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38 Cards in this Set

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  • Back
What Class of antiarrhythmic is verapamil in?
Class IV
<What kind of agent is verapamil?>
<calcium channel blocker
has NEGATIVE inotropic, chromotropic, dromotropic effect>
<What is a brand of verapamil?>
<Calan
Isoptin>
What is the MOA for verapamil?

slows impulse...what does this do to atria?

decreases it
slows influx of calcium ions into smooth muscle cells...what does this do to the AV node?

atria do not beat too fast...what does this action do to arterial resistance and oxygen demand?
What is the therapeutic use of verapamil? (4)
antianginal
antiarrhythmic (class IV)
antihypertensive
vascular headache suppresants
What are the indications for the use of verapamil?
management of:
hypertension
angina pectoris
and/or vasospastic
(Prinzmetal's) angina
supraventricular arrhythmias
rapid ventricular rates in
atrial flutter or
fibrillation
prevention of migraine
headaches
management of cardiomyopathy
MOA of verapamil?

INHIBITS transport of what ion into myocardial and vascular smooth muscle cells?
calcium...and subsequently inhibits contraction
MOA of verapamil?

What does the med do to the AV and SA node?
DECREASES SA and AV conduction and PROLONGS AV node refractory period in conduction tissue
Therapeutic effect of verapamil?

Systemic vasodilation that results in?
decreased blood pressure
Therapeutic effect of verapamil?

Coronary vasodilation resulting in?
decreased frequency and severity of attacks of angina
Therapeutic effect of verapamil?

Suppression of what kind of tachyarrhythmia?
ventricular
Verapamil is contraindicated in?
hypersensitivity
sick sinus syndrome
2nd or 3rd degree AV block
(unless an artificial
pacemaker is in place)
BP less than 90 mmHg
CHF, severe ventricular
dysfunction, or cardio-
genic shock, unless
associated with supra-
ventricular tachyarrhythmia
concurrent IV beta blocker
therapy
What should nurse monitor with verapamil?
monitor blood pressure and pulse before, during and after
Why should ECG be monitored when taking verapamil?
may cause prolonged PR interval
What, besides ECG, BP, and pulse rate should be monitored throughout verapamil therapy?
I & O
daily weight
What should be assessed when taking verapamil?
CHF (peripheral edema)
rales/crackles
dyspnea
weight gain
jugular venous distention
If patient is taking digoxin concurrently with CCBs, what should nurse be wary of?
serum digoxin toxicity
What should an ECG be monitored continuously while on verapamil?
because of possible bradycardia or prolonged hypotension...notify physician...monitor bp and pulse throughout
Are total serum calcium concentrations affected by CCBs?
no
Monitor serum potassium due to possibility of?
hypokalemia which increases the risk of arrhythmias
Monitor renal and hepatic functions periodically during long-term therapy...why?
possible increase in hepatic enzymes after several days of therapy, which returns to normal on d/c of therapy
How should PO verapamil be administered?
with meals or milk to avoid gastric irritation
Can patient chew, open, crush, break sustained release capsules?
no....empty tablets in stool not significant
To avoid hypotensive effects, have patient?
remain recumbent for at least 1 hour
Instruct patient on correct technique for monitoring pulse and to contact hcp if heart rate is less than?
50 bpm
Teach patient to change positions?
slowly
It's a good idea for the patient not to drive due to?
possible dizziness or drowsiness
Dental appointments are advised to avoid?
tenderness
bleeding
gingival hyperplasia
(gum enlargement)
Avoid ______ esp. cold meds, without consulting hcp
alcohol
Advise patient to notify physician for the following?
irregular heartbeats
dyspnea
swelling of hands and feet
pronounced dizziness
nausea
constipation
hypotension occurs
* headache is severe or
persistent
If photosensitivity reactions occur?
wear sunscreen and protective
clothing
How can patient reduce hypertension?

(medication controls it but does not cure it)
weight reduction
low-sodium diet
smoking cessation
moderation of alcohol
consumption
regular exercise
stress management
Evaluation.
Effectiveness of therapy can be demonstrated by?
decrease in blood pressure
decrease in severity and
frequency of anginal
attacks
decrease in need for nitrate
therapy
increase in activity
tolerance and sense of
well being
suppression and prevention
of atrial tachyarrhythmias
<Verapamil (calcium channel blocker) is a potent vasodilator of coronary vessels and peripheral vessels...it has a negative ____, _____ ,_____ effect>
<inotropic...reduces myocardial oxygen consummption

chronotropic...frequency of hyperactive tissue is reduced so it decreases arrhythmias and takes out hyperactivity of muscle

dromotropic...slows conduction through AV node and it helps reducs oxygen consumption of heart>
Define inotropic?
an agent that increases the force of muscular contractions
Define chronotropic?
influencing the rate of occurrence of an event, such as heartbeat
Define dromotropic?
affecting the conductivity of nerve or muscle fibers
<Case study #8: angina pectoris.
Physician orders Verapamil (Isoptin, Calan) at what dosage, what route, and over how much time to relieve angina pectoris?
5 mg IV to be administered over 3 minutes