Cardiovascular

Medications
Digoxin (Lanoxin)
C= Cardiac glycoside
Used for the treatment of heart failure and atrial fibrillation and flutter
H= increased cardiac output (positive inotropic effect), increased
forces of contractions, decreased heart rate (negative
chronotropic effect, decreased AV conduction speed, increased
urinary output, decreased edema, decreased dyspnea and crackles,
decreased fatigue, resolution of paroxysmal nocturnal dyspnea,
improves peripheral pulses, skin color, and temperature





Digoxin (Lanoxin) cont.
E= Iv dose- monitor closely
Oral dose
Capsules- do not break, chew, or crush
Tablets-with or without food, may crush, only mix with foods and fluids
C= not to stop abruptly; about all aspects of the drug, to take
exactly as ordered; how to monitor heart rate
To avoid OTC medications, herbal remedies because many adverse product
interactions may occur; not to take antacids at the same time
To notify prescriber of loss of appetite, lower stomach pain, diarrhea,
weakness, drowsiness, headache, blurred or yellow vision, rash, depression,
toxicity
About the toxic symptoms of this product and when to notify prescriber
To maintain a sodium restricted diet
To report shortness of breathe, difficulty breathing, weight gain, edema,
persistent cough
Digoxin (Lanoxin) cont.
K= c
Check apical pulse for 1 min before giving product; if pulse is <60 in adult or
<90 in infant, take again in 1 hr; if <60 in adult call prescriber, note rate,
rhythm, character, monitor ECG continuously during parenteral loading
dose.
Check electrolytes
I&O ratio, daily weights, monitor turgor, lung sounds, edema

Please add the therapeutic digoxin level and the signs and symptoms of
digoxin toxicity

Nitroglycerin
C= Coronary vasodilator, antianginal
H= Decrease in anginal pain
E= This drug comes in extended release caps, topical ointment,
rectal ointment, SL, translingual spray, and transderma
PO swallow whole, do not break, crush, or chew, 8 oz h2o, empty stomach-
1 hr before, or 2 hr after meals


Nitroglycerin cont.
C= NEVER to use erectile dysfunction products: may cause serve
hypotension or death
If 3 SL tabs in 15 min do not relieve pain, to see immediate medical attention
To avoid alcohol
This drug may cause headache
Can be taken before stressful activities
Avoid hazardous activities if dizziness occurs
To comply with complete medical regimen
To make position changes slowly to prevent failing

Add health teachings when they apply the nitro patch
Nitroglycerin
K= Assess:
Pain- duration, time started, activity being preformed, character
Orthostatic BP, pulse prior to and after administration
Tolerance if taken over a long time period,
Headache, lightheadedness, decreased BP; may indicate a need for
decreased dosage
Tenecteplase (TNKase)
C= Thrombolytic. Used for acute myocardial infarction, coronary artery
thrombosis
H= Resolution of MI
E= Powder for injection, administer as soon as thrombi identified: not
useful if more than one week old
C= about proper tooth brushing technique to avoid bleeding, notify
prescriber immediately of sudden sever headache, and to notify
prescriber of bleeding, hypersensitivity: fast, slow, or uneven heart rate;
feeling of faintness; blood in urine; stools; nose bleeds

BULLET FORMAT FOR CLIENT TEACHING
Tenecteplase (TNKase)
K= Assess: Allergies, BLEEDING, blood studies, hypertensive
reactions, VS, neurological changes that may indicate intracranial
bleeding, retroperitoneal bleeding, back pain, leg weakness,
diminished pulses
Asprin (otc)
C= antiplatelet, non opiod analgesic, nonsteriodal anti-
inflammatory, antipyretic
H= decreased pain, inflammation, and fever
E= hr before planned exercise, with food or milk to decrease
gastric symptoms; separate by 2 hr for enteric products, with 8 oz
h20, sit up right for a hr after dose to facilitate product passing
into stomach

Asprin
C=
to take as prescribed with other antivirals that are prescribed
If dose is missed take one hr before next dose , do not double dose
Is to be taken daily to maintain blood levels for duration of therapy
May cause photo sensitivity; to use protective clothing, and stay out of the sun
To notify prescriber if diahrea, nausea, vomiting, rash, dizziness,
lightheadedness, ECG may be altered
That this product interacts with many others, such as: St.Johns wort, and
herbal products. Advice prescriber of all medications taken
Redistribution of body fat may occur
Product does not cure HIV infec,or protect transmission to others, but only
controls symptoms
If taking phosphodiesterase type 5 inhibitor with atazanavir, there may be
increased risk of phosphodiesterase type 5 inhibitor- associated adverse affects
such as: hypotension prolonged penile erection; notify physician promptly of
these symptoms

Asprin

K= Asses:
Hepatic failure, hepatic studies
For lactic acidosis, hyperbilirubinemia (females, pregnancy, obesity)
Sign of infection, anemia
Bowel pattern before and during. If severe abdominal pain with bleeding occur
discontinue, and monitor hydration
Viral load
Skin eruptions, rash, urticarial, itching,
Allergies before treatment, reaction to each medication; place allergies on
chart

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Aggregox
C= a combination drug of aspirin and dipyridamole ( classification
is antiplatelet)
H= used to reduce risk of stroke in people who have had blood
clots or mini strokes (transient ischemic attack or TIA)
E=Take each dose with a full glass (8 ounces) of water, You may
take aspirin and dipyridamole with or without food. Do not crush,
chew, break, or open an extended-release capsule. Swallow the
pill whole. It is specially made to release medicine slowly in the
body. Breaking or opening the pill would cause too much of the
drug to be released at one time.
Bullet format if theres a lot to know for E

Aggregox
C=if you miss a dose,take the missed dose as soon as you
remember. If it is almost time for the next dose, skip the missed
dose and wait until your next regularly scheduled dose. Do not use
extra medicine to make up the missed dose
Taking the combination of aspirin and dipyridamole (Aggrenox) is
not equivalent to taking each of the medications separately. Take
only the medication your doctor has prescribed.
AVOID drinking alcohol, it may cause stomach bleedings
Notify doctor of all OTC meds, many contain aspirin, and may lead
to overdose taken together
k= Report if you are pregnant or become pregnant. Monitor for any
allergies or adverse effects