page_content stringlengths 12 2.63M | metadata unknown |
|---|---|
Quinidine is a class IA antidysrhythmic drug. It is available as an oral immediate-release tablet and an extendedrelease tablet. These tablets are different salt forms of quinidine; the immediate-release form is quinidine sulfate, and the extended-release form is quinidine gluconate. It is important to note that these ... | {
"Header 1": "CHAPTER 17 Antidysrhythmic Drugs",
"Header 2": "**Quinidine**",
"token_count": 204,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Because lidocaine may cause central nervous system toxicity, the nurse should assess the client frequently. Signs and symptoms to watch for include sedation and irritability (twitching), which could progress to convulsions and respiratory depression/arrest.
Lidocaine is available in many formulations, some of which a... | {
"Header 1": "CHAPTER 17 Antidysrhythmic Drugs",
"Header 2": "Lidocaine",
"token_count": 239,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Flecainide is a class IC antidysrhythmic drug that is available as an oral tablet. It is used for clients with paroxysmal symptomatic supraventricular tachycardias, including atrial fibrillation and atrial flutter. It can also be used for lifethreatening ventricular tachyarrhythmias.
Propafenone is also a class IC dr... | {
"Header 1": "CHAPTER 17 Antidysrhythmic Drugs",
"Header 2": "Lidocaine",
"Header 3": "**Flecainide and Propafenone**",
"token_count": 747,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
By the end of this section, you should be able to:
- 17.3.1 Identify the characteristics of the beta-adrenergic blocker drugs used to treat dysrhythmias.
- 17.3.2 Explain the indications, actions, adverse reactions, and interactions of beta-adrenergic blocker drugs used to treat dysrhythmias.
- 17.3.3 Describe the nu... | {
"Header 1": "CHAPTER 17 Antidysrhythmic Drugs",
"Header 2": "**LEARNING OUTCOMES**",
"token_count": 358,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Esmolol is an intravenous beta-adrenergic blocker that is selective for the beta-1 receptors in the heart. Esmolol is very fast acting and slows the heart rate within 2–10 min of administration. It also has a short duration; the half-life of esmolol in adults is only 9 min. For this reason, esmolol is often administere... | {
"Header 1": "CHAPTER 17 Antidysrhythmic Drugs",
"Header 2": "**Esmolol**",
"token_count": 213,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
By the end of this section, you should be able to:
- 17.4.1 Identify the characteristics of the potassium channel blocker drugs used to treat dysrhythmias.
- 17.4.2 Explain the indications, actions, adverse reactions, and interactions of potassium channel blocker drugs used to treat dysrhythmias.
- 17.4.3 Describe th... | {
"Header 1": "CASE STUDY",
"Header 2": "**LEARNING OUTCOMES**",
"token_count": 266,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Amiodarone is a class III antidysrhythmic drug; however, it has all four Vaughan Williams mechanisms: It blocks sodium channels (class I), functions as a beta-adrenergic blocker (class II), blocks potassium channels (class III), and blocks calcium channels (class IV). It is available in both intravenous and oral dosage... | {
"Header 1": "CASE STUDY",
"Header 2": "**Amiodarone and Dronedarone**",
"token_count": 686,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Dofetilide and ibutilide are both pure class III antidysrhythmic medications with no additional mechanisms of action. Dofetilide is an oral medication used for atrial fibrillation and atrial flutter. It has a high risk for causing proarrhythmia, specifically torsade de pointes. Therefore, dofetilide must be initiated i... | {
"Header 1": "CASE STUDY",
"Header 2": "**Dofetilide and Ibutilide**",
"token_count": 433,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
All class III drugs are proarrhythmic and can cause QT prolongation, leading to torsade de pointes. Aside from that, the adverse effect profile depends on the agent being used.
Amiodarone has many potential toxicities and adverse effects, which include:
- Optic neuropathy and/or optic neuritis, which can lead to pe... | {
"Header 1": "CASE STUDY",
"Header 2": "**Adverse Effects and Contraindications**",
"token_count": 1035,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
The nurse should do the following for clients who are taking potassium channel blockers:
- Perform a complete medication history to assess for relevant drug interactions, including other drugs that also prolong the QTc interval.
- Monitor ECG (including QTc interval), vital signs, and electrolyte levels.
- Be prepare... | {
"Header 1": "CASE STUDY",
"Header 2": "**Nursing Implications**",
"token_count": 210,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Amiodarone can cause pulmonary toxicity (hypersensitivity pneumonitis or interstitial/alveolar pneumonitis) that has resulted in clinically manifest disease at rates as high as 17% in some series of clients. Pulmonary toxicity has been fatal about 10% of the time. The client should have a baseline chest x-ray and pulmo... | {
"Header 1": "CASE STUDY",
"Header 2": "**Amiodarone**",
"token_count": 255,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
By the end of this section, you should be able to:
- 17.5.1 Identify the characteristics of the calcium channel blocker drugs used to treat dysrhythmias.
- 17.5.2 Explain the indications, actions, adverse reactions, and interactions of calcium channel blocker drugs used to treat dysrhythmias.
