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49 Cards in this Set
- Front
- Back
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describe the signs and symptoms and treatments of digitalis toxicity.
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overdose or accumulation of digoxin caues digitalis toxicity, signs and symptons include, anorexia, diarrhea, nausea, and vomiting, bradycardia, prmemature ventircaular contrctions, cardiac dyshthymia, headaches, maliase, blurred vision, visual illusion, confusion, delirium, older adults are more prone to toxicity.
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cardiotoxicity is a very serious adverse action to digoxin:ventricular dysrhymias result there are 3 cardiacaltered functions that contribute to digoxin-induced ventricular dyrhymeas
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1 suppresion of av conduction
2 increased automatcity 3 a decreased refractory period in ventricular muscle |
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What are antianginal drugs?
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they are drugs used to treat angina pectoris, This is a condition of acute cardiac pain caused by inadequate blood flow to the myocardium resulting from either plaque occulsions within or spasms of the coronary arteries
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types of antianginal drugs
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antianginal drugs increase blood flow either by increasing O2 supply or by decreasing O2 demand by the mycardium
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three types of antianginals are nitrates, beta blockers and calcium channel blockers
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the major system effect of nitrate is the reduction of venous tone, which decreaes the workload of the heart and promotes vasodilation. beta blockers and calcium cahnnel blockers decrease the workload of the heart and decrease O2 demand.
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nitrates and calcium cahnnel blockers are effective in treating variant(vasopastic) angina pectoris, beta blockers are not effective for this type of angina. with stable angina beta blockers can be effectively used to prevent angina attacks
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types of
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Nitrates
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nitrats developed in the 1840's were the firsst agents used to treat angina. this group pd drug reduces myocardial ischemia but causes hyptension.
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what is the most commonly used nitrate
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SL Nitroglycerin, it is not swalloed because it undergoes first pass metabolism by the liver, which decreases it's effectiveness, instead it is given sl sublingually
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what are the side effects of Nitroglycerin
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Headaches are the most common side effect. others are hypotension, dizziness, waekness and faintness.
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what are some adverse actions of Nitroglycerin
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Hypotension, reflex tachycardia, paradoxical bradycardia
Life threatening+Circulatory collapse |
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What are beta-blockers
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Beta adregenic blockers block the beta receptor site, they decrease the effects of the sympathectic nervous system by blocking the release of the catecholamines epinephrine and nonepinephrene thereby decreasing the heart rate and myocardial contractibility, they reduce the need for O2 consumptipn and consequently reduce anginal pain
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side effects of beta blockers
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nonselective and selectiv beta blockers cause a decrease in pulse rate and blood pressure, vital signs need to closely monitored in the early stage of beta bloclker therapy
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what are calcium channel blockers
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they were introduced in 1982 for treatment of angina pectoris, certain dysrhthmias and hypertension, calcium activates myocardiaul contraction, increasing the workload of the heart and the need for more O2, 80-90% are absorbed through the GI mucosa
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What are the side effects of calcium blockers
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headaches, hypotension, dizziness and flushing skin
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what are some adverse reactions of calcum blockers
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calcium blockers can cause changes in liver and kidney function, serum liver enzymes shoulkd be checked periodically
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Explain the actions of cardiac glycoslides
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cardiac or digitalis glycosides, inhibits calcium in cells. causes cardiac muscle fibers to contract
Outcome improvement of myocardial contractibility reduction of the hearts workload |
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explain the actions of antianginal drugs
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used to treat Angina pectoris(chest pain), antianginal drugs increase blood flow either by increasing O2 supply or by decreasing O2 demand by the myocardium
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what are the three types of antianginals drugs
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Nitrates, Beta-blockers, and calcium cahnnel blockers
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Describe the sing syptoms and and treatment of digitalis toxicity
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Overdose or accumulation of Digoxin causes digitalis toxicity.
