Cardiovascular Medications: Section 1

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Author:
Msrhey
ID:
76140
Filename:
Cardiovascular Medications: Section 1
Updated:
2011-03-30 01:24:35
Tags:
Antianginals Peripheral vasodilators
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Description:
Antianginals & Peripheral vasodilators: actions, uses, adverse effects, drug interactions, nursing implications, patient teaching.
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  1. What are nitrates used for?
    best drugs for treating coronary artery disease; acute and chronic anginal attacks
  2. How does nitrate takes effect?
    • Nitrate prodcuts directly cause vascular smooth muscle to relax in arterial and venous circulation.
    • It decreases the myocardial O2 use.
    • It increases collateral-vessel circulation to the heart.
  3. Common adverse reaction of nitrates:
    • Flushing
    • headache
    • postural hypotension
    • dizziness
    • tachycardia
    • weakness
    • vertigo
  4. Clinical Goldmine: Tolerance to nitrate
    Tolerance to nitrates may develop over time with repeated use. If the patient develops tolerance to one nitrate, it is likely that tolerance to other nitrates (Cross-tolerance) will develop. Alternative coronary vasodilators may have to be used.
  5. Isosorbide dinitrate (PO, sublingual [SL], and chewable
    • classification: Antianginal
    • trade name: Dilatrate Sr, Titradose
    • uses: Prophylaxis of angina; acute angina
    • Adverse reaction: flushing, headache, dizziness, tachycardia, weakness, vertigo
    • dose ranges: 5-30 mg PO 2-3 times daily; 2.5-30 mg SL; 5mg chewable; increase as needed
  6. Isosorbide mononitrate
    • classifiaction: Antianginal
    • trade name: Ismo, Imdur
    • uses: prophylaxis of angina
    • adverse reaction: flushing, headache, dizziness, tachycardia, wekaness, vertigo
    • dose ranges: 20 mg PO twice daily
  7. Nitroglycerin (SL)*
    • classifiaction: Antianginal
    • trade name: Nitrostat, NitroQuick
    • uses: prophylaxis of angina, treatment, and management of angina
    • adverse reaction: flushing, headache, dizziness, tachycardia, wekaness, vertigo
    • dose ranges: 1 tab SL; repeat in 5 min 3 times as needed
  8. Nitroglycerin (sustained release)*
    • classification: Antianginal
    • trade name: Nitro-Time
    • uses: prophylaxis or management of angina
    • adverse reaction: flushing, headache, dizziness, tachycardia, wekaness, vertigo
    • dose ranges: 1 cap or tab every 8-12h
  9. Nitroglycerin (topical)*
    • classification: Antianginal
    • trade name: Nitro-Bid
    • uses: prevention and treatment of angina caused by CAD
    • adverse reaction: flushing, headache, dizziness, tachycardia, wekaness, vertigo
    • dose ranges: 1-2 inches every 5-8h (1 inch = 15 mg NTG)
  10. Nitroglycerin (transdermal)*
    • classification: Antianginal
    • trade name: MiniTran, Nitro-Dur
    • uses: Prevention and treatment of angina caused by CAD
    • adverse reaction: flushing, headache, dizziness, tachycardia, wekaness, vertigo
    • dose ranges: apply pad daily; leave on for 12-14 hr; take off for 10-12hr
  11. Nitroglycerin (translingual)*
    • classification: Antianginal
    • trade name: Nitrolingual Pump spray
    • uses: prophylaxis and treatment of acute angina
    • adverse effects: flushing, headache, dizziness, tachycardia, weakness, vertigo
    • dose ranges: 1 oe 2 metered doses sprated onto oral mucosa or under tongue
  12. Nitroglycerin nursing considerations:
    • 1. very fragile & chemically breaks down rapidly; sunligh speeds up this process
    • 2. drugs lose their strengths 3 montsh after the bottle has been opened.
    • 3. Medication that is still active will produce a throbbing headache.
    • 4. If patients fails to feel the throbbing headache, usually the medication has lost its potency (strength)
  13. Nursing consideration: Storing nitroglycerin
    • active ingredient in NTG is easily destroyed:
    • storage in plastic or in a cardboard box allows the nitrate to escape.
    • placing cotton in the top of the container or storing other drugs with NTG (ex. pillbox) will absorb the ntirate.
    • NTG should be stored in the original dark glass container.
    • All cotton should be removed
    • container should be kept tightly capped and out of sunlight
    • store NTG in the refrigerator.
  14. Nitroglycerin Patient and Family Teaching
    • should be taken on an empty stomach
    • common side effects
    • headache usually lasts no longer than 20 minutes and may be relieved with analgesics
    • Patient should rest for 10-15 mins after the pain is relieved.
    • Notify physician if blurred vision, persistent headache, or dry mouth occurs.
    • If tolerance occurs, stop drug for several days then take the smallest dose to reduce the risk od tolerance
    • patient should record every anginal attack, number of pills taken, and any side effects. Patient should bring this record to each visit to the health care provider.
    • Keep medications out of reach of children or others.
    • In hospital, BP should be taken before administering NTG

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