Term
| An example of a non-selective beta blocker. |
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Definition
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Term
| Mechanism of action for beta blockers. |
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Definition
| Blocks beta 1 receptors in the heart (reduces HR, force of contraction, and AV conduction); can also block beta 2 receptors in lungs; beta receptors respond to sympathetic nervous system stimulation. |
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Term
| Indications for beta blockers. |
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Definition
| HTN, angina pectoris, cardiac dysrhythmias, myocardial infarctions, heart failure, migraines, stage fright. |
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Term
| Contraindications for beta blockers. |
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Definition
| Severe allergy, diabetes, sinus bradycardia, asthma, bronchospasm, depression. Precaution: hx of heart failure and AV block. |
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Term
| Serious adverse effects of beta blockers. |
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Definition
Beta 1- bradycardia, AV heart block
Beta 2- bronchoconstriction and glycogenolysis w/ diabetics |
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Term
| Common adverse effects of beta blockers. |
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Definition
| Postural hypotension and fatigue |
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Term
| Preadministration assessment for beta blockers. |
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Definition
| HR, BP (standing and supine), angina attacks (when, severity, and triggers); baseline ECG. |
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Term
| Monitoring for beta blockers. |
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Definition
| Watch BP and HR before each dose and look for improvement in ECG for cardiac dysrhythmias. |
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Term
| Patient education for beta blockers. |
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Definition
| Don't discontinue use w/out doctor (rebound cardiac excitation). Monitor BP, HR, incidence/circumstance of angina. |
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Term
| An example of a Ca channel blocker. |
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Definition
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Term
| Mechanism of action for Ca channel blockers. |
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Definition
| Prevents Ca ions from entering cells; act selectively on peripheral arterioles and arteries/arterioles of the heart; reduces blood pressure through arteriolar dilation. |
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Term
| Indications for Ca channel blockers. |
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Definition
| Used to treat HTN, angina pectoris, and cardiac dysrhythmias (except Nifedipine); not favored in heart failure. Verapamil- for migraines. |
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Term
| Contraindications for Ca channel blockers. |
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Definition
| Pts w/sick sinus syndrome or 2nd/3rd degree AV block, severe hypotension. Use caution in pts w/ heart failure, liver impairment, digoxin and beta blockers. |
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Term
| Serious adverse effects of Ca channel blockers. |
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Definition
| Can exacerbate cardiac dysfunction in pts w/certain conditions. Can cause bradycardia. Don't use in pts w/sick sinus syndrome, heart failure, or 2nd/3rd degree AV block. |
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Term
| Common adverse effects of Ca channel blockers. |
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Definition
| Constipation, dizziness, facial flushing, headache, edema of ankles and feet. |
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Term
| Preadministration assessment for Ca channel blockers. |
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Definition
| Baseline BP and HR; labs for kidney and liver function; baseline ECG; angina pectoris- incidence/circumstance. |
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Term
| Monitoring for Ca channel blockers. |
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Definition
| Continue to monitor BP and angina attacks. Beta blockers intensify (multiply) cardiosupression. |
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Term
| Patient education for Ca channel blockers. |
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Definition
| Do not chew SR tabs. Record info about angina attacks. Monitor and record BP. |
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Term
| An example of an ACE inhibitor. |
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Definition
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Term
| Mechanism of action for an ACE inhibitor. |
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Definition
| Reduced levels of Angiotensin II (dilates blood vessels, reduces blood volume, and prevents/reverses pathologic changes in heart and vessels by Angiotensin II and Aldesterone. Also increases Bradydinin whic causes vasodilation. |
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Term
| Indications for an ACE inhibitor. |
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Definition
| Malignant HTN; HTN secondary to renal arterial stenosis; heart failure; myocardial infarction; diabetic and nondiabetic nephropathy; prevention of MI, stroke, and death of high risk CV pts. |
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Term
| Contraindications for an ACE inhibitor. |
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Definition
| Pts w/bilateral renal artery stenosis or renal artery stenosis to single remaining kidney; hypersensitivity; 2nd or 3rd trimester of pregnancy. |
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Term
| Serious adverse effects of an ACE inhibitor. |
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Definition
| Hypotension after 1st dose due to vasodilation; renal failure in kidney w/renal artery stenosis; Angioedema- similar to allergic reaction (treated w/epinephrine); hyperkalemia (b/c aldesterone gets rid of K); neutropenia (reduced white blood cells). |
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Term
