PHARM EXAM 3 > Chapter 49 > Flashcards

Chapter 49 Flashcards

Vasodilators (41 cards)

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1
Q

-What do vasodilators do?
-What are they used to treat?

A

-They directly affect smooth muscles of the arteries
-HTN

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2
Q

What are the 3 vasodilators that we will focus on?

A
  1. Hydralazine
  2. Minoxidil
  3. Sodium Nitroprusside
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3
Q

HYDARALAZINE
-What is the drug class?

A

Direct-acting vasodilator

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4
Q

HYDARALAZINE: Therapeutic Uses
-What 3 things is this used for?

A
  1. Essential HTN & chronic HTN
  2. Hypertensive crisis
  3. HF
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5
Q

HYDRALAZINE: Therapeutic Uses
-How does hydralazine relate to being used for chronic hypertension?

A

It is the 3rd line drug for chronic HTN

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6
Q

HYDRALAZINE: Therapeutic Uses
-It is used alone when used for HF (T/F)

A

FALSE; it must be combined with another drug

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7
Q

HYDRALAZINE: Mechanism of Action
-What does it do?

A

It dilates arterioles & decreases afterload

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8
Q

HYDRALAZINE: Pharmacokinetics
-What is the route?

A

PO & IV

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9
Q

HYDRALAZINE: Adverse Effects
-What is the main effect of hydralazine?

A

It causes a drop in BP

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10
Q

HYDRALAZINE: Adverse Effects
-What does a drop in BP cause? (3)

A
  1. Reflex tachycardia
  2. Renin release
  3. Fluid retention
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11
Q

HYDRALAZINE: Adverse Effects
-Blood volume (increases/decreases)

A

Increases

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12
Q

HYDRALAZINE: Adverse Effects
-You will DISCONTINUE the medication if the patient develops what?

A

Systemic lupus erythematosus-like syndrome –> break out in rashes

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13
Q

HYDRALAZINE: Adverse Effects
-Tell the patient that they should report what 5 things?

A
  1. Dizziness
  2. Fainting spells
  3. Fatigue
  4. Headaches
  5. Weakness
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14
Q

HYDRALAZINE: Drug Interactions
-(Always/never) use this with other drugs.
-Why?

A

-ALWAYS
-to counteract the adverse effects experienced

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15
Q

HYDRALAZINE: Drug Interactions
-DO NOT use hydralazine with what other medications?
-Why?

A

-Antihypertentsive agents
-We want to avoid excessive hypotension

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16
Q

HYDRALAZINE: Drug Interactions
-How do you prevent tachycardia & renin release?

A

With beta blockers

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17
Q

HYDRALAZINE: Drug Interactions
-How do you prevent fluid retention?

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A

With diuretics

18
Q

MINOXIDIL
-What drug class is this?

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A

Direct-acting vasodilator

19
Q

MINOXIDIL: Therapeutic Uses
-When will this be used?
-Why?
-Usually, the patients have not…

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A

-ONLY for severe hyertensive emergencies/crisis
-Because it is VERY POTENT
-Responded to safer drugs

20
Q

MINOXIDIL: Therapeutic Uses
-What is a separate formulation of this & what is it used for?

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A

-Topical minoxidil
-hair growth

21
Q

MINOXIDIL: Mechanism of Action
-What does this do?

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A

It dilates arterioles & decreases afterload

22
Q

MINOXIDIL: Pharmacokinetics
-What is the route?

23
Q

MINOXIDIL: Adverse Effects
-What are the MOST SERIOUS adverse effects?

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A
  1. Reflex tachycardia
  2. Sodium & water retention
  3. Pericardial Effusion
24
Q

MINOXIDIL: Adverse Effects
-What is pericardial effusion?
-What can it lead to?

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A

-Fluid accumulation beneath the pericardium
-Tamponade & compression of the heart

25
**MINOXIDIL**: *Adverse Effects* -What is an adverse effect that typically causes patients to stop taking the medication? -Is it dangerous?
-Hypertrichosis --> excessive hair growth -No, just cosmetically disturbing
26
**MINOXIDIL**: *Drug Interactions* -Would you use this with other drugs? -Why or why not? -If so, which ones
-Yes, to counteraact the adverse effects -Beta blockers, diuretics
27
**SODIUM NITROPRUSSIDE** -What is the drug class?
Poten IV vasodilator
28
**SODIUM NITROPRUSSIDE**: *Therapeutic Uses* -What is the first line use? -Where do you give this?
-Hypertensive emergencies -ONLY in the ICU
29
**SODIUM NITROPRUSSIDE**: *Therapeutic Uses* -What are 3 other uses
1. Cardiogenic shock 2. Enhances vasodilation (for non-cardiogenic shock use) 3. Acute decompressed heart failure (ADHF)
30
**SODIUM NITROPRUSSIDE**: *Mechanism of Action* -What does it do?
Dilates **arteries AND veins**
31
**SODIUM NITROPRUSSIDE**: *Pharmacokinetics* -What is the route?
IV ONLY
32
**SODIUM NITROPRUSSIDE**: *Adverse Effects* -What are the 4?
1. Excessive hypotension 2. Cyanide posioning 3. Thiocyanate toxicity 4. Sodium & water retention
33
**SODIUM NITROPRUSSIDE**: *Adverse Effects* -What can you do if the patient starts bottoming out (BP lowering too fast)?
Slow the IV rate
34
**SODIUM NITROPRUSSIDE**: *Adverse Effects* -When does thiocyanate toxicity develop?
With prolonged use of over 72 hours
35
**SODIUM NITROPRUSSIDE**: *Adverse Effects* -How do you counteract sodium & water retention?
With furosemide (diuretic)
36
**SODIUM NITROPRUSSIDE**: *Adverse Effects* -Special precautions should be taken for what 2 diseases? -Why? (2)
-Pulmonary artery disease & cerebral vascular disease 1. It drops BP & dilates --> if you have CAD and BP drops, then pt will be in trouble 2. Pt is on bedrest, so getting up causes severe cerebral ischemia
37
**SODIUM NITROPRUSSIDE**: *Nursing Interventions* -What will you monitor? (3)
1. BP continuously 2. ECG for dysrhythmias & ischemia 3. Urine output HOURLY to assess renal perfusion --> you can put a foley in!
38
**NURSING INTERVENTIONS** -What do you monitor & why? (5)
1. BP --> orthostatis hypotension 2. HR --> reflex tachycardia 3. Daily weights --> fluid retention 4. ECG --> dysrhythmias & ischemia 5. Hourly urine output --> renal perfusion
39
**NURSING INTERVENTIONS** -What are you assessing? (4)
1. Cardiac 2. Lungs 3. Renal function 4. Neurologic (LOC, pupils, movement)
40
**NURSING INTERVENTIONS** -What are you going to combine these medications with? -Why?
-Beta blockers & diuretics -To counteract compensatory mechanisms
41
**NURSING INTERVENTIONS**: *Education* 1. Rise (quickly/slowly). Why? 2. Monitor ____ at home 3. Report ____ 4. Adhere to _______ therapy 5. Report ____ ____ so that the medication can be changed or discontinued 6. AVOID ______ _____
1. Slowly. They are a fall risk 2. BP 3. Palpitations 4. combination 5. side effects 6. Abrupt discontinuation
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