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108 Cards in this Set

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What is the class of Prazosin (Minipress)?
Adrenergic Agent; Alpha1-Blockers (antihypertensives; peripherally acting antiadrenergics?)
What is the action of Prazosin (Minipress)?
Dilates both arteries and veins by blocking postsynaptic alpha1-adrenergic receptors; Decreases contractions in smooth muscle of prostatic capsule
What is Prazosin (Minipress) used for?
Decreases contractions in smooth muscle of prostatic capsule
Unlabeled: Decreases contractions in smooth muscle of prostatic capsule
What is contraindication for Prazosin (Minipress)?
Hypersensitivity
What are some A/E of Prazosin (Minipress)?
Dizziness, headache, weakness, first dose orthostatic hypotension, palpitations
What are some implications or things the nurse should look for with Prazosin (Minipress)?
Following initial dose, patient may develop first-dose orthostatic hypotensive reaction, which most frequently occurs 30–90 min after initial dose and may be manifested by dizziness, weakness, and syncope. Observe patient closely during this period, and take precautions to prevent injury.
What are the drug interactions of Prazosin (Minipress)?
Additive hypotension with acute ingestion of alcohol, other antihypertensives, or nitrates.
Antihypertensive effects may be decreased by NSAIDs.
What is the classification of Clonidine (catapres)?
Centrally Acting Adrenergic Agent
Alpha2-Adrenergic Receptor stimulator (antihypertensives, centrally acting adrenergic)
What is the action of Clonidine (catapres)?
Stimulates alpha-adrenergic receptors in the CNS; which results in decreased sympathetic outflow inhibiting cardioacceleration and vasoconstriction centers; Prevents pain signal transmission to the CNS by stimulating alpha-adrenergic receptors in the spinal cord
What is Clonidine (catapres) used for?
PO, Transdermal: Management of mild to moderate hypertension. Epidural: Management of cancer pain unresponsive to opioids alone.
Unlabeled: Management of opiod withdrawal
What are the contraindications of Clonidine (catapres)?
Hypersensitivity;
Epidural: injection site infection, anticoagulant therapy, or bleeding problems
What are the AE of Clonidine (catapres)?
Drowsiness, dry mouth, withdrawal phenomenon
What are some implications or assessments the nurse should look for with Clonidine (catapres)?
PO: Administer last dose of the day at bedtime. Transdermal: Transdermal system should be applied once every 7 days. May be applied to any hairless site; avoid cuts or calluses. Absorption is greater when placed on chest or upper arm and decreased when placed on thigh. Rotate sites. Wash area with soap and water; dry thoroughly before application.
What are some interactions of Clonidine (catapres)?
Additive sedation with CNS depressants.
Additive hypotension with other antihypertensives and nitrates.
Additive bradycardia with myocardial depressants, including beta blockers.
MAO inhibitors, amphetamines, beta blockers, prazosin, or tricyclic antidepressants may decrease antihypertensive effect.
Withdrawal phenomenon may be increased by discontinuation of beta blockers.
Epidural clonidine prolongs the effects of epidurally administered local anesthetics.
May decrease effectiveness of levodopa.
Increased risk of adverse cardiovascular reactions with verapamil.
What is the classification of Reserpine (Serpasil)?
Peripherally Acting Agents
Adrenergic Neuronal Blockers (antihypertensives)
What is the action of Reserpine (Serpasil)?
Depletes stores of norepinephrine and inhibits uptake in postganglionic adrenergic nerve endings
What is the use of Reserpine (Serpasil)?
Used in combination with other antihypertensives in the management of hypertension
What are the contraindications of Reserpine (Serpasil)?
Hypersensitivity, active GI disease, severe renal insufficiency, mental depression, electroconvulsive therapy
What are the AE of Reserpine (Serpasil)?
Depression, lethargy, drowsiness, nasal stuffiness, bradycardia, diarrhea
What are some implications or assessments the nurse should look for with Reserpine (Serpasil)?
PO: Administer with meals or milk to minimize GI irritation. Monitor blood pressure and pulse frequently during initial dosage adjustment and periodically throughout course of therapy. Monitor blood pressure and pulse frequently during initial dosage adjustment and periodically throughout course of therapy. Monitor blood pressure and pulse frequently during initial dosage adjustment and periodically throughout course of therapy.
