Term
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Definition
increase myocardial contraction
ex: phosphodiesterase inhibitors (Type III) and Natrecor (nesiritide) |
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Term
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Definition
decrease myocardial contraction
beta blockers |
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Term
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Definition
increase heart rate
dopamine
epinephrine |
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Term
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Definition
decrease heart rate
digoxin |
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Term
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Definition
at risk for cardiovascular injury
should educate patient to take and monitor own blood pressure
monitor for end organ damage
teach patient about adverse affects |
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Term
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Definition
antiotensin- converting enzyme inhibitor
a. ACE inhibits enzymes from converting angiotensin I in II in the lungs.
i. Decrease vasoconstriction
ii. Decrease aldosterone levels
iii. Block SNS
iv. End in “pril”
v. Side effects
1. Cough (increase in women), hyperkalemia, may increase serum digoxin levels
vi. Run baseline renal function tests, repeat 3-4 days later |
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Term
| Angiotensin II receptor blockers |
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Definition
ARBs
i. Blocks angiotensin II receptors only
ii. Blocks vasoconstriction
iii. Blocks aldosterone release
SE:Upper respiratory infections and headaches are the most common. Occasional dizziness, diarrhea, dyspnea, heartburn, nasal congestion, back pain, and fatigue can occur
v. Little effect on serum K+
vi. Less likely to have a cough
1. Ex: Losartan (Cozaar) |
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Term
| direct vasodilation agents |
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Definition
i. Arterial vasodilators
1. Direct arteriolar smooth muscle relaxation
2. Given with BBs or diuretics
3. Apresolne (hydralazine)
4. Rogaine (minioxidil)
a. Used topically for male-pattern baldness |
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Term
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Definition
i. Alpha 2 Adrenergic Agonists
1. Act on CNS in brain
2. Results in decrease SNS outflow
3. Vasodilatation in peripheral blood vessels
4. Decreases BP and HE
5. Catapres (clonidine)
ii. Peripheral acting SNS Agents
1. Peripheral alpha 1-adrenergic blocer
2. Additive effects with BBs and diuretics
3. “azosin” (decreases urinary outflow resistance with BPH)
a. Example: Cardura (doxazosin) |
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Term
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Definition
vasodilates: draws blood back to ischemic areas of heart and redistributes blood flow from eqicardium to endocardium
decreases cardiac workload; less oxygen needed
increases synthesis of cGMP in smooth muscle, interfering with muscle contractions so that they relax
routes: SL, PO, IV, buccal spray, topical (cream, patch) |
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Term
| Beta-adrenergic blocking agents |
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Definition
Attaches onto the Beta 1 receptors in the heart which are normally bound to epinephrine and norepinephine.
With beta blockers they slow the contractility of the heart and the firing of the AV node.
These reduce myocardial oxygen demand which aids in the treatment of angina by reducing the workload of the heart |
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Term
| Calcium channel blocking agents |
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Definition
| Cause smooth muscle relaxation by blocking the binding of calcium to its receptors, which thereby prevents contraction. This then causes the coronary arteries to dialate which increases blood flow to the ischemic heart, raises oxygen levels in the heart to normal and decreases angina. |
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Term
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Definition
1. How to take
a. 1 tab gr. 1/150 SL q 3-5 minutes x 3 prn CP
2. Tolerance: people become accustomed to this drug after a while and do not feel the effects as much. You may want them to take off the patch when they are sleeping and reapply it in the morning
3. Sensations: they can feel a burning sensation under their tongues
4. Storage: is light and heat sensitive so you have to teach them to store it in a cool location
5. Watchout: BB (beta blockers) /CCB (calcium channel blockers)/ETOH (potentiates vasodilatation and hypotension)
SE:
1. Headache * because you dilate all of your blood vessels. This is very common
2. Hypotension due to vasodilation
3. Tachycardia
4. Flushing on the face and neck where the blood vessels are dialated
5. N&V |
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Term
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Definition
i. Increases calcium in heart muscle
1. Inhibits adenosine triphosatase (ATPase)
a. ATPase for K+/Na+ pump
2. Increases sodium in cell, exchanges it for extracellular calcium
ii. Prolongs AV node refractory time
iii. Slows and strengthens
1. Improves CO (cardiac output)
iv. Hold if AP (apical pulse) < 60
1. teach patient how to take their pulse for a full minute
v. Watch out!
1. Therapeutic range 0.8-1.8
a. Low therapeutic index meaning that therapeutic response and toxic levels are very close, must monitor
2. Caution: low K+
a. Encouraged to eat bananas to increase their K+
3. Many drug interactions
vi. Toxicity
1. Anorexia, N&V, diarrhea, arrhythmias
2. Visual disturbances (green-yellow halos, double vision)
3. Weakness, headache, drowsiness |
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Term
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Definition
• Raises action potential threshold of cells, stabilizes cellular membranes, treats irregular rhythms (automaticity, conductivity or a combination of the two)
o Can either treat or prevent (prophylaxis)
• Nursing considerations:
o Very potent drugs
o Common drug and food interactions
o Possible drug toxicity
o Electrolyte imbalances (more concerned about potassium than magnesium)
o Proarrhythmic effects (may cause you to develop arrhythmias)
o Adherence issues (have to take them more often during the day) |
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Term
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Definition
o Given for ventricular arrhythmias
o Numbs the heart |
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Term
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Definition
Uses: ventricular arrhythma, ACLS, V-fib, pulseless V-Tach, atrial fibrillation, hypertonic cardiomyopathy
Blocks alpha and beta receptors, relaxes smooth muscle, coronary and peripheral vasodilation, decreases automaticity |
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Term
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Definition
| prevent clots from forming |
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Term
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Definition
| prevent platelets from sticking together |
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Term
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Definition
| lyse clots that are present |
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