Organic Nitrates - CORRECT ANSWERS-Nitroglycerin (NTG)
Used for angina by vasodilating to decrease preload and myocardial oxygen demand
Side effects: headache, orthostatic hypotension, reflex tachycardia
If someone is having chest pain you have them stop and sit down. You put one
sublingual tablet under tongue and rest for five minutes. If they are still have chest pain
they should call an ambulance and take a second. Five minutes later they can take a
third but NO more!
If patch: place on hairless area and rotate sites. Remove old patch and clean with soap
and water and dry well before applying new patch.
Wear gloves when applying!
Antidysrhythmic medications
Class One - CORRECT ANSWERS-Procainamide, Lidocaine
Used for Supraventricular tachycardia (SVT), ventricular tachycardia, atrial flutter, atrial
fibrillation. "If you were 'ProMcCain' when he was running for President, you might have
gotten really upset and developed 'tachycardia' when he lost. Then you would need to
take 'Procainamide'
Sodium channel blocker
Side effects: hypotension, lupus, leukopenia, thrombocytopenia, and arrhythmias
Antidysrhythmic Medications
Class Two - CORRECT ANSWERS-Propranolol
Non-selective beta blocker
A-fib, A-flutter, paroxysmal SVt, HTN, angina
Impact Beta-1 and Beta-2 receptors in both heart and lungs. Which means it can cause
bronchspasm and cannot be used in asthma
Side effects: hypotension, bronchospasm, fatigue, weakness
Antidysrhythmic Medications
Class Three - CORRECT ANSWERS-Amiodarone
Used for A-fib, A-Flutter, Ventricular fibrillation, Ventricular tachycardia
Potassium channel blocker. Very serious med with serious side effects
Side effects: hypotension, bradycardia, pulmonary toxicity, visual disturbances, liver
toxicity, GI upset, thyroid dysfunction
Antidysrhythmic Medications
Class Four - CORRECT ANSWERS-Verapamil, Diltiazem
Calcium channel blockers
Used for hypertension, A-fib, A-flutter, SVT, angina
Side effects: Hypotension, bradycardia, GI upset
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,HMG-CoA Reductase Inhibitors - CORRECT ANSWERS-(Statins) Atorvastatin
Lowers cholesterol and decreases risk of MI by increasing HDL and decreasing LDL.
Side effects: Hepatotoxicity, Muscle pain, GI upset, Rhabdomyolysis
Administer in the evening with a meal because cholesterol is synthesized at night
Monitor liver function and CK labs
Patient should avoid alcohol
Cholesterol Absorption Inhibitors - CORRECT ANSWERS-Ezetimibe
Lowers cholesterol by inhibiting absorption in small intestine
"eZetimibe causes cholesterol to Zip on through"
Side effects: hepatotoxicity and muscle pain
Monitor liver function and CK levels
Bile-acid Sequestrants - CORRECT ANSWERS-Colesevelam, Colestipol
Used to lower cholesterol by binding bile acids in intestine which causes more
cholesterol to be pulled from the blood stream to be used for new bile
Side effects: constipation!
Take with food and full glass of water
Can interfere with absorption of fat soluble vitamins (DEKA) and oral contraceptives
Nicotinic Acid - CORRECT ANSWERS-Niacin
Used to lower cholesterol by decreasing lipoprotein and triglyceride synthesis which
lowers LDL and triglycerides
Side effects: flushing, hepatotoxicity, GI distress, hyperglycemia
Monitor liver function and blood glucose
Fibrates - CORRECT ANSWERS-Gemfibrozil
Lowers cholesterol by decreasing triglyceride production and transport and increases
HDL
Side effects: GI upset, Gallstones, hepatotoxicity, and muscle pain
Give 30 minutes before breakfast and dinner
Monitor liver function and CK levels
Parenteral Anticoagulation - CORRECT ANSWERS-Heparin, enoxaparin
Used for stroke, PE, DVT
Prevents new clots from forming but does not break up clots that are already formed
Side effects: BLEEDING, heparin induced thrombocytopenia (HIT), hypersensitivity
HIT- decreased platelets and formation of clots in the body
Monitor aPtt levels: Normally 30-40 seconds but therapeutic levels will be 1.5-2 times
the baseline. Max should be 80. If higher than 80, blood is way too thin
Antidote is protamine
Monitor for signs of bleeding like black tarry stools or coffee ground emesis
Use soft toothbrush and electric razor
Oral anticoagulants - CORRECT ANSWERS-Warfarin (Coumadin)
2|Page
, Used for Venous thrombosis, A-fib with thrombosis, prevention of TIA, PE, MI, and DVT
Antagonist of vitamin K which prevents the formation of several clotting factors
Side effects: BLEEDING, GI upset, hepititis
Monitor PT: 11-13 but 18-24 for therapy and INR: 2-3
It takes 3-5 days for therapeutic level to be achieved. This means that they will be on
Warfarin and heparin at the same time until warfarin can catch up.
