*Medication Aide Chapters 18-23

*Lipids

*Lipids are fats

*Hyperlipidemia

*Cholesterol

*Triglycerides

*Anti-lipemics

*Used to reduce the LDL and triglycerides in blood, reducing risk of hardening of arteries and prevention of heart attacks

*Common side affects

* Headaches

* Runny nose

* Upset stomach

* Nausea, vomiting

* Diarrhea

* Muscular aching

* Joint pain

*Nursing precautions

* Observe for changes in bowel habits, stomach cramps, joint pain,

* Some of “statin” medications should be given with food, others at bedtime

*cont

*Questran give with meals to decrease LDL’s

*Mix with juice(do not give other meds 1 hr. before or 4 hrs. after other meds)

*Enc. High fluid intake & a diet high in fiber

*Niacin give @ night lowers cholesterol & triglycerides-used with statins

*Side effects; flushing, itching, nausea, headache, fatigue, muscle aches & weakness

*Statins

*Reduce risk of MI & stroke

*Do not give with grapefruit juice

*Lipitor

*Mevacor

*Crestor

*Zocor

*Side effects

*Fatigue, anorexia, nausea

*Muscle aches & weakness

*Fibric acids

*Lowers triglycerides & LDL’s

*Lopid

*Tricor

Side effects

nausea & diarrhea

flatulence & abd. Discomfort

fatigue, anorexia, nausea

muscle aches

* Common Conditions of the circulatory system

*Anemia

*Arrhythmias

*CHF (congestive heart failure)

*CVA (Cerebral Vascular accident)

*Hyperlipidemia

*Hypertension

*MI (Myocardial Infarct)

*Peripheral Vascular Disease

*Shock

*Thrombus

*Hypertension

*High blood pressure

*Systolic greater than 140

*Diastolic greater than 90

*Narrow blood vessels are the common cause

*Anti-hypertensives

* Used to restore blood pressure to within normal range

* Common side affects

* Dizziness

* Low blood pressure

* Irregular pulse

* Edema

* Confusion

* Breathing difficulties

* Headache

* Heartburn & indigestion

* Nursing precautions

* Take blood pressure regularly

* Observe for unsteady walking and mobility

* Monitor dietary salt intake and weight loss/gain

*examples

* Diuretics (Lasix, Bumex, Dyazide) increases urine output-lowers edema

* Beta-adrenergic blockers (Inderal, Lopressor, Corgard)

* Lowers heart rate & cardiac output, thus lowers BP

* Must reduce dosages slowly

* Angiotensin converting enzyme inhibitors (Altace, Zestril, Lotensin)Ace Inhibitors

* Less vasoconsrtiction & less sodium & water retention

* Usually combined with diuretic for more effectiveness

* Antiotensin II receptor blockers –ARB’s(Avapro, Cozaar, Micardis, Benicar)

* Less vasoconstriction & less sodium & water retention

* Calcium ion antagonists (Cardizem, Procardia, Calan)

* Calcium Channel Blockers

* Relaxes smooth muscle(vaso-dilation)

* Remind to change positions slowly

* Monitor wt. dly.(may cause edema)

*Cont.

*Alpha-1Adrenergic Blocking agents(Minipress, Cardura, Hytrin)

*Causes vaso-dilation

*Relaxes smooth muscle of the bladder & prostate

Alpha-2 Agonist(Catapress, Aldomet)

Used with other anti-hypertensive agents

Lowers ht. rate & peripheral vascular resistance

If a transdermal patch becomes loose, secure with a piece of adhesive

*Peripheral-acting adrenergic

antagonists

*Lowers peripheral vascular resistance(lowers BP)

*Lowers venous blood return(may cause increase of edema)

*Hyorel

*Ismelin

*Serpasil

*Direct vaso-dilators

*Reduces peripheral vascular resistance, thus it lowers the BP(relaxes smooth muscle)

*Apresoline-Increases cardiac output & sodium retention

*Loniten-same response(does cause increased body hair)

*Both are used with diuretics

*Combination drugs

*A combination of a anti-hypertensive drug & a diuretic

*Usually very expensive as not on the generic lists @ this time

*Hyzaar

*Lopressor HCT

*Corzide

*Aldoril

*Dysrhythmias

*Lack or correlation between diastole and systole

*Can be related the electrical system of the heart.

*cont

* Electrical cardiograms are what maps the electrical activity of the heart

* They can help to diagnose different arrhythmias(heart rhythm)

* You won’t be expected to read or interpret them; however you need to know that if when you’re taking a pulse, & it is irregular, you need to let you nurse know, so that she can check it out to see if there’s a problem

*Check with your facility to see if can take apical pulses

* Frequently are given with the same guidelines as digoxin(don’t give if pulse is below 60 or greater then 100)

* Dr. will have written guidelines if in force)

*Beta Blockers

*Are frequently used for dysrhythmias

*Lowers ht. rate, cardiac output & BP

*Lopressor

*Toperal

*Indural

*Other Meds

*Used to restore rhythms(affects the electrical impulses)

*Always monitor for changes in the rhythm of the heart

*Norpace

*Tambocor(may cause the dysrhythmias to worsen)

*Procanbid

*Quinidine

*Cordarone

* Medications affecting circulatory system

*Anti-anginal

* Used to relieve chest pain

* Common side affects

* Weakness

* Dizziness

* Rapid lowering of blood pressure

* Nursing precautions

* Monitor blood pressure during course of administering the medication

* Stay with patient during report of chest pain

* If chest pain unrelieved, call supervisor immediately

* Examples

* Nitroglycerin products: Nitrostat, Nitro-bid

* isosorbide dinitrate

* Calcium channel blockers (Cardizem, Procardia, verapamil)

*Angina

* The coronary arteries are in the heart.

