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Which exemplar is our cholesterol-lowering drug?
What is its action?
- Actions: HMG-CoA inhibitor --> decrease in cholesterol, lowers LDLs and triglycerides.
- (HMG-CoA is the cholesterol producing enzyme in the liver)
What are the uses of lovastatin?
Lovastatin is used for: hyperlipidemia and CHD
What are some contraindications of lovastatin?
(think about our lady, Lova)
pregnancy, liver disease
What are the side effects and adverse effects of lovastatin?
(think of our lady, Lova!)
side effects: blurred vision, photosensitivity, chest pain, diarrhea & constipation.
adverse effects: rhabdomyolysis, fetal skeletal anomolies
Name two interactions with lovastatin.
grapefruit juice and erythromycin.
Based on Lova's side effects and adverse reactions, name some nursing actions for each.
- Side effects:
- blurred vision: check eyes, provide lighting.
- photosensitivity: wear shades, long clothing, sunscreen.
- chest pain: assess pain level.
- d/c: encourage fiber, fluid, fruit.
- Adverse reactions:
- rhabdo: assess for muscle pain/weakness.
- liver disease (contra): check lab results AST/ALTs.
What are your 3 types of angina? Explain.
Stable: pain, no damage to cardiac muscle.
Unstable (pre-infarct): pain at rest; plaque build-up & if breaks off may lead to MI.
Prinzmetal's (variant): caused by spasm of BV; pain at rest, recurrent, EKG shows changes to muscle.
What medications treat angina? (of all our meds)
BB (B1): metoprolol
Nitrates: relaxes smooth muscle & decreases muscle tone.
*Improves blood delivery to heart.
What are some classic symptoms of angina?
Chest pain or discomfort.
Pain in your arms, neck, jaw, shoulder or back accompanying chest pain.
nausea, fatigue, SOB, sweating, dzziness.
What is the exemplar for our antianginal drug?
What is its action?
Action: dilates coronary arteries to increase perfusion = more vasodilation of veins than arteries = possible pooling of peripheral blood; heart consumes less O2 = decreased workload.
What is nitroglycerin used for? (NTG, Nitrostat)
What are the contraindications for NTG?
What class is NTG used for?
- Contraindicated for:
- severe anemia
- tamponade (arrythmia)
- head trauma
What are some side effects for NTG?
- dizziness (get up slowly or call for help)
- blurred vision
- dermititis (from transdermal patch use)
What are some adverse reactions to NTG?
- Increased ICP
- Avoid in Pts w/ head injury/c. hemorrhage
What other drugs interact with NTG?
What might it cause if interacted?
(think of our man, Nitro)
Viagra and Livitra (may cause severe HYPOtn)
Heparin (decreases heparin effects)
What are some nursing actions/Pt teaching for NTG?
(think about our man, Nitro)
- Check BP
- Do not use patch for emergency
- *Store in dark, cool, glass container.
- *Take 1 tab/5 minutes up to 3 tabs.
What is the difference between plasmin and fibrinogen, naturally occurring anticoagulants?
Plasmin: blood protein that breaks down clots.
Fibrinogen: stabilizes the clot.
What is the difference between intrinsic and extrinsic pathway of the clotting cascade?
intrinsic: clots form inside BV.
extrinsic: clot forms outside of BV.
*Results in same pathway in the end.
What is the action of anti-platelets?
What is the action of anti-coagulants?
anti-platelets: decrease platelet aggregation by preventing ATP to bind from binding to platelet receptors.
anti-coagulant: prevents formation of new clots and extension of existing clots.
Which exemplar is our anti-platelet drug?
What is its action?
Action: decrease platelet aggregation by preventing ATP from binding to platelet receptors.
What are the uses for clopidogrel (anti-platelet)? (2)
Decreases platelet aggregation and vascular death in Pts w/ atherosclerosis.
What are the contraindications for clopidogrel?
1) acute bleeding disorders.
2) peptic ulcers.