What are some interactions of Reserpine (Serpasil)?
Additive hypotension with other antihypertensives, nitrates, or acute ingestion of alcohol.
• Increased risk of arrhythmias with digoxin, quinidine, procainamide, or other antiarrhythmics.
• Excitement and hypertension may result from concurrent MAO inhibitor therapy.
• May decrease the therapeutic response to ephedrine or levodopa.
• May increase responsiveness to direct-acting adrenergic amines (dopamine, dobutamine, metaraminol, phenylephrine).
• Additive CNS depression with other CNS depressants, including alcohol, antihistamines, antidepressants, opioid analgesics, or sedative/hypnotics.
• Effectiveness may be decreased by concurrent NSAIDs
What are some natural products that may interact with Reserpine (Serpasil)?
Concomitant use of kava, valerian, skullcap, chamomile, or hops can increase CNS depression.
What is the classification of Captopril (Capoten)?
ACE Inhibitors antihypertensives)
What is the action of Captopril (Capoten)?
Angiotensin-converting enzyme (ACE) inhibitors block the conversion of angiotensin I to the vasoconstrictor angiotensin II. ACE inhibitors also prevent the degradation of bradykinin and other vasodilatory prostaglandins. ACE inhibitors also increase plasma renin levels and reduce aldosterone levels. Net result is systemic vasodilation.
What is the use of Captopril (Capoten)?
Alone or w/other agents in the management of HTN. Management of HF, reduction of risk of death, HF related hospitalizations, and development of overt HF following MI.

Treatment of diabetic nephropathy in patients with Type 1 DM and retinopathy.
What are the contraindications of Captopril (Capoten)?
Hypersensitivity, history of angioedema w/previous use of ACE inhibitors.

OB: can cause injury or death of fetus.

Lactation: appears in breastmilk
What are the AE of Captopril (Capoten)?
Angioedema, agranulocytosis, cough, hypotension, taste disturbances
What are some implications of assessments the nurse should look for with Captopril (Capoten)?
Administer 1 hr before meals or 2 hr after meals. May be crushed if patient has difficulty swallowing. Tablets may have a sulfurous odor. Monitor blood pressure and pulse frequently during initial dose adjustment and periodically during therapy. Monitor blood pressure and pulse frequently during initial dose adjustment and periodically during therapy.
What are some interactions of Captopril (Capoten)?
• Excessive hypotension may occur with concurrent use of diuretics.
• Additive hypotension with other antihypertensives.
• Increased risk of hyperkalemia with concurrent use of potassium supplements, potassium-sparing diuretics, potassium-containing salt substitutes, or angiotensin II receptor antagonists.
• Antihypertensive response may be blunted by NSAIDs.
Increases levels and may increase the risk of lithium toxicity.
What foods or natural products should be avoided with Catopril (Capoten)?
Avoid natural licorice (causes sodium and water retention and increases potassium loss).
Food significantly reduces absorption. Administer captopril 1 hr before meals.
What is the classification of Losartan (Cozaar)?
Angiotensin !! Receptor Blockers
What is the action of Losartan (Cozaar)?
Treatment of diabetic nephropathy in patients with Type 1 DM and retinopathy
What is the use of Losartan (Cozaar)?
Alone or w/other agents in the management of HTN.
Treatment of diabetic nephropathy in patients with Type 2 DM.
Prevention of stroke in patients w/HTN and left ventricular hypertrophy
What is C/I in Losartan (Cozaar)?
Hypersensitive, Bilateral renal artery stenosis. OB: potential for injury or death of fetus. Laction: Discontinue drug or use formula
What are the AE of Losartan (Cozaar)?
Angioedema, diarrhea
What are some implications or assessments the nurse should look for with Losartan (Cozaar)?
For patients with difficulty swallowing tablets, pharmacist can compound an oral suspension; stable for 4 wk if refrigerated Shake suspension before each use. Assess blood pressure (lying, sitting, standing) and pulse frequently during initial dosage adjustment and periodically during therapy. Assess blood pressure (lying, sitting, standing) and pulse frequently during initial dosage adjustment and periodically during therapy)
What are some interactions of Losartan (Cozaar)?
