Interactions and Nursing Considerations for Exam 3

Catopril Interactions

K- sparing, K supplements, NSAIDs, Diuretics, other antihypertensives, Lithium, sacubitril

Catopril- Nursing Considerations

Monitor potassium levels, blood pressure, renal function, and watch for signs of angioedema. Educate patients about persistent cough.

Carvedilol- Nursing Considerations

Monitor blood pressure and heart rate, assess for signs of heart failure, and educate patients about potential side effects such as dizziness or fatigue.

Doxazosin Interactions

May interact with other antihypertensives, PDE5 inhibitors, and diuretics. Assess for additive hypotensive effects.

Enalapril- Nursing Considerations

Monitor blood pressure, renal function, and potassium levels. Educate patients about potential side effects like cough and angioedema.

Hydralazine- Nursing Considerations

Monitor blood pressure closely, assess for signs of systemic lupus erythematosus, and educate patients about potential side effects such as headache and palpitations.

Sodium Nitroprusside- Nursing Considerations

Monitor blood pressure continuously, protect from light, and educate about cyanide toxicity signs. Educate patient on symptoms of hypotension.

Amlodopine- Nursing Considerations

Monitor blood pressure regularly, assess for peripheral edema, and educate patients about potential side effects such as dizziness and flushing. Assess for signs of worsening heart failure. 

Diltiazem- Nursing Considerations

Monitor heart rate and blood pressure, assess for signs of heart failure, and educate about potential side effects like dizziness and constipation.

Isosorbide Dinitrate- Nursing Considerations

Monitor blood pressure, assess for headaches, and educate patients about tolerance development with prolonged use. Warn about potential dizziness and orthostatic hypotension. Assess for signs of worsening heart failure. 

Metoprolol- Nursing Considerations

Monitor blood pressure and heart rate regularly; educate patients about the importance of adhering to their medication regimen; assess for signs of respiratory distress, especially in patients with a history of asthma.

Nitroglycerin- Nursing Considerations

Monitor blood pressure closely, educate patients about potential headaches and dizziness, and apply as needed for chest pain while noting the importance of drug tolerance. Instruct patient to check expirations date. 

Digoxin- Interactions

K-depleting diuretics, amiodarone, and P-glycoprotein inducers/inhibitors.

Digoxin- Nursing Considerations

Monitor heart rate prior to administration, educate regarding signs of toxicity such as nausea or visual changes, and assess renal function regularly. Have Digifab in case of severe toxicity.

Dobutamine- Interactions

MAOIs, Beta Blockers, and Tricyclic antidepressants.

Dobutamine- Nursing Considerations

Assess heart rate and blood pressure before administration, monitor for arrhythmias, and ensure adequate fluid status. Adjust dosage based on patient response and titrate as needed.

Hydralazine- Nursing Considerations

Monitor blood pressure regularly, assess for signs of peripheral edema, and educate patients on possible side effects such as dizziness or headache. Monitor renal function and adjust dose as necessary.

Lisinopril- Interactions

Avoid using with potassium supplements, NSAIDs, and diuretics. Monitor for decreased effectiveness when combined with other antihypertensives.

Lisinopril- Nursing Considerations

Monitor blood pressure and renal function, assess for signs of hyperkalemia, and educate patients on potential side effects such as cough or dizziness. Adjust dosage as needed based on response.

Valsartan- Interactions 

K-diuretics, heparin, other hypertensives, and NSAIDs

Valsartan- Nursing Considerations

Monitor blood pressure and heart rate regularly, assess renal function and potassium levels, and educate patients about the signs and symptoms of angioedema.

Alteplase- Nursing Considerations

Monitor for signs of bleeding, perform regular neurological assessments, and ensure proper administration protocols are followed. Educate patients about potential side effects and the importance of reporting unusual symptoms.

Aspirin- Nursing Considerations

Monitor for gastrointestinal bleeding, assess for any allergic reactions, and educate patients on the importance of taking with food to minimize stomach upset.

Aspirin- Interactions

Anticoagulants

Clopidogrel- Interactions 

PPIs, Anticoagulants, NSAIDs, Opioid

Clopidogrel- Nursing Considerations

Monitor for platelet counts regularly to assess for signs of bleeding, ensure discontinuation prior to surgery, and educate patients on potential interactions with other medications.

Dabigatran- Nursing Considerations

Monitor renal function and adjust dose as needed, assess for bleeding risks (including hematuria), ensure proper storage, and educate patients on timing of doses.

Enoxaparin- Nursing Considerations

Monitor for signs of bleeding, adjust dosing in renal impairment, educate patients on proper injection techniques, and assess platelet counts regularly. Educate patients about signs of bleeding, such as unusual bruising or blood in urine/stool.

Heparin- Nursing Considerations

Monitor for signs of bleeding, adjust dose based on aPTT results, educate patients on injection techniques, and assess for signs of heparin-induced thrombocytopenia.

Rivaroxaban- Interactions

P-gp and strong Cyp3A4 inhibitors

Rivaroxaban- Nursing Considerations

Monitor for signs of bleeding, assess renal function, educate patients on adherence, and avoid use with strong CYP3A4 inducers. Monitor for altered mental status. Educate the patient on the risks of discontinuation. 

Warfarin- Interactions

Aspirin, NSAIDs, antibiotics, and drugs affecting liver enzymes.

Warfarin- Nursing Considerations

Monitor INR regularly, educate about dietary vitamin K, and assess for signs of bleeding. Advise patients to avoid taking any new medications without consulting their healthcare provider.

Atorvastatin- Nursing Considerations

Monitor liver function tests, assess for muscle pain or weakness, and educate patients on adherence to prescribed dosage and lifestyle modifications.

Exetimibe- Nursing Considerations

Monitor lipid levels, assess for liver function, and educate patients about potential gastrointestinal side effects. Educate patients on lifestyle changes, including diet and exercise, to enhance medication efficacy.

Gemofibrozil- Nursing Considerations

Monitor liver function tests, assess for muscle pain, and educate patients on potential side effects such as gastrointestinal issues. Advise patients to adhere to lifestyle changes for better lipid management.

Niacin- Nursing Considerations

Monitor liver function, assess for flushing and gastrointestinal upset, and educate patients on the importance of taking with food to minimize side effects.

Simvastatin- Nursing Considerations

Monitor liver function tests (LFTs) regularly and educate patients on the signs of muscle pain or weakness.

Furosemide- Nursing Considerations

Monitor electrolyte levels, assess for dehydration, and educate patients on the importance of taking in the morning to avoid nocturia.

Hydrochlorothiazide- Nursing Considerations 

Monitor electrolyte levels regularly, especially potassium and sodium; assess renal function prior to initiation and during therapy; educate patients on signs of dehydration and the importance of sun protection due to increased photosensitivity.

Spironolactone- Nursing Considerations

Monitor potassium levels closely, assess renal function before starting treatment, educate patients on potential side effects like dizziness, and advise against high potassium foods.

Primary Concern for Coagulation Modifiers

Bleeding is a primary concern when administering anticoagulants; therefore, it is crucial to instruct patients to report any unusual bruising, blood in urine or stool, and prolonged bleeding from cuts.