- 17.5.3 Describe the nu... | {
"Header 1": "CASE STUDY",
"Header 2": "**LEARNING OUTCOMES**",
"token_count": 356,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Diltiazem is a non-DHP calcium channel blocker antidysrhythmic. It is available in both oral and intravenous dosage forms; oral options include immediate-release and extended-release products. It is FDA approved for hypertension and angina. The intravenous form is also FDA approved for heart rate control in atrial fibr... | {
"Header 1": "CASE STUDY",
"Header 2": "**Diltiazem**",
"token_count": 274,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Verapamil is a non-DHP calcium channel blocker approved for the treatment of angina, atrial fibrillation/atrial flutter, hypertension, and supraventricular tachycardia. It is available in both oral and intravenous dosage forms. As with diltiazem, the FDA recommends limiting the dose of simvastatin to 10 mg daily with c... | {
"Header 1": "CASE STUDY",
"Header 2": "**Verapamil**",
"token_count": 374,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Digoxin is an older antidysrhythmic drug that was first approved in 1954 and is used for rate control of atrial fibrillation or atrial flutter. As an antidysrhythmic drug, it works by suppressing conduction through the AV node, slowing the rate of conduction and, thus, the ventricular heart rate. It does this by enhanc... | {
"Header 1": "CASE STUDY",
"Header 2": "**Digoxin**",
"token_count": 353,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Adenosine is another unclassified antidysrhythmic drug that is approved for treating paroxysmal supraventricular tachycardia. It works by enhancing potassium efflux and suppressing calcium influx into the cells of the AV node, slowing its conduction and extinguishing arrhythmias that originate there. Adenosine is avail... | {
"Header 1": "CASE STUDY",
"Header 2": "**Adenosine**",
"token_count": 610,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
18.1 [Hypertension and Angina](#page-528-2) 18.2 [Angiotensin-Converting Enzyme \(ACE\) Inhibitors](#page-535-0) 18.3 [Angiotensin II Receptor Blockers \(ARBs\)](#page-538-0) 18.4 [Beta-Adrenergic Blockers](#page-541-0) 18.5 [Calcium Channel Blockers](#page-544-0) 18.6 [Diuretics](#page-547-0) 18.7 [Nitrates](#page-550... | {
"Header 1": "CHAPTER 18 Antihypertensive and Antianginal Drugs",
"Header 2": "**CHAPTER OUTLINE**",
"token_count": 278,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
The cardiovascular system transports blood and oxygen throughout the body. Blood flows from a system of higher resistance to one of lower resistance—from arteries to capillaries to veins. Blood pressure (see [Figure 18.2\)](#page-529-0) represents the force that blood flow exerts on arterial walls.
![](_page_529_Figu... | {
"Header 1": "CHAPTER 18 Antihypertensive and Antianginal Drugs",
"Header 2": "**Hypertension**",
"token_count": 1104,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
The American Heart Association (AHA) (n.d-a) reports that prolonged elevation of blood pressure leads to the deterioration of blood vessels. The deterioration of blood vessels is measured by grades of hypertension. Normal blood pressure is a systolic reading of less than 120 mm Hg and a diastolic reading of less than 8... | {
"Header 1": "CHAPTER 18 Antihypertensive and Antianginal Drugs",
"Header 2": "**Grades of Hypertension**",
"token_count": 370,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
A physical examination by a health care provider with a sphygmomanometer (blood pressure cuff or device) will identify an elevated blood pressure, and a 12-lead electrocardiogram (ECG, EKG) can assist in determining if the heart has a normal or abnormal rhythm. The health care provider also obtains blood work to determ... | {
"Header 1": "CHAPTER 18 Antihypertensive and Antianginal Drugs",
"Header 2": "**Grades of Hypertension**",
"Header 3": "**Diagnostics**",
"token_count": 205,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
The AHA conducted a critical assessment of research and clinical knowledge on cardiovascular disease across the United States specifically addressing women's health. In its report to the president [\(https://openstax.org/r/](https://openstax.org/r/heartorgennews) [heartorgennews\),](https://openstax.org/r/heartorgennew... | {
"Header 1": "CHAPTER 18 Antihypertensive and Antianginal Drugs",
"Header 2": "TRENDING TODAY",
"Header 3": "Gender and Racial Bias in Cardiovascular Disease Treatment",
"token_count": 293,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
**Angina** (also called angina pectoris) is characterized by discomfort in the front of the chest, neck, shoulders, jaw, or arms that is precipitated by physical exertions and relieved by rest within 5 minutes or sublingual nitrates (Ueng et al., 2023). Angina is caused by reduced blood flow to the heart. The four type... | {
"Header 1": "CHAPTER 18 Antihypertensive and Antianginal Drugs",
"Header 2": "**Angina**",
"token_count": 373,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
**Angiotensin-converting enzyme (ACE) inhibitors** are a classification of drugs that block the body's production of angiotensin II. Angiotensin II induces oxidative stress and inflammation of cardiac tissue, which contributes to adverse remodeling processes. Angiotensin II also causes vasoconstriction and inhibits the... | {
"Header 1": "UNFOLDING CASE STUDY",
"Header 2": "**Introduction and Use**",
"token_count": 264,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Some clients with hypertension demonstrate a lower response to ACE inhibitor monotherapy. ACE inhibitors interfere with the renin-angiotensin-aldosterone system, which causes high blood pressure when renin levels are high. Black clients often have hypertension, but also have lower levels of renin. Therefore, concomitan... | {
"Header 1": "UNFOLDING CASE STUDY",
"Header 2": "ACE Inhibitors",
"token_count": 327,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
**Angiotensin II receptor blockers (ARBs)** are a classification of drug that binds to and inhibits angiotensin II type I receptors. Renin secretion catalyzes the conversion of angiotensinogen to angiotensin in the liver where it is then converted to angiotensin II by the angiotensin-converting enzyme.
