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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