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Pharmacology

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Identify purpose and use of anticoagulant, antiplatelet, and ... Visual disturbances such as photophobia & altered color perception may be a sign ... – PowerPoint PPT presentation

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Title: Pharmacology


1
Pharmacology
  • Cardiovascular Medications
  • Classifications Characteristics

2
Objectives
  • Identify cardio-inotropic agents.
  • Describe antiarrythmic drugs.
  • Identify common antianginal drugs.
  • Describe common diuretics.
  • Identify purpose and use of anticoagulant,
    antiplatelet, and thromboembolytic agents.
  • Identify and describe antilipemics and peripheral
    dilators.

3
Cardiotonic - Inotropic Agents
  • PURPOSE
  • Used in the treatment of cardiovascular disease.
  • Examples
  • Digitalis
  • Phosphodresterase inhibitors

4
Digitalis Preparations
  • Action increases force of myocardial contraction
    of heart, slows rate of ventricular
    contraction(heart rate).
  • Example digoxin (Lanoxin)
  • Uses acute chronic CHF, atrial fibrillation,
    atrial flutter.
  • Side effects Visual disturbances, bradycardia,
    arrythmias, anorexia, N/V, H/A, fatigue,
    weakness, drowsiness, confusion..

5
Question?
  • Digitalis preparations ___________ the force of
    myocardial contractions ______ the heart rate.
  • The daily dose of digoxin is called the
    _____________ dose.
  • Administration of a relatively large initial dose
    of digoxin is called the ___________ dose.
  • Visual disturbances such as photophobia altered
    color perception may be a sign of toxicity in
    clients taking _______________gt

6
Phosphodresterase Inhibitors
  • Action increases cardiac contractility
    decreases preload afterload by relaxing muscle
    of the heart to produce vasodilation.
  • Example Primacor, Inocar
  • Uses Short term treatment of CHF
  • Side effects Ventricular arrythmias,
    hypotension, H/A, thrombocytopenia, anorexia,
    N/V, abdominal pain, hepatotoxicity.

7
Antiarrythmic Drugs
  • Purpose
  • Used to treat the tachyarrythmias of the heart.
  • Examples
  • Na channel blockers
  • beta adrenergic blockers
  • K channel blockers
  • Ca channel blockers

8
Antiarrythmic Drugs
  • Action reduce automaticity, slow conduction
    of electrical impulses through the heart and
    prolong refractory (rest) period of myocardial
    cells.

9
Examples
  • Examples
  • Class I Na channel blockers
  • Class I A quinidine (Cardioquin)
  • Class I B lidocaine (Xylocaine)
  • Class I C
  • Class II beta-adrenergic blockers propanolol
    (Inderal)
  • Examples
  • Class III K channel blockers
  • amiodarone(Cordarone)
  • Class IV Ca channel blockers
  • diltiazem(Cardizem)
  • Unclassified
  • adenosine(Adenocard)

10
Antiarrythmics - Uses
  • To convert atrial fibrillation or flutter to a
    normal sinus rhythm, maintain normal sinus rhythm
    after conversion, when ventricular rate is so
    fast or irregular that cardiac output is
    impaired, and when dangerous arrythmias occur
    may be fatal.
  • Check apical/radial pulse before each dose.
  • Check blood pressure daily.

11
Antiarrythmics - Side Effects
  • Heart Block
  • Arrythmias
  • Hypotension
  • Dizziness
  • Fatigue
  • Malaise
  • Bradycardia
  • Confusion
  • Weight gain
  • Seizures
  • N/V
  • hypothyroidism
  • Paresthesia
  • Peripheral neuropathy

12
Questions?
  • _____________ drugs reduce automaticity of
    myocardial cells slow conduction of electrical
    impulses through the heart.

