/01

B S N 2 - E

CARDIOVASCULAR
MEDICATION

G R O U P 3
 ACE
INHIBITOR
benazepril (Lotensin)

enalapril
(Vasotec)
lisinopril
(Prinivil, Zestril)
 Mechanism of Action
MAJOR ADVERSE EFFECTS
Severe hypotension
ACE inhibitors produce vasodilation by
Dry,nonproductive cough
inhibiting the formation of angiotensin II .
Rash This vasoconstrictor is made by the
Metallic taste proteolytic action of renin (released by the
Angioedema kidneys) working on circulating
angiotensinogen to make angiotensin I.
Hyperkalemia
Neutropenia
 nursing rationale
actions
> prescribed by the doctor.
Give 1 hr before meals >will be variably absorbed.
Given by PO route >start at low dose and increased gradually
Start with low dose and gradually increase > prevent an enzyme producing angiotensin II
.>To monitor how the severe the cough is
dose
>to prevent spontaneous eruption, maintain a
Monitor BP after first dose
patent airway if eruption does occur, and to stop
IV fluid therapy for severe hypotension
progression of disease.
Monitor and report dry cough
>To monitor treatment for illnesses that can cause
Treat severe angioedema with IV
abnormal potassium, levels in the body. monitoring
epinephrine
of white blood cell count is usually recommended
Monitor potassium levels and WBC
 ARB
Angiotensin II Receptor
Blockers
GENERIC/BRAND
NAMES

losartan (Cozaar)
azilsartan(Edarbi)
candesartan (Atacand)
 Mechanism of Action
Block ARB receptors on veins that causes widening of
arteries and veins;
MAJOR ADVERSE EFFECT

at that point block ARB receptors on the heart that keeps

Angioedema
ARB from initiating pathologic changes in cardiovascular
Headache structure.
Dizziness
Finally block ARB on the adrenals that reduction arrival of
Hypotension
aldosterone which increments renal discharge of sodium
Insomnia and water
NURSING ACTIONS R A T I O N A L E

1. Given by PO route 1. PO for immediate response

2. to monitor the sudden decrease of blood
2. May be taken with or without pressure that causes chest pain and
food shortness of breath
3. Treat severe angioedema with 3. Angioedema may indicate allergy to a
IV epinephrine drugs
4. Discontinue if angioedema 4. provide further assessment of the effects
to the CNS
occurs 5. For pass absorption to normalized the
5. IV fluid therapy for severe blood pressure
hypotension 6. It can absorbed even without empty
6. Monitor and report CNS stomach as long you it is taken properly
7. IV epinephrine can reduce the risk of the
effects effect of the drugs
7. Monitor BP
 /06
Did you know?

Calcium Channel
Blockers
GENERIC/BRAND NAMES
amlodipine (Norvasc)
nisoldipine (Sular)
nifedipine (Adalat)

Biotin Benefits | Arizzia Medical Center

 MAJOR
ADVERSE
Mechanism of Action EFFECT
Calcium channel blockers bring down your
circulatory strain by keeping calcium from Hypotension
entering the cells of your heart and arteries. Bradycardia
Calcium makes the heart and arteries
Heart failure
contract all the more unequivocally. Peripheral edema of the legs
and feet
Lightheadedness
Dizziness
 NURSING ACTIONS
1. When giving IV form, lay client
supine for 1 hr. after administering
and monitor cardiac rhythm and
vital signs
2. Monitor BP, I&O, and heart rate
3. Monitor and report crackles in the
lungs and edema
4. Notify provider and withhold
drug for BP systolic less than 90 mm
Hg
5. PO and IV route; give PO with
food and give IV over 2-3 min
RATIONALE
1. Helps the blood to circulate
easily.
2. to ensure the possible risk of
heart failure
3. Murmurs in the lungs indicate
severe problem.
4. Edema causes from lymphatic
blockage due to blood activities
5. Inform the patient about the
contraindication and adverse
effect, if persist consult
physician
 Alpha
1
Blocker
Generic/ Brand
Names
prazosin hydrochloride
(Minipress)
alfuzosin (Uroxatral)
doxazosin mesylate
(Cardura)
 Major Adverse
Mechanism of Action Effect
When catecholamines is activated
including epinephrine and norepinephrine Orthostatic
it causes vasoconstriction wherein it
causes an increase in both systemic hypotension
arterial blood pressure and peripheral
resistance. Also, norepinephrine has a Reflex tachycardia
higher affinity for this receptor than
epinephrine. Headache

