This document summarizes several classes of cardiac drugs, their effects, and important nursing considerations for each. It discusses platelet inhibitors that prevent platelet aggregation, beta-blockers that reduce heart rate and contractility, peripheral alpha blockers that dilate blood vessels and lower blood pressure, central alpha agonists that stimulate receptors in the brain to decrease effects, ACE inhibitors that decrease pulmonary congestion and promote sodium excretion, calcium channel blockers that manage coronary vasospasm, the positive inotropic agent digoxin, vasodilators that dilate blood vessels, and diuretics that decrease intravascular volume. For each drug class, it provides examples of drugs and highlights monitoring parameters and side effects to watch for.
This document summarizes several classes of cardiac drugs, their effects, and important nursing considerations for each. It discusses platelet inhibitors that prevent platelet aggregation, beta-blockers that reduce heart rate and contractility, peripheral alpha blockers that dilate blood vessels and lower blood pressure, central alpha agonists that stimulate receptors in the brain to decrease effects, ACE inhibitors that decrease pulmonary congestion and promote sodium excretion, calcium channel blockers that manage coronary vasospasm, the positive inotropic agent digoxin, vasodilators that dilate blood vessels, and diuretics that decrease intravascular volume. For each drug class, it provides examples of drugs and highlights monitoring parameters and side effects to watch for.
This document summarizes several classes of cardiac drugs, their effects, and important nursing considerations for each. It discusses platelet inhibitors that prevent platelet aggregation, beta-blockers that reduce heart rate and contractility, peripheral alpha blockers that dilate blood vessels and lower blood pressure, central alpha agonists that stimulate receptors in the brain to decrease effects, ACE inhibitors that decrease pulmonary congestion and promote sodium excretion, calcium channel blockers that manage coronary vasospasm, the positive inotropic agent digoxin, vasodilators that dilate blood vessels, and diuretics that decrease intravascular volume. For each drug class, it provides examples of drugs and highlights monitoring parameters and side effects to watch for.
Spotlight on Cardiac Drugs Spotlight on Cardiac Drugs
Drug Class Effect Nursing Considerations
Platelet Inhibitors Aspirin Ticlopidine (Ticlid) Clopidogrel (Plavix) Glycoprotein IIb/IIa inhibitors (abciximab, tirofiban, eptifibatide) nfractionated heparin !o"#molec$lar#"eight heparin (enoxaparin %!ovenox&) Inhibit factors necessary for platelets to aggregate on r$pt$red arterial pla'$e Ticlodipine can ca$se thrombocytopenia and agran$locytosis, so fre'$ently monitor platelet co$nts nfractionated heparin has limited and changeable bioavailability, so the patient needs fre'$ent activated partial thromboplastin times to monitor for therape$tic levels !o" molec$lar heparin has greater bioavailability and more predictable effects, so it doesn(t re'$ire coag$lation assays Beta-blockers Cardioselective types (metoprolol %Toprol, !opressor&) ) bloc* beta + receptors in the heart Noncardioselective types (propanolol %Inderal&, labetalol % ,ormodyne, Trandate,&, Carvedilol %Coreg&) ) bloc* both the beta + receptors in the heart and beta - receptors in the l$ngs and blood vessels .ed$ce heart rate, contractility, and speed of imp$lse cond$ction thro$gh the A/ node 0eta#bloc*ers are $sed to treat hypertension, angina, cardiac arrhythmias, myocardial infarction, hyperthyroidism, migraines, stage fright, and gla$coma1 ,oncardioselective beta#bloc*ers aren(t appropriate for someone "ith a history of constrictive air"ay disease beca$se they can ca$se bronchoconstriction1 They can also mas* signs of hypoglycemia1 Carvedilol may be $sed "ith AC2 inhibitors, digitalis, and di$retics to manage heart fail$re, b$t the combination can slo" A/ cond$ction, so closely monitor the patient for cardiac rhythm dist$rbances Peripheral alpha 1-adrenergic blockers Pra3osin (4inipress) Tera3osin (5ytrin) 6oxa3osin (Card$ra) 6ilate blood vessels and decrease blood press$re The first dose can ca$se severe orthostatic hypotension, ca$sing the patient to feel light#headed or to faint1 7ho$ld not be $sed alone to treat hypertension beca$se monotherapy increases the ris* of heart fail$re, stro*e, and chest pain1 Central alpha 2- agonists Clonidine (Catapres) 4ethyldopa (Aldomet) 7tim$late receptors in the brain to decrease 5. and C8, dilate 0/ and decrease 0P Clonidine and methyldopa are approved for hypertension Clonidine is also being investigated as treatment for menopa$sal fl$shing,, migraines, and "ithdra"al from opioids, alcohol and tobacco1 ACE Inhibitors !osartan (Co3aar) /alsartan (6iovan) Irbesartan (Avapro) Candesartan (Atacand) Telmisartan (4icardis) 6ecrease p$lmonary congestion and peripheral edema9 promote sodi$m and "ater excretion, and dilate 0/9 decrease ventric$lar remodeling related to 4I or 5:1 4onitor for first dose hypotension The most common reason to d/c is a dry, irritating co$gh 4onitor the patient for hyper*alemia and avoid potassi$m#sparing di$retics and potassi$m s$pplements1 6iscontin$e immediately if angioedema develops1 Ta*ing ,7AI6s may increase 0P Calcium Channel Blockers Affecting peripheral blood vessels ,ifedipine (Adalat, Procardia) Amlodipine (,orvasc) :elodipine (Plendil) Isradipine (6ynaCirc) ,icardipine (Cardene) Affecting the heart /erapamil (Calan, Isoptin) 6iltia3em (Cardi3em, 6ilacor) 4anage coronary vasospasm and decrease the heart(s "or*load by dilating blood vessels (nondihydropyridines also decrease contractions) After 4I, $se only if beta bloc*ers are contraindicated or the patient can(t tolerate them, sef$l in patients "ith diabetes, asthma, or migraines Positie Inotropic Agent 6igoxin Increases force of ventric$lar contraction9 decreases a$tomaticity of 7A node to maintain an acceptable heart rhythm Tell the patient to report irreg$lar heartbeat, vis$al dist$rbances (bl$rred vision, yello" halo aro$nd ob;ects), fatig$e, anorexia, na$sea and vomiting1 !asodilators ,itroglycerin (,itrostat) Isosorbide (Isordil) 6ilate blood vessels to decrease ventric$lar filling, preload, and myocardial oxygen demand If the patient develops a tolerance to nitroglycerin, the physician may prescribe a <nitro#free= period each day (s$ch as removing the dr$g patch at bedtime) Diuretics !oop di$retic (:$rosemide) Thia3ide di$retic (5CT>) 8smotic di$retic (4annitol) ?#7paring di$retic (7pironolactone) 0loc* reabsorption of sodi$m and chloride to decrease intravasc$lar vol$me 4onitor for dehydration, hypo*alemia ($nless the patient is ta*ing a potassi$m#sparing di$retic), and hypotension Teach the patient to ta*e the di$retic in the morning beca$se it "ill increase the need to $rinate for @ to A ho$rs1 Tell her to "eigh herself daily and to report any "eight gain of more than B po$nds (+1C *g) to her health care provider1 Teach her the signs of orthostatic hypotension1 Tell her to get $p slo"ly and to sit or lie do"n if she feels di33y or faint1 Lifted from: How Cardiac Drugs Do What They Do by Anne Marie Palatnik !" C#C M#" "ursing $%%& '&:( ()*+%