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  1. Anticoagulant Therapy

    • Purpose: Prevent clot formation/extension.
    • Common meds:
      • Heparin: IV/SQ, short-acting.
      • Warfarin: Oral, long-acting, requires INR monitoring.
      • DOACs: Apixaban, rivaroxaban.
    • Nursing: Watch for bleeding, check labs (aPTT for heparin, INR for warfarin), educate on bleeding precautions.

  2. INR Ranges

    • Used for warfarin monitoring.
    • Normal (no anticoagulation): (≈1.0)(\approx1.0)
    • Therapeutic Range:
      • Most uses: 2.0–3.0
      • Mechanical heart valve: 2.5–3.5
    • Nursing: Monitor to avoid bleeding/clotting.

  3. SSRI Premedication Assessment

    • Mental Status: Mood, suicidal thoughts.
    • Med History: MAOIs, anticoagulants.
    • Physical: Weight, appetite, sleep, liver/renal function if needed.
    • Other: Watch for serotonin syndrome.

  4. SSRIs vs. TCAs

    FeatureSSRIsTCAs
    MechanismInhibit serotonin reuptakeInhibit serotonin & norepinephrine reuptake
    ExamplesFluoxetine, sertralineAmitriptyline, imipramine
    Adverse EffectsGI upset, insomnia, sexual dysfunctionAnticholinergic, sedation, cardiac toxicity
    Overdose RiskLowHigh (can be fatal)

  5. MAOI Nursing Assessment

    • Before: Check BP (hypertensive crisis risk), med/diet history (tyramine).
    • Teach: Avoid aged cheese, wine, decongestants. Report headache, palpitations.
    • Drugs: Phenelzine, tranylcypromine

  6. SNRIs Nursing Responsibilities

    • Examples: Venlafaxine, Duloxetine, Desvenlafaxine.
    • Action: Inhibit serotonin and norepinephrine reuptake.
    • Nursing:
      • Baseline weight/BP.
      • Monitor GI/CNS symptoms.
      • Watch for hypertension, hepatic/renal issues.
      • Teach about sedation, avoid machinery if dizzy.
      • Taper when stopping.
      • Monitor suicidal thoughts.

  7. TCAs Adverse Effects

    • Common: Dry mouth, constipation, urinary retention, orthostatic hypotension, sedation, dizziness.
    • Serious: Cardiac toxicity (fatal overdose).
    • Nursing: Avoid other CNS depressants, assess suicide risk, monitor vitals/ECG.

  8. Lithium Adverse Effects

    • Therapeutic range: 0.4–1.2 mEq/L
    • Common: Nausea, tremor, polyuria.
    • Serious Toxicity: Vomiting, hyperreflexia, nephrotoxicity, seizures.
    • Nursing: Monitor hydration, electrolytes, renal/thyroid function, watch for toxicity signs.

  9. Blood Clot Treatment/Prevention

    • Anticoagulants: Heparin (aPTT), Warfarin (INR), DOACs (factor Xa inhibitors).
    • Antiplatelets: Aspirin, clopidogrel.
    • Thrombolytics: Alteplase (dissolve clots).
    • Prevention: Early ambulation, compression stockings.

  10. Psychotic Behavior S/Sx

    • Positive: Delusions, hallucinations, disorganized thinking/behavior.
    • Negative: Flat affect, alogia, asociality, anhedonia, poor hygiene.

  11. Antipsychotic Uses/Adverse Effects

    • Treats: Schizophrenia, mania, psychotic depression, bipolar, autism irritability.
    • Adverse: EPS, weight gain, hyperglycemia, agranulocytosis, QT prolongation, anticholinergic effects.

  12. Seizure Disorders/Meds

    • Disorders: Generalized, partial, status epilepticus.
    • Meds: Phenytoin, valproic acid, carbamazepine, levetiracetam.
    • Nursing: Monitor drug levels (phenytoin: 10–20 mcg/mL), seizure activity, adverse effects, safety, adherence.

  13. Opiate Agonists

    • Action: Relieve pain, suppress cough, reduce anxiety by binding to opioid receptors.
    • Examples: Morphine, hydromorphone, fentanyl, oxycodone.
    • Adverse: Respiratory depression, hypotension, sedation, nausea, constipation, dependence.
    • Nursing: Monitor respiratory rate, pain/sedation, encourage fluids/fiber, watch for overdose.

  14. Naloxone

    • Use: Reverses opioid overdose/respiratory depression.
    • Outcome: Restores breathing and consciousness.
    • Nursing: Monitor respiratory rate, LOC, BP, watch for withdrawal.

  15. Salicylates

    • Action: Analgesic, anti-inflammatory, antipyretic, antiplatelet.
    • Adverse: GI upset, ulcers, bleeding, tinnitus, Reye’s syndrome.
    • Nursing: Monitor GI, bleeding, avoid in children with viral illness, take with food.

  16. Angina/Nitrates

    • Angina Types:
      • Chronic stable: Predictable, relieved by rest/nitroglycerin.
      • Unstable: Unpredictable, severe, not relieved by rest.
    • Nitrates: Dilate veins/arteries, ↓ preload & myocardial oxygen demand.
    • Uses: Acute attacks (sublingual) and prevention (patches, oral).
    • Adverse: Headache, dizziness, hypotension.
    • Teaching: Storage, timing, fall precautions.

  17. Hypertensive Medications

    • Drug Classes: Diuretics, ACE inhibitors, ARBs, beta-blockers, calcium channel blockers, alpha-1 blockers, vasodilators.
    • Nursing: Monitor BP, adherence, side effects. Teach medication timing, home BP checks. Encourage lifestyle changes.
    • Lifestyle: ↓ sodium, weight loss, physical activity, smoking cessation.

  18. Atherosclerosis

    • Atherosclerosis: Plaque buildup in arteries → CAD, stroke.
    • Meds: Statins (lower LDL), PCSK9 inhibitors, bile acid resins, ezetimibe.
    • Aim: Slow progression, prevent MI.

  19. Hyperlipidemia

    • Hyperlipidemia: High cholesterol/triglycerides → atherosclerosis and CAD.
    • Meds: Statins, niacin, fibrates, omega-3s, PCSK9 inhibitors, bile acid