NSG 3253 Cardiac Jennifer Carter
SOUTH COLLEGE
PHARMACOLOGY EXAM
ADENOSINE (780; 787)
Antiarrhythmic agent
Indication – SVT (Supra-Ventricular Tachycardia) Heartbeat over 150
Onset of Action – 5 second onset of action – fast push via IV
Administration – Asystole occurs within 15 seconds of administration, flatlining the heart
to re-start it
Adenosine is another antiarrhythmic agent that is used to convert SVT to sinus rhythm is vagal
maneuvers have been ineffective. It is often the drug of choice for terminating SVTs, including those
associated with the use of alternative conduction pathways around the AV node (e.g. Wolff Parkinson
White syndrome), for two reasons. (1) It has a short duration of action (about 15 seconds), after which it
is picked up by circulating red blood cells and cleared through the liver, and (2) it is associated with few
adverse effects (headache, flushing, and dyspnea of short duration).
WARFARIN (842; 845)
Therapeutic Levels – 2-3
Anti-Coagulant
Does not break up clots, but does prevent new clots from forming and already formed
clots from continuing to grow larger
Subtherapeutic Level – Under 2
Supratherapeutic Level – Over 3
Patient Education – Bleeding risk with Warfarin, use an electric razor, do not climb
ladders, contact HCP with new bleeding, routine lab work is needed, report black or
tarry stools, cloudy or dark urine, sore throat, fever or chills and severe headache or
dizziness.
An anticoagulant slows the body’s normal blood-clotting process to prevent harmful
blood clots from forming. This type of drug is often called a blood thinner, however it
cannot dissolve clots that have already formed and does not make your blood thin.
Never change any of the medication that you are taking or stop one that you are taking
without consulting your HCP.
Avoid any situation in which you can be easily injured,
INR Reversal – Vitamin K is the antidote medication; Fresh Frozen Plasma can also be
administered if the bleeding is severe
HEPARIN (834)
Breast Feeding Mothers – Heparin Is safe for breastfeeding mothers
Anti-coagulant
Reversal Agent – Protamine Sulfate is the reversal for too much Heparin
, NSG 3253 Cardiac Jennifer Carter
Labs to monitor – Monitor the aPPT lab values (1.5 – 2.5 times the baseline)
ENOXAPARIN (LOVENOX) (838; 850)
Proper Administration – 90-degree, sub q Site
Route of Administration – Usually Abdominal Administration
Site Rotation - Rotate site for each administration
For prevention of DVT that may lead to PE after hip replacement or abdominal surgery;
with warfarin to treat acute DVT or PE, prevention of ischemic complications of unstable
angina or non-Q wave MI, prevention of DVT in patients with severely restricted mobility
due to illness.
Low-molecular weight heparin
ASPIRIN (270; 837)
Adverse Effects – Bleeding, coffee ground emesis, tinnitus
Indication- Reduction of blood clots that could cause an MI
Antiplatelet agent- Decrease the formation of the platelet plug by decreasing the
responsiveness of the platelets to stimuli that would cause them to stick and aggregate
on a vessel wall
Reduction of the incidence of TIA’s and strokes in Men; reduction of the risk of death or
non-fatal MI in patients with a past history of MI or with angina
ALTEPLASE (849, 838)
Nursing Interventions prior to Administration – Weigh client, weight-based medication
Treatment of MI; acute PE and acute ischemic stroke; restoration of function in occluded
central venous access devices
Anti-coagulant
DIGOXIN (761-764; 780; 787)
Digoxin Toxicity signs and symptoms – Vision changes, hallucinations, arrhythmias
Digoxin toxicity is a serious syndrome that can occur when digoxin levels are too high;
the patient may present with anorexia, nausea, vomiting, malaise, depression, irregular
heart rhythms including heart block; atrial arrhythmias, and ventricular tachycardia
Can be used to treat arrhythmias; slows the conduction and heart rate; effective in
treating atrial arrhythmias; results in increased cardiac output; which increases
perfusion of the coronary arteries and may eliminate the cause of some arrhythmias as
hypoxia is resolved and waste products are removed more effectively
Cardiac Glycoside – treatment of acute HF and atrial arrhythmias
ATORVASTATIN (LIPITOR) (816; 821)
Patient Education – Give at night, liver makes lipids at night
Adverse Effects – Rhabdomyolysis, severe muscle pain and fatigue
Contraindications – Do not give to patients that have hepatic dysfunction
Drug – Food Interactions – If given with grapefruit juice will cause rhabdomyolysis
SOUTH COLLEGE
PHARMACOLOGY EXAM
ADENOSINE (780; 787)
Antiarrhythmic agent
Indication – SVT (Supra-Ventricular Tachycardia) Heartbeat over 150
Onset of Action – 5 second onset of action – fast push via IV
Administration – Asystole occurs within 15 seconds of administration, flatlining the heart
to re-start it
Adenosine is another antiarrhythmic agent that is used to convert SVT to sinus rhythm is vagal
maneuvers have been ineffective. It is often the drug of choice for terminating SVTs, including those
associated with the use of alternative conduction pathways around the AV node (e.g. Wolff Parkinson
White syndrome), for two reasons. (1) It has a short duration of action (about 15 seconds), after which it
is picked up by circulating red blood cells and cleared through the liver, and (2) it is associated with few
adverse effects (headache, flushing, and dyspnea of short duration).
