Diuretic and Hyperlipidemia Therapy Overview

Diuretic Therapy

• A desired effect of diuretic therapy is polyuria.
• The goal of anti-cholesterol drugs is to lower LDL levels.

Hyperlipidemia Teaching

• Lifestyle changes may avoid medication for hyperlipidemia.
• Statin drugs are the most common hyperlipidemia medication.
• Statin medication may be lifelong for some.

Bumetanide

• Bumetanide is a loop diuretic.

Heart Failure Management

• Clients with heart failure should monitor sodium intake and fluid intake.
• Decreased afterload can increase cardiac output.

Lidocaine (IV) Adverse Effects

• CNS toxicity, potentially including confusion and psychosis.
• Numbness and tingling are also possible side effects.

Fluid Overload with IV Crystalloids

• Can lead to heart failure development.

Aspirin and Apixaban

• Should not be taken together.

Alteplase (Thrombolytic)

• Used to dissolve clots in central lines.

Monoclonal Antibody PCSK9 Inhibitors

• Block LDL cholesterol production.

Furosemide Administration

• Administer slowly to prevent hearing loss.
• Furosemide is a loop diuretic.

Right Heart Failure (Right HF)

• Note:
  • Relevant information from the text only, no additional details.

Atorvastatin

• Inhibits HMG-CoA reduction.
• Adverse effects include severe muscle pain, weakness, and dark urine.

Lipid Panel

• Should be ordered before statin medication administration.
• Indicates pregnancy category X.

Atorvastatin Client Instructions

• Need for periodic lipid tests.

Atorvastatin Indications

• Hyperlipidemia and prevention of cardiovascular disease in clients with hypertension, or diabetes, or those who smoke.

Cholestyramine

• Reduces serum cholesterol and LDL.
• Administer 2 hours before or 4 hours after medication.
• Administer with 60-80ml of liquid.

Gemfibrozil

• Increases HDL and reduces VLDL with high cholesterol.
• May cause complications like gallstones, RUQ abdominal pain, GI distress when taken with food, and potential heartburn.

Ezetimibe

• Lowers cholesterol.
• May cause angioedema.

Alirocumab

• Binds LDL receptors on the liver for hypercholesterolemia.
• Potential flu-like symptoms as side effects.

Rivaroxaban

• Oral administration.
• No INR monitoring required (less interactions).
• System clearance is within 1-2 days after cessation.
• Andexanet alfa is antidote.

Ezetimibe (Continued)

• Cholesterol absorption inhibitor.
• Nasopharyngitis is a potential adverse effect.

Metoprolol

• Slows heart rate and lowers blood pressure.
• Abrupt cessation should be avoided

Lisinopril

• ACE inhibitor, not to double dose if missed.
• Pregnancy is a contraindication for this med.

Propranolol

• Beta blocker useful for chest pain, anxiety and high blood pressure.
• Masking of hypoglycemia can be a concern for new DMs.

Amiodarone

• Antiarrhythmic, used for atrial and ventricular dysrhythmias
• Half-life is up to 50 days, use reliable contraception.
• Adverse effects include bradycardia, pulmonary toxicity, ARDS, hypotension, blue-gray skin discoloration.

Milrinone

• Increases myocardial contractility and cardiac output.
• Primary use is short-term therapy for advanced heart failure.
• Continuous ECG monitoring is recommended.

Digoxin (Cardiac Glycoside)

• Increases heart contractions and force while decreasing rate.
• Used for heart failure and abnormal heart rhythm.
• Prior to administration check apical pulse and hold if under 60 bpm.
• Digoxin toxicity symptoms include visual disturbances (yellow halos), anorexia, vomiting, and fatigue.

Verapamil

• Calcium channel blocker that treats dysrhythmias.
• Avoiding grapefruit juice is important with this medication.

Heparin

• aPTT is the monitored value when taking heparin.

Warfarin

• Contraindicated with ginkgo ginger and most antibiotics.
• PT and INR are monitored values, not to increase dietary broccoli, and same time everyday dosages.
• INR can be 2-3 times higher than normal (0.9-1.1) when taking warfarin.
• Vitamin K is the reversal agent.

Clopidogrel

• Antiplatelet, assessing for bleeding and bruising prior to administration is important.

(SATA) Bleeding/Symptoms

Bleeding gums, black tarry stools, flu-like symptoms, petechiae.

Nitroglycerin

• Common side effect is headache.
• Heart rate and blood pressure are priority assessments before administering Carvedilol.

Carvedilol

Heart rate and blood pressure are priority assessments before administering.

Enalapril

• ACE inhibitor used for hypertension and heart failure.

Enoxaparin

• Lower molecular weight heparin given by injection (often abdomen subQ).

This quiz covers essential aspects of diuretic and hyperlipidemia therapies, including medication effects, management, and associated risks. Learn the differences between various medications, lifestyle changes, and the importance of monitoring for patients with these conditions.