Additive hypotension with other antihypertensives.
• Excessive hypotension may occur with concurrent use of diuretics.
• Increased risk of hyperkalemia with concurrent use of potassium supplements, potassium-containing salt substitutes, angiotensin-converting enzyme inhibitors, or potassium-sparing diuretics.
• NSAIDs and rifampin may antihypertensive effects.
• May increase the effects of amiodarone, fluoxetine, glimepiride, glipizide, phenytoin, rosiglitazone, sertraline and warfarin.
What is the classification of Hydralazine (Apresoline)?
Vasodilators
What is the action of Hydralazine (Apresoline)?
Direct-acting peripheral arteriolar vasodilator
What is the use of Hydralazine (Apresoline)?
Moderate to severe hypertension (with a diuretic).
Unlabeled use: Moderate to severe hypertension (with a diuretic).
What is C/I with Hydralazine (Apresoline)?
Hypersensitivity, Some products contain tartrazine and should be avoided in patients with known intolerance
What are the AE of Hydralazine (Apresoline)?
Tachycardia, Sodium retention, drug induced lupus syndrome
What are some implications or assessments the nurse should look for with Hydralazine (Apresoline)?
Administer with meals consistently to enhance absorption. Administer with meals consistently to enhance absorption
What are some interactions with Hydralazine (Apresoline)?
• hypotension with acute ingestion of alcohol, other antihypertensives, or nitrates.
• MAO inhibitors may exaggerate hypotension.
• May pressor response to epinephrine.
• NSAIDs may antihypertensive response.
• Beta blockers tachycardia from hydralazine (therapy may be combined for this reason) .
• Metoprolol and propranolol hydralazine levels.
• blood levels of metoprolol and propranolol
What is the classification of Nitroprusside (Nipride)?
Vasodilators
What is the action of Nitroprusside (Nipride)?
Produces peripheral vasodilation by a direct action on venous and arteriolar smooth muscle
What is the use of Nitroprusside (Nipride)?
Hypertensive crisis, Controlled hypotension during anesthesia, cardiac pump failure or cardiogenic shock (alone or with dopamine)
What is C/I in Nitroprusside (Nipride)?
Hypersensitivity, Decreased cerebral perfusion
What are the AE of Nitroprusside (Nipride)?
Cyanide toxicity, dizziness, headache, abdominal pain, nausea
What are some implications or assessments the nurse should look for with Nitroprusside (Nipride)?
If infusion of 10 mcg/kg/min for 10 min does not produce adequate reduction in blood pressure, manufacturer recommends nitroprusside be discontinued. Monitor blood pressure, heart rate, and ECG frequently throughout therapy; continuous monitoring is preferred. Consult physician for parameters. Monitor for rebound hypertension following discontinuation of nitroprusside.
What are dome interactions with Nitroprusside (Nipride)?
If infusion of 10 mcg/kg/min for 10 min does not produce adequate reduction in blood pressure, manufacturer recommends nitroprusside be discontinued. Monitor blood pressure, heart rate, and ECG frequently throughout therapy; continuous monitoring is preferred. Consult physician for parameters. Monitor for rebound hypertension following discontinuation of nitroprusside.
What is the classification of Furosemide (Lasix)?
Loop Diuretics
What is the action of Furosemide (Lasix)?
Inhibits the reabsorption of sodium and chloride from the loop of Henle and distal renal tubule. Increases renal excretion of water, sodium, chloride, magnesium, potassium, and calcium. Effectiveness persists in impaired renal function.
What is the use of Furosemide (Lasix)?
Edema due to heart failure, hepatic impairment or renal disease, HTN
What is C/I in Furosemide (Lasix)?
Hypersensitivity, cross-sensitivity w/thiazides and sulfonamides, hepatic coma or anuria, alcohol intolerance
What are some AE with Furosemide (Lasix)?
Aplastic anemia, agranulocytocis, dehydration, hypochloremia, hypokalemia, hypomagnesium, hyponatremia, hypovolemia, metabolic alkalosis
What are some implications or assessments the nurse should look for with Furosemide (Lasix)?
