Drugs Affecting The Cardiovascular System

Front 1

Drugs used as to treat Thromboembolic Disorders

Back 1

Heparin
Coumadin(Warfarin)
Ticlid

Front 2

Heparin

Back 2

Has no fibrinolytic activity.
Used sq post-op to prevent occurence of thrombi.
Low doses prevents conversion of prothrombin to thrombin.

Front 3

Nursing Process for Heparin

Back 3

Check aPTT (Activated Partial Thromboplastin Time)
Heparin is measured in units
Antidote: protamine sulfate
Use caution with other meds that cause an anticoagulant effect... ASA (Asprin)

Front 4

Hepain drug class

Back 4

Anticoagulant

Front 5

What does heparin do?

Back 5

Makes blood thinner so that it will flow around the clot. Has no fibrinolytic activity.

Front 6

Activated Partial Thromboplastin Time related to Heparin

Back 6

aPTT
Therapy considered to be in normal range if aPTT is 1.5-2.5 tmes the control.

Hint 6

If control is 30 seconds (time to form clot)
Then 1.5-2.5 times this is 45 - 75 seconds.

Front 7

Heparin Antidote

Back 7

Protamin sulfate

Front 8

Heparin Cautions

Back 8

Use caution with other meds that cause an anticoagulant effect... ASA (Asprin)

Front 9

Coumadin's generic name

Back 9

warfarin

Front 10

Coumadin Antidote

Back 10

Vitamin K
Another treatment would be transfusion with plasma (FFP) or whole blood that has the clotting factor in it.

Hint 10

Inhibits the activity of Vitamin K

Front 11

Coumadin is used to treat what prophylactically

Back 11

DVT
A-Fib
PE
Coronary occlusion
Heart Valves

Hint 11

Pt can be on coumadin and heparin

Front 12

Labs to check for Coumadin

Back 12

PT/INR

Hint 12

Protime/international normailized ratio

Front 13

PT/INR for Coumadin

Back 13

2-3 unless has mechanical prosthetic valves or recurrent systemic embolism then is 2.5-3.5

Front 14

Potential side effects of blood thinners.

Back 14

Bleeding Gums
Nosebleeds
Tarry Stools
Coffee Groud or blood emesis
Petechiae
Hematuria
Bleeding that is difficult to control

Front 15

Ticlid

Back 15

Use bleeding time as baseline, not PTT or INR values
Do not use with Asprin (ASA)
Reduces risk of stroke
Side effects: agranulaocytosis

Front 16

Asprin

Back 16

ASA
Inhibit platelet aggregation with prolongation of bleeding time.
Given to reduce risk of recurrent TIA and stroke.
Reduce the risk of MI

Front 17

Thrombolytic Agents

Back 17

Streptokinase
Cause the dissolution of fibrin clots
Dangerous: can cause stroke, bleeding including intracranial.

Front 18

Streptokinase

Back 18

Destroys clots
Easy to use
Low cost
Possible allergic reaction next time it is used on you.
Potential for hemorage in other parts of the body.

Front 19

Goalof Thrombolytic Agents

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Goal is to lyse the clot, limit the damage to surrounding tissue, restore circulation
Makes the body's own mechanisms dissolove the clot.
Used for MI, PE, Stroke, DVT

Front 20

Asprin Drug class

Back 20

Platelet Inhibitor

Front 21

Ticlid Drug Class

Back 21

Platele Inhibitor

Front 22

Coumadin Drug Class

Back 22

Anticoagulants

Front 23

Red Clot

Back 23

A venous thrombus composed of fibrin and erthrocytes with a few platelets.
Form in response to venous stasis.
Most common form is DVT of the lower ext.
These can move upward and cause a PE

Front 24

White Clot

Back 24

Develop in the arteries in areas of high blood flow.
Form in response to injured vessels.
Consists of fribrin and platelets.
Common form is Coronary Artery Occlusion leading to MI.

Front 25

Patient Education - Coumadin (warfarin)

Back 25

Limit food high in Vitamin K
Walking, calf stretching
Minimize activites that could cause injury.
Rough housing
use of heavy equipment
Electric Razor only
Brush teeth with soft bristle brush

Front 26

Bleeding Gums

Back 26

Early sign of coumadin overdose.

Front 27

Ecchymosis

Back 27

Side effect of Coumadin(warfarin)
a discoloration due to extravasation of blood, as in a bruise.

Front 28

What are diuretics

Back 28

They act on the kidney in different locations to enchance the extretion of sodium.

Front 29

Main uses for Diuretics

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Heart Failure
Remove excess sodium and water
Hypertension
Fluid Overload
edema (pitting and nonpitting)
crackles in the lungs

Front 30

Signs and Symptoms of Digoxin Toxicity

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Anorexia
Nausea
Vomiting
Vision Distrubances
Arrythmias - Tachy and Brady
Diarrhea
Fatigue

Front 31

Diuretic Therapy - Hypokalemia

Back 31

Low Potassium
Due to diuresis, vomiting diarrhea

Front 32

Diuretic Therapy - Hyperkalemia

Back 32

High Potassim Levels
Can occur as an adverse effect of potassim-sparing diuretics.

Front 33

Diuretic Therapy -
Hyponatremia

Back 33

Low Soduim
Where sodium goes, water goes

Front 34

Diuretic Therapy -
Hypernatremia

Back 34

High Sodium levels
r/t excess IV fluids and patient may need diuretic.

Front 35

Low Urine Output

Back 35

<50 ml/hr - report

Front 36

What times should you give a diuretic?

Back 36

AM and early afternoon

Front 37

Loop Diuretics

Back 37

Ascending loop of Henely- Bumex, Edecrin, Lasix, Demadex

Front 38

Lasix Generic Name

Back 38

furosemide

Front 39

furosemide

Back 39

Lasix a Loop Diurectic

Front 40

What is Lasix (furosemide) used for?

Back 40

One of the most potent and effective diuretics currently available. In addition to treating edema caused by heart failure, renal disease and cirrhosis of the liver, lasix may be used to treat hypertension

Front 41

How long does Lasix last

Back 41

6 hours

Front 42

Assessment before giving lasix's.

Back 42

Check for hypotension, electrolytle imbalance, dehydration.
Know s/s of digoxin toxicity that can occur wtih excessive loss of potassium.

Front 43

Gouty Arthritis

Back 43

Caused by Lasix due to the inhibited excretion of uric acid.

Front 44

Thiazide Diuretics - Distal tubule

Back 44

acts on the distial tubule of the kidney to block reabsorption of sodium and choride ions from the tubule.

Front 45

What do you treat with Thazide Diuretics?

Back 45

Edema associated with heart failure, renal disease, hepatic disease, pregnancy, obesity, premenstrual syndrome.
Also used as a antihypertensive due to its vasodilatory action on the peripheral arterioles and as stated above.

Front 46

Thiazide and Diabetes

Back 46

Blood sugar needs to be monitored due to possiblity of hyperglycemic.

Front 47

Side effects of Diuretics?

Back 47

Can use often: No extreme side effects.

Front 48

Potassium Sparing Diurectics

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Acts at the distal renal tuble to retain potassium and excrete sodium, resulting in mild diuresis.

Front 49

Spironolactone

Back 49

blocks the sodium-retaining and potassium and magnesium-excreting properties of aldosterone.

Front 50

Salt Substitues

Back 50

Potassium

Front 51

Assessment for Diuretics in General

Back 51

Check electrolyte values
I&O important
Check pt weight daily
check B/P daily for orthostaic hypertension
Don't give at bedtime
Dig. toxicity can occur with loss of potassium.