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Pharmacotherapeutics for Advanced Nursing Practice, 1st. Ed., Demler & Rhoads, 2018/
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Pharmacotherapeutics for Advanced Nursing Practice, 1st. Ed., Demler & Rhoads, 2018 | Nursing (RN) School Study Aid
Class I Antiarrhythmics (Na+ Channel Blockers) Overview
- Indications
- Arrhythmias
- Local Anesthesia
- Mechanism of Action
- Block or Slow Conduction
- Block Na+ Channels
- Raise Threshold
- State Dependent
- Contraindication
- Hyperkalemia
1 min
Class IA Antiarrhythmics (Na+ Channel Blockers)
- Indications
- Arrhythmias
- Mechanism of Action
- Increase AP, ERP, and QT interval.
- Drugs
- Disopyramide
- Procainamide
- Drug-induced Lupus
- Quinidine
- Cinchonism
- Shared Side Effects
- Thrombocytopenia
- Torsades de Pointes
1 min
Class IB Antiarrhythmics (Na+ Channel Blockers)
- Indications
- Arrhythmias
- After Myocardial Infarction
- Mechanism of Action
- Affect Ischemic Tissue
- Decrease AP duration
- Drugs
- Mexiletine
- GI Upset
- Lidocaine
- CNS Depression
- Tocainide
- Phenytoin
- Hirsutism
2 mins
Class IC Antiarrhythmics (Na+ Channel Blockers)
- Indications
- Used as Last Resort
- V-Tach
- Mechanism of Action
- No Effect on AP Duration
- Drugs
- Propafenone
- Flecainide
- Contraindications
- Post-Myocardial Infarction
55 secs
Class III Antiarrhythmics (K+ Channel Blockers)
- Indications
- Arrhythmias
- Mechanism of Action
- Increase AP Duration, ERP, and QT Interval
- Drug Names
- Amiodarone
- Check Function Tests
- Dirty Drug
- Ibutilide
- Dofetilide
- Sotalol
- Beta-Blocker
2 mins
Class IV Antiarrhythmics (Ca2+ Channel Blockers)
- Indications
- SVT
- Subarachnoid Hemorrhage
- Mechanism of Action
- Decrease Conduction Velocity
- Increase PR Interval and ERP
- Drugs
- Verapamil
- Diltiazem
- Nimodipine
- Side Effects
- Cardiovascular
- Constipation
2 mins
Hypertension Medications
- Diuretics
- Beta Blockers
- Angiotensin Receptor Blockers (ARBs)
- Calcium Channel Blockers
- ACE Inhibitors
1 min
Lidocaine
- Mechanism
- Blocks Na+ Channels
- Indications
- Ventricular Arrhythmia
- Anesthetic
- Side Effects
- Paresthesias
- Seizures
- Respiratory Depression
- Drowsiness
- Consideration
- Anesthetic Effects Extended with Epinephrine
1 min
Adenosine (Adenocard)
- Mechanism
- Slows AV Conduction
- Indications
- Supraventricular Tachycardia (Paroxysmal)
- Side Effects
- Bradycardia
- Flushing
- Dyspnea
- Considerations
- Rapid IV Push
- Caffeine and Theophylline Decrease Effectiveness
- Dipyridamole May Intensify Effects
2 mins
Digoxin Mechanism and Indication
- Direct inhibition of Na K ATPase
- Indirect inhibition of Na Ca exchanger
- Increase Ca in cell
- Positive Inotropy
- CHF
- Stimulates Vagus Nerve
- Decreased conduction at AV node
- Atrial Fibrillation
1 min
Acute Digoxin Toxicity
- Clinical Symptoms
- Hyperkalemia
- Cholinergic (Nausea, Vomiting, Diarrhea)
- Blurry Yellow Green Vision with Halo of Light
- Arrhythmia
- Bradycardia
- EKG Changes
- Prolonged PR interval
- Decreased QT
- Scooping on EKG
- T Wave Inversion
2 mins
Digoxin Toxicity Treatment
- Activated Charcoal
- Slowly Normalize K+
- Digibind (Anti-Digoxin Fab)
- Magnesium Sulfate
- Lidocaine
- Cardiac Pacing
2 mins
Dobutamine
- Mechanism
- Beta-1 Agonist
- Inotropic
- Indications
- Heart Failure
- Side Effects
- Tachycardia
- Arrhythmias
- Considerations
- Closely Monitor Patients
- Other Meds May Increase Potency
1 min
Bile Acid Resins
- Indications