* They supply the heart with blood.

*Coronary artery disease (CAD) causes the arteries to become narrow therefore the heart gets less oxygen and blood.

*Angina means chest pain related to lack of blood and oxygen.

* tightness

* Pressure

* Squeezing

* Burning

* SOB

* Radiating pain

*Cont…

*Things that cause angina are avoided.

*Over-exertion

*Heavy meals

*Emotional stress

Some individuals need medication

If rx is in disk form & it becomes loose, remove & apply a new disk

*Peripheral Vascular Disease

*Involves the blood vessels in the arms and legs

*Deep vein thrombosis

*Blood clots

*Arteriosclerosis obliterans

*Hardening of the arteries

*Raynaud’s disease

*Blood vessel spasms (vaso-spasms)

*Hemorrheologic agent

*Prevents red blood cells & platelets from clumping

*Monitor for SOB or chest pain or indigestion

*Monitor for poor tolerance to caffeine products

*Trental

*Heart failure

*Or also called congestive heart failure (CHF)

*Occurs when the heart is weakened and cannot pump normally.

*Blood backs up

*Tissue congestion occurs

*Left-side failure causes pulmonary congestion

*Right-side failure causes peripheral congestion

*Cardiotonics

*Used to help cardiac muscle to beat more slowly & stronger

*Common side affects

* Accumulative affect may become toxic

* Nausea, vomiting

* Headache

* Blurred vision

* Dizziness

* Irregular pulse

* Loss of appetite

* Weakness

* confusion

*Nursing precautions

* Take pulse before each dose, if under 60 or over 100 hold medication and report to supervisor

* Examples

* Digoxin

* Crystodigin

*diuretics

* Used to promote formation, excretion of urine

* Common side affects

* Weakness

* Leg cramps

* Thirst

* Jaundice

* GI stress

* Nursing precautions

* Measure, record I&O

* Weigh as directed

* Monitor BP as directed

* Do not switch to salt substitute without checking with physician

* Dietary restrictions of low salt intake apply

* Examples

* Lasix (furosemide)

* Bumex (bumetanide)

* Diuril (chlorothiazide)

* Hydrodiuril (hydrocholorothiazide)

* Enduron (methylclothiazide)

* Lozol (indapamide)

* Edecrin (ethacrynic acid)

* Demadex (torsemide)

* Midamor Iamiloride)

* Aldactone Ispironolactone)

* Diazide (hydrocholorthiazide)

*Diuresis

* Means the increased formation and excretion of urine

* Lab values of K*, Na*, & frequently Ca* are monitored q 3 mo.

* Very often on a K* supplement

* Encourage to eat foods high in K* such as bananas, tomatoes, potatoes, orange juice etc.

* Dyazide & Aldactazide are considered to be K* sparing

* Diuretics are used to treat several disorders

* Ascites

* Hypertension

* Heart failure

* Cerebral edema

* Liver disease

*Thrombo-embolic diseases

*Thrombosis

*Is the process of clot formation

*Thrombus

*Blood clot

*Embolus

*Clot that travels through the blood vessels

* Ischemia – decreased blood supply

* Infarction- local area of tissue death

*Cont.

*Major causes

* Immobility

*Surgery

*Leg trauma

*Vaso-spasm

*Cancer

*Pregnancy

*Contraceptive agents

*Heredity

*Diseases caused by clotting within blood vessels

*anticoagulants

* Used to thin the blood and reduce clot formation

* Common side affects

* Bleeding

* Nausea, vomiting

* Prolonged bleeding time

* Bruises

* Black tarry stools

* Brownish colored urine

* Nursing precautions

* Monitor patients for bleeding & bruises during ADL cares (report immediately)

* Prevent prolonged sitting and tissue damage by careful positioning and turning

* Prevent falls, skin tears, injury

* Examples

* Coumadin

* Heparin (Warfarin)

* Platelet Inhibitors

* ASA

* Persantine (dipyridamole)

* Plavix (clopidogrel)

* Ticlid (ticlopidine)

*Coagulants

*Used to help blood form clots

*Common side affects

*Vertigo

* Flushing

*Rash

*Headache

* Leg pain/swelling

*Nursing precautions

*Monitor for leg tenderness, redness, swelling, cramping, pain

*Observe dietary intake potential interactions

*Report any chest pain or shortness of breath immediately

*Examples

*Vitamin K

*Added Treatments

*Leg exercises

*Elevating the legs

*Early ambulation

*Teds or Compression hose

*Placing of stents to reopen a artery

*Bypass grafts

*Angioplasty(balloon surgery)