Uses:
Treats hypertension by reducing blood pressure through the diuretic effect.
Treats heart failure by reducing fluid overload and improving symptoms.
Treats cirrhosis of the liver by alleviating edema and ascites.
Side Effects (SE):
Hypokalemia: Low potassium levels, which may cause muscle cramps and arrhythmias.
Hypercalcemia: Elevated calcium levels that can lead to muscle weakness and confusion.
Dehydration: Increased urination often leads to dehydration symptoms such as dry mouth and dizziness.
Hyperglycemia: Monitoring is vital for diabetic patients, as these drugs can increase blood sugar levels.
Gout: Monitor uric acid levels closely, since diuretics can precipitate gout attacks.
Patient Education (PT ED):
Encourage intake of potassium-rich foods (e.g., bananas, spinach, orange juice, potatoes) to mitigate hypokalemia.
Advise adequate hydration to prevent dehydration.
For elderly patients, recommend taking the medication in the morning to avoid frequent urination at night.
Instruct to report pain or swelling in joints as it could indicate gout flare-ups.
Stress the importance of daily weight monitoring to track fluid retention or loss.
Nursing Interventions:
Regularly monitor blood pressure (BP) and heart rate (HR) to assess the drug's effectiveness and side effects.
Check electrolyte levels, particularly potassium and calcium, to avoid complications.
Watch for signs of dehydration, such as reduced urine output and dry mouth.
Uses:
Effective in treating hypertension and managing pulmonary edema due to heart failure.
Used in acute situations to rapidly reduce excess fluid in patients.
Side Effects (SE):
Hypokalemia: Similar risk as thiazides but may occur more rapidly.
Dehydration: Patients should be monitored for volume status frequently.
Hyperglycemia: Risk for patients with diabetes.
Ototoxicity: Risk of hearing loss, especially when IV pushed too quickly.
Patient Education (PT ED):
As with thiazides, recommend potassium-rich foods and adequate hydration.
Alert elders to avoid nighttime dosing to minimize urination disturbances.
Advise to report any changes in hearing or symptoms of leg/feet swelling and dark urine.
Instruct to report any episodes of dizziness, as it can indicate a fall risk.
Nursing Interventions:
Continually monitor BP and HR to optimize dosages.
Assess kidney function through BUN and creatinine levels.
Regularly check electrolyte levels, especially potassium, to avoid complications.
Daily weight monitoring is imperative to assess fluid retention effectively.
Uses:
Commonly prescribed for hypertension and heart failure management, particularly in patients who develop hypokalemia from other diuretics.
Useful in cirrhosis of the liver as well to manage fluid overload.
Side Effects (SE):
Deepened voice: Hormonal effects can alter vocal cords, especially in women.
Hyperkalemia: Risk of high potassium levels leading to arrhythmias.
Irregular menstrual cycles in women and gynecomastia in men due to hormonal imbalances.
Dehydration: Patients should be aware of signs of dehydration.
Postural hypotension: Care needed when standing up to avoid dizziness.
Patient Education (PT ED):
Advise against potassium-rich foods and supplements to prevent hyperkalemia.
Report any hormonal changes like breast enlargement in men or menstrual irregularities in women.
Suggest hydration and slow position changes to mitigate postural hypotension.
Nursing Interventions:
Regularly monitor potassium levels to prevent hyperkalemia.
Assess menstrual changes in women and monitor for gynecomastia in men.
Observe for signs of dehydration and check BP regularly.
Uses:
Treats hypertension effectively by relaxing blood vessels.
Helps in heart failure management, improving morbidity and mortality.
Beneficial in treating diabetic neuropathy by slowing progression.
Side Effects (SE):
Dry cough: Can be a cause for discontinuation of therapy.
Severe hypotension: Particularly after the initial dose; monitoring is essential.
Metallic taste: May affect adherence to therapy.
Angioedema: Serious condition requiring immediate medical attention, manifested by swelling in the face, throat, and skin.
Hyperkalemia: Second to renal impairment; monitor potassium levels.
Contraindicated in pregnancy: Significant teratogenic effects.
