ATI drugs

Lisinopril / Enalapril

Class: ACE inhibitors; Lowers BP by blocking conversion of angiotensin I to angiotensin II; decreases vasoconstriction and aldosterone. Major side effects: Cough, hyperkalemia, angioedema, hypotension. Key nursing points: Monitor BP, potassium, kidney function; avoid in pregnancy; watch for facial swelling.

Losartan / Valsartan

Class: ARBs; Blocks angiotensin II receptors, causing vasodilation and less aldosterone effect. Major side effects: Hyperkalemia, hypotension, dizziness, angioedema can still happen. Key nursing points: Similar to ACE inhibitors, but less cough; monitor BP, potassium, renal function.

Metoprolol / Propranolol

Class: Beta blockers; Slows heart rate, lowers BP, reduces cardiac workload. Major side effects: Bradycardia, hypotension, fatigue, depression; can mask hypoglycemia. Key nursing points: Check HR and BP before giving; use cautiously in asthma, especially propranolol; do not stop abruptly.

Amlodipine / Nifedipine

Class: Dihydropyridine calcium channel blockers; Vasodilation, lowers BP. Major side effects: Hypotension, dizziness, flushing, peripheral edema, headache. Key nursing points: Good for hypertension/angina; monitor BP; edema is common.

Diltiazem / Verapamil

Class: Non-dihydropyridine calcium channel blockers; Slows AV conduction and lowers HR; also lowers BP. Major side effects: Bradycardia, hypotension, constipation, heart block. Key nursing points: Check HR and BP; used for dysrhythmias too; avoid if HR already low.

Furosemide

Class: Loop diuretic; Makes kidneys excrete sodium and water; also loses potassium. Major side effects: Hypokalemia, dehydration, hypotension, ototoxicity. Key nursing points: Monitor potassium, BP, I&O, daily weight; give in morning; watch for dehydration.

Hydrochlorothiazide

Class: Thiazide diuretic; Promotes excretion of sodium and water. Major side effects: Hypokalemia, dehydration, hypotension, hyperglycemia. Key nursing points: Monitor electrolytes and BP; give earlier in day.

Spironolactone

Class: Potassium-sparing diuretic / aldosterone antagonist; Excretes water and sodium but retains potassium. Major side effects: Hyperkalemia, dizziness, gynecomastia. Key nursing points: Monitor potassium carefully; avoid potassium supplements and salt substitutes.

Digoxin

Class: Cardiac glycoside; Increases force of contraction and slows heart rate. Major side effects: Digoxin toxicity: nausea, vomiting, bradycardia, confusion, yellow/green vision halos. Key nursing points: Check apical pulse before giving; monitor digoxin level and potassium; hypokalemia increases toxicity risk.

Nitroglycerin

Class: Nitrate; Vasodilation; decreases preload and relieves angina. Major side effects: Headache, hypotension, dizziness. Key nursing points: Check BP before giving; sit patient down; no sildenafil or tadalafil use with it; can cause strong headache.

Isosorbide mononitrate

Class: Nitrate; Prevents angina through vasodilation. Major side effects: Headache, hypotension, dizziness. Key nursing points: Used more for prevention than immediate rescue; same nitrate precautions.

Atorvastatin

Class: Statin; Lowers LDL cholesterol by decreasing cholesterol synthesis in liver. Major side effects: Muscle pain, liver toxicity, rhabdomyolysis rare. Key nursing points: Monitor liver enzymes; report muscle pain/weakness.

Heparin / Enoxaparin

Class: Anticoagulants; Prevents clot formation. Major side effects: Bleeding, thrombocytopenia; heparin can cause HIT. Key nursing points: Heparin: monitor aPTT; Enoxaparin: often no routine aPTT monitoring; antidote: protamine sulfate.

Warfarin

Class: Anticoagulant; Inhibits vitamin K-dependent clotting factors. Major side effects: Bleeding. Key nursing points: Monitor INR; antidote is vitamin K; keep vitamin K intake consistent; takes a few days to work.

Aspirin / Clopidogrel

Class: Antiplatelets; Prevents platelets from clumping. Major side effects: Bleeding, GI irritation; aspirin can cause tinnitus in toxicity. Key nursing points: Used after stroke/MI and for clot prevention; monitor for bleeding; aspirin should be used cautiously with ulcers.

Alteplase

Class: Thrombolytic; Breaks up existing clots. Major side effects: Severe bleeding, intracranial hemorrhage. Key nursing points: Used in stroke/MI/PE in the right time window; assess carefully for bleeding risk before giving.

Rivaroxaban / Apixaban / Dabigatran

Class: DOACs / direct oral anticoagulants; Prevents clot formation through direct factor inhibition. Major side effects: Bleeding. Key nursing points: Usually no routine INR monitoring; assess kidney function and bleeding.

Ferrous sulfate

Class: Iron supplement; Treats iron deficiency anemia. Major side effects: Constipation, dark stools, GI upset. Key nursing points: Best absorbed on empty stomach with vitamin C; liquid form can stain teeth.

Albuterol

Class: SABA; Rapid bronchodilation; rescue inhaler. Major side effects: Tachycardia, tremor, nervousness. Key nursing points: Used for acute bronchospasm; rescue med, not maintenance.

Salmeterol

Class: LABA; Long-acting bronchodilation. Major side effects: Tachycardia, tremor. Key nursing points: Not for acute attack; maintenance only.

Fluticasone / Budesonide

Class: Inhaled corticosteroids; Reduces airway inflammation. Major side effects: Oral thrush, hoarseness. Key nursing points: Rinse mouth after use; maintenance, not rescue.

Prednisone

Class: Systemic corticosteroid; Decreases inflammation and immune response. Major side effects: Hyperglycemia, infection risk, fluid retention, mood changes. Key nursing points: Do not stop abruptly if used long term; monitor glucose and infection signs.

Ipratropium

Class: Anticholinergic bronchodilator; Relaxes airways and decreases secretions. Major side effects: Dry mouth, blurred vision, urinary retention. Key nursing points: Often used in COPD/asthma; not as fast as albuterol for rescue.

Montelukast

Class: Leukotriene receptor antagonist; Reduces inflammation and bronchoconstriction. Major side effects: Headache, possible mood/neuropsychiatric effects. Key nursing points: Used for maintenance, not acute attack.

Theophylline

Class: Methylxanthine bronchodilator; Relaxes bronchial smooth muscle. Major side effects: Toxicity can cause tachycardia, insomnia, seizures. Key nursing points: Narrow therapeutic range; monitor drug levels if needed.

Morphine / Hydromorphone / Fentanyl

Class: Opioid analgesics; Relieves moderate to severe pain by depressing CNS pain perception. Major side effects: Respiratory depression, sedation, constipation, hypotension, nausea. Key nursing points: Monitor RR, LOC, BP; hold if respirations too low; fall risk; constipation prevention matters.

Naloxone

Class: Opioid antagonist; Reverses opioid overdose. Major side effects: Can trigger acute withdrawal, pain returns. Key nursing points: Shorter acting than some opioids, so repeat dosing may be needed; monitor airway and breathing.

Acetaminophen

Class: Non-opioid analgesic / antipyretic; Reduces pain and fever. Major side effects: Liver toxicity in overdose. Key nursing points: Watch total daily dose; be careful because many combo meds also contain it.

Ibuprofen / Ketorolac

Class: NSAIDs; Reduces pain, inflammation, fever. Major side effects: GI bleeding, kidney injury, upset stomach. Key nursing points: Give with food if needed; avoid in ulcers, bleeding risk, kidney issues; ketorolac is especially hard on GI/kidneys.