ARBs resemble ... | {
"Header 1": "UNFOLDING CASE STUDY",
"Header 2": "**Introduction and Use**",
"token_count": 371,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
**Beta-adrenergic blockers** (beta blockers) are a classification of drugs that inhibit chronotropic, inotropic, and vasoconstrictor response to catecholamine—such as epinephrine and norepinephrine—by exerting effects on adrenergic receptors beta 1, beta 2, and alpha.
Beta 1 receptors are found primarily in the heart... | {
"Header 1": "UNFOLDING CASE STUDY",
"Header 2": "**Introduction and Use**",
"token_count": 435,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Adverse effects of beta blockers are dizziness, fatigue, weight gain, constipation, cold hands and feet, hypercholesterolemia, shortness of breath, depression, nausea, dry mouth, and dry eyes. Serious adverse effects include bradycardia, arrhythmias, hypoglycemia, and hypotension. Rare side effects include sexual and e... | {
"Header 1": "UNFOLDING CASE STUDY",
"Header 2": "**Adverse Effects and Contraindications**",
"token_count": 845,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
**Calcium channel blockers** are a classification of drug that blocks calcium from entering cells by binding to long-
acting voltage-gated calcium channels in the heart, smooth muscle, and pancreas. Calcium causes vasoconstriction. Calcium channel blockers inhibit calcium and allow for vasodilation, thereby causing t... | {
"Header 1": "UNFOLDING CASE STUDY",
"Header 2": "**Introduction and Use**",
"token_count": 242,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Older clients using nitrates are at a higher risk for postural hypotension and should rise from a lying or sitting position slowly to prevent falls and injuries.
(Source: Lee & Gerriets, 2023)
| Drug | Routes and Dosage Ranges ... | {
"Header 1": "UNFOLDING CASE STUDY",
"Header 2": "Nitrates",
"token_count": 608,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Nitrates can induce hypotension. They should not be taken with PDE inhibitors because they can cause severe hypotension and cardiac decompensation.
[Table 18.14](#page-552-0) is a drug prototype table for nitrates featuring nitroglycerin. It lists drug class, mechanism of action, adult dosage, indications, therapeuti... | {
"Header 1": "UNFOLDING CASE STUDY",
"Header 2": "Nitrates",
"token_count": 812,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
- **aldosterone** a hormone made in the adrenal cortex that helps to control the balance of water and salts in the kidneys, retaining sodium and releasing potassium from the body
- **angina** chest discomfort in the front of the chest, neck, shoulders, jaw, or arms that is precipitated by physical exertions and relieve... | {
"Header 1": "UNFOLDING CASE STUDY",
"Header 2": "**Key Terms**",
"token_count": 387,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Common antihypertensive and antianginal drug classifications were covered in the chapters. Drug classifications covered included ACE inhibitors, ARBs, beta-adrenergic blockers, calcium channel blockers, diuretics, and nitrates. These drug classifications are used as mono- or multi-drug treatment therapy for hypertensio... | {
"Header 1": "UNFOLDING CASE STUDY",
"Header 2": "**Key Terms**",
"Header 3": "typical findings.",
"token_count": 397,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
19.1 [Heart Failure](#page-558-2) 19.2 [Drugs Affecting the Renin-Angiotensin-Aldosterone System](#page-563-0) 19.3 [Beta-Adrenergic Blockers](#page-571-0) 19.4 [Sodium-Glucose Cotransporter 2 Inhibitors \(SGLT2Is\)](#page-575-0) 19.5 [Diuretics](#page-577-0)
19.6 [Adjunct Medications Used in Heart Failure](#page-581... | {
"Header 1": "CHAPTER 19 Heart Failure Drugs",
"Header 2": "**CHAPTER OUTLINE**",
"token_count": 232,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
The importance of cardiac output cannot be stressed enough; it is necessary for every organ in the body. **Cardiac output** is a function of heart rate (HR) and stroke volume (SV): . Normal resting CO is 4–5 liters per minute. **Heart rate** is the number of times the heart beats per minute. **Stroke volume** is the am... | {
"Header 1": "CHAPTER 19 Heart Failure Drugs",
"Header 2": "**Pathophysiology of Heart Failure**",
"token_count": 576,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Heart failure with reduced ejection fraction is a problem stemming from inadequate contractility. It is the most common type of heart failure. There are multiple causes of HFrEF, including coronary artery disease and acute myocardial infarction (AMI). Both cause decreased oxygenation to the individual cardiac muscle ce... | {
"Header 1": "CHAPTER 19 Heart Failure Drugs",
"Header 2": "**Heart Failure with Reduced Ejection Fraction**",
"token_count": 305,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Heart failure with preserved ejection fraction stems from muscle stiffness. As people age, muscles can become stiff and not move as well as they did in younger years. This also can happen to the left ventricle; the muscle tissue can become stiff, which does not allow for adequate ventricular opening. If the ventricles ... | {
"Header 1": "CHAPTER 19 Heart Failure Drugs",
"Header 2": "**Heart Failure with Preserved Ejection Fraction**",
"token_count": 386,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
It can be difficult to diagnose heart failure because it is based on symptom recognition. People often have symptoms but don't recognize them as a manifestation of heart failure. In order for heart failure to be diagnosed, a health care provider must do a thorough history and physical exam. If there are signs and sympt... | {
"Header 1": "CHAPTER 19 Heart Failure Drugs",