- Hyperlipidemia
- Mechanism of Action
- Bile Acid Reabsorption Prevented
- Slight Increase HDL/Triglycerides
- Decrease LDL
- Drugs
- Colestipol (Colestid)
- Cholestyramine
- Colesevelam
- Side Effects
- Cholesterol Gallstones
- Decreased Absorption of Fat-soluble Vitamins
- Patients Hate It
2 mins
Hypercholesterolemia Treatment
- Lifestyle Modifications (Diet, Exercise, Smoking Cessation)
- Statins
- Niacin
- Ezetimibe
- Fibrates
- Bile Acid Resins
- Screening
- Men greater or equal to 35 Years Old (20-35 if at increased risk)
- Women greater or equal to 45 Years Old (20-45 if at increased risk)
2 mins
Ezetimibe
- Indications
- Hyperlipidemia
- Mechanism of Action
- Cholesterol Absorption Blocker
- Decreases LDL
- Side Effects
- Diarrhea
- Increased LFT Values
56 secs
Fibrates
- Indications
- Hyperlipidemia
- Mechanism of Action
- Upregulate LPL
- Decreases Triglycerides
- Slight Increase in HDL
- Slight Decrease in LDL
- Side Effect
- Hepatotoxicity
- Cholesterol Gallstones
1 min
Atorvastatin (Lipitor)
- -statin suffix
- Mechanism
- HMG-CoA Reductase Inhibitors
- Indications
- High Cholesterol
- Side Effects
- Hepatotoxicity
- Rash
- Rhabdomyolysis
- Myopathy
- Considerations
- Monitor Liver Enzymes
- Administer at Bedtime
- Avoid Grapefruit
2 mins
Statins
- Rhabdomyolysis
- Hepatotoxicity
- HMG-CoA reductase inhibitors
- Decrease LDL
- Decrease Triglycerides
- Increase HDL
2 mins
Niacin Therapy (Vitamin B3)
- Mechanism
- Inhibits Lipolysis in Adipose Tissue
- Reduces Hepatic VLDL Secretion
- Indications
- Decrease Triglycerides
- Decrease LDL
- Increase HDL
- Side Effects
- Flushing
- Decreased by Aspirin
- Hyperglycemia
- Hyperuricemia
2 mins
Alpha-2 Agonists (Sympathoplegics)
- Indications
- Hypertension
- Renal disease
- Mechanism of Action
- Centrally acting Alpha-2 Agonist
- Drugs
- Clonidine
- Rebound Hypertension
- Alpha-Methyldopa
- Pregnancy
- Coombs (+) Hemolytic Anemia
- SLE Like Syndrome
2 mins
Hydralazine
- Indications
- Reduce Afterload
- Severe Hypertension
- Safe during Pregnancy
- CHF
- Mechanism of Action
- Increases cGMP
- Vasodilates Arterioles
- Side Effects
- Drug-induced Lupus
- Reflex Tachycardia
1 min
Minoxidil (Loniten, Rogaine)
- Mechanism
- Vasodilates Arterioles
- Indications
- Severe Hypertension
- Baldness
- Side Effects
- Reflex Tachycardia
- Blood Volume Expansion
- Hypertrichosis
- Pericardial Effusion
- Rash
- Considerations
- Give with Beta Blocker and Diuretic
2 mins
Nitroprusside
- Mechanism of Action
- Direct Release of NO
- Increase cGMP
- Short Half-Life
- Indications
- Malignant Hypertension
- Side Effect
- Cyanide Toxicity
1 min
Acetazolamide
- Indications
- Glaucoma
- Altitude Sickness
- Pseudotumor Cerebri
- CHF
- Metabolic Alkalosis
- Mechanism of Action
- Carbonic Anhydrase Inhibitor
- Sodium Bicarbonate (NaHCO3) Diuresis
- Side Effects
- Metabolic Acidosis
- Paresthesias
1 min
Ethacrynic Acid
- Mechanism of Action
- Non-sulfa Drug
- Phenoxyacetic Acid Derivative
- Loop Diuretic
- Inhibits Na+-K+-2Cl- Cotransporter
- Thick Ascending Loop of Henle
- Indications
- Diuresis
- Side Effects
- Hypokalemia
- Ototoxicity
- Gout
2 mins
Loop Diuretics
- Mechanism of Action
- Thick Ascending Limb of Loop of Henle
- Inhibits Na+-K+-2Cl-
- Sulfa Drug
- Drug Names
- Furosemide
- Lasix
- Side Effects
- Gout
- Ototoxicity
- Hypocalcemia
- Hypokalemia
4 mins
Mannitol (Osmitrol)
- Indications
- Increased Intracranial Pressure (ICP)
- Glaucoma
- Drug Overdose
- Mechanism of Action
- Osmotic diuretic
