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16 Cards in this Set
- Front
- Back
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Ace Inhibitor |
Captopril - Increase cardiac output by lowering blood pressure and decreasing blood volume - inhibits the arterioles and stimulates the kidney to produce urine output ** the resultant reduction of arteriole blood pressure diminishes the after load, thus improving cardiac output** |
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Captopril |
- lower peripheral resistance (decreased blood pressure)
- inhibit aldosterone secretion (reduced blood volume) - dilation of veins to decrease pulmonary congestion and reduce peripheral edema |
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Captopril: Contraindications |
- breast feeding
- very low systemic BP (<80 systolic) - too much Cr - too much potassium - hypersensitivity - heart block - potassium sparing diuretics - bilateral renal artery stenosis - angioedema |
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Captopril: Major adverse effects |
- hypotension - dizziness (esp after increasing dosage) - worsening of renal function - hyperkalemia (esp with K sparing diuretics and K supplements) - cough - angioedema (swelling of the deep layers of skin, usually around the eyes or mouth) |
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Captopril: Nursing considerations |
- Blood dyscrasias: blood studies: decreased platelets; WBC with differential at baseline and periodically; if neutrophils are less than 1000/mm3 discontinue use - Hypertension: B/P and pulse rates - Renal Studies: protein, BUN, creatinine, watch for raised levels as may indicate nephrotic syndrome; increased LFTs; uric acid - Allergic Reaction: rash, fever, pruritus, urticaria; discontinue product if antihistamines fail to help - CHF: edema, dyspnea, wet crackles, increased BP, weight gain |
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ARB's |
Lisinopril - blood pressure is decreased and cardiac output in increased - inhibits the arterioles and stimulates the kidney for increased cardiac output |
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Losartan |
- lower peripheral resistance (decreased blood pressure) - inhibit aldosterone secretion (reduced blood volume) - dilation of veins to decrease pulmonary congestion and reduce peripheral edema ** selectively blocks the binding of angiotensin 2 to the AT1 receptor found in tissues** |
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Lostartan: Major Adverse Effects |
- Dizziness, insomnia, anxiety, migraine, abnormal dreams - angina, cerebrovascular accident, hypotension, MI, dysrhythmias - blurred vision - diarrhea, anorexia - real failure - angioedema - worsening of renal function - hyperkalemia |
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Losartan: Contraindications |
- hypersensitivity |
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Losartan: Nursing considerations |
Assess:
- Anxiety: decrease i anxiety; mental status: mood, affect, sleeping pattern, drowsiness, dizziness, and suicidal tendencies - Renal/hepatic/blood status - Physical dependency / withdrawal symptoms |
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ACEIs... |
prevent cardiac remodeling ( changes in the size, shape, and structure of the myocardial cells (myocytes) occur) |
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Beta Blockers
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Must know: propanolol, metoprolol and carvedilol - reduce cardiac workload by decreasing contractility and slowing the heart rate (B1) and decreasing blood pressure (a1) -> results in decreased myocardial oxygen consumption - can improve left ventricular heart failure - usually used in combination with other drugs |
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Beta Blocker Groups: Selective |
1. Selective: block beta 1 - results in decreased HR (negative chronotropic), force of contraction (negative inotropic), conduction velocity (negative dromotropic) ** Metoprolol (Lopressor)** |
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Beta Blockers: Non Selective |
2. Nonselective: blocks both Beta 1 and 2 - results in negative inotropic, chronotropic and dromotropic ** Propanolol (inderal) |
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Beta Blockers: Combined Alpha 1 and Beta |
1. Combined Alpha 1 and Beta: - promotes arteriolar and venous dilation at Alpha 1, decrease in BP without reflex tachycardia or reduction in HR *Carvedilol (Coreg)* |
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Metoprolol: how it works |
lowers B/P by Beta 1 blocking effects; reduces |