If administering twice daily, give last dose no later than 5pm to minimize disruption of sleep cycle Assess fluid status. Monitor daily weight, intake and output ratios, amount and location of edema, lung sounds, skin turgor, and mucous membranes. Monitor blood pressure and pulse before and during administration.
What are some interactions with Furosemide (Lasix)?
If administering twice daily, give last dose no later than 5pm to minimize disruption of sleep cycle Assess fluid status. Monitor daily weight, intake and output ratios, amount and location of edema, lung sounds, skin turgor, and mucous membranes. Monitor blood pressure and pulse before and during administration.
What is the classification of Mannitol (Osmitrol)?
Osmotic Diuretic
What is the action of Mannitol (Osmitrol)?
Increases the osmotic pressure of the glomerular filtrate, thereby inhibiting reabsorption of water and electrolytes. Causes excretion of: water, NA, K, CL, CA, PH, MG, Urea, Uric Acid
What is the use of Mannitol (Osmitrol)?
IV: adjunct in the treatment of acute oliguric renal faiure, edema, increased ICP or IOP, toxic overdose. GU irrigant during transurethral procedures
What is are the C/I of Mannitol (Osmitrol)?
Hypersensitivity, anuria, dehydration, active intracranial bleeding
What are some AE of Mannitol (Osmitrol)?
Transient volume expansion
What implications or nursing assessments the nurse should look for with Mannitol (Osmitrol)?
Monitor vital signs, urine output, CVP, and pulmonary artery pressures (PAP) before and hourly throughout administration. Assess patient for signs and symptoms of dehydration (decreased skin turgor, fever, dry skin and mucous membranes, thirst) or signs of fluid overload (increased CVP, dyspnea, rales/crackles, edema).
What are some interactions of Mannitol (Osmitrol)?
Hypokalemia increases the risk of digoxin toxicity.
What is the classification of Spirolactone (Aldactone)?
Potassium Sparing Diuretic
What is the action of Spirolactone (Aldactone)?
Causes loss of sodium bicarbonate and calcium while saving potassium and hydrogen ions by antagonizing aldosterone.
What is the use of Spirolactone (Aldactone)?
Management of primary hyperaldosteronism, management of edema associated w/CHF, cirrhosis and nephritic syndrome, management of essential HTN, treatment of hypokalemia (counteracts K loss caused by other diuretics)
What in C/I in Spirolactone (Aldactone)?
Hypersensitivity, Anuria, Acute renal insufficiency, Significant renal impairment (CCr <30 ml/min), Hyperkalemia
What are some AE of Spirolactone (Aldactone)?
Hyperkalemia
What are some implications or assessments the nurse should look for in Spirolactone (Aldactone)?
Administer in AM to avoid interrupting sleep pattern. Adminster w/ food or milk. Monitor I&O rations and daily weight. If medication is given as an adjunct to antihypertensive therapy, blood pressure should be evaluated before administering. Monitor response of signs and symptoms of hypokalemia (weakness, fatigue, U wave on ECG, arrhythmias, polyuria, polydipsia). Assess patient frequently for development of hyperkalemia (fatigue, muscle weakness, paresthesia, confusion, dyspnea, cardiac arrhythmias). Monitor response of signs and symptoms of hypokalemia (weakness, fatigue, U wave on ECG, arrhythmias, polyuria, polydipsia). Assess patient frequently for development of hyperkalemia (fatigue, muscle weakness, paresthesia, confusion, dyspnea, cardiac arrhythmias).
What are some interactions in Spirolactone (Aldactone)?
• hypotension with acute ingestion of alcohol, other antihypertensive agents, or nitrates.
• Use with ACE inhibitors, indomethacin, potassium supplements, angiotensin II receptor antagonists, angiotensin converting enzyme inhibitors, or cyclosporine risk of hyperkalemia.
• lithium excretion.
• Antihypertensive and diuretic effectiveness may be by NSAIDs.
• May the effects of digoxin.
• hypoprothrombinemic effect of oral anticoagulants.
What is the classificaiton of Hydrochlorothiazide (Diurill)?