Patient Education (PT ED):
Report dry cough or any swelling to the healthcare provider immediately.
Encourage regular BP monitoring at home.
Be aware of signs and symptoms associated with hyperkalemia and when to contact a physician.
Uses:
Prevents stroke and manages hypertension effectively.
Helps manage diabetic neuropathy, improving renal function.
Side Effects (SE):
Hyperkalemia risk is present.
Possibility of angioedema, though less frequent than with ACE inhibitors.
Headaches and dizziness are commonly reported.
Patient Education (PT ED):
Recommend avoiding high potassium foods and regular BP checks.
Report any sudden position changes that lead to dizziness or swelling.
Advise against use during pregnancy due to risks.
Uses:
Effective in treating hypertension and managing heart failure symptoms post-myocardial infarction.
Side Effects (SE):
Risk of hyperkalemia necessitates frequent potassium monitoring.
Patient Education (PT ED):
Advise against potassium-rich food intake and certain supplements.
Report muscle pain or weakness immediately as these may indicate elevated potassium levels.
Uses:
Treats hypertension effectively.
Side Effects (SE):
Risk for hyperkalemia along with potential cough or angioedema.
Possible gastrointestinal issues such as diarrhea and abdominal pain.
Patient Education (PT ED):
Report any persistent cough that develops after starting this drug.
Uses:
Treats stable angina and moderate to severe hypertension.
Side Effects (SE):
Lowers BP and HR; patients should be monitored closely.
Commonly reports facial flushing, peripheral edema, and headaches.
Can lead to growth of gum tissue and potential for bleeding gums.
Patient Education (PT ED):
Monitor heart rate and report any rapid increases or peripheral swelling.
Advise gradual position changes to avoid hypotension.
Recommend avoiding grapefruit, which can affect drug metabolism.
Uses:
Indicated for life-threatening supraventricular tachy dysrhythmias and for long-term management in atrial fibrillation.
Adverse Reactions:
May exacerbate heart failure, fluid retention, and edema.
Shortness of breath should be monitored closely.
Patient Education (PT ED):
Patients may require Holter monitoring for ECG assessment.
Immediately report any visual changes to their healthcare provider.
Uses:
Effectively treats hypertension and affects heart rate negatively.
Side Effects (SE):
Bradycardia and breathing difficulties, especially in patients with asthma.
Can negatively affect heart failure and glycemic control.
Patient Education (PT ED):
Report peripheral edema and check pulse regularly.
Advise reporting symptoms of shortness of breath and new onset chest pain.
Emphasize daily weight monitoring for fluid retention assessment.
Uses:
Treats tachydysrhythmias and reduces mortality after myocardial infarction.
Side Effects (SE):
Primarily bradycardia, necessitating pulse monitoring.
Patient Education (PT ED):
The same as for first-generation beta blockers.
Uses:
Treats hypertension and benign prostatic hyperplasia (BPH).
Side Effects (SE):
Risk for postural/orthostatic hypotension, headaches, and dizziness.
Patient Education (PT ED):
Advise gradual position changes and recommend morning doses for elders to minimize nighttime issues.
Uses:
Used primarily for hypertension.
Side Effects (SE):
Can cause dizziness and dry mouth; potential for rebound hypertensive crisis if stopped abruptly.
Patient Education (PT ED):
Recommend nightly dosing and to refrain from driving initially after starting the medication.
Encourage hydration and sucking on hard candy for dry mouth relief.
Uses:
Prescribed for hypertension; may be used with digitalis and other vasodilators for heart management.
Side Effects (SE):
Common side effects include headache, dizziness, and fatigue.
Risk of tachycardia, fluid retention, and edema.
Patient Education (PT ED):
Monitor pulse regularly and report any notable swelling or changes in symptoms.
Emphasize not stopping medications abruptly to avoid heart failure risks.
Uses:
Primarily used for treating angina pectoris (chest pain).
Side Effects (SE):
Typical side effects include headache, orthostatic hypotension, tachycardia, and hot flashes.
Patient Education (PT ED):
Suggest taking over-the-counter medications for headaches and changing positions slowly.
Advise against activities that can lead to accidents (e.g., driving) due to potential dizziness.
