, atrial fibrillation and atrial flutter.
It has a narrow range of safety
CHF: Digoxin is administered in combination with an ACE inhibitor or ARB + a Diuretic.
Drug where you will monitor serum lvls

Front 22

Digoxin (Lanoxin)
NI?

Back 22

Monitor for digoxin toxicity
Percautions for pt. with hypokalemia
Foods high in potassium:fruits green leafy veggies
Correct hypokalemia before administration "digby giving patients oral potassium supplement medication.

Front 23

Improvements with digoxin (Lanoxin): Nurse should observe

Back 23

decrease in shortness of breath
increased activity tolerance
Monitor body weight daily for increased fluid loss

Front 24

Digoxin Toxicity Signs and Symptoms:

Back 24

anorexia (loss of appetite)
nausea and vomiting
yellowed vision
Diarrhea
arrhythmias (most frequently seen in bradycardia; nurse should teach to monitor pulse, hold dose if HR < 60 and notify physician.)

Front 25

Antidote for Digoxin Toxicity

Back 25

Digoxin immune fab (Digibind

Front 26

olol beta blockers
Prototype ?

Back 26

Propanolol (Inderal)

Front 27

Propanlolol (Inderal )
Uses?

Back 27

angina
hypertension
arrythmias

“OLOLs” are cardioprotective; they help restore cardiac tissue structure and function; they reduce the workload of the heart and reduce oxygen demands.

Front 28

What does Propanolol do?

Back 28

Reduce heart to normal size by reversing remodeling.

Suppress sympathetic nervous system stimulation of the heart.

Reduced heart rate, force of contraction

Reverse cardiac remodeling overtime

Improve left ventricular ejection fraction (increased cardiac output)

Cardioprotective

Front 29

Adverse effects of Propanolol

Back 29

Bradycardia
Hypotension
Sedation
Depression
edema (monitor for any worsening of CHF…rales, SOB)

Front 30

CHF: “OLOLs” Beta Blockers
Nursing interventions and pt. teachings

Back 30

teach client how to monitor pulse and blood pressure.
Warn the client against stopping the medication abruptly(could cause a myocardial infarction, or worsen angina, or cause rebound hypertension, or death)

Administration: oral; initially administer a low dose Metoprolol then increase dose; combine with ACE inhibitor or ARB + Diuretic; may add Digoxin

Front 31

Cautions for OLOL betablockers

Back 31

caution diabetics that beta blockers mask hypoglycemia and potentiate the hypoglycemia effects of antidiabetic drugs.

caution COPD patients that beta blockers may cause wheezing.

Front 32

Cardio selective drug uses?

Back 32

Cardiac selective beta blockers are recommended for Asthma, COPD and Diabetc Mellitus Patients, ie Metoprolol (Lopressor)

Front 33

Direct vasodialators

Back 33

hydralazine (Apresoline)

Front 34

hydralazine (Apresoline)
What it does

Back 34

These antihypertensive drugs directly relax smooth muscle in blood vessels to cause dilation and decreased peripheral vascular resistance
. They also reduce afterload and can be used in the treatment of congestive heart failure

Front 35

Nitroglycerin (Nitrostat)

Back 35

Potent vasodilator affecting arterial and venous systems
Decrease preload
May be administered sublingual, I.V., topical patch, paste or oral (sustained release form)

Front 36

Nitrates Adverse Effects

Back 36

Hypotension
Headache (caused by dilation of cerebral vessels
weakness dizziness, flushing

Front 37

Normal blood pressure

Back 37

SBP<120 and DBP<80

Front 38

Pre-hypertension

Back 38

SBP120–139 or DBP80–89

Front 39

Hypertension

Back 39

>140/90

Front 40

Stage 1 Hypertension

Back 40

SBP140–159 or DBP90–99

Front 41

Stage 2 Hypertension

Back 41

SBP>160 or DBP>100

Front 42

“PRILS”: ACE Inhibitors
NAME A DRUG AND HOW IT DEC.BP

Back 42

Enalapril (Vasotec)

reduce blood pressure by decreasing peripheral vascular resistance (vasodilation) and reducing cardiac output by increasing fluid and sodium loss (decreasing aldosterone levels)

Front 43

ARBS”: Angiotension Receptor BlockersNAME A DRUG AND HOW IT DEC.BP

Back 43

Losartan (Cozaar)

Front 44

OLOLs”: Beta Blockers NAME A DRUG AND HOW IT DEC.BP

Back 44

Atenolol (Tenormin)

OLOLs”, lower blood pressure by reducing heart rate, force of contraction and cardiac ejection fraction, cardiac output.

Front 45

bETA BLOCKER

Back 45

Prazosin (Minipress)

Front 46

CCBs”: calcium channel blockers

Back 46

Amlodipine (Norvasc)

Front 47

Thiazide Diuretics
name a drug and how it dec bp

Back 47

Hydrochlorothiazide (HCTZ)

reduce blood pressure by increasing urine output, fluid loss and decreasing cardiac output.

Front 48

Direct Vasodilators
name a drug and how it dec bp

Back 48

Hydralazine, Nitrate

Reduce blood pressure by decreasing peripheral vascular resistance (vasodilation).