Thiazides and Thiazide-Like Diuretics
What is the action of Hydrochlorothiazide (Diurill)?
Increases excretion of sodium and water by inhibiting sodium reabsorption in the distal tubule. Promotes excretion of chloride, potassium, magnesium, and bicarbonate. May produce arteriolar dilation.
What is the use of Hydrochlorothiazide (Diurill)?
Management of mild to moderate hypertension, Treatment of edema associated with: CHF, Renal dysfunction, Cirrhosis, Corticosteroid therapy, Estrogen therapy.
What is C/I in Hydrochlorothiazide (Diurill)?
Hypersensitivity, Cross-sensitivity with other thiazides or sulfonamides may exist, Some products contain tartrazine and should be avoided in patients with known intolerance, Anuria, Lactation
What are some AE of Hydrochlorothiazide (Diurill)?
Hypokalemia, hyperuricemia
What are some implications or assessments the nurse should look for with Hydrochlorothiazide (Diurill)?
Administer in the morning to prevent disruption of sleep cycle. Monitor blood pressure, intake, output, and daily weight and assess feet, legs, and sacral area for edema daily. Assess patient, especially if taking digitalis glycosides, for anorexia, nausea, vomiting, muscle cramps, paresthesia, and confusion. Notify physician or other health care professional if these signs of electrolyte imbalance occur.
What are some interactions in Hydrochlorothiazide (Diurill)?
• Additive hypotension with other antihypertensives, acute ingestion of alcohol, or nitrates.
• Additive hypokalemia with corticosteroids, amphotericin B, piperacillin , or ticarcillin.
• Decreases the excretion of lithium.
• Cholestyramine or colestipol decreases absorption.
• Hypokalemia increases risk of digoxin toxicity.
• NSAIDs may decrease effectiveness.
What is the classification of Atorvastin (Lipitor)?
HMG-CoA Reductase Inhibitors
What is the action of Atorvastin (Lipitor)?
Inhibits 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, an enzyme which is responsible for catalyzing an early step in the synthesis of cholesterol.
What is the use of Atorvastin (Lipitor)?
Adjunctive management of primary hypercholesterolemia and mixed dyslipidemia. Primary prevention of coronary heart disease (myocardial infarction, stroke, angina, and coronary revascularization) in asymptomatic patients with increased total and low-density lipoprotein (LDL) cholesterol and decreased high-density lipoprotein (HDL) cholesterol.
What is C/I with Atorvastin (Lipitor)?
Hypersensitivity, Active liver disease, pregnancy or lactation
What are some AE of Atorvastin (Lipitor)?
rhabdomyolysis, hypersensitivity reactions including angioneurotic edema, abdominal cramps, constipation, diarrhea, flatus, heartburn, rashes
What are some implications or assessments the nurse should look for with Atorvastin (Lipitor)?
Avoid grapefruit and grapefruit juice during therapy; may increase risk of toxicity. Obtain a diet history, especially with regard to fat consumption.
What are some interactions with Atorvastin (Lipitor)?
• Metabolized by the hepatic CYP3A4 enzyme system.
• Cholesterol-lowering effect may be additive with bile acid sequestrants (cholestyramine, colestipol).
• Bioavailability may be decreased by bile acid sequestrants.
• Risk of myopathy is increased by concurrent cyclosporine, gemfibrozil, clofibrate, erythromycin, large doses of niacin, and azole antifungals (combined use with clofibrate or gemfibrozil not recommended; temporary discontinuation of atorvastatin recommended during azole antifungals).
• May slightly increase serum digoxin levels.
• May increase levels of oral contraceptives.
• May increase effects of warfarin.
• Levels are significantly increased by amprenavir (use lower doses of atorvastin or consider fluvastatin or pravastatin
What food should be avoided with Atorvastin (Lipitor)?
Grapefruit juice levels and risk of rhabdomyolysis.
What is the classification of Cholestyramine (Questran)?
Bile Acid Sequestrants
What is the action of Cholestyramine (Questran)?
Bind bile acids in the GI tract, forming an insoluble complex. Result is increased clearance of cholesterol.
What is the use of Cholestyramine (Questran)?
