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21 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Vasodilator
Decreases myocardial oxygen demand Improve blood supply to myocardial tissue Dilates peripheral veins to increase venous capacity hold more fluid Dilates coronary arteries to increase 02 to myocardium Titration based on chest pain, VS, PCWP |
Nitroglycerin
Pharmacoloy |
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-VS Q 15 minutes
- Preload Reducer Symptoms -Dizziness (sit up or lie down when taking it or pt will fall) -Tachycardia reflex -Warm flush mm & skin -hypotension -H/A (give tylenol) |
Nitroglycerin
Nursing Teaching |
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Used in acute situation
-Pt should always carry at all times -Take 1rst sign of chest pain, X 3tab, 5 minutes apart -after 3rd tab call 911 -sit up or lie down when taking -may/may not feel burning/tingling sensation (not bad) -keep it small brown bottle, no pocket *NTG does not cure agina just treats it |
Nitroglycerin
Sub Lingual |
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Paste 1/2 - 2 inches paste
-absorbed slowly via skin -wash hands p administering -Use for maintainance NOT ACUTE -* Take off if orthostatic HypoTN -Vascular NO hairy part -No forarms, lower extremities, forhead |
Nitroglycerin
Topical/ Paste |
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Anti Platlet Agent (decrease platelet aggregation/clumpling)
* When patient has chest pain we are not sure if it is angina or MI pain so we give them chew on ASA (325mg) *if its an MI, ASA makes the platelet more responsive to tx -Contraindicated in GI bleed, ulcer, laceration -Pain relief, analgesic |
ASA
Pharmacology |
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Morphine Sulfate (drug of choice Pain)
-decrease anxiety, pain, venous pooling, workload, respirations -DECREASES PRELOAD, AFTERLOAD, WORKLOAD Oxygen 2L NC NTG - IV infusion, want remainder of fx arteries to have good perfusion Decrease BP, decrease Preload ASA- Anti platelet therapy |
MONA PROTOCOL
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-Diuretics
-Vasodilators -Ace Inhibitors -Angiotension II blockers -Beta Blockers -Morphine Sulfate |
Meds to Reduce Cardiac Workload
Heart Failure -Decreases venous return -Decreases peripheral resistance |
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-Upright position
-Nitrates (low dose) -Lasix -Oxygen -Aminophylline (Bronchodilators) -Digoxin -Fluids (decreased) -Afterload (decrese) -Sodium Restriction -Test (dig level, ABG, K) |
UNLOAD FAST
HEART FAILURE TREATMENT |
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-Digoxin
-Dobutamine -Dopamine -Inocor -Natrecor Drip |
Meds that increase contractility
decreases HR 3D COR = increase contraction |
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REDUCE CARDIAC WORKLOAD
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Beta Blockers
Ace Nitrates Diuretics ARB Narcotics Aldosterone |
BANDANA
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DECREASE PRELOAD/AFTERLOAD
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Calcium Channel Blockers
Ace Inhibitors Thyazide Diuretics Morphine Arbs Nitroglycerine |
CAT MAN
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DECREASES VENTRICULAR REMODELING
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ACE
BETA |
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NATRECOR
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Vasodilator
-Relax smooth muscles, dilates (veins and arteries) -Decreases PCWP, inhibits NA & H20 retention USED FOR ACUTELY DECOMPENSATED HEART FAILURE (DYSNEA & REST) S/E Hypotension, arrythmias, bradycardia effective when: PCWP decreases and dyspnea improves |
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HEPERIN ACTION
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Inhibits effects of thrombin and prevents conversion of fribrinogen to friben
-weight based -Initial bolus followed continuous infusion -PTT every 6 hours Normal 25-39 (78 highest) 1/2 - 2 x theraupetic level |
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LOW MOLECULAR HEPRIN
LOVENOX |
Prevents conversion of prothrombin to thrombin, liberation of thromboplastin from platelets and formation of a stable cot
PREVENTION OF DVD |
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Coumadin (Warfarin)
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Interferes with synthesis of Vitamin K dependent clotting factors by the liver
-Stops existing thrombi and formation of new clots Start 2-3 days prior to Heprin infusion is discontinued Monitor PT INR PT 11-13 (1.5x) INR 1.0 (2-3x) (2.0-2.5) |
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PULMONARY EDEMA
TREATMENT |
Morphine
Airway (bronchodilators) Digitalis (inotropics) Dieuretics Oxygen Gases Blood (ABG) |
MAD DOG
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PRELOAD REDUCERS ONLY
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LASIX
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DIRECT AFTERLOAD REDUCERS ONLY
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DIRECT VASODILATORS
NATRACOR |
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INCREASSES FORCE OF CONTRACTION
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DIGOXIN
DOPAMINE DUBOTAMINE INOCOR |
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STATINS
ACTION S/E |
MAIN LDL REDUCTION
HMG - COA inhibitors S/E Rhabdomyolysis abdominal cramps Constipation Diarrhea Heartburn MEMORY LOSS with high doses RHABDOMYLITIS LIVER PROBLEMS NI Increase fluids & fiber Takes 8 weeks to work Check LFT'S 3month/6months/yearly |
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