"Header 2": "**Diagnostics**",
"token_count": 212,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Dietary modification for clients with heart failure are similar to those for clients with hypertension (see
[Antihypertensive and Antianginal Drugs](#page-528-1)). Clients with heart failure should follow a 2000 mg/day sodium-restricted diet and are often instructed to record the amount of sodium they consume daily. ... | {
"Header 1": "CHAPTER 19 Heart Failure Drugs",
"Header 2": "**Dietary Modification**",
"token_count": 240,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
The primary goal of treatment for clients with heart failure is to reduce morbidity and mortality. Another goal is to decrease the cardiac workload and the heart's demand for oxygen. There are five guideline-directed classifications of medications for HFrEF (Heidenreich et al., 2022):
- 1. Medications affecting the r... | {
"Header 1": "CHAPTER 19 Heart Failure Drugs",
"Header 2": "**Pharmacologic Treatment of Heart Failure**",
"token_count": 372,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
As mentioned in [Antihypertensive and Antianginal Drugs,](#page-528-1) **Angiotensin-converting enzyme (ACE) inhibitors** are a classification of drugs that block the body's production of angiotensin II. Angiotensin II is one of the products of the **renin-angiotensin-aldosterone system (RAAS)** (see [Figure 19.4](#pag... | {
"Header 1": "CHAPTER 19 Heart Failure Drugs",
"Header 2": "**Angiotensin-Converting (ACE) Enzyme Inhibitors**",
"token_count": 567,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
ACE inhibitors cause fetal toxicity and should be immediately discontinued if pregnancy occurs. Clients with renal impairment should use cautiously. Clients with a previous hypersensitivity reaction to an ACE inhibitor should not be prescribed this classification of drug.
[Table 19.4](#page-565-0) is a drug prototype... | {
"Header 1": "CHAPTER 19 Heart Failure Drugs",
"Header 2": "SPECIAL CONSIDERATIONS",
"Header 3": "may develop.",
"token_count": 494,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
**Angiotensin II receptor blockers (ARBs)** are a classification of drugs that bind to and inhibit angiotensin II type I receptors. ARBs work directly at the receptor site to block angiotensin II from binding with receptors on the cells (see [Figure 19.4](#page-564-0)). The effect of ARBs is similar to that of ACE inhi... | {
"Header 1": "CHAPTER 19 Heart Failure Drugs",
"Header 2": "**Angiotensin II Receptor Blockers**",
"token_count": 362,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Recently, a new classification of heart failure medication was developed, **angiotensin receptor/neprilysin inhibitors (ARNIs)**. This combination medication is a first-line medication for many classifications of heart failure. It is a combination of an ARB and a new type of medication, a neprilysin inhibitor. There cu... | {
"Header 1": "CHAPTER 19 Heart Failure Drugs",
"Header 2": "**Angiotensin Receptor/Neprilysin Inhibitors**",
"token_count": 285,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
It is important for the nurse to review all of a client's medications. Clients should not take ACE inhibitors, ARBs, or ARNIs at the same time. Clients should be prescribed only one of these classifications of medication at a time.
[Table 19.7](#page-569-0) is a drug prototype table for angiotensin receptor/neprilysi... | {
"Header 1": "CHAPTER 19 Heart Failure Drugs",
"Header 2": "Reviewing Medications",
"token_count": 465,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
**Mineralocorticoid receptor antagonists (MRAs)** (also known as aldosterone antagonists) are often categorized as diuretics because they ultimately do cause diuresis. When the RAAS is activated, one of the end results is the stimulation of the adrenal glands to secrete aldosterone. (See [Figure 19.4](#page-564-0) earl... | {
"Header 1": "CHAPTER 19 Heart Failure Drugs",
"Header 2": "CLIENT TEACHING GUIDELINES",
"Header 3": "**Mineralocorticoid Receptor Antagonists**",
"token_count": 360,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
By the end of this section, you should be able to:
- 19.3.1 Identify the characteristics of beta-adrenergic blocker drugs used to treat heart failure.
- 19.3.2 Explain the indications, actions, adverse reactions, and interactions of beta-adrenergic blocker drugs used to treat heart failure.
- 19.3.3 Describe nursing ... | {
"Header 1": "CHAPTER 19 Heart Failure Drugs",
"Header 2": "**LEARNING OUTCOMES**",
"token_count": 990,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Adverse effects of beta blockers include dizziness, fatigue, weight gain, constipation, cold hands and feet, hypercholesterolemia, shortness of breath, depression, nausea, dry mouth, and dry eyes. Serious adverse effects include bradycardia, arrhythmias, hypoglycemia, and hypotension. Rare side effects include sexual a... | {
"Header 1": "CHAPTER 19 Heart Failure Drugs",
"Header 2": "**Adverse Effects and Contraindications**",
"token_count": 241,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Nonselective beta blockers should not be used in clients with asthma who are taking a short-acting beta agonist because they may cause worsening bronchospasm.
Beta blockers block aspects of the sympathetic nervous system, which is activated when blood sugar is too low. Beta blockers may mask symptoms of hypoglycemia.... | {
"Header 1": "SAFETY ALERT",
"Header 2": "Beta Blockers",
"token_count": 570,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
By the end of this section, you should be able to:
- 19.4.1 Identify the characteristics of sodium-glucose cotransporter 2 inhibitor drugs used to treat heart failure.