Management of primary hypercholesterolemia. Pruritus associated with elevated levels of bile acids. Unlabeled Use: Diarrhea associated with excess bile acids.
What is C/I with Cholestyramine (Questran)?
Hypersensitivity, complete billary obstruction, Some products contain aspartame and should be avoided in patients with phenylketonuria
What are some AE of Cholestyramine (Questran)?
Abdominal discomfort, constipation, nausea
What are some implications or assessments the nurse should look for with Cholestyramine (Questran)?
Administer before meals. Administer other medications 1 hr before or 4–6 hr after the administration of this medication.
What are some interactions of Cholestyramine (Questran)?
• May decrease absorption/effects of orally administered acetaminophen, amiodarone, clindamycin, clofibrate, digoxin, diuretics, gemfibrozil, glipizide, corticosteroids, imipramine, mycophenolate, methotrexate, methyldopa, niacin, NSAIDs, penicillin, phenytoin, phosphates, propranolol, tetracyclines, tolbutamide, thyroid preparations, ursodiol, warfarin, and fat-soluble vitamins (A, D, E, and K).
• May decrease absorption of other orally administered medications.
What is the classification of Niacin (Nocobid)?
Niacin, lipid-lowering agents, vitamins
What is the action of Niacin (Nocobid)?
Required as coenzymes (for lipid metabolism, glycogenolysis, and tissue respiration). Large doses decrease lipoprotein and triglyceride synthesis by inhibiting the release of free fatty acids from adipose tissue and decreasing hepatic lipoprotein synthesis (niacin only). Cause peripheral vasodilation in large doses (niacin only).
What is the use of Niacin (Nocobid)?
Treatment and prevention of niacin deficiency (pellagra). Adjunctive therapy in certain hyperlipidemias (niacin only).
What is C/I with Niacin (Nocobid)?
Hypersensitivity, Cross-sensitivity with other thiazides or sulfonamides may exist, Some products contain tartrazine and should be avoided in patients with known intolerance, Alcohol intolerance (Nicotinex only)
What are some AE of Niacin (Nocobid)?
Hepatoxicity (ER oral form only), GI upset, flushing of face and neck, pruitis
What are some implications or assessments the nurse should look for with Niacin (Nocobid)?
Vitamin Deficiency: Assess patient for signs of niacin deficiency (pellagra — dermatitis, stomatitis, glossitis, anemia, nausea and vomiting, confusion, memory loss, and delirium) prior to and periodically throughout therapy. Hyperlipidemia: Obtain a diet history, especially with regard to fat consumption.
What are some interactions of Niacin (Nocobid)?
• Increased risk of myopathy with concurrent use of HMG-CoA reductase inhibitors.
• Additive hypotension with ganglionic blocking agents (guanadrel).
• Large doses may decrease the uricosuric effects of probenecid or sulfinpyrazone.
What is the classification of Gemfibrozil (Lopid)?
Fibric Acide Derivatives
What is the action of Gemfibrozil (Lopid)?
Inhibits peripheral lipolysis, Decreased triglyceride production by the liver, decreases production of the triglyceride carrier protein, increases HDL
What is the use of Gemfibrozil (Lopid)?
Management of type II-b hyperlipidemia (decreased HDLs, increased LDLs, increased triglycerides) in patients who do not yet have clinical coronary artery disease and have failed therapy with diet, exercise, weight loss, or other agents (niacin, bile acid sequestrants).
What is C/I with Gemfibrozil (Lopid)?
Hypersensitivity, Primary biliary cirrhosis, concurrent use of HMG-CoA reductase inhibitors
What are some AE of Gemfibrozil (Lopid)?
Abdominal pain, epigastric pain, diarrhea
What are some implications or assessments the nurse should look for with Gemfibrozil (Lopid)?
Administer 30 min before breakfast or dinner. Obtain patient’s diet history, especially regarding fat and alcohol consumption.
What are some interactions with Gemfibrozil (Lopid)?
• May increase the effects of warfarin or sulfonylurea oral hypoglycemic agents.
• Concurrent use with HMG-CoA reductase inhibitors may increase the risk of rhabdomyolysis (avoid concurrent use).
• May decrease the effect of cyclosporine.