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= Cardiovascular Meds to Know

Name of Medication & Classification/Purpose Digoxin (0.5-2 therapeutic range) Antiarrhythmic agent Nursing Implications/Responsibiliti es -apical pulse for 1min & hold if <60 BPM -monitor I&O, daily wt. -auscultate lungs for rales/crackles -assess for peripheral edema -monitor electrolytes (esp. K+ - predisposes to toxicity decreased K+) -monitor LFT & RFT -assess K+ level (3.5-5.0) & BP prior to adm -watch ECG for arrhythmias -bone marrow suppression can occur -low K+ causes Digoxin toxicity -photosensitivity may be severe -monitor I&O, daily wt. -assess K+ level (3.5-5.0) & BP prior to adm -monitor ECG for symptoms of hyperkalemia (tented T waves) Patient Education for SelfManagement -rpt N/V or anorexia -inform all HCP of this drug regimen -routine follow-up exams

Lasix( furosemide) Loop diuretic 3 Ls: Lasix diuretic Loop of Henle Low K+

Aldactone ( spironolactone) K+ sparing diuretic

-report prior to use an allergic reaction to sulfonamides -change positions slowly to decrease effects of orthostatic hypotension -consume increased K+ foods or K+ supplements -use sunscreen -rpt unusual bleeding, bruising, SOB, or sore throat -AVOID K+ rich foods & Na+ substitutes -may cause dizziness -BP & lab work will be monitored -notify HCP of muscle weakness, cramps, fatigue, severe N/V, palpitations, & diarrhea

Potassium supplement Vasotec (enalapril) ACE inhibitor Antihypertensive agent -take BP prior to adm -monitor I&O, daily wt. -monitor for signs of angioedema -assess for S&Sx of CHF -monitor LFT, RFT, CBC, serum glucose, & K+ (increased) -take BP prior to adm -may cause drowsiness -rpt to HCP immediately: chest pain, palpitations, swelling of lips, face, or tongue

Cozaar (losartan)


Antihypertensive agent Angiotensinll receptor antagonist

-assess for S&Sx of CHF -monitor I&O, daily wt. -monitor LFT, RFT, CBC, K+ level -monitor ECG (may cause prolonged PR interval)

Lopressor (metropolol) Beta-blocker Antihypertensive agent

Mevacor (lovastantin) Lipid lowering agent

Nitroglycerin (p.o.; sublingual; patch; IV drip) Anti-anginal agent

-SE: bradycardia, CHF, pulmonary edema -assess pulse & BP prior to adm -monitor LFT, RFT, electrolytes, ANA, I&O, daily wt. -evaluate serum cholesterol & triglyceride levels before initiating medication, after 2-4 wks of therapy, & periodically after -monitor LFT prior to & @ 6 mo. -muscle tenderness w/CPK increase=rhabdomyolysis -increased risk for serious & potentially fatal hypotension -assess BP prior to adm -pts IV nitrates require continuous ECG & BP monitoring

SUBSTITUTES -rpt immediately: rash, mouth sores, sore throat, fever, swelling of hands/feet, irregular heartbeat, chest pain, dry cough, hoarseness, swelling of face, lips, or tongue, difficulty breathing or swallowing -rpt N/V, diarrhea, metallic taste causes anorexia -notify HCP if slow pulse or dyspnea occurs

-avoid drinking >1Qt of grapefruit juice/day -notify HCP of unexplained muscle pain, tenderness, or weakness occurring (esp. w/fever or malaise) -avoid pregnancy or breast feeding -HA common SE -avoid concurrent use of alcohol w/this med -acute angina attack sit, use med, if pain does not subside repeat dose & call EMS -store tabs in dark glass container & away from (body) heat -replace every 6 months -rpt symptoms of unusual bleeding or bruising to HCP immediately -DO NOT take antiplatelet agents -use soft toothbrush & electric razor -wear medic alert bracelet

Heparin ( IV) Anticoagulant Antithrombotic agent

-assess for S&Sx of bleeding & hemorrhage -monitor for hypersensitivity reactions -assess LFT, K+ level, CBC, PTT -2 practitioners check order, calculate dose, & set pump -protamine

Low Molecular Weight Heparin (sq) Lovenoxadm in love handles Anticoagulant Antithrombotic agent

sulfate=antidote -assess for S&Sx of bleeding & hemorrhage -monitor CBC w/platelets, LFT -protamine sulfate=antidote

Coumadin Anticoagulant

-assess for S&Sx of bleeding & hemorrhage -monitor PT, INR, & CBC -takes 3-5 days to reach effective levels -assess stool & urine occult blood before & throughout therapy -VIT K=antidote -monitor LFT, RFT, electrolytes, bleeding time, CBC, & serum drug levels -tinnitus=toxicity -monitor drug effectiveness -assess for S&Sx of stroke, PVD, & MI during therapy -monitor for S&Sx of thrombotic thrombocytic purpura -monitor bleeding time, CBC w/diff, & platelet count periodically -monitor LFT, lipid panel, & uric acid concentrations -contraindicated in idiopathic thrombocytopenic pupura

ASA Antipyretic Non-opioid analgesic Part of MONA for MI

Plavix (clopidogrel) Antiplatelet agent

-rpt symptoms of unusual bleeding or bruising to HCP immediately -DO NOT take antiplatelet agents -use soft toothbrush & electric razor -wear medic alert bracelet -follow instructions for proper method of injecting the drug -DO NOT eat excessive amts of food w/VIT K -use soft toothbrush & electric razor; DO NOT floss -frequent lab tests will be done -DO NOT drink alcohol or take antiplatelet agents -rpt S&Sx of unusual bleeding or bruising -smells like vinegar-no longer effective -take w/food or milk -avoid taking w/other NSAIDS -contraindicated <16 yrs -325mg of ASA if unrelieved chest pain occurs -notify HCP immediately: fever, chills, sore throat, unusual bleeding or bruising -avoid taking OTC meds containing ASA or NSAIDS w/o consulting HCP

Cardiovascular Lab and Diagnostic Tests to Know

Labs and Diagnostic Tests CBC Hgb; Hct; WBCs; platelets Chemistry Profile (potassium; sodium; magnesium; BUN/Cr) Purpose/Patient Preparation Significance of Abnormal Findings

Lipid Panel (total cholesterol; HDLs; LDLs; triglycerides BNP Homocysteine C-Reactive Protein

Cardiac Serum Markers (CKMB)& Troponin Microalbuminuria Protime APTT Digoxin Level Echocardiogram Stress Test

Chest x-ray