- Increased Urine Flow
- Side Effects
- Dehydration
- Contraindications
- Anuria
- CHF
2 mins
Spironolactone (Aldactone)
- Mechanisms
- Inhibition of Aldosterone
- Potassium Retention
- Indications
- Hypertension
- Edema
- Heart Failure
- Side Effects
- Hyperkalemia
- Endocrine Effects
- Consideration
- Avoid Potassium Supplements
2 mins
Hydrochlorothiazide HCTZ
- Mechanism of Action
- Inhibits Reabsorption NaCl and H2O
- Indications
- Edema
- Mild to Moderate Hypertension
- Side Effects
- Hypokalemia
- Hyponatremia
- Dehydration
- Hyperglycemia
- Gout
- Contraindications
- Sulfa Allergy
- Pregnancy and Breastfeeding
1 min
Nonselective Alpha-Blockers
- Indications
- Phentolamine
- Reversible
- Pheochromocytoma (Diagnosis)
- Hypertensive Crisis
- Phenoxybenzamine
- Pheochromocytoma (Treatment)
- Side Effects
- Orthostatic Hypotension
- Reflex Tachycardia
2 mins
Nitroglycerin
- Mechanism of Action
- Decreases Preload
- Indications
- Angina
- Up to 3 doses q 5 mins
- Side Effects
- Headache
- Hypotension
- Contraindications
- Viagra (Sildenafil)
- Nursing Considerations
- Assess Blood Pressure
- Protect From Light
- Use Glass Bottle and Special Tubing
- Gloves for Applying Topically
2 mins
Calcium Channel Blockers (Verapamil and Diltiazem)
- Mechanism of Action
- Slows AV Conduction
- Indications
- Angina Pectoris
- Essential Hypertension
- Arrhythmias
- Side Effects
- Bradycardia
- Hypotension
- Constipation
- Peripheral Edema
- Gingival Hyperplasia
- Nursing Consideration
- Medication Education
2 mins
Prazosin (Minipress)
- -osin suffix
- Mechanisms
- Selective Alpha-1 Receptor Blocker
- Indications
- Hypertension
- Benign Prostatic Hyperplasia (BPH)
- Nightmares
- Side Effects
- Orthostatic Hypotension
- Tachycardia
- Priapism / Inhibition of Ejaculation
- Nasal Congestion
- Considerations
- First Dose Effect
- Administer at Bedtime
2 mins
Nonselective Beta-Blockers
- "-olol" Suffix
- Nonselective
- Propranolol
- Timolol
- Nadolol
- Partial β Agonist
- Pindolol
- Nonselective β with α Blocking
- Carvedilol
- Labetalol
2 mins
Selective Beta-1 Blockers
- Characteristics
- "-olol" Suffix
- Drug Names
- Beta-1 selective
- Atenolol
- Esmolol
- Metoprolol
- Partial Beta agonists
- Acebutolol
1 min
Cardiovascular Effects of Beta-Blockers
- Cardiac Myocytes and Vasculature
- Decrease cAMP
- Decreases SA and AV Node Conduction Velocity
- Lower Blood Pressure
- Decrease O2 Consumption
- Decreases Mortality Post-MI
2 mins
Systemic Effects of Beta-Blockers
- Respiratory
- Bronchoconstriction
- Metabolic
- Decreased Insulin
- Decreased Glycolysis and Lipolysis
- Eye
- Reduces Intraocular Pressure
1 min
Angiotensin-Converting Enzyme (ACE) Inhibitors
- "-pril" Suffix
- Mechanism of Action
- Block Renin Angiotensin-Aldosterone System (RAAS)
- Indications
- Hypertension
- Heart Failure
- Side Effects
- Dry Non-productive Cough
- Hypotension
- Dizziness
- Possible Hyperkalemia
- Angioedema
- Nursing Considerations
- Slowly Change Position
- Do Not Stop Abruptly
2 mins
ACE Inhibitor Toxicity
- CAPTOPRIL Mnemonic
- Cough
- Angioedema
- Potassium Changes (Hyperkalemia)
- Taste Change
- Hypotension
- Pregnancy Changes
- Rash
- Increased Renin
- Lower Angiotensin II
2 mins
Angiotensin Receptor Blockers (ARBs)
- -sartan suffix
- Indications
- Hypertension
- CHF
- Diabetic Nephropathy
- Mechanism of Action
- Angiotensin II Receptor Blockers
- Side Effect
- Hyperkalemia
- Contraindication
- Pregnancy
1 min
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