SIGNS AND SYMPTOMS=anorexia, diarrhea, nausea, and vomiting, BRADYCARDIA(below 60) premature ventricular contrtaction, cardiac dyrhthmias, headaches, mailaise blurred vision, viusal illusions, confusion and delirium Digoxin immune Fab(ovine<Digibind) can be given to treat severe digitalis toxicity. this agen binds with the dogoxin to form complex molecules that can be excreted in the urine, and digoxin is unable to bind at the cellular site of action |
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Digitalis Toxicity can result in first degree, second degree or complete heart block
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diitalis toxicity
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Identify the actions, of Nitrates
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nitrates developed in 1840's were teh first agents used to relieve angina, the nitrates affect the blood vessels in the venous circulation and coronary arteries, they cause generalized vascular and coronary vasodilation thus increasing bloof flow throgh the coronary arteris to the myocardial cells. the drugs in this group reduces myocardial ischemia but can cause hypotension.
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what are side effects and adverse actions to Nitrates
Nitroglycerin(most common Nitrate |
headaches are the most common side effects of Nitroglycerin, acetaminophen may provide may provide some releif. Other side effects include hypotension, dizziness, weakness and faintness.
when patches or ointment is discountinued it should be spread out to prevent rebond effects of severe pain caused by myocardial ischemia(lack of blood supply to the heart muscles0 in addition reflex tachycardia may occur if nitrate is given to often. |
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Identify the actions to beta blockers
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decrease the effect of the sympathetic nervous systme by blocking the release of the catecholamines epinephrine and norephinephrine therby decreeasing the heart rate and blood pressure
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what are the the side effects and adverse actions of Beta Blockers
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Non seletive and selectie beta blockers cause a decrease in pulse rate and blood pressure.(bradycardia and hypotension
The nonselective beta blockers, bronchospasm, behavorial or psychotic response, impotence are potential adverse reactions |
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Identify the actions of calium cahnnel blockers
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block calcium access to the cess, causing dexcreased heart contractibility and conductivity and leading to a decreased demand for oxygen
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What are the side effects and adverse actions of calcium channel blockers
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headaches, hypotension, dizziness and flushing of the skin
Adverse=Refelex tachycardia can occur as a result of hypotension, calcium channel blockers can cause changes in liver and kidney function and serum liver enzymes should be checked periodically. |
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What are the effects of Quinidines and procainamide
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The first drug to treat cardiac dysrhythmias were quinidines.
uses=to control cardiac dysrthmias(premature ventricular contractions, ventricular tachycardia |
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What are the side effects of Procainidines, and quinidines
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Side effects=anorexia, nausea, vomiting, diarrhea, dizziness, weakness, flush, and lupus like syndrome with rash
adverse actions=life threatening, atrioventricular block, pleural effusion, ventricular tachycaria/fibirilation |
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xplain the actions and uses of diuretics
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to decrease hypertension(lower blood pressure, and to decrease edema in congestive heart failure(chf
Diuretics have an antihypertenion effect by promoting sodium and water loss by blocking sodium and chloride reabsorption) |
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iDENTIDY THE GROUPS OF DIURECTICS AND DISCUSS THEIR SIDE EFFECTS(5)
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1 Thiazides and thiazide like
2 loop or celing 3 Osmotic 4 carbonic anhydrase inhibitor 5 potassium sparing |
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What are the side effects of thiazide and thiazde like diuretics
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elctrolye imblance(hypokalemia, hpercalemia, hypomagnesemia and bicarbonate loss0 hyperglycemia(elevated blood sugar, hyperuricmia(elevated serum uric acid level) and hyperlipidemia(elevated blood lipid level)
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what are the side efects of loop diurectics
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Most common side efects are fluid electrolyete imbalances, such as hypokalmeia, hyponatremia, hypocalecemia, hypomagnesemia, and hypochloremia, prolonged use of loop diuretics could cause thiamine deficiency
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What are the side effects of of osmotic diuretics
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Mannitol is the most frequentky used loop diuretic, followed by urea
Side effects and adverse reations=fluid and elctrolyet imbalance, pulmonary edema from rapid shifts of fluids, nausea, vomiting, tachycardia from rapid fluid loss and acidosis, crystallization of mannitol int he vial may occur when drug is exposed to low temps, this drug should not be used IV |
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What are the side effects of carbonic anyhydrase inhibitors
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This group of drug is used primarly to decrease IOP
One of the drugs acetazolamide can cause fluid electrolyte imabalnce, metabolic acidosis, nausea, vomiting, anorexia, confusion. Hemolytic anemia and renal calculi can occur |
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What are the effects of potassium sparing diuretics
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potassium sparing diuretics, weaker than thiazades and loop are used as mild diuretics or in combo with another diuretic, they act primarily in the collecting distal duct renal tubules to promote soduim and water excretion and K retention
side effects=the main side efect is Hyperkalemia, if they are givne with ACE inhibitor, it could become sever or life threatening becasue both drugs retain potassium |
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Identify the categories of antihypertension drugs 6 categories
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-diuretics
-sympatholytics -direct acting arteriolar vasodilators -angiotension antaganost(opposite effect) -angiotensin 11 receptor antagonist -calcium channel blockers |
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Describe the pharmacologic actions and side effects of antihypertension drugs
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blood pressure is regulated by cardiac output and peripheal vascular resistance (PVC) Medicaitons that influene either one of these systems leads to blood pressure control. Antihypertensive drugs that influenc these systems to lower the BP are Angiotensin-converting enzyme(ACE inhibitors, Beta adrenergic blockers, and clacium channel blockers(CCB)
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identidy the actions of anticoagulants and side effects.
