ch 11 cardiovascular system meds

Antianginal

Nitroglycerin - Dilates blood vessels and is used to relieve chest pain. It can be administered through a patch, spray, or IV. Should not be taken with Viagra. Causes vasodilation.

Anticoagulants

Heparin - Given subcutaneously, it helps stop clots from forming. Uses aPTT test to monitor blood clot levels. Has a reversal agent called protamine sulfate. Watch for bleeding and bruising.

Anticoagulants

Warfarin - Given orally, it helps stop clots from forming. Uses INR or PT tests to monitor blood clotting time. Has a reversal agent called vitamin K. Watch for bleeding and bruising.

Antiplatelets

Aspirin - Increases survival rate of heart attack but can cause GI bleeds and tinnitus.

Thrombolytic

Alteplase - Dissolves clots and should be given within 1 hour.

Antihypertensives

-        For high blood pressure

-        watch for heart rate and BP prior to administration

-        if too low, should not give

-        Erectile dysfunction

-        Orthostatic hypotensionà dizziness and falls

-        Fluid volume imbalances (deficiencies)à dehydration

-        Elderly may be more sensitive and need a lower dose

ACE inhibitors

Pril drugs - Stop blood vessels from constricting and tightening. Can cause a persistent dry cough and decrease pulse. Check pulse and blood pressure before administration. Give 1 hour prior to meals. Blackbox Warning: Avoid in pregnancy.

Angiotensin receptor blockers (ARBs): Losartan

Ends in sartan - Check pulse and blood pressure. Can cause harm to babies in the womb. Give 1 hour before meals.

Beta-blockers

Olol - Decrease fight or flight response, slow heart rate, and lower blood pressure. Check pulse and blood pressure before administration. Give 1 hour prior to meals. Can have an antianxiety effect. Avoid abrupt discontinuation.

Alpha/beta-blocker: Carvedilol

May treat hypertension, heart failure, and left ventricular dysfunction (myocardial reinfarction). May cause drowsiness or dizziness. Use caution.

Diuretics: Thiazide (hydrochlorothiazide)

Potassium wasting, works within 2 hours and lasts 6-12 hours. Monitor blood glucose levels and watch for photosensitivity. Assess for sulfonamide allergy if patient is on digoxin. if patient is on digoxin, can cause hypercalcemia

Diuretics: Loop (furosemide)

Potassium wasting, starts to work in an hour and lasts 6-8 hours. Assess for sulfonamide allergy.

Diuretics: Potassium sparing (spironolactone)

Can cause hyperkalemia, monitor urine output.

Calcium channel blocker: Amlodipine

Blocks calcium, reduces the workload of the heart. Avoid grapefruit juice.

Vasodilator: Hydralazine

Decreases the pressure required for the heart to pump. Watch for signs of infection and monitor CBC.

Cardiac glycoside: Digoxin

Monitor heart rate, avoid giving if HEART RATE BELOW 60. Bulk laxatives and antacids increase levels. Monitor blood and potassium levels. Watch for signs of dig toxicity.

Sodium channel blocker (class I): Lidocaine

Slows rate of electrical conduction in supraventricular rhythms.

Potassium channel blocker: Amiodarone (class III)

Treats ventricular and supraventricular arrhythmias. Used in patients with internal defibrillators. Monitor closely for toxicities and adverse effects. Avoid grapefruit juice. Neurological impairments.

Lipid-lowering agents: HMG-Co-A reductase inhibitor

(statins) - Atorvastatin.

Encourages the liver to make less cholesterol. Best taken at bedtime or with the evening meal. Grapefruit juice can increase levels. Can cause myopathy (report muscle aches)

Lipid-lowering agents

Fibric acid derivatives - Gemfibrozil. Lowers triglyceride levels by blocking the production of VLDL. Starts with FEN or FIB.

Lipid-lowering agents

Bile acid sequestrants - Cholestyramine, Colesevelam, Colestipol. Cause the liver to make more bile acids from cholesterol. Start with CHOLE or COLE.

Beta-adrenergic blockers (Class II):

slow electrical conduction

Calcium channel blockers (Class IV):

Dilate blood vessels & Decrease the workload of the heart. Used for very rapid arrhythmias.