Dizziness
 NURSING
ACTIONS
1. Monitor for orthostatic hypotension 1. To obtain the cause and determine
2. Report drop of >20 mm Hg systolic
between lying and standing to
provider
3. Report tachycardia to provider
4. Monitor and report headache and
dizziness
5. Given by PO route
6. Give at bedtime
RAT I O NAL
E
appropriate treatment
2. To assess your body’s cardiovascular
response to the change in position
3. alleviate patient discomfort
4. To prevent patient injury
5. To minimize orthostatic hypotension
6. To decrease CNS effects
/23

Beta -Blockers
· acebutolol(Sectral)
a t e n o l o l ( Te n o r m i n )
bisoprolol(Zebeta)
 Mechanism of Major Adverse
Action Effect
beta-blockers are drugs that
predicament to beta-
adrenoceptors and consequently >Bradycardia
block the authoritative of
norepinephrine and epinephrine >Heart failure
to these receptors. This restrains
ordinary thoughtful impacts that >Angina pain
demonstration through these
receptors. >MI
 1. Monitor heart rate and signs of
heart failure
2. Report heart rate less than 60 bpm
and signs of heart failure
3. Educate client to not stop beta
blocker suddenly
4. On discontinuation, taper slowly
over 1-2 weeks
5. Given by PO or IV route
6. Take before meals or at bedtime
6. Encourage for fats absorption of the
Nursing Actions
Rationale
1. To observe heart movement and
rhythm to prevent the risk of heart
failure
2. Immediately assess any experience
bradycardia
3. Beta-blockers helps to relax the
muscle in the heart
4. So that the patient will not go
overdose
5. PO and IV route is the ideal way
for fast absorption and therapeutic
effects.
blood to the system if the stomach is
empty
ALPHA/BETA BLOCKERS
acebutalol (Secral)

atenolol (Tenormin)

betaxolol (Kerlone)

Generic/Brand
Names
 Mechanism of
Action
Alpha blockers work by blocking
Major Adverse the effect of nerves in the
sympathetic nervous system. This
Effect is done by binding to
1. Dizziness
2. Hypotension the alpha receptors in smooth
3. Bradycardia muscle or blood vessels.
4. Postural hypotension
5. Eacerbation of asthma
NURSING ACTIONS
1. Monitor BP and report
hypotension to provider
2. Monitor heart rate and report
rate less than 60 bpm to
provider
3. Given by PO route
4. Move client slowly from
lying to standing positions
RATIONALE
1. Guides the nurse when to take and to
stop the drug
2.To avoid the possible risk of the heart
when the BP and BPM are below in the
normal range.
3. To ensure the absorption of the drug
that is must be directed to the specific
organ to stimulate immediately via PO.
4. After drug taken, nurse must assist
the position of the patient to slow the
circulation of the blood so that it will
not cause hypertension.
GENERIC/BRAND Centrally acting Alpha
Antagonist
NAMES
doxazosin (Cardura)
prazosin (Minipress)
terazosin (Hytrin)
 Mechanism of Action
Major Adverse Effect
Alpha-1B receptors are found in
the smooth muscle and are
activated by adrenaline in the
blood vessels. Vessels are Drowsiness
constricted by activating alpha-
1B receptors and blood pressure Dizziness
increases. Alpha blockers block
alpha-1B receptor activation and Dry mouth
prevent the constriction of blood Rebound
vessels.
hypertension
URSING ACTIONS
1. Monitor client for CNS
effects
2. On discontinuation, taper dose
slowly over several days
3. Given by PO or transdermal
patch route
4. Give drug at bedtime to
prevent sedation during the day
5. Begin dose low and gradually
increase
6. Monitor skin for irritation or
inflammation
RATIOBALE
1. To create safety precautions when there
are CNS effects
2. Provide assistance and motivation to help
the patient cope with the medication
regimen
3. Reduce any harmful effect to the patient
4. To reduce the risk of cardiovascular
diseases; also the body is at rest.
6. To prevent sudden response of6.the drug
taken normally
7. To prevent an allergic reaction and in
result from adverse effects.
 Mechanism of
Action
Vasodilator medications dilates blood Art e ri a l
vessels. They help prevent muscles from
o di l a t or
contracting and walls from reducing which Va s
results to easy access of blood flow to your
vessels.

