Cardiac Medications Review

This set of flashcards covers key concepts, uses, side effects, and nursing considerations related to cardiac medications, anticoagulants, antihypertensives, diuretics, and antiarrhythmics.

What are the primary uses for anticoagulants?

To prevent blood clots in patients at high risk for MI, Stroke, or DVT.

What precautions should be taken when using anticoagulants?

Prevent bleeding from gums, nose, urine, bowel, joints, and bruising.

What is Warfarin's mechanism of action?

It blocks vitamin K dependent clotting.

What is the target PT/INR range for patients on Warfarin?

2-3.

What is the antidote for Warfarin?

Phylliquinone (Vitamin K) PO if high INR but no bleed, IV if active bleed.

What dietary considerations should be made for patients on Warfarin?

Be mindful of vitamin K-rich foods and avoid sudden diet changes.

Name three direct oral anticoagulants (DOACs).

Rivaroxaban, Apixaban, and Dabigatran.

What is a pro for using DOACs compared to traditional anticoagulants?

Less severe bleeding events and no required lab draws.

What is a con of using DOACs?

They are expensive and lack a direct antidote.

What is the antidote for Dabigatran?

Praxbind.

What does Heparin do?

Prevents and treats blood clots but does not break them down.

What is the antidote for Heparin?

Protamine sulfate.

What lab value should be monitored while administering Heparin?

PTT, aiming for 1.5 to 2.5 times the baseline.

What is a common use for Enoxaparin?

DVT prophylaxis, especially post-op or in patients with decreased mobility.

What precaution should be taken when administering anticoagulants?

Weight-based dosing and verify calculations with a second nurse.

Who are candidates for antiplatelet therapy?

Those at risk for myocardial infarction (MI) and stroke.

What is the typical dosage of Aspirin for prevention?

81 mg daily.

What should be monitored for in patients taking Clopidogrel?

Signs of salicylate toxicity: nausea, vomiting, diaphoresis, tinnitus.

What type of adverse reaction should be considered when administering NSAIDs with antiplatelet drugs?

Increased bleeding risk.

What medication is used as a thrombolytic agent?

Alteplase (tPA).

What type of stroke requires careful assessment when using thrombolytics?

Ischemic stroke.

What nursing considerations are necessary for thrombolytics?

Monitor for significant risk of bleeding and perform neuro checks regularly.

What do diuretics do to lower blood pressure?

They reduce blood volume, leading to decreased blood pressure.

What is the mechanism of action for Thiazide diuretics like Hydrochlorothiazide?

They inhibit sodium reabsorption in the kidneys, increasing urine output.

What are potential side effects of loop diuretics like Furosemide?

Hypokalemia and tinnitus.

What should be monitored in patients taking potassium-sparing diuretics like Spironolactone?

Serum potassium levels, as they can cause hyperkalemia.

What is the role of the Renin-Angiotensin-Aldosterone System (RAAS)?

Regulates blood pressure through vasoconstriction and sodium retention.

How do ACE inhibitors function in the body?

They block the conversion of Angiotensin I to Angiotensin II, leading to vasodilation.

What suffix do most ACE inhibitors have?

-pril.

What side effect is commonly associated with ACE inhibitors?

A dry, hacky cough.

What are common ARBs and their suffix?

Losartan and Valsartan; they end in -sartan.

What is often caused by both ACE inhibitors and ARBs?

Angioedema.

What medication class is used for hypertension and angina that includes Amlodipine and Nifedipine?

Calcium Channel Blockers.

What is a notable side effect of Calcium Channel Blockers?

Peripheral edema.

What class of medications ‘blocks’ the sympathetic nervous system?

Beta-Adrenergic Blockers.

What is the implication of using beta blockers in patients with diabetes?

They can mask signs of hypoglycemia.

What should be monitored in patients on beta blockers?

Heart rate, ensuring it doesn't go below 60 beats per minute.

What are the general cardiovascular effects of Beta Blockers?

Vasodilation and reduced heart rate.

What is Digoxin used for?

To increase myocardial contractility and slow heart rate.

What are signs of Digoxin toxicity?

Nausea, vomiting, anorexia, blurry vision, and seeing halos.

What is the reversal agent for Digoxin toxicity?

Digibind.

What is the primary mechanism through which nitrates work?

They promote vasodilation, increasing coronary blood flow.

What form can Nitroglycerin be given in?

Tablets, sprays, ointments, patches, or IV.

What patient education should be given for Isosorbide mononitrate?

This is an oral long-acting nitrate used for angina prevention.

What medication should be used for bradyarrhythmias?

Epinephrine.

What is a treatment option for tachyarrhythmias?

Adenosine.

What monitoring is necessary when administering Adenosine?

Telemetry, monitor continuously with resuscitation equipment available.

What are the side effects of statins?

GI upset, myopathy, rhabdomyolysis, liver function abnormalities.

Which statin is commonly known as Lipitor?

Atorvastatin.

What is a common concern when prescribing statins?

Monitoring for liver function and muscle pain.

What should patients taking statins be advised to monitor?

Their muscle pain and liver function tests.

What is the effectiveness measure for thiazide diuretics?

Reduction in blood pressure and improvement in urination.

What drugs act as calcium channel blockers and are used for hypertension?

Amlodipine, Diltiazem, and Verapamil.

What signifies bradycardia in a patient requiring adjustment in medication?

A heart rate lower than 60 beats per minute.

What side effects can occur with enoxaparin?

Risk of bleeding and injection site reactions.

What is the relationship between antihypertensives and patient monitoring?

Always assess blood pressure before administering.

What class of drugs are mentioned as requiring close monitoring for orthostatic hypotension?

Antihypertensives.

What medication is used for acute coronary syndromes and MI?

Nitroglycerin.

What should be checked before administering diuretics?

Electrolyte levels, especially potassium.

What is the action of antiplatelet drugs like Aspirin?

Inhibits platelet aggregation to prevent clotting.

What should patients avoid while on anticoagulants?

Those high in vitamin K and NSAIDs.

What indicates a reaction to a thrombolytic agent such as alteplase?

Significant change in bleeding patterns.

What is critical to check post administration of nitroglycerin?

Blood pressure, as it may drop significantly.

What is a classic side effect of nitrates?

Headache due to vasodilation.

What are the contraindications for administering thrombolytics?

Active bleeding, history of bleeding disorders, or recent surgery.

What is done to assess the efficacy of diuretics?

Monitoring weight and fluid balance.

Which medications interact with digoxin leading to potential toxicity?

Those affecting renal function or electrolyte levels.

What is pivotal in education for patients receiving anticoagulants?

Teaching them about bleeding precautions.

What kind of input should patients be encouraged to have on their diet while on diuretics?

Increase potassium-rich foods unless contraindicated.

What drug class is specifically indicated for heart failure management?

Cardiac glycosides like Digoxin.

What considerations are important for female patients in childbearing age taking RAAS drugs?

Both ACE inhibitors and ARBs are not safe in pregnancy.

What is the dispensing consideration for beta blockers for asthmatic patients?

Use caution as it may induce bronchospasm.

What complications can arise from ineffective diuretic therapy?

Fluid overload, increased blood pressure, and edema.

What must nursing staff monitor for after administering thrombolytics?

Neurological status and signs of bleeding.