Antidote: vitamin K
Maintain consistent intake of vitamin K
Monitor for signs of bleeding, use soft toothbrush, etc.
Direct inhibitor of factor Xa - CORRECT ANSWERS-Rivaroxaban (Xarelto)
"Make your blood flow like a river"
Prevention of DVT, PE, and stroke by selectively inhibiting factor Xa which blocks
coagulation
Side effects: BLEEDING, elevated liver enzymes
Monitor liver enzymes, hemoglobin, and hematocrit levels
Antiplatelets - CORRECT ANSWERS-Aspirin, Abciximab, Clopidogrel
Inhibit platelet aggregation to prevent MI, strokes
Side effects: GI upset, BLEEDING, and with aspirin tinnitus
Do not give aspirin to children with fever do to risk of Reye's Syndrome
Do not give in patients with bleeding disorders
Thrombolytic medications - CORRECT ANSWERS-Alteplase (tPA) "-ase"
"If you're trying to break up clots you've come to the right "plase"
Break us clots by converting plasminogen to plasmin which breaks up fibrinogen
Used with MI, Stroke, PE, clogged PICC lines
Side effects: BLEEDING
Do not give with patients with internal bleeding, hemorrhagic stroke, recent trauma or
surgery, or severe HTN
Given within three hours of onset of symptoms of MI or stroke (ischemic only!)
Closely monitor labs and vitals
Limit venipunctures and IM injections
Epoetin alfa (Epogen) - CORRECT ANSWERS-Used in anemias to help increase
production of RBCs in patients with chronic kidney disease, chemotherapy, or HIV by
stimulating bone marrow
Side effects: HTN (due to increased hematocrit), risk of DVT, stroke, or MI
Do not agitate vial
Monitor blood pressure for HTN
Monitor Hgb and Hct twice a week
Ensure the patient has sufficient iron levels or med will not work
Filgrastim - CORRECT ANSWERS-Used with neutropenia to increase production of
neutrophils and decreases risk of infection. Usually for those on chemo
Stimulates bone marrow to increase production of neutrophils
3|Page
Used for angina by vasodilating to decrease preload and myocardial oxygen demand
Side effects: headache, orthostatic hypotension, reflex tachycardia
If someone is having chest pain you have them stop and sit down. You put one
sublingual tablet under tongue and rest for five minutes. If they are still have chest pain
they should call an ambulance and take a second. Five minutes later they can take a
third but NO more!
If patch: place on hairless area and rotate sites. Remove old patch and clean with soap
and water and dry well before applying new patch.
Wear gloves when applying!
Antidysrhythmic medications
Class One - CORRECT ANSWERS-Procainamide, Lidocaine
Used for Supraventricular tachycardia (SVT), ventricular tachycardia, atrial flutter, atrial
fibrillation. "If you were 'ProMcCain' when he was running for President, you might have
gotten really upset and developed 'tachycardia' when he lost. Then you would need to
take 'Procainamide'
Sodium channel blocker
Side effects: hypotension, lupus, leukopenia, thrombocytopenia, and arrhythmias
Antidysrhythmic Medications
Class Two - CORRECT ANSWERS-Propranolol
Non-selective beta blocker
A-fib, A-flutter, paroxysmal SVt, HTN, angina
Impact Beta-1 and Beta-2 receptors in both heart and lungs. Which means it can cause
bronchspasm and cannot be used in asthma
Side effects: hypotension, bronchospasm, fatigue, weakness
Antidysrhythmic Medications
Class Three - CORRECT ANSWERS-Amiodarone
Used for A-fib, A-Flutter, Ventricular fibrillation, Ventricular tachycardia
Potassium channel blocker. Very serious med with serious side effects
Side effects: hypotension, bradycardia, pulmonary toxicity, visual disturbances, liver
toxicity, GI upset, thyroid dysfunction
Antidysrhythmic Medications
Class Four - CORRECT ANSWERS-Verapamil, Diltiazem
Calcium channel blockers
Used for hypertension, A-fib, A-flutter, SVT, angina
Side effects: Hypotension, bradycardia, GI upset
1|Page
,HMG-CoA Reductase Inhibitors - CORRECT ANSWERS-(Statins) Atorvastatin
Lowers cholesterol and decreases risk of MI by increasing HDL and decreasing LDL.