WARFARIN (842; 845)
Therapeutic Levels – 2-3
Anti-Coagulant
Does not break up clots, but does prevent new clots from forming and already formed
clots from continuing to grow larger
Subtherapeutic Level – Under 2
Supratherapeutic Level – Over 3
Patient Education – Bleeding risk with Warfarin, use an electric razor, do not climb
ladders, contact HCP with new bleeding, routine lab work is needed, report black or
tarry stools, cloudy or dark urine, sore throat, fever or chills and severe headache or
dizziness.
An anticoagulant slows the body’s normal blood-clotting process to prevent harmful
blood clots from forming. This type of drug is often called a blood thinner, however it
cannot dissolve clots that have already formed and does not make your blood thin.
Never change any of the medication that you are taking or stop one that you are taking
without consulting your HCP.
Avoid any situation in which you can be easily injured,
INR Reversal – Vitamin K is the antidote medication; Fresh Frozen Plasma can also be
administered if the bleeding is severe
HEPARIN (834)
Breast Feeding Mothers – Heparin Is safe for breastfeeding mothers
Anti-coagulant
Reversal Agent – Protamine Sulfate is the reversal for too much Heparin
, NSG 3253 Cardiac Jennifer Carter
Labs to monitor – Monitor the aPPT lab values (1.5 – 2.5 times the baseline)
ENOXAPARIN (LOVENOX) (838; 850)
Proper Administration – 90-degree, sub q Site
Route of Administration – Usually Abdominal Administration
Site Rotation - Rotate site for each administration
For prevention of DVT that may lead to PE after hip replacement or abdominal surgery;
with warfarin to treat acute DVT or PE, prevention of ischemic complications of unstable
angina or non-Q wave MI, prevention of DVT in patients with severely restricted mobility
due to illness.
Low-molecular weight heparin
ASPIRIN (270; 837)
Adverse Effects – Bleeding, coffee ground emesis, tinnitus
Indication- Reduction of blood clots that could cause an MI
Antiplatelet agent- Decrease the formation of the platelet plug by decreasing the
responsiveness of the platelets to stimuli that would cause them to stick and aggregate
on a vessel wall
Reduction of the incidence of TIA’s and strokes in Men; reduction of the risk of death or
non-fatal MI in patients with a past history of MI or with angina
ALTEPLASE (849, 838)
Nursing Interventions prior to Administration – Weigh client, weight-based medication
Treatment of MI; acute PE and acute ischemic stroke; restoration of function in occluded
central venous access devices
Anti-coagulant
DIGOXIN (761-764; 780; 787)
Digoxin Toxicity signs and symptoms – Vision changes, hallucinations, arrhythmias
Digoxin toxicity is a serious syndrome that can occur when digoxin levels are too high;
the patient may present with anorexia, nausea, vomiting, malaise, depression, irregular
heart rhythms including heart block; atrial arrhythmias, and ventricular tachycardia
Can be used to treat arrhythmias; slows the conduction and heart rate; effective in
treating atrial arrhythmias; results in increased cardiac output; which increases
perfusion of the coronary arteries and may eliminate the cause of some arrhythmias as
hypoxia is resolved and waste products are removed more effectively
Cardiac Glycoside – treatment of acute HF and atrial arrhythmias
ATORVASTATIN (LIPITOR) (816; 821)
Patient Education – Give at night, liver makes lipids at night
Adverse Effects – Rhabdomyolysis, severe muscle pain and fatigue
Contraindications – Do not give to patients that have hepatic dysfunction
Drug – Food Interactions – If given with grapefruit juice will cause rhabdomyolysis