- 19.4.2 Explain the indications, actions, adverse reactions, and interactions of the sodium-glucose cotransporter 2 inhibitor drugs used to treat hea... | {
"Header 1": "SAFETY ALERT",
"Header 2": "**LEARNING OUTCOMES**",
"token_count": 658,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Adverse effects of SGLT2Is include ketoacidosis in clients with diabetes mellitus, urinary tract infection, pyelonephritis, genital infection, necrotizing fasciitis of the perineum, volume depletion, and hypotension.
Contraindications to SGLT2Is include history of serious hypersensitivity reaction to dapagliflozin, c... | {
"Header 1": "SAFETY ALERT",
"Header 2": "**Adverse Effects and Contraindications**",
"token_count": 492,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Adverse effects include severe anaphylactic/anaphylactoid reaction, excessive loss of water and electrolytes, ototoxicity, tinnitus and hearing loss, vertigo, dizziness, aplastic anemia, thrombocytopenia, agranulocytosis, hemolytic anemia, leukopenia, anemia, Stevens-Johnson syndrome, drug rash, and cramping/diarrhea. ... | {
"Header 1": "SAFETY ALERT",
"Header 2": "**Adverse Effects and Contraindications**",
"token_count": 752,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Hydralazine and isosorbide dinitrate (BiDil) are administered as a combination drug in clients with heart failure who have optimized therapy with other medications but still have a low ejection fraction and/or symptoms. This drug combination has been shown to reduce mortality in Black clients with heart failure (Heiden... | {
"Header 1": "CASE STUDY",
"Header 2": "**Hydralazine and Isosorbide Dinitrate**",
"token_count": 329,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Adverse effects include orthostatic hypotension, tachycardia, paradoxical bradycardia, flushing, peripheral edema, nausea/vomiting, headache (nitrates), blurred vision, drug-induced lupus erythematosus, hemolytic anemia, and glomerulonephritis.
Contraindications include allergy to nitrates and use with phosphodiester... | {
"Header 1": "CASE STUDY",
"Header 2": "**Hydralazine and Isosorbide Dinitrate**",
"Header 3": "**Adverse Effects and Contraindications**",
"token_count": 645,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
**Cardiac glycosides** used to be a first-line therapy in heart failure. Over the years, medications that are safer and more efficacious have been introduced on the market. However, cardiac glycosides may be used as adjunct therapy if first-line medications for heart failure have been optimized and the client still has... | {
"Header 1": "CASE STUDY",
"Header 2": "**Cardiac Glycosides**",
"token_count": 270,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Adverse effects include fatal cardiac arrhythmias, sinus bradycardia, sinoatrial block, visual disturbances (yellow or green halo around lights), atrial tachycardia, and rash.
Digoxin has a narrow therapeutic index and a high potential for toxicity. Signs and symptoms of digoxin toxicity include anorexia, nausea, vom... | {
"Header 1": "CASE STUDY",
"Header 2": "**Cardiac Glycosides**",
"Header 3": "**Adverse Effects and Contraindications**",
"token_count": 570,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
20.1 [Introduction to Clotting and Coagulation](#page-591-0)
20.2 [Anticoagulants](#page-596-0)
20.3 [Antiplatelets](#page-605-0)
20.4 [Thrombolytics](#page-609-0)
**INTRODUCTION** Blood moves through the cardiovascular system to deliver oxygen and nutrients to the various tissues, including those that make up ... | {
"Header 1": "CHAPTER 20 Anticoagulant, Antiplatelet, and Thrombolytic Drugs",
"Header 3": "**CHAPTER OUTLINE**",
"token_count": 473,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Human blood moves as a fluid; however, when injury occurs, hemostasis is accomplished in two major ways: primary hemostasis and secondary hemostasis. Primary hemostasis is the process of platelet adhesion to form a platelet plug, or platelets that are aggregated on the injured vessel wall or tissues. Platelets can be a... | {
"Header 1": "CHAPTER 20 Anticoagulant, Antiplatelet, and Thrombolytic Drugs",
"Header 2": "**Blood Coagulation**",
"token_count": 1224,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
The pathologic formation of thrombi (plural of thrombus) occurs as the result of endothelial injury, hypercoagulability, and stasis of blood flow; this is known as Virchow's Triad and is depicted in [Figure 20.5](#page-595-0). Endothelial injury activates clotting as described above and occurs due to events such as cat... | {
"Header 1": "CHAPTER 20 Anticoagulant, Antiplatelet, and Thrombolytic Drugs",
"Header 2": "**Thrombus Formation**",
"token_count": 338,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
A **deep vein thrombosis (DVT)** is a blood clot that forms within a vein. It most commonly occurs within the legs but can occur elsewhere, such as the pelvis and arms. The clot can break off, travel through the circulatory system, and lodge within the lungs, causing a **pulmonary embolism (PE)**, which can be life-thr... | {
"Header 1": "CHAPTER 20 Anticoagulant, Antiplatelet, and Thrombolytic Drugs",
"Header 2": "**Thrombus Formation**",
"Header 3": "**Deep Vein Thrombosis and Pulmonary Embolism**",
"token_count": 341,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
