Cardiac Medications

what does an alpha 2 agonist (simulator) do? (clonidine)

stimulates alpha 2 receptors in the brain which inhibits the release of epinephrine and norepinephrine

why take clonidine (catapres)?

hypertension and opioid withdrawal

what are some contraindications with clonidine (catapres)? think dining

acute heart failure, MAOIs, severe liver disease

adverse reactions to clonidine (catapres)? think dine

orthostatic hypotension, rebound hypertension, dizziness, fatigue, dry mouth

what causes rebound hypertension?

sudden discontinuation of meds

how do angiotensin-renin blockers work? (-sartan)

binds with angiotension 2 receptors in smooth muscle and blocks vasoconstriction and aldosterole release, skips lung process so no cough

why take valsartan (diovan)?

hypertension, especially for those who had a cough with ACE inhibitors

contraindications with valsartan (diovan)? think of both As

renal/hepatic failure and pregnancy/lactation

adverse reactions to valsartan (diovan)?

dry mouth, hypoglycemia, dizziness

what do you caution when taking -sartans?

digoxin

what labs are important to monitor when taking -sartans?

ALT + AST, BUN + creatinine, blood sugar

what does a cardiac glycoside do? (digoxin)

inhibits the Na and K pump which slows the impulse from the SA to the AV node, also increases the force of contraction

how does lanoxin (digoxin) work?

treats ventricular rhythms like atrial fibrillation

contraindications for lanoxin (digoxin)? think digging

hypokalemia and kidney problems

adverse reactions to lanoxin (digoxin)? think drug

vision changes, dizziness, headaches

how long do you give lanoxin (digoxin) IV?

five minutes

what labs do you monitor with lanoxin (digoxin)?

BUN/creatinine, potassium, digoxin levels 0.5 - 2 ng/mL

what are signs of digoxin toxicity and what is the antidote?

confusion, seeing spots/halos, potassium level >5; digoxin immune Fab

what foods should a person on lanoxin (digoxin) avoid?

high potassium foods

what do calcium channel blockers (amlodipine) do?

blocks calcium from entering cells causing blood vessels to relax

why take amlodipine (norvasc)?

hypertension, heart failure, angina

contraindications of amlodipine (norvasc)?

hypotension

adverse effects of amlodipine (norvasc)? think dentist

gingival hyperplasia, warm flush skin, prolonged headaches

what labs do you monitor with amlodipine (norvasc)?

calcium

when should patients on amlodipine (norvasc) notify their MD?

swollen gums

how do ace inhibitors (-pril) work?

prevents conversion of angiotensin 1 into angiotensin 2 in the lungs

why take captopril (capton)?

hypertension, especially in patients with diabetes

contraindications with captopril (capton)?

pregnancy, anything altering electrolytes

adverse reactions to captopril (capton)? think ACE

dry hacking cough, angioedema, hyperkalemia

what labs do you check for captopril (capton)?

serum potassium and BUN + creatinine

when do you take captopril (capton) and what foods should you avoid?

1 hour before meals and foods high in salt/potassium

what can captopril (capton) do to kidneys?

decrease protein urea and decreases glomerular filtration rate

what do nitrates do?

dilates blood vessels/ relaxes smooth muscles

why take nitroglycerin?

acute angina

contraindications with nitroglycerin? think run/rin and fall

severe anemia, closed angle glaucoma, severe head injury, use of erectile dysfunction drugs

adverse reactions to nitroglycerin? think energy drink nitro

hypotension, severe headache, tachycardia, skin irritation

how is nitroglycerin administered?

sublingually

what to tell patients when starting nitroglycerin?

stop/sit immediately, call EMS after first does, 1 tab every five minutes x 3, keep medicine in cool dark place, no more than 3 months old

what do beta blockers (-olol) do?

blocks beta receptors which decrease effects of epinephrine and norepinephrine, decrease HR and BP

why take metoprolol (lopressor)?

hypertension, heart failure, angina

contraindications of metoprolol (lopressor)?

heart blocks, bradycardia syndrome, sick sinus syndrome

adverse reactions to metoprolol (lopressor)?

rebound hypertension, fatigue, cold hands and feet

when should you hold metoprolol (lopressor)?

if the bpm is under 60

if a patient is diabetic and taking metoprolol (lopressor) what do you do?

hold glucose as it interfers with insulin production

how do alpha -1 blockers (osin) work?

dilates arteries and veins blood vessels by blocking alpha -1 receptors

why take doxazosin (cardura)?

hypertension

contraindications of doxazosin (cardura)?

MAOIs, kidney failure, CNS depressants

adverse reactions to doxazosin (cardura)?

first dose effect, dizziness, headaches, nasal congestion

may take how many weeks for doxazosin (cardura) to work?

1 to 2

what is excreted in stool when taking doxazosin (cardura)?

capsule

why might someone take tamsulosin (flomax)?

benign prostatic hyperplasia, smooth bladder relaxation

what to avoid when taking cardiac medications?

hot baths and hot tubs

what do you assess before ambulating with cardiac medications?

orthostatic hypotension