HTN, LIPIDS, ANGINA

Atorvastatin

• cholesterol

AE: headache, fatigue, heartburn, myositis, rhabomyolysis, hepatotoxicity

D/D: azole antifungals, HIV protease inhibitors, grapefruit juice

CI: pregnancy & liver disease

Assess: LFTs, CK, alcohol use

Implementation: take w/ food in PM, assess for liver toxicity, myopathy

Educate: report myopathy, S/S if liver dysfunction and notify, avoid alcohol

Losartan

• antihypertensive

• blocks actions of Angiotensin II

Black Box: fetal injury & death

AE + Monitor: ^ K+, angioedema

Educate: do NOT get pregnant

Nifedepine

• block movement of Ca only in arterioles

For: HTN and angina

AE: reflex tachycardia, dizziness, lightheadedness

D/D: digoxin and BB

Assess: reflex tachycardia, edema

Educate: report dizziness and change positions slowly

Metoprolol

• rate control

• selective — block beta 1

For: HTN, angina, post MI, tremors, anxiety, stage fright, hyperthyroid, pheochromocytoma

AE: bradycardia, hypotension, hypoglycemia unawareness

D/D: CCB

Assess: HR, BP, CNS effects (depression, insomnia, nightmares)

Educate: early signs of HF, do NOT stop abruptly

Nitrate

• arterial & venous dilation

Sublingual:

• acute angina, onset 1-3 min, last 30-60 min, every 5 min 3x

Transdermal:

• check BP & pulse, do NOT cut, remove old cream/ don’t touch, 10-12 hr free period (pm)

IV:

• special PVC tubing, infuse 5mcg/min - 200mcg/min, do NOT stop abruptly

AE: headache, tachycardia, postural hypotension

D/D: alcohol, BB, CCB, erectile dysfunction meds

CI: severe head injury

Educate: avoid alcohol & sidenafil, SL before activity; store in airtight, dark glass bottle w/ metal cap w/ NO cotton