When a clot obstructs blood flow to the brain, it can cause an **ischemic stroke**. Two types of ischemic stroke are atherosclerotic and embolic. An atherosclerotic ischemic stroke can be caused by a buildup of fatty substances, cholesterol, and other substances that can narrow the artery and cause blood clots to form.... | {
"Header 1": "CHAPTER 20 Anticoagulant, Antiplatelet, and Thrombolytic Drugs",
"Header 2": "**Thrombus Formation**",
"Header 3": "**Ischemic Stroke (Cerebral Infarction)**",
"token_count": 434,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Clients with atherosclerosis in their coronary arteries are said to have coronary artery disease. The disease states of coronary artery disease and myocardial infarction are expanded upon in the chapters [Antihypertensive and](#page-528-1) [Antianginal Drugs](#page-528-1) and [Cardiac Emergency and Shock Drugs.](#page-... | {
"Header 1": "CHAPTER 20 Anticoagulant, Antiplatelet, and Thrombolytic Drugs",
"Header 2": "**Myocardial Infarction and Coronary Artery Disease**",
"token_count": 208,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
**Anticoagulants** are commonly referred to as blood thinners. They work in different parts of the coagulation cascade to decrease the propensity of the blood to form a clot. There are many types of anticoagulants that work in various ways and can be administered by intravenous, subcutaneous, or oral routes, depending ... | {
"Header 1": "CHAPTER 20 Anticoagulant, Antiplatelet, and Thrombolytic Drugs",
"Header 2": "**Anticoagulants Used as Blood Thinners**",
"token_count": 777,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Heparin is an injectable anticoagulant used primarily in the hospital setting. It is FDA approved for the treatment and prevention of thromboembolism. Heparin works by inactivating clotting factors in the coagulation cascade. It binds to antithrombin and the complex inactivates IIa (thrombin), Xa, IXa, XIa, and XIIa. H... | {
"Header 1": "CHAPTER 20 Anticoagulant, Antiplatelet, and Thrombolytic Drugs",
"Header 2": "**Anticoagulants Used as Blood Thinners**",
"Header 3": "**Heparin**",
"token_count": 1035,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Enoxaparin is a derivative of heparin and is referred to as a low molecular weight heparin. It is FDA approved to treat thromboembolism and acute coronary syndromes. It is also approved to decrease the rate of thromboembolism after surgery and during prolonged immobilization. It works similarly to heparin; however, it ... | {
"Header 1": "CHAPTER 20 Anticoagulant, Antiplatelet, and Thrombolytic Drugs",
"Header 2": "SAFETY ALERT",
"Header 3": "**Enoxaparin**",
"token_count": 429,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Warfarin is an oral anticoagulant that is FDA approved to treat and prevent thromboembolism disorders. Warfarin inhibits the production of vitamin K in the body. Vitamin K is needed for production of clotting factors II, VII, IX, and X. When warfarin is administered, the production of those clotting factors is decrease... | {
"Header 1": "CHAPTER 20 Anticoagulant, Antiplatelet, and Thrombolytic Drugs",
"Header 2": "SAFETY ALERT",
"Header 3": "**Warfarin**",
"token_count": 897,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Direct-acting oral anticoagulants (DOACs) have the advantage of more standardized dosing than warfarin without the need for regular INR monitoring. They also have minimal food and drug interactions in comparison.
The first DOAC, dabigatran, was approved in 2010. It works by directly inhibiting thrombin in the coagula... | {
"Header 1": "CHAPTER 20 Anticoagulant, Antiplatelet, and Thrombolytic Drugs",
"Header 2": "SAFETY ALERT",
"Header 3": "**Direct-Acting Oral Anticoagulants**",
"token_count": 1535,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Vitamin K is also known as phytonadione. It is the same substance present in food and is an antidote for the effect of warfarin. It is FDA approved for the reversal of anticoagulation due to warfarin, vitamin K deficiency, and for prophylaxis and treatment of vitamin K deficiency–related bleeding in newborns. It is ava... | {
"Header 1": "CHAPTER 20 Anticoagulant, Antiplatelet, and Thrombolytic Drugs",
"Header 2": "SAFETY ALERT",
"Header 3": "**Vitamin K (Phytonadione)**",
"token_count": 208,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Aspirin is an over-the-counter antiplatelet agent used for many indications. Some of those indications are secondary prevention of stroke, coronary artery disease, acute coronary syndromes, primary prevention of cardiovascular disease, peripheral artery disease, and prevention of thromboembolism in clients with certain... | {
"Header 1": "CASE STUDY",
"Header 2": "**Antiplatelet Drugs**",
"Header 3": "**Aspirin**",
"token_count": 235,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
P2Y12 inhibitors are potent antiplatelet agents that work as antagonists at the P2Y12 subunit of the ADP receptor on the platelet surface, which decreases platelet activation at the site of vessel injury. Because of their effect on bleeding, it is recommended that P2Y12 inhibitors be discontinued 5–7 days prior to surg... | {
"Header 1": "CASE STUDY",
"Header 2": "Chew Aspirin for Faster Absorption",
"Header 3": "**P2Y12 Inhibitors**",
"token_count": 274,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Clopidogrel requires a loading dose if immediate onset is desired, such as during an acute coronary syndrome. Initiating clopidogrel without a loading dose will result in a delayed effect up to several days, putting the client at risk for a thromboembolic event.
