Transcript medication administration

MEDICATION
ADMINISTRATION
Topic 7 Cardiac drugs
MAJOR DRUG GROUPS






Generic and trade names of drug
Action
Use
Dosage
Stability
Compatibility
MAJOR DRUG GROUPS
Adverse reactions
 Interactions
 Precautions/ Contraindications
 Nursing Implications

Drugs affecting the heart and
vascular system
Overview of the heart and vascular
system
 Drugs affecting cardiac function
 Drugs affecting vascular smooth
muscle
 Lipid lowering drugs

CARDIAC FUNCTION
Drugs affecting this group
include cardiac glycosides
used to treat heart failure
and anitarrhythmic drugs
used to treat abnormalities in
cardiac rhythm.
Origin of digitalis demonstrates a herbal
remedy ( housewife’s recipe ) that was
used for 100s of years by common people
like farmers and housewives for dropsy
(fluid accumulation)
MAIN EFFECTS OF DIGOXIN



Increased force of contraction
Decreased heart rate
Decreased conduction through SA
and AV nodes by enhancing vagal
tone.
ADVERSE REACTIONS
Anorexia
Nausea, vomiting and diarrhoea
Drowsiness
Dizziness
Headaches
Blurred vision
Diplopia
ADVERSE REACTIONS
Hypotension
Chest pain
Problem with color vision
Muscle weakness
DIGITALIS TOXICITY






Nausea
Vomiting
Abdominal pain
Diarrhoea
Facial pain
Flashing lights
DIGITALIS TOXICITY





Blind spots
Blurred vision
Deliriums
Hallucinations
Bradycardia
CONTRAINDICATIONS
Caution with Renal Impairment
Hypothyroidism ( increased
sensitivity )
Hyperthyroidism ( digoxinresistance )
Electrolyte abnormalities
Complete heart block
Ventricular arrhythmias ( VF )
NURSING IMPLICATIONS
Always check the heart rate/rhythm
before administering
Teach patient to monitor own HR
Always use the correct preparation
e.g. paediatric strength, or adult
strength
Do not cut or break tablets
NURSING IMPLICATIONS
Report improvement in condition
e.g. normal pulse rate, reduced
dyspnoea and cyanosis
Monitor serum digoxin levels
Monitor BP when drugs are given IV
Stop drugs at least 3 days before
cardiac surgery.
ANTIARRHYTHMIC DRUGS
Used to treat abnormalities in cardiac
rhythm or a dysrhythmia.
Antiarrhythmic drugs are subdivided
into various classes depending on
their effect on the heart’s electrical
conduction.
ADVERSE EFFECTS
o
o
o
o
o
o
o
Headache
Confusion
Nervousness
Seizures
Heart Block
Bradycardia
Dizziness
NURSING IMPLICATIONS
Drugs given by rapid IV infusion
may cause severe hypotension
Photosensitivity can occur
Monitor BP, HR and ECG during
therapy
Ensure drugs are diluted and
stored according to manufacturers
guidelines.
Patients are not to double dose if
one is missed.
NURSING IMPLICATIONS
Patients to carry identification which
lists the drugs they are prescribed
Teach patients how to monitor their
own pulse
IV infusions are not normally ceased
until the oral version is commenced
to prevent the arrhythmia returning .
DRUGS AFFECTING VASCULAR
SMOOTH MUSCLE
These types of drugs cause
vasodilation of blood vessels by
relaxing the smooth muscle in the
blood vessel walls. Used for the
treatment of angina, hypertension
and heart failure.
Antianginal agents do not treat the cause of
the diminished blood suppply but treat the
acute pain and prevent further attacks
ADVERSE EFFECTS







Flushing
Headache
Dizziness
Faintness
Syncope
Weakness
Hypotension related to vasodilation
PRECAUTIONS
Not used for those clients with
hypotension, hypovolaemia or valve
stenosis
NURSING IMPLICATIONS
Do not swallow SL tablets
 Advise patients to rest to allow pain
to subside
 SL Tabs/sprays should be taken
straight away as soon as pain begins
 Carry medication at all times
 If pain is not relieved in 15 mins
following 2 tabs, seek medical
advice.

MEDICAL IMPLICATIONS




Store in cool place in the original
bottle
Avoid postural hypotension
If pain is relieved and a headache
has developed any part of the tab.
May be removed
Apply patches to an area of skin
without too much hair e.g upper arm
or chest, and rotate site
NURSING IMPLICATION







Do not use patches for acute episodes
Do not cut patches
Monitor pulse and BP during IV infusion
If headache develops give analgesics
Avoid alcohol during treatment as it also
causes vasodilation
Tolerance may become a problem
Use an infusion pump for IV GLYCERAL
TRINITRATE
ANTIHYPERTENSIVE AGENTS
How should we
manage or control
hypertension ?
ANTIHYPERTENSIVES
These drugs work by
improving blood
volume, cardiac
output and /or
peripheral
resistance.
ADVERSE EFFECTS






Dizziness
Weakness
Sweating
Flushing
Hypotension
Palpatations
NURSING IMPLICATIONS
Advise pt to sit or lie down if they
are feeling dizzy
 Always monitor BP both lying and
standing
 Monitor HR
 Warn patients not to cease
medications or miss a dose

NURSING IMPLICATIONS


Patients should not operate
machinery if feeling dizzy
Treat dry cough often associated
with treatment
LIPID REGULATING DRUGS
What is hyperlipidaemia and what can
you tell me about atherosclerosis ?
ADVERSE EFFECTS
Constipation
Flatulance
Nausea
Abdominal cramps
Reduced ability to absorb fat soluble
vitamins
NURSING INTERVENTIONS
Baseline date for blood cholesterol/
triglycerides and monitor regularly,
even after drugs are ceased when
levels have returned to normal
Mix powder/granules forms very
well in fluid e.g. water, juice or milk
Follow a high fibre diet
ADVERSE EFFECTS
Nervousness
 Anxiety/fear
 Restlessness
 Tremor
 Nausea/Vomiting
 Tachycardia/palpatations
