NUR 221 Perfusion Pharmacology

Anticoagulant medication – INR must be monitored regularly, medication can cause major or fatal bleeding. Teach client to watch for signs of bleeding/bruising, keep consistent amount of vitamin K in diet.

•Cardiac glycoside/inotropic medication – Adverse reactions include dysrhythmias and heart block; muscle weakness, paresthesia, light-flashes; ellow-green halos, anorexia, nausea and vomiting. Blood levels must be monitored. Teach client how to check pulse and to notify provider if heart rate less than 60 before taking medication.

•Anticoagulant medication – High risk for bleeding, especially if dosage error occurs. Most facilities require two nurses to verify dose. Protamine sulfate is used to treat severe overdose. Clients and families should be taught to watch for signs of bleeding/bruising; to avoid OTC drugs containing aspirin or any medication that may interact with drug.

Heparin antagonist – given for severe overdose of heparin. Must have resuscitation equipment available before giving. Rapid administration may cause acute hypotension, bradycardia, dyspnea and flushing.

Antilipemic – Adverse reactions includeheadache, abdominal pain, rhabdomyolysis. Sould not be taken with grapefruit juice. LFT should be done at the start of therapy, 6 and 12 weeks after and periodically. Client should be taught to report unexplained muscle pain, tenderness, weakness to provider, especially if accompanied by fever.

Antihypertensive/ACE inhibitor – Adversereactions include hypotension, dry, persistent cough, angioedema. Should not be taken during pregnancy. Clients should be taught to make position changes slowly, as dizziness is possible, especially early in therapy.

Nitrate/Vasodilator – Used transdermally to prevent angina or as sublingual tablet for acute angina pectoris. When applying transdermally caregivers should always wear gloves to protect themselves from accidental exposure. Sublingual tablets should be stored in a cool, dark place in original container.

Antihypertensive/Beta-blocker – Medication may be prescribed for hypertension, angina or heart failure. Adverse reaction of wheezing and bronchospasm, question use in clients with asthma. Other adverse reactions include bradycardia and hypotension

Antihypertensive/Calcium channel blocker – Prescribed for angina, hypertension, atrial fib, or SVT. Question dose for systolic BP less than 90 or HR less than 60.

NSAID/Salicylate/Antiplatelet – OTC drug used for pain, inflammation and fever as well as antiplatelet actions. Should be stopped prior to planned surgeries. Teach client to watch for signs/symptoms of bleeding.

Antiplatelet – Prescribed to reduce thrombotic events. Should be stopped 5 says before planned surgery. Contraindicated in clients with history of bleeding disorders (peptic ulcer disease, intracranial bleeding). Teach clients that it may take longer to stop bleeding, inform provider if unusual bleeding or bruising occurs.

Anticoagulant/low-molecular weight heparin – Given to prevent PE and DVT after surgery or with decreased mobility. Clients who have had spinal procedures are at increased risk of epidural or spinal hematoma – this is a black box warning. Clients should be instructed not to use OTC medications containing aspirin while taking this medication.

Anticoagulant adjunctive – Injectable used to treat prothrombin deficiency – most often used to reverse the effects of warfarin.

Classification of medications used to break down thrombi that have been formed – this is done by stimulation of the plasmin system. Greatest risk is bleeding after administration. Long-list of precautions and situations that would exclude the client from eligibility to receive.

Diuretic/Loop diuretic – Prescribed for edema, pulmonary edema or hypertension. Common diuretic. May cause orthostatic hypotension, client should be taught to manage. Weight, BP and pulse should be monitored as well as electrolytes, particularly potassium.

•Antihypertensive/Diuretic – often given in combination with HCTZ
– often given in combination with other medications for hypertension. Is potassium-sparing – may be given in combination with potassium-wasting diuretic. Potassium should be monitored as well as renal function. Clients should be taught to notify provider if fluid loss occurs, not to use salt-substitutes containing potassium

Diuretic/Thiazide diuretic – Prescribed for edema or hypertension. May lead to hypokalemia – often given in combination with potassium-sparing diuretic. Electrolytes need to be monitored, especially potassium as well as weight, BP. Teach clients to manage orthostatic hypotension.

Classification of drugs used as vasodilators to treat hypertension, decrease afterload in heart failure. Side effects include reflex tachycardia, GI upset, unrelenting dry cough (med may need to be changed).

Classification of drugs used to lower heart rate and blood pressure, prescribed for hypertension or angina. Contraindicated in clients with asthma. Monitor heart rate, blood pressure. Question administering if heart rate lower than 60.

Thrombolytic agent – used for lysis of thrombi obstructing coronary, cerebral thrombi or PE. Must meet criteria for administration – including time elapsed since onset of symptoms. Greatest risk is bleeding.

Classification of drugs used to control hyperlipidemia – given for elevated cholesterol. Serious side effects include myopathy and rhabdomyolysis and liver damage. Contraindicated in clients with liver disease. LFTs must be monitored

Classification of drugs used to control edema or decrease blood pressure by decreasing blood volume. Sub-categories include thiazide, loop and potassium-sparing

Classification of drugs used to decrease BP, decrease cardiac workload and myocardial oxygen consumption. Often prescribed for angina. Adverse reactions include dizziness, headache and fatigue, as well as bradycardia and hypotension

Broad classification of drugs used to treat hypertension. Orthostatic hypotension is a common adverse reaction