Ticagrelor and prasugrel are two additional oral P2Y12 ... | {
"Header 1": "CASE STUDY",
"Header 2": "Clopidogrel",
"token_count": 391,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Eptifibatide inhibits the GPIIbIIIa receptor on the platelet surface, preventing activation by von Willebrand's factor and fibrinogen. This receptor is responsible for the final step in platelet-to-platelet adhesion; thus, this is a very potent antiplatelet agent. It is FDA approved for use during percutaneous coronary... | {
"Header 1": "CASE STUDY",
"Header 2": "Clopidogrel",
"Header 3": "**Eptifibatide**",
"token_count": 575,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Like anticoagulants, the major side effect of all antiplatelet medications is bleeding complications. This can manifest in many different ways, including excessive bleeding in response to trauma or during surgery, gastrointestinal bleeding, or spontaneous intracranial hemorrhage. Some symptoms of bleeding are blood in ... | {
"Header 1": "CASE STUDY",
"Header 2": "**Adverse Effects and Contraindications**",
"token_count": 624,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Alteplase is an intravenous thrombolytic drug that is approved to treat acute ischemic stroke, acute myocardial infarction, and pulmonary embolism. Alteplase works quickly upon administration, and the half-life is less than 5 minutes. It requires reconstitution prior to administration, which is somewhat complicated and... | {
"Header 1": "CASE STUDY",
"Header 2": "Alteplase",
"Header 3": "**Alteplase**",
"token_count": 292,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Tenecteplase is approved for treatment of ST-elevation myocardial infarction (STEMI). The most common adverse effects are bleeding and hypersensitivity. Like alteplase, it has many contraindications that would put the client at an unacceptable risk of bleeding: active internal bleeding, history of cerebrovascular accid... | {
"Header 1": "CASE STUDY",
"Header 2": "Alteplase",
"Header 3": "**Tenecteplase**",
"token_count": 575,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
The main adverse effect of thrombolytic therapy is bleeding, which is sometimes severe and can be fatal. This is especially frequent at arterial and venous puncture sites, which leads to nursing implications regarding vascular access described in the next section. Hypersensitivity reactions are also possible. When used... | {
"Header 1": "CASE STUDY",
"Header 2": "Alteplase",
"Header 3": "**Adverse Effects and Contraindications**",
"token_count": 727,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
The nurse should do the following for clients who are taking thrombolytics:
- Obtain baseline vital signs.
- Avoid intramuscular injections, internal jugular, and subclavian venous punctures during infusion. If an arterial puncture is necessary during infusion, the nurse should use an upper extremity blood vessel tha... | {
"Header 1": "CASE STUDY",
"Header 2": "**Nursing Implications**",
"token_count": 302,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
- 21.1 [Introduction to Lipoprotein and Apolipoproteins](#page-616-2)
- 21.2 [Statins \(HMG-CoA Reductase Inhibitors\) and PCSK9 Inhibitors](#page-621-0)
- 21.3 [Bile Acid Sequestrants, Fibrates, and Niacin](#page-626-0)
- 21.4 [Cholesterol Absorption Inhibitors](#page-631-0)
**INTRODUCTION** Lipids are fatty, waxy, ... | {
"Header 1": "CHAPTER 21 Lipid-Lowering Drugs",
"Header 2": "**CHAPTER OUTLINE**",
"token_count": 237,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
**Triglycerides** are the main dietary source of fat. They are composed of three long fatty acid chains attached to a glycerol backbone, as depicted in [Figure 21.2](#page-617-0). The major sterol in the body is cholesterol. **Cholesterol** is important for the structure of cell membranes and for the production of horm... | {
"Header 1": "CHAPTER 21 Lipid-Lowering Drugs",
"Header 2": "**Understanding Lipids**",
"token_count": 545,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
**Lipoproteins** are combinations of lipids and proteins that carry cholesterol and triglycerides in the blood.
**Chylomicrons** are lipoproteins produced by enterocytes in the gut. They carry triglycerides to the tissues after dietary consumption. Three major types of lipoproteins are made by the liver. They vary in... | {
"Header 1": "CHAPTER 21 Lipid-Lowering Drugs",
"Header 2": "**Lipoproteins**",
"token_count": 581,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Fats from the diet are emulsified by bile acids, which are made in the liver and secreted by the gallbladder when food is consumed. The emulsified fats are absorbed in the small intestine and carried via chylomicrons to the tissues. Chylomicrons interact with an enzyme called **lipoprotein lipase** on muscle and adipos... | {
"Header 1": "CHAPTER 21 Lipid-Lowering Drugs",
"Header 2": "**Lipid Metabolism**",
"token_count": 355,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
This interactive slide presentation from the American Heart Association introduces the role of cholesterol in the pathophysiology of CAD.
Because of this pathophysiology, hypercholesterolemia due to elevated LDL-cholesterol is an independent risk factor for heart disease. Lipid-lowering therapy that targets LDL-chole... | {
"Header 1": "CHAPTER 21 Lipid-Lowering Drugs",
"Header 2": "[Cholesterol and Coronary Artery Disease](https://openstax.org/r/watchlearnli) (https://openstax.org/r/watchlearnli)",
"token_count": 231,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Access multimedia content [\(https://openstax.org/books/pharmacology/pages/21-1-introduction-to-lipoprotein](https://openstax.org/books/pharmacology/pages/21-1-introduction-to-lipoprotein-and-apolipoproteins)[and-apolipoproteins\)](https://openstax.org/books/pharmacology/pages/21-1-introduction-to-lipoprotein-and-apoli... | {
"Header 1": "CHAPTER 21 Lipid-Lowering Drugs",
"Header 2": "Cholesterol Guidelines",
"token_count": 461,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
By the end of this section, you should be able to:
- 21.2.1 Identify the characteristics of statins (HMG-CoA reductase inhibitors) and PCSK9 inhibitor drugs used to lower lipid levels.