Headache Major sodium nitroprusside

(Nitropress)
Adverse
Dizziness
Weakness nitroglycerin (Nitrostat)
Fatigue
Reflex tachycardia
Edema
Effect hydralazine (Apresoline)

Rebound hypertension

Nursing
Actions
1. Monitor pulse and report tachycardia
to provi der
2. Monitor for hypotension, signs of
facial rash, joint pain, or fatigue and
report to provider
3. Monitor for edema and crackles in the
lungs
4. On discontinuation, taper slowly
Rationale
1. to be able to respond immediately
with right intervention if the situation
occurs.
2. To be aware of any adverse
reactions that individuals may show
after taking medication.
3. Edema cause crackling sounds in
your lungs which is a risk for
congestive heart failure mostly have
pulmonary edema.
4. To avoid side effects from abrupt
medication withdrawal.
 DIURETICS Mechanis
m of
They act byAction
bumetanide (Bumex)
ethacrynic acid (Edecrin) diminishing sodium
furosemide (Lasix) reabsorption at different sites
within the nephron, thereby
increasing urinary sodium and
water losses.
Major
Adverse
Effects
>Increase urine output
>Postural hypotension
>Possibility of dehydration
>Hypo/Hyper-kalemia
>Eectrolytes imbalance
1. Give in the early morning if ordered
daily
2. Keep a bedpan within reach.
3. Assist to the bathroom anyone who
is elderly, weak, dizzy, or unsteady in
walking.
4. Assist the patient to get up slowly
5. Record fluid intake & output
regularly
6. Monitor serum potassium level
(within 3.5-5 mEq)
Nursing Actions
Rationale
1. Diuretics can cause patients to urinate more and
can disrupt sleep if taken near bedtime.
2. t enables the patient to take urinating much
easier.
3. It will prevent patient to overstrain his body.
4. Monitoring a resident's fluid balance with an
intake and output record intake and output allows
nursing staff to stop dehydration.
5. potassium in your blood can result in serious
health problems.
6. to analyzed in a routine urine sample
Antianginal Drugs Major Adverse Effects
>Headache
ranexa (Ranolazine) >Orthostatic
isosorbide dinitrate (Isordil) hypotension
minitran (Nitroglycerin)
>Tolerance
Mechanism of
Action
Increases coronary blood flow and
oxygen supply. It can help to
provide immediate relief from
symptoms and prevent chest pain.
 NURSING ACTIONS
1. Inform patients that headache will
diminish with continued drug use. Can be
relieved by mild analgesics.
2. Slowly change from a sitting or lying
position to an upright position.
3. Use the minimum effective dose. For
long-acting preparations, they should be
used on an intermittent schedule to allow at
least 8 drug-free hours.
R AT I O N A L E
1. To reassure patients that their
symptoms are not.
caused by a serious disease.
2. Upright position promotes
oxygenation improvements to
patients.
3. To administer medications safely
and effectively.
DIGITALIS, acetyldigoxindigitoxin (Lanoxin)
B- Acetyldigoxin (Adenocin,
CARDIAC Adenocinum)
digoxin (Lanoxin)
GLYCOSIDES Major Adverse
it hinders the Na-K-ATPase; also expands
Effects
the intracellular concentrations of calcium
that may advance the actuation of >Dysrhythmias
contractile proteins. >Bradycardia
>Toxicity
>Anorexia, nausea, vomiting
>Disturbances of color vision
>Fatigue
Mechanism of Action
 Nursing Rationale
Actions
1. Withhold the drug & contact the
physician if there are any signs of
digoxin toxicity or marked changes in the
1. Digoxin toxicity occurs when you take
too much digitalis so should monitor your
intake to make sure you are taking too much
pulse rate/rhythm (bradycardia) digitalis
2. Monitor digoxin levels closely: should
be smaller than 2 ng/mL 2. To prevent Digoxin toxicity
3. Because these incorporate an age-related
3. Older adults are particularly prone to decline in renal work and a diminish in
digoxin toxicity volume of digoxin dissemination.
Screen for factors that potentiate digitalis
toxicity:hypokalemia, impaired renal A low level of potassium within the body
function, oral antibiotics, quinidine, can increment the hazard of digitalis
amiodarone, Ca++ toxicity.