Side effects: Hepatotoxicity, Muscle pain, GI upset, Rhabdomyolysis
Administer in the evening with a meal because cholesterol is synthesized at night
Monitor liver function and CK labs
Patient should avoid alcohol
Cholesterol Absorption Inhibitors - CORRECT ANSWERS-Ezetimibe
Lowers cholesterol by inhibiting absorption in small intestine
"eZetimibe causes cholesterol to Zip on through"
Side effects: hepatotoxicity and muscle pain
Monitor liver function and CK levels
Bile-acid Sequestrants - CORRECT ANSWERS-Colesevelam, Colestipol
Used to lower cholesterol by binding bile acids in intestine which causes more
cholesterol to be pulled from the blood stream to be used for new bile
Side effects: constipation!
Take with food and full glass of water
Can interfere with absorption of fat soluble vitamins (DEKA) and oral contraceptives
Nicotinic Acid - CORRECT ANSWERS-Niacin
Used to lower cholesterol by decreasing lipoprotein and triglyceride synthesis which
lowers LDL and triglycerides
Side effects: flushing, hepatotoxicity, GI distress, hyperglycemia
Monitor liver function and blood glucose
Fibrates - CORRECT ANSWERS-Gemfibrozil
Lowers cholesterol by decreasing triglyceride production and transport and increases
HDL
Side effects: GI upset, Gallstones, hepatotoxicity, and muscle pain
Give 30 minutes before breakfast and dinner
Monitor liver function and CK levels
Parenteral Anticoagulation - CORRECT ANSWERS-Heparin, enoxaparin
Used for stroke, PE, DVT
Prevents new clots from forming but does not break up clots that are already formed
Side effects: BLEEDING, heparin induced thrombocytopenia (HIT), hypersensitivity
HIT- decreased platelets and formation of clots in the body
Monitor aPtt levels: Normally 30-40 seconds but therapeutic levels will be 1.5-2 times
the baseline. Max should be 80. If higher than 80, blood is way too thin
Antidote is protamine
Monitor for signs of bleeding like black tarry stools or coffee ground emesis
Use soft toothbrush and electric razor
Oral anticoagulants - CORRECT ANSWERS-Warfarin (Coumadin)
2|Page
, Used for Venous thrombosis, A-fib with thrombosis, prevention of TIA, PE, MI, and DVT
Antagonist of vitamin K which prevents the formation of several clotting factors
Side effects: BLEEDING, GI upset, hepititis
Monitor PT: 11-13 but 18-24 for therapy and INR: 2-3
It takes 3-5 days for therapeutic level to be achieved. This means that they will be on
Warfarin and heparin at the same time until warfarin can catch up.
Antidote: vitamin K
Maintain consistent intake of vitamin K
Monitor for signs of bleeding, use soft toothbrush, etc.
Direct inhibitor of factor Xa - CORRECT ANSWERS-Rivaroxaban (Xarelto)
"Make your blood flow like a river"
Prevention of DVT, PE, and stroke by selectively inhibiting factor Xa which blocks
coagulation
Side effects: BLEEDING, elevated liver enzymes
Monitor liver enzymes, hemoglobin, and hematocrit levels
Antiplatelets - CORRECT ANSWERS-Aspirin, Abciximab, Clopidogrel
Inhibit platelet aggregation to prevent MI, strokes
Side effects: GI upset, BLEEDING, and with aspirin tinnitus
Do not give aspirin to children with fever do to risk of Reye's Syndrome
Do not give in patients with bleeding disorders
Thrombolytic medications - CORRECT ANSWERS-Alteplase (tPA) "-ase"
"If you're trying to break up clots you've come to the right "plase"
Break us clots by converting plasminogen to plasmin which breaks up fibrinogen
Used with MI, Stroke, PE, clogged PICC lines
Side effects: BLEEDING
Do not give with patients with internal bleeding, hemorrhagic stroke, recent trauma or
surgery, or severe HTN
Given within three hours of onset of symptoms of MI or stroke (ischemic only!)
Closely monitor labs and vitals
Limit venipunctures and IM injections
Epoetin alfa (Epogen) - CORRECT ANSWERS-Used in anemias to help increase
production of RBCs in patients with chronic kidney disease, chemotherapy, or HIV by
stimulating bone marrow
Side effects: HTN (due to increased hematocrit), risk of DVT, stroke, or MI
Do not agitate vial
Monitor blood pressure for HTN
Monitor Hgb and Hct twice a week
Ensure the patient has sufficient iron levels or med will not work
Filgrastim - CORRECT ANSWERS-Used with neutropenia to increase production of
neutrophils and decreases risk of infection. Usually for those on chemo
Stimulates bone marrow to increase production of neutrophils
3|Page
