Pharm Class Indications, Actions, Effects, Contraindications (WEEK 7)

Week 7

Nitrates

Indication: Drug of choice to terminate and/or prevent acute angina

Formularies:

• Short-acting—Terminate acute angina episode

• Long-acting—Decrease severity and frequency of episodes

Adverse Effects: hypotension…headache

Contraindications: safety not established in pregnancy; not to be used during lactation; hepatic/renal disease

CAUTION: older adults; hypotension; hypovolemia; conditions that limit CO

Antiplatelet Drugs

Indication: CV diseases that are prone to producing occluded vessels, maintenance of venous/arterial grafts, prevent ischemic CVA, PAD, adjunct to thrombolytic therapy for MI

Adverse Effect: bleeding; increased bruising; h/a, dizziness, weakness; n/v; skin rash

Contraindications: hypersensitivities

Caution: bleeding disorders; active bleeding; recent surgery; head injuries; pregnancy; lactation

—AVOID herbal supplements (garlic, gingko, psyllium, turmeric and more)→ ALWAYS teach client to confirm safety of herbal supplements prior to starting——

Anticoagulants

Indication: prevention and treatment of thrombosis

Action: interfere w/normal clotting cascade and thrombin formation

Adverse Effect: bleeding

Contraindications: hemorrhagic disorders; recent trauma; spinal puncture; GI ulcers; recent surgery

CAUTION: renal/hepatic impairment; pregnancy; lactation

—AVOID herbal supplements (garlic, gingko, psyllium, turmeric and more)→ ALWAYS teach client to confirm safety of herbal supplements prior to starting——

Thrombolytics

Indication: dissolve active clot that is disrupting hemodynamics

Action: break down thrombus that has been formed by stimulating the plasmin system

Adverse Effect: bleeding; cardiac arrhythmias; hypotension; mental status changes

Contraindications: Active bleeding

CAUTION: If condition would worsen with clot dissolution (recent surgery, active bleeding, CVA w/in last 3 months); OB delivery, recent CPR, liver disease, uncontrolled HTN; pregnancy; lactation

ADP Receptor Blocker

Indication: Prevention of MI, reinfarction s/p MI; Prevention of ischemic CVA; Acute coronary syndromes

Adverse Effect: bleeding, bruising, petechia, diarrhea, dyspepsia, pain

Contraindications: thrombocytopenia; PUD; ICH (inner cranial hemorrhage)

CAUTION: renal impairment; pregnancy; lactation

Hemostatics

Indication: Used to stop bleeding

Action: Prevents fibrin from dissolving; prevents clot breakdown

Adverse Effects: excessive clotting

Contraindications: Acute DIC (person is clotting everywhere in their body)

CAUTION: cardiac disease; renal/hepatic dysfunction; pregnancy and lactation