| Common adverse effects of an ACE inhibitor. |
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Definition
| Persistant, dry, irritating cough- #1 reason pts discontinue use; 1st dose hypotension can be worse if pt on other diuretics, reduced if start dose low, watch orthostatic BP, and take @ bedtime); angioedema, dysgeusia, rash, loss of sense of taste |
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Term
| Preadministration assessment of an ACE inhibitor. |
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Definition
| BP readings, assess kidneys, WBC count |
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Term
| Monitoring for an ACE inhibitor. |
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Definition
| Lithium levels, BP, WBC count and differential, signs of heart failure, proteinuria, K levels |
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Term
| Patient education for an ACE inhibitor. |
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Definition
| Avoid K supplements; if pregnant or become pregnant, discontinue use; take meds 1 hr before meals, 2-3 times/day; promote home BP monitoring. May increase hypotensive effects of other anti-hypertensives; asprin, ibeuprofin, and NSAIDs reduce effects. |
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Term
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Definition
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Term
| Mechanism of action for ARBs. |
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Definition
| Blocks access of Angiotensin II to its receptors in blood vessels (dilation of arterioles and veins), adrenals (decreases release of aldosterone, increases excretion of Na and water), and heart (prevents angiotensin II from inducing pathologic changes in cardiac structure). |
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Term
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Definition
HTN, heart failure, diabetic, nephropathy, MI, stroke prevention, migraine headaches.
Does not reduce CV morbidity and mortality like ACE do, so not preferred even through it does not cause the cough that ACE does. |
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Term
| Contraindications for ARBs. |
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Definition
| During 2nd and 3rd trimesters of pregnancy. For pts w/bilateral renal artery stenosis or renal artery stenosis to single remaining kidney. |
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Term
| Serious adverse effects of ARBs. |
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Definition
| Fetal harm during 2nd and 3rd trimesters; kidney failure in pts w/bilateral renal stenosis; angioedema. |
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Term
| Common adverse effects of ARBs. |
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Definition
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Term
| Preadministration assessment for ARBs. |
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Definition
| Baseline BP and HR, may be taken w/ diuretic. |
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Term
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Definition
| watch BP, s/s of heart failure, resp complications, protinuria. |
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Term
| Patient education for ARBs. |
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Definition
| May increase hypotensive effects of other anti-hypertensives (monitor signs of edema); promote home BP monitoring plan around mealtime (taken w/food). |
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Term
| Example of cardiac glycoside. |
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Definition
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Term
| Mechanism of action for cardiac glycoside. |
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Definition
| Positive inotropic action (increases the force of ventricular contraction); Increases CO, inhibits sodium-potassium ATPase which causes calcium accumulation in myocytes which results in increased interaction between acti and myosin filaments due to Ca accumulation in the cell. Digibind is used as antagonist. |
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Term
| Indications for cardiac glycoside. |
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Definition
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Term
| Contraindications for cardiac glycoside. |
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Definition
| Possibly for women- may shorten lifespan? Ventricular fibrillation and venricular tachycardia, digoxin toxicity. |
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Term
| Serious adverse effects of cardiac glycoside. |
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Definition
| Cardiac dysrhythmia (althers the electrical activity of the heart), causes all types of dysrhythmias, predisposed by hyperkalemia and toxicity of itself. Many drug interactions. |
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Term
| Common adverse effects of cardiac glycoside. |
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Definition
| Gi (anorexia, N/V) and CNS (fatigue) side effects. More serious side effects (sign of impending toxicity): visual disturbances (blurring, yellow tinge, and appearance of halos) |
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Term
| Preadministration assessment for cardiac glycoside. |
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Definition
| HR- check apical pulse for 60 secs, hold if pt is brady/tachycardiac; s/s of heart failure; baseline values and max activity tolerated that causes symptoms. |
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Term
| Monitoring for cardiac glycoside. |
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Definition
| Monitor plasma digoxin levels, assess for reduction of orthopenia, dyspnea on exertion, paroxysmal nocturnal dyspnea, neck vein distention, edema and rales, increased capacity for physical activity, and potassium levels. |
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Term
| Patient education for cardiac glycoside. |
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Definition
| Drug is very toxic, small thereputic range- need to take exactly as advised; watch for side effects- possible indicator of toxicity; limit salt; limit fluids; lifestyle changes for improvement of heart failure. |
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