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- ~Therapeutic levels .5-2ng/ml
- ~Monitor K+ low levels can increase rick for toxicity
- ~Monitor pulse and teach pt to. Hold for<60
- ~slow IV over 5 min.
- ~Loading digitalizing does given to bring serum to therapeutic levels.
(Adverse effects/ Toxicity)
- AE- Fatigue, anorexia, Bradycarida
- Toxicity- HA, Vertigo, Photophobia, yellow-green halos, tachycardia, AV heart block
- Antidote: Digibind
- ~short term use for heart failure
- ~reserved for pt who don't respond well to cardiac glycosides (dig) and ACE inhibitors
- ~Ventricular arrhythmias, hypotension, HA, hypokalemia, tremors, thrombocytopenia, chest pain
- ~Direct Vasodilator
- ~Cardiac arrhythmias, hypotension, anxiety, HA, fainting
- ~DC with hypotension
- ~Monitor kidney function
- ~For sublingual use store in dark container light resistance, replace every 6 months.
- ~Up to 3 tabs SL
- ~Topical use, use gloves non-hair site rotate avoid lower extremities.
- ~Contraindicated with preexisting hypotension, head trauma orincreased intracranial pressure, and pericardial tamponaade.
- ~Adequate hydration status required for administration
~HA, most commonly reported adverse effect, others include hypotension, tachycardia and contact dermatitis with topical forms.
bradycardia, hypotension, second and third degree heart block, fatigue, lethargy, depression, wheezing, dyspnea, impotence and decreased libido, altered glucose and lipid metabolism.
- ~Hold for HR < 60
- ~ Withdraw gradually to avoid rebound hypertension, angina and MI.
- ~ Periodically monitor blood sugar, cholesterol and triglycerides.
- ~ Use with caution in patient with history of asthma or diabetes
Calcium Channel Blockers
- ~bradycardia or tachycardia, heart block, hypotension, dyspnea, wheezing, GI complaints and dermatitis.
- **used in Raynaud's disease
Angiotensin-converting enzyme(ACE) Inhibitors
- ~Suppress the renin angiotensin system
- ~Adverse effects are generally mild and include dizziness,fatigue, HA, hypotension, dry nonproductive cough, chest pain,tachycardia, hyperkalemia, hypermagnesemia.
- ~Serious but rare adverse effect: Angioedema
- ~Monitor K+ and Mg levels.*Enhance the effects of thiazide diuretics
Angiotensin II Receptor Blockers (ARBS)
( Adverse effects)
- ~Blocks angiotension 2 receptors and causes a decrease in arterial pressure and decrease BP.
- ~mild, HA, upperrespiratory infections, dizziness, GI complaints and fatigue.
- ~ Potent vasodilator.
- ~ Often used in combination therapy for the management ofhypertension
Hydralazine (Apresoline), Nitroprusside(Nipride)
- * Adverse effects include HA, dizziness, reflex tachycardia, hypotension, rebound hypertension, hyperglycemia, Na+ and water retention
- * Monitor I & O, blood glucose
- * Nipride indicated for emergency management of hypertension,titrated IV infusion.
- *Monitor VS frequently with continuous cardiac monitoring.
- *Adverse effects eliminate use as drugs of first choice.