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These Drugs are what class?Plavix, effient, brilinta, ticlid, persantadine, pletal, integrillin, aggrastat
antiplatlet agents
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What class is plavix?
antiplatlet
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what class is effient
antiplatlet
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what class is brilinta
antiplatlet
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what class is ticlid
antiplatlet
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what class is persantadine?
antiplatlet
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what class is pletal
antiplatlet
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what class is integrillin
antiplatlet
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what class is aggrastat?
antiplatlet
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what do antiplatlets do?
prevent the aggregation of platlets
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What do anticoagulants do?
- prevent clot formation by inhibiting clotting factors
- therefore prevent thromboembolic events
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What is the main risk with anticoagulants
BLEEDING
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What lab needs to be checked with heparin and what is the therapeutic level
- ptt
- 1.5-2.5 times the norm
- normal is 30-40 secs
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what is the antidote for heparin
protamine sulfate
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When giving heparin how do you give it and what should you do or not do?
sq do not aspirate, massage, or rub the area of injection
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What drug class are these drugs
LMWH
lovenox
fragmin
anticoagulants
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what is lovenox
an anticoag
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what is fragmin
an anticoag
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what benefits do lovenox have over heparin?
no frequent lab tests, it is more stable
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what is the heparin alternative for heparin induced thrombocytopenia
refludan
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what drug class is coumadin and how is it administered
oral anticoagulant
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what drug class is pradaxa and how is it given
oral anticoagulant
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what drug class is xarelto and how is it given?
oral anticoagulant
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what is the antidote for coumadin?
Vitamin K
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what drug class comes from meds ending in ase
and what do they do?
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tpa, activase, tnkase retavase, streptase, abbokinase are all what class of drugs?
thrombolytics
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what labs should be monitered when on thrombolytics?
pt, ptt, h&H platlet count
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what drug class is amicar
antithrombolytic
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what drug class is trasylol
antithrombolytic
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what drug class is desmopresin
antithrombolytic
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what drug class is digoxin
cardiac glycosides
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what is the action of cardiac glycosides or dig?
- positive inotrope(increase the contraction of heart)
- negative chronotropic effect (decrease hr)
- negative dromotropic (slow conduction)
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what does inotrope mean
increase or decrease in the force of contration
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what does chronotrope mean
- chronotrope - increase or decrease in hr
- think chrono time
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what does dromotrope mean?
increase or decrease in conduction
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does dig increase or decrease stroke volume?
increases
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dig
- decreases jvd
- increases coronary artery perfusion
- promotes diuresis
- helps with chf symptoms
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If a patient is on dig what do you need to assess?
- b/p, pulse, heart sounds, breath sounds, weight I&O, ecg, renal function (creatnine, bun, uop) lfts
- know that hypokalemia can contribute to dig toxicity
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what class of drugs are nitrates
anti-anginals
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what do nitrates do
- vasodialate
- increase blood supply to heart
- decrease preload, afterload and b/p
- relax smooth muscle, helping with coronary artery spasms
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what is preload
venous return to heart
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if you have a decreased preload what does that do
- decreases volume and pressure to the heart
- which decreases myocardial oxygen demand
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what is afterload
- peripheral vascular resistance
- the work the blood has to push against to get to the heart
- so decreased after load is good
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how can nitrates be administered?
oral, sublingual, iv, ointments, patches
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what are s/e of nitrates
- h/a
- tachycardia
- postural hypotension
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what is nitro used for and what by what route can it be administered?
anginal relief, iv, sl (tab or spray), topically or by patch
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nitro info
large first pass effect
q5 mins X3 doses
iv dose titrated as long as sbp>90
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what kind of container should iv nitro be in
glass bottle
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how long is nitro tabs good for?
3 months
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how should nitro be applied
non hairy part of body with gloves, remove old patches prior to placing new patch
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with nitro there should be a 8-12 nitrate free period each day to prevent tolerance, teach pt how to monitor hr and to keep a log
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when giving nitro asses for
h/a, decreased b/p and dizziness
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beta blocker specific for beta 1 are called
cardioselective
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beta blockers that are for beta 1 and 2 are
non-specific
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what do cardioselective drugs do
decrease hr, slow conduction and decrease 02 demand (by decreasing contractility
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what do the drugs end in that are beta blockers
olol
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what do nonselective beta blocker do as well as cardioselective
- in addition to decreasing hr, 02 demand and slowing conduction
- it also constricts the bronchiole which can lead to sob
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when are beta blockers used?
- angina to decrease 02 demand
- mi as a cardioprotective measure
- dysrhythmias slows conduction
-
atenolol carvedolol and labetolol are used to treat
hypertension and angina
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metoprolol is used to treat
mi and hypertension
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propranonol is non selective
-
sotalol
nonselective used for ventricular dysrhythmias
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what class is cardizen
ccb
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how can cardizem be administered and what does it do?
- oral and parenteral , comes in sustained release,
- affinity for conduction system so it slows the hr
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what drug class is verapamil
ccb
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what does verapamil do and what are the forms of administration?
- tx of angina
- slows hr and conduction
- oral and iv
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when giving verapamil iv what should be done
give slowly because it can severely decrease b/p
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what is ranexa
anti-anginal
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while taking anti-anginals patents should report
- blurred vision
- persistent hh/a
- dry mouth
- dizziness, fainting episodes
- edema weight gain
- p<60
- dyspnea
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what do ace inhibitors end in?
pril
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what do ace inhibitors do
inhibit the raas, therefore preventing the vasoconstriction and sodium and water reabsoption
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what are the effects of ace inhibitors
- decreased svr (afterload)
- prevent sodium and water reabsorption helping chf
- decreased preload (volume returning to heart)
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what lab values must be monitored closely while taking ace inhibitors
- potassium because it causes potassium retention
- renal funtion
- drug must be discontinued with elevated potassium
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what are ace inhibitors used to treat
hf and htxn
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what is minoxidil
vasodilator
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what is apresoline
vasodilater
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what is nipride
vasodilater
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what do vasodilators do?
direct acting arteriolar smooth muscle relaxants
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What do diuretics do
- increase urine formation
- remove Na+ and H2o
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what do diretics tx
htxn and chf
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what are the actions of diuretics
- arteriolar vasodilation
- decrease volume
- decrease co leading to decreased b/p
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what do cai's (carbonic anhydrase inhibitors )tx
- used as a diuretic
- altitude sickness
- metabolic alkalosis
- glacoma
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what do cai's do
reabsorb NA+ and H2o and release h202
-
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what is lasix
loop diuretic
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what does lasix do?
- loop of henley
- decrease blood volume and decrease preload
- rapid onset
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while taking lasix what electrolyte is has a potential to plummet
K+
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what are umex, edecrine, demadex
loop diuretics
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what do loop diuretics tx
- chf
- pulmonary edema
- ascites
- htxn
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while taking diuretics what kind of foods should you eat?
- high in K+
- strawberries
- oranges
- bannanas
- fresh veggies
- potatoes (especially the skin)
- low in Na
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what vs do you need to monitor while taking diuretics
b/p
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what assesments check fluid volume status
- I & O's
- skin turgor
- mucous membranes
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what are signs of hypokalemia
- muscle weakness
- constipation
- irregular pulse rate
- lethargy
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wha are normal total cholesterol levels
-
-
-
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should the goal ldl for someone with dad or diabetes be lower or higher than those without risk factors
lower
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what is niacin
- lipid lowering agent
- inhibits triglyceride synthesis in liver
- increased uric acid secretion
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