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Used to inhibit clot formation, unlike thrombolytic it prevent new clots from forming, , HEPARIN IS A MAIN ONE GIVEN, GIVEN IN LOVE HANDLES,
Side effects=injectin site reactins, transient thrombocytopenia, large doses may suppress renal function, spontaneous bleeding at mucous membranes watch for bleeding |
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identify the action and side effects of antiplatelets
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are used to prevent thrombis in the arteries by suppressing platelet aggregation, heparin and coumadin prevent thrombosis in the veins
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What is the drug coumadin used for
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it is an anticoagulant that suppresses production of fibrin, which disrupt the coagulation cascade
avoid vitamin k foods, and decrease green leefy vegtables |
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Identify the action and side effects of thrombolytics
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work to convert plasminogen to plasmin, an enzymethat acts to digest teh fibirin matrix of clots.
major complication is hemorraging |
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Identify the actions and side effects of antilipemics
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lower abnormal bloop lipid levels
LDL-low density lipids-bad HDL-high density lipids=good one of the first antilipemics was cholestyramine Side effects and eadverse reactiomns=constipation and peptic ulcers |
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identify the actions and adverse actions of peripheal vasodilators
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they increase blood flow to the extremeties, all the drugs used for this promote vasodilation
side effects and adverse actions=light headness, dizziness, orostaic hypotension, tachycardia, palpitaion,flush and gi stress may occur |
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Explain the nursing interventions, including client teaching related to glycosides
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check apical pulse before giving-hold for HR less than 60 beats per minute, monitor for hypokalmia
client teaching=teach client to take pulse before taking, explain importance of compliance, take at same time, avoid OTC meds unless cleared by MD, report side effects, discuss herb drug interaction, eat foods high in potassium |
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Explain nursing interventions and client teaching related to antianginals
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Monitor vital signs, monitor SE, have patients sit or lie when taking for the first time
Client teaching=instruct howa nd whne usage of SL nitroglycerin, instruct rotation of sites topically, dont get paste on fingers, it's easily absorbed, avoid caffein, coffe and tabacco |
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Describe nursing interventions, including client teaching for antidysrhymic drugs
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monitor vital signs and monitor ECG for dysrhythmia, bradycardia
client teaching=discuss drug compliance, report Side Effects, avoid alcohol, caffeine and tabacco |
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Describe Nursing interventins, and client teaching for diuretics
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assess vital signs, weight, input and output, chemisrty values for baseline, check weight same time everyday, s/s of hypokalemia(muscle weakness) leg cramps, cardiac dysrhymias,
teaching=compliance, take early to avoid sleep disturbances, discuss herbal OTC, instruct change positions slowly-orthastatic, eat food rich in potassium, take food with meds to avoid GI stress,cultural consideration |
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Descibe Nursing interventions and client teachings for antihypertensive
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monitor renal fumction and blood glucose, monitor for bruising, petechiae,
Teaching=compliance, dont stop abrubtly, report side effects |
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Describe Nursing interventions and teachings for peripheal vasodilators
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monitor vital signs, especially blood pressure and heart rate, tachycardia and orthostatic hypotension can be problematic
teaching=inform client that a desird therapeutic response may take 1.5-3 months, dont smoke, smoking increases vasospasms, use aspirin or aspirin like compuounds only with doctors approval |
