Cardiac Meds Grid.docx

Beta-Adrenergic Blockers (-olol) ACE Inhibitors (-pril) Angiotensin II Receptor Blockers (-sartan) atenolol (Tenormin) SE: Impotence, Dizziness, weakness, lethargy, insomnia/nightmare, shortness of breath, depression AE: Slow, Fast, or Irregular Heart rate, dyspnea Nursing Interventions: Monitor vit...

Beta-Adrenergic Blockers (-olol) ACE Inhibitors (-pril) Angiotensin II Receptor Blockers (-sartan) atenolol (Tenormin) SE: Impotence, Dizziness, weakness, lethargy, insomnia/nightmare, shortness of breath, depression AE: Slow, Fast, or Irregular Heart rate, dyspnea Nursing Interventions: Monitor vital signs, Labs (Kidney/Liver funct). Do not stop taking beta blockers due to rebound HTN, can cause or exacerbate Heart Failure. Monitor asthma patients carefully and use selective beta blockers. Tell MD about weakness or depression! enalopril (Vasotec) Intended Responses: Decreased Blood Pressure, Vasodilation of Blood Vessles, Diuresis, Decreased workload of heart. SE: hypotension, hyperkalemia, taste disturbance, headache, persistant dry cough AE: fever/chills, angioedema, jaundice, blood dyscrasias, hoarseness valsartan (Diovan) Intended Response: Same as ACE, but with fewer side effects (Better Tolerated) SE: Hypotension, Dizziness, Headache, Diarrhea, GI Upset, Heartburn AE: Hyperkalemia, Hyperglycemia Calcium Channel Blockers Organic Nitrates Cardiac Glycosides amlodipine (Norvasc) Block calcium from entering muscle cells of heart and arteries Intended Response: Vasodilation of arteries/arterioles, decreased myocardial contractility. SE: hypotension, bradycardia, flushing, constipation, nausea, headache, AE: Dysrhythmia, Worsening heart failure, Stevens-Johnsons syndrome **Avoid grapefruit juice** nitroglycerin (Nitrostat) Many Routes SE: Headache, Hypotension, Tachycardia, Flushing, Dizziness AE: Anaphylaxis, Circulatory Collapse (rare) Nursing Intervention: Teach about proper administration of nitro, warn about headache (can use tylenol) digoxin (Lanoxin) VERY Narrow Therapeutic Range 0.8-2 ng/mL Negative chronotrope, positive inotrope Nursing Intervention: Must take apical pulse (needs to be above 60) Monitor for signs of toxicity (nausea, vomiting, green and yellow halos in vision, confusion) Antidote: digoxin immune fab (Digibind) Direct-acting Arteriolar Vasodilators Alpha Adrenergic Antagonists Potassium Channel Blockers hydralazine (Apresoline) directly dialates peripheral arteries SE: Tachycardia, Hypernatremia AE: Steven Johnson Syndrome **Report increase in pulse of 20 bpm or more IMMEDIATELY** prazosin (Minipress) behaves like beta blockers, buts acts on smooth muscle and arteries SE: Impotence, Dizziness, weakness, lethargy, insomnia/nightmare, shortness of breath AE: Slow, Fast, or Irregular Heart rate, dyspnea **Do not give with erectile dysfunction meds- will lead to hypotensive event** amiodarone (Cordarone) converts afib/flutter to normal sinus SE: neurological changes, photosensitivity, peripheral neuropathy, nausea/vomiting AE: ARDS, pulmonary fibrosis, worsening of heart failure, dysrhythmias, TEN Nursing Intervention: Monitor Vital Signs, Monitor EKG, Report Side Effects Anticholinergics (Parasympatholytics) Atropine Treats symptomatic bradycardia SE: Think Dry; dry mouth, urinary retention, blurred vision, tachycardia AE: Rare Not used for long term use