13
Antianginal Drugs
  • PURPOSE to treat angina pectoris
  • ACTION decrease myocardial demand for oxygen or
    increase blood supply to the myocardium.
  • EXAMPLES
  • Organic Nitrates nitroglycerin
  • Beta-adrenergic Tenormin, Inderal
  • Ca channel blockers Cardizem, Procardia

14
Antianginal Drugs Treatment of acute chronic
angina
  • Purpose
  • To treat angina pectoris
  • Action
  • To decrease myocardial demand for oxygen or
    increase blood supply to the myocardium.
  • Examples
  • Organic nitrates
  • Beta-adrenergic blocking agents
  • Ca channel blockers

15
Organic Nitrates
  • Example
  • nitroglycerin (Nitrostat, Nitrobid) Prototype
  • Side effects
  • dizziness
  • H/A
  • hypotension
  • tachycardia

16
Beta-adrenergic Blocking Agents
  • Example
  • propanolol (Inderal)
  • atenolol (Tenormin)
  • Side effects
  • fatigue - CHF
  • weakness - pulmonary edema
  • impotence
  • bradycardia

17
Ca Channel Blockers
  • Example
  • diltiazem (Cariazem) - verapamil (Isoptin)
  • Nifedipine (Procardia)
  • Side effects
  • peripheral edema - dizziness
  • H/A - CHF
  • flushing - weakness
  • arrythmias - constipation

18
Antihypertensive Drugs To Treat Hypertension
  • Action decrease BP by decreasing cardiac output
    or peripheral vascular resistance.
  • Uses
  • Angiotensin-converting enzyme (ACE) inhibitors
  • Example catopril (Capoten)
  • Side effects cough, hypotension, taste
    disturbance, proteinuria

19
Antihypertensives
  • Angiotensin II Receptor Antagonist
  • losartan ( Cozaar)
  • valsartan (Diovan)
  • Antiadrenergics
  • Alpha1 blocking agents
  • Alpha2 agonists
  • Postganglionic-active drugs
  • Beta-adrenergic blocking agents

20
Antihypertensives
  • Calcium channel blockers
  • dilitiazem (Cardiazem)
  • nifedipine (Procardia)
  • verapamil (Isopton)
  • Other vasodilators
  • hydralazine (Apresoline)

21
Antihypertensives
  • Use
  • to treat primary hypertension
  • Side effects
  • postural hypotension - impotence
  • dizziness - bradycardia
  • weakness - GI disturbances
  • Na water retention

22
Diuretics
  • Purpose to treat excessive fluid in the body.
  • Action act on kidneys to decrease reabsorption
    of Na, Cl, water other substances.
  • Uses edema hypertension

23
Diuretics
  • Thiazide related
  • chlorothiazide (Diuril)
  • indapamide (Lozol)
  • Loop diuretics
  • furosemide (Lasix)
  • torsemide (Demadex)
  • K-sparing diuretics
  • spironolactone (Aldactone)
  • Osmotic diuretics
  • mannitol (Osmitrol)

24
Diuretics - Side Effects
  • Hypokalemia (Lasix)
  • Dehydration
  • Low Na levels
  • Low magnesium levels
  • Low chloride levels
  • Hyperglycemia
  • Hyperuricemia
  • Give diuretics in the early AM for daily dose.

25
Anticoagulant, Antiplatelet Thrombolytic Agents
  • Purpose To treat clotting disorders.
  • Action alter some aspect of the blood
    coagulation process in the body.
  • Uses prevention or treatment of blood clot
    formation.

26
Diuretics - Examples
  • Anticoagulants
  • heparin
  • Enoxaparin (Lovenox)
  • warfarin(Coumadin)
  • Antiplatelet agents
  • aspirin
  • Thrombolytic agents
  • alteplase(Activase)
  • Side effects
  • bleeding (gums, vomitus, stool, urine, sputum),
    bruising, petechiae, tissue irritation at
    injection site.

27
Diuretics - Key Points
  • The antidote for heparin is protamine sulfate.
  • The antidote of warfarin is vitamin K.
  • Do not aspirate or massage injection site.

28
Antilipemics
  • Purpose
  • To lower blood lipids, especially total LDL
    cholesterol to prevent or delay development of
    fatty plaques to promote regression of
    existing fatty plaques.

29
Antilipemics
  • Action alter production, metabolism or removal
    of lipoproteins from the body, resulting in lower
    lipid levels.
  • Uses
  • hyperlipoproteinemia not controlled by diet and
    exercise
  • clients with S S of CAD, family hx CAD
  • Other risk factors (HTN, diabetes, smoking)

30
Antilipemics
  • Examples
  • HMG-CoA reductase inhibitors (Statins)
  • atorvastatin (Lipitor)
  • simvastatin (Zocor)
  • Fibrates
  • Bile acid sequestrants
  • cholestyramine (Questran)
  • Side effects
  • GI problems
  • abdominal cramps
  • constipation
  • diarrhea
  • flatus
  • heartburn
  • rashes

31
Questions?
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