Uses:
Treatment for chronic angina.
Side Effects (SE):
Allergic reactions such as constipation, nausea, headache, and blurred vision might occur.
Risk of syncope and dizziness, especially upon initiation or dosage changes.
Patient Education (PT ED):
Avoid consuming grapefruit and alcohol, and instruct to report any allergic reactions.
Uses:
Class of medications used as antidysrhythmics for A-fib and tachycardia treatment.
Side Effects (SE):
GI manifestations such as nausea or diarrhea, hypotension, and risk of arterial embolism (dislodging blood clots).
Patient Education (PT ED):
Instructions to take the medication with food to minimize GI upset and report any significant changes in pulse, BP, and HR.
Uses:
Critical for treating ventricular tachycardia and ventricular fibrillation that are resistant to other therapies; also used for atrial dysrhythmias (A-fib).
Side Effects (SE):
GI manifestations such as loss of appetite, nausea, vomiting, or constipation.
Serious adverse effects include acute respiratory distress syndrome (ARDS) and pulmonary toxicity.
Patient Education (PT ED):
Instruction to take with food to decrease GI irritability.
Report vision changes, fever, dry cough, or shortness of breath immediately as these may indicate serious toxicity.
Uses:
Typically used as a second-line medication for heart failure; also effective for treating cardiac dysrhythmias like atrial fibrillation.
Side Effects (SE):
Monitor for cardiac dysrhythmias and assess pulse regularly.
Patients may experience GI manifestations, including nausea and possible vision changes indicating digoxin toxicity.
Patient Education (PT ED):
Required to report heart palpitations, GI symptoms, and vision changes as these can all indicate digotoxicity.
Emphasize close monitoring of digoxin levels due to narrow therapeutic window to avoid toxicity (potassium levels should stay above 3.5).
Meds:
Nitro, Nicardipine, Clevidipine, Analaprilat, Esmolol.
Monitoring:
Patients must be put on cardiac monitors to observe any adverse effects and ensure quick intervention if necessary.
Uses:
Primarily used in treating cardiac dysfunction and anaphylaxis.
Side Effects (SE):
Severe side effects include chest pain, myocarditis, hypertensive crises, cardiac arrhythmias, and tissue necrosis at injection sites.
Patient Education (PT ED):
Instruct patients about continuous monitoring requirements when administered and emphasize this treatment should only occur in a hospital setting for severe cardiovascular dysfunction.
Report any chest pain immediately.
Uses:
Softens ear wax to facilitate easier removal.
Side Effects (SE):
May cause redness, itchiness, or rash in some patients.
Patient Education (PT ED):
Stress the importance of reporting any side effects and avoid administration if there is a known ear infection.
Advise to tilt the head to the side when administering the solution for effective action.
Uses:
Effective at decreasing intraocular pressure (IOP) in conditions like glaucoma.
Side Effects (SE):
Side effects can include pigmentation changes of the eyelid and eyelashes, as well as sensations of irritation in the eye.
Patient Education (PT ED):
Caution against rubbing the eyes and advise using a different tissue for drops in each eye.
If a dose is missed, resume with the next dose without doubling.
Recommend removing contact lenses prior to administration and waiting 2-3 minutes between multiple drops if applicable.
Uses:
Primarily treats acute angle-closed glaucoma and decreases intraocular pressure.
Side Effects (SE):
Similar sensations to other eye drops, including feeling something in the eye, irritation, and stinging.
Patient Education (PT ED):
Educate on possible sensations of curtain-like visual obstructions; advise against driving until after effects are known.
Uses:
Decreases intraocular pressure in patients with glaucoma.
Side Effects (SE):
Can cause urinary urgency, bradycardia, and constriction of bronchioles.
Patient Education (PT ED):
Suggest wearing sunglasses in bright light conditions and prohibit driving due to potential side effects.
Uses:
Another option for decreasing IOP in glaucoma management.
Side Effects (SE):
Side effects may include urinary urgency, bradycardia, constriction of bronchioles, and decreased visual acuity, particularly at night.
