Exam 4 - Angina/MI - Chapter 28
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What is the action of nitroglycerin?
what are the adverse effects of nitroglycerin or isosorbide?
what is the difference between nitroglycerin and isosorbide?
- nitro - short acting
- isosorbide - long acting
what class of drugs are nitro and isosorbide?
- organic nitrates
nursing considerations for nitroglycerin?
- change patch every 12-24 hours
- sublingual tabs Q5 min up to 3 times in 15 min
- adverse effects - watch for
- monitor BP, HR, ECG
- healthy diet
- no smoking
- no ETOH
what class of drugs is atenolol (Tenormin)?
what is the action of atenolol?
- slows heart rate
- reduces contractility
- lowers myocardial oxygen demand
what are the adverse effects of atenolol?
- digoxin may slow AV conduction --> Heart block
what class of drugs is diltiazem and the "dipines"?
calcium channel blocker
what is the action of diltiazem and the "dipines"?
- relaxes coronary and peripheral blood vessels
- increases oxygen to myocardium
- reduces cardiac workload
what are the adverse effects of diltiazem and the "dipines"?
- edema of ankles and feet
nursing considerations for diltiazem and the "dipines"?
- many drug-drug interactions
- St. Johns wort, ginseng ↓ effectiveness
- garlic, hawthorn, goldenseal ↑ effect
What does research show about giving MI patients ACE inhibitors?
- increased survival rates with therapy started within 24 hours
- captopril or lisinopril
what class of drug is reteplase (Retavase)?
what are the uses of reteplase (Retavase)?
- dissolve existing clots
- treat acute MI (within 12 hrs)
- treat DVT
- treat CVA (within 3 hrs)
- treat PE
- treat arterial thrombosis
- clear IV caths
what are the adverse effects of reteplase (Retavase)?
- excessive bleeding (CVA)
what classes of drugs can cause heart failure?
- ACE inhibitors
- Ca+ channel blockers
- beta blockers
what are the s/s of heart failure from heart drugs?
- fatigue and weakness
- edema of LE
- tachycardia or irregular HR
- persistent coughing (pink tinged phlegm)
- difficulty sleeping
- confusion, impaired memory
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