-
Calcium Channel Blockers
*inhibits calcium transport into myocardium
*for HTN/angina
*^ vasodilation
*decrease PVR
- verapamil Calan
- amlodipine Norvasc
- Assessment:monitor peripheral edema
- change pt slowly
- swelling hands/feet??!!!!
THIS WORK BETTER ON AA FOR BP
-
Beta Blockers LOLS :]
TO DECREASE BP, HR, ANGINA
cardioselective
block beta 1 heart
Non-cardioselective
block beta 2 lungs
metoprolol Lopressor
atenolol Tenormin
esmolol Brevibloc
- ASSESSMENT
- take apical pulse <50 or arrythmia hold
- BUN, creatine, AST, LDH
AA dont respond to BB so give with Diuretics
- AE:(
- fatigue, weak, dizzy. bradycardia, hf, edema
-
Nitrates
for vascular/coronary vasodilation on smooth muscle...decrease preload
- Short acting
- nitroglycerin Nitrostat, Nitrobib
- Long acting
- isosorbide Isordil, Imdur
- Assessment
- orthostatic hypotension *patch remove nightly yo avoid tolerance
- no alcohol
- HEADACHE A COMMON SIDE EFFECTMEDS WITH ERECTILE DISFUCTION MIGHT CAUSE FATAL HYPOTENSION
-
Inotrope *cardiac glycoside
FOR HF
digoxin (Lanoxin)
- assessment check apical pulsetherapeutic level *toxicity = n/v pain, blurred vision, anorexia
- AE: (
- fatigue, headache, yellow/green vision
-
Anticoagulants
for DVT prevention
- lmw heparin
- enoxoparin
Lovenox ....sub Q IN Abd
apTT
warfarin Coumadin
pt/INR
- assessmentpt should be 1.25-2.5
- INR 2-3X
- PTT 1.5-2x
- protamine for heparin
- vit k for warfarin
pt avoid BLEEDING AND NSAIDS
-
Renin Inhibitor
binds to renin reduces angie 1,2 aldo
*for hTN
aliskiren Tekturna
- ASSESSMENT
- *angioedema (face, lips, tongue difficult breathing)
- PO once daily
- avoid fat
check diahrrea/dizzy
-
Aldosterone Receptor Blocker
BLOCK ALDO SO bp goes down so sodium is reabsorbed in kidneys.
eplerenone Inspra
- once daily
- not use salt substitus or grapejuice!
HYPERKALEMIA***
-
ACE Inhibitors pril
blocks conversion of angie 1and realease of aldo
***HTN
capto pril capoten DECREASE PROGRESSION OF DM nephropathy
enala pril Vasotec
lisino pril Prinivil
rami pril Altace ^ SURVIVAL AFTER MI
- Assesseement:hyperkalemia
- report irritant cough
- postural hypotension with first doses
AA need diuretics with ACES
-
Angiotensin 2 receptor Blockers ARBS sartans =]
for pts that cant tolarate ACES or have hyperkalemia
- candesartan Atacand
- losartan Cozaar
- valsartan Diovan
- take same time daily
- monitor liver/renal labs
- URI?
-
DIURETICS
Thiazides
prevent na and h2o reabsorption in kidneys
lower BP slowly
for edema
- hydrochlorothiazide hydroDiurilchlorothiazide Diuril
- assessment
- hypokalemia
- give food with K
- watch for sugar elevations
-
DIURETICS
LOOP ide
- furosemide Lasix
- bumetanide Bumex
more potent than thiazides but short duration
- ASSESSMENT
- check weight daily
- lungs sounds
- dehydration?
- iV slowly over 2 MIN give am to prevent sleep disruption
- check
- hypochloremia
- hypokalemia
- hypomagnesia
-
DIURETIC
POTASSIUM SPARING
- spironolactone Aldactone
- amiloride Midamor
- weak diuretic/antihypertensive
- ***hyperkalemia (muscle weakness, fatigue, arrhythmia, paresthesia)
- **hyponatremia
- keeps K
- avoid food rich in K
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