Patient Education (PT ED):
Like other eye drops, teach clients not to rub their eyes, and report decreased vision promptly.
Uses:
Functions to thin platelets for preventing clot formation.
Side Effects (SE):
Risk of notable GI manifestations and increased bleeding risk, particularly in individuals with peptic ulcers.
Patient Education (PT ED):
Urge clients to take the medication with food and report any signs of bleeding, prolonged bleeding, or severe headache.
Uses:
Alters clotting time factors, typically given postoperatively, in hip replacements, and other interventions requiring anticoagulation.
Side Effects (SE):
Significant risk of bleeding/hemorrhage and potential for low platelet count (thrombocytopenia).
Patient Education (PT ED):
Advise avoiding NSAIDs that can induce bleeding and using soft toothbrushes and electric razors.
Report any signs of black, tarry stools and calf pain/swelling, as they indicate deep vein thrombosis (DVT).
Report any episodes of shortness of breath, which could signal a pulmonary embolism.
Uses:
Prevents cerebral vascular accidents (CVA) related to atrial fibrillation; an alternative to warfarin.
Side Effects (SE):
Significant risk for bleeding complications.
Patient Education (PT ED):
Educate on the importance of reporting bruising, hematomas, or black tarry stools.
Stress the need to take prescribed doses regularly and inform healthcare providers before any surgical procedures.
Uses:
Prevents venous thrombosis, pulmonary embolism, recurrence of myocardial infarctions (MI), and thromboembolic prevention.
Side Effects (SE):
Observe for signs of hemorrhage; potent anticoagulation can sometimes lead to life-threatening bleeding.
Patient Education (PT ED):
Instruct to report any bleeding, bruising, or changes associated with black tarry stools.
No use of NSAIDs, particularly aspirin, without consulting healthcare providers.
Recommend electric razors, soft toothbrushes, and wearing a bracelet indicating they are on anticoagulants.
Nursing Intervention:
Regular check of blood tests (PT/INR); target INR ranges from 2-3, with clotting times falling within 11-13.5 seconds.
Uses:
Dissolves clot formations in DVT, pulmonary embolism, and acute ischemic CVAs.
Side Effects (SE):
Major concern is bleeding complications.
Patient Education (PT ED):
Instruct to report any prolonged bleeding immediately.
Uses:
Supports red blood cell production in conditions such as chemotherapy-induced anemia or preoperative anemia.
Side Effects (SE):
Potentially leads to hypertension and seizures, requiring close monitoring.
Patient Education (PT ED):
Inform about the need for frequent blood pressure checks during therapy.
Advise reporting symptoms like headaches or sudden chest pain.
Nursing Intervention:
Baseline blood pressure should be recorded before initiation and monitored thereafter.
Frequent monitoring of hemoglobin, CBC, BUN, and creatinine levels is essential; hold treatment if hemoglobin exceeds 12 or above 10 for cancer patients.
Uses:
Treats and prevents iron deficiency anemia.
Side Effects (SE):
Gastrointestinal issues such as constipation, metallic taste in the mouth, potential staining of teeth in liquid form, and harmless dark green or black stool.
Risk of fatal iron toxicity in children due to overdose.
Patient Education (PT ED):
Recommend taking with food to mitigate GI symptoms, expect dark stools as harmless, and to increase fluid intake and dietary fiber to counter constipation.
Suggest rinsing the mouth after taking to prevent staining.
Uses:
Treats pernicious anemia and vitamin B12 deficiency conditions such as malabsorption issues.
Side Effects (SE):
May cause erythema, hypertension, and hypokalemia.
Patient Education (PT ED):
Report any signs of muscle spasms, weakness, nausea, palpitations, or paresthesia to a healthcare provider promptly.
Uses:
Prevents megaloblastic anemia caused by folate deficiency and is critical in pregnancy for fetal neural development.
Side Effects (SE):
Can lead to increased yellowing of urine, increased risk of developing colorectal or prostate cancer.
Patient Education (PT ED):
Encourage clients to consume a diet high in folic acid, including dark leafy vegetables and fortified cereals.
Monitoring reticulocyte count (RBC levels) is important to ensure treatment effectiveness.