Medications

beta blockers

“lol” or “olol”

• metoprolol

• atenolol

• esmolol

• labetalol

indications for beta blockers

HTN, angina, MI, CHF, arrythmias

decreases afterload and pulse. decrease the amount of blood the heart pumps out (CO) and contractility, all which lower BP.

negative inotrope and chronotrope.

administration for beta blocker

• PO

• IV

side effects for beta blocker

• hypotension

• dizziness

• bradycardia

• depression

• fatigue / weakness

• bronchospasm with hx of asthma

nursing considerations for beta blockers

• check apical pulse - hold <50

• monitor I&O, daily weights, BP

• don’t discontinue abruptly - taper over 2 weeks

• take with meds

• provide rest periods

• monitor DM carefully - blocks SS of hypoglycemia

• educate about other therapies for BP: exercise, decrease weight, etc.

ACE inhibitors

“pril” or “il”

• benazepril

• enalapril

• lisinopril

ACE inhibitors indications

HTN, CHF, MI

blocks conversions of angiotensin I to angiotensin II. decreases afterload. does not increase heart rate, contractility, or CO.

negative inotrope and chronotrope.

ACE inhibitors administrations

PO

ACE inhibitors side effects

• rash / pruritis

• persistent dry non-productive cough

• orthostatic hypotension

• elevated K+

ACE inhibitors nursing considerations

• monitor BP

• decrease absorption if taken with food.

• take 1hr before meals or 2hr after meal

• change position slowly

• use of NSAIDs with ACE inhibitors may decrease antihypertensive effects

• other therapies for HTN

nitrates

“nitro” or “nitr”

• nitrodur

• nitrostat

• nitrobid

nitrates indications

relief of angina, increased coronary blood flow and collateral flow.

positive inotrope.

decrease preload, afterload, and workload.

nitrates administration

• SL

• ointment

• PO

• IV

nitrates side effects

• hypotension

• headache

• dizziness

• tachycardia

nitrates nursing consideration

• assess angina, BP, P

• med timing (can give every 5 minutes x3 doses)

• rotate sites if ointment

• store in a dark container (good for 6 months)

calcium channel blockers

“dipine”

• nifedipine

• amlodipine

• diltiazem

• verapamil

calcium channel blockers indications

HTN, angina, arrhythmias

slows movement of Ca into the cells of the heart, which makes it eaesier for the heart to pump and widens blood vessels, causing vasodilation and lower BP.

negative inotrope and chronotrope.

calcium channels blockers administration

• PO

  • IV

calcium channel blocker side effects

• flushing, rash

• arrhythmias

• bradycardia

• edema

• hypotension

• heart failure

calcium channel blockers nursing considerations

• montitor BP, P

• notify HCP if BP <90/60

• avoid grapefruit - increases levels

• other therapies for HTN

• monitor for HF

antiplatelets

clopidogrel

antiplatelets indication

prevents platelet aggregation. management of angina, prevention of clot formation

antiplatelets administration

PO

antiplatelets side effects

• hemorrhage

• bleeding

• thrombocytopenia

antiplatelets nursing considerations

• observe for bleeding - gums, blood/dark stool, bruising, hematuria.

• no garlic, ginseng, or gingko herbs

• stop 5 days prior to surgery

anticoagulants

“-ban” or “tran”

• apixaban

• edoxaban

• rivaroxaban

• dabigatran

anticoagulant indication

• inhibits factor Xa (ban)

• inhibits thrombin (tran)

anticoagulant administration

PO

anticoagulant side effects

• bruising

• increased risk of bleeding

• thrombosis from discontinuation

• GI ulcers

anticoagulant nursing considerations

• monitor for bleeding

• monitor BUN and creatinine

• avoid ASA, NSAIDs, antiplatelets

• andexanet alfa - antidote for bans

• idarucizumab - antidote for dabigatran

adenosine indication

conversion of SVT o NSR. coronary artery vasodilation

½ life - 10 secs.

adenosine administration

IV (rapid IV push) 6mg, may repeat with 12 mg x2

adenosine side effects

• arrhythmias

• hypotension

• dizziness

• dyspnea

digoxin indications

CHF, arrhythmias

positive inotrope, negative chronotrope, prolongs AV conduction time.

digoxin administration

IV (loading dose, then maintenance PO)

digoxin side effects

• dizziness

• radycardia

• confusion

• irregular pulse

• vision changes:

  • blind spots

  • blurred vision

  • halo (toxicity)

• NVD

digoxin nursing considerations

• hold HR <60bpm

• monitor for toxicity:

  • confusion

  • irregular pulse

  • NVD

  • vision changes

• use catiously with decreased K (increase risk of toxicity)

• monitor I&O, BUN, creatinine

• therapeautic level: 0.5-2.0mg/mL

amiodarone (K+ channel blocker) indication

cardiac arrest - VF / pulseless VT

aminodarone slows conduction rate (may be used orally for chronic arrhythmias)

amiodarone (K+ channel blocker) administration

IV or IO 1mg a

amiodarone (K+ channel blocker) side effects

• increased BP

• increased CO

amiodarone (K+ channel blocker) nursing administration

give every 3-5 minutes as needed.

monitor P and ECG

lipid lowering agents

“statin”

lovastatin

atorvastatin

simvastatin

lipid lower agents indications

managment of hypercholesterolemia, prevention of CAD

metabolized through liver

lipid lowering agents administration

POlipi

lipid lower agents side effects

• abdominal cramping

• diarrhea / constipation

  • skin rash

lipid lowering agent nursing consideration

• grapefruit increase levels

• monitor LFT every 6 months

• monitor cholesterol, LDL, HDL

• avoid alcool consumption