- 21.2.2 Explain the indications, action, adverse reactions, and interactions of statins (HMG-CoA reductase inhibitors) and PCSK9 inh... | {
"Header 1": "CHAPTER 21 Lipid-Lowering Drugs",
"Header 2": "**LEARNING OUTCOMES**",
"token_count": 1923,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
At its highest prescribed doses, simvastatin is considered a moderate-intensity statin. Therefore, it is not appropriate for clients who have very high cardiovascular risk. Nurses should instruct clients to take simvastatin in the evening because of its shorter half-life compared to rosuvastatin or atorvastatin. Simvas... | {
"Header 1": "CHAPTER 21 Lipid-Lowering Drugs",
"Header 2": "**Atorvastatin**",
"Header 3": "**Simvastatin**",
"token_count": 238,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Some of the most common and limiting adverse effects associated with statins are muscular in nature. Myalgia, or muscle pain, is common and occurred in 5%–10% of clients taking statin therapy in observational studies (Grundy et al., 2019). Myositis is rare and is characterized by muscular pain or weakness and elevated ... | {
"Header 1": "CHAPTER 21 Lipid-Lowering Drugs",
"Header 2": "SAFETY ALERT",
"Header 3": "**Adverse Effects and Contraindications**",
"token_count": 586,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
The nurse should do the following for clients taking statin medications:
- Teach clients about nonpharmacologic modalities for cardiovascular risk reduction and lipid lowering.
- Obtain an accurate home medication list and check it for possible drug and food interactions.
- Monitor for signs and symptoms of muscle-re... | {
"Header 1": "CHAPTER 21 Lipid-Lowering Drugs",
"Header 2": "SAFETY ALERT",
"Header 3": "**Nursing Implications**",
"token_count": 294,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Bile acid sequestrants are a class of drugs that lower cholesterol. Bile acids are made from cholesterol and are released from the small intestine to aid in fat digestion after the individual consumes food. The majority of bile acids are reabsorbed back into the body after use. Bile acid sequestrants work by binding to... | {
"Header 1": "CHAPTER 21 Lipid-Lowering Drugs",
"Header 2": "**Bile Acid Sequestrants**",
"token_count": 1016,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Fenofibric acid is an active drug that directly stimulates peroxisome proliferator-activated receptors as described
above. It is available in the active form under the brand name Fibricor and as generic drugs. An inactive form called fenofibrate is also available; this form converts to fenofibric acid in the body aft... | {
"Header 1": "CHAPTER 21 Lipid-Lowering Drugs",
"Header 2": "**Fenofibric Acid Derivatives**",
"token_count": 712,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Gemfibrozil is another fibrate approved for the treatment of hypertriglyceridemia and for primary prevention of CAD in clients who have failed to respond to lifestyle changes and other pharmacologic therapies. Gemfibrozil is generally administered orally, twice daily, 30 minutes before breakfast and dinner. The most co... | {
"Header 1": "CHAPTER 21 Lipid-Lowering Drugs",
"Header 2": "**Fenofibric Acid Derivatives**",
"Header 3": "**Gemfibrozil**",
"token_count": 272,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Niacin (vitamin B3) is a water-soluble vitamin. The chemical name for niacin is nicotinic acid. It is approved for treatment of hyperlipidemia, dyslipidemia, and hypertriglyceridemia; for secondary prevention of myocardial infarction; and, in combination with a bile acid sequestrant, for slowing the progression or prom... | {
"Header 1": "CHAPTER 21 Lipid-Lowering Drugs",
"Header 2": "**Niacin**",
"token_count": 310,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
**Bile acid sequestrants.** Because these drugs are not absorbed into the systemic circulation, systemic adverse effects are limited; side effects from bile acid sequestrants are generally related to their effect on the gastrointestinal system. Constipation is the most common one; it can be severe and can aggravate hem... | {
"Header 1": "CHAPTER 21 Lipid-Lowering Drugs",
"Header 2": "**Adverse Effects and Contraindications**",
"token_count": 672,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
The nurse should do the following for clients taking bile acid sequestrants:
- Monitor for constipation and instruct client about appropriate management (increase fluids and dietary fiber and, if needed, take a stool softener).
- Administer other drugs at least 1 hour before or 3–4 hours after bile acid sequestrant a... | {
"Header 1": "CHAPTER 21 Lipid-Lowering Drugs",
"Header 2": "**Nursing Implications**",
"token_count": 338,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
- **atherosclerosis** formation of fatty material called plaques on inner arterial walls
- **cholesterol** major sterol in the body; important for the structure of cell membranes and the production of hormones, bile acids, and vitamin D
- **chylomicrons** lipoproteins produced by enterocytes in the gut; carry triglycer... | {
"Header 1": "CHAPTER 21 Lipid-Lowering Drugs",
"Header 2": "**Key Terms**",
"token_count": 218,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
22.1 [Introduction to Cardiac Emergencies and Shock](#page-636-2)
22.2 [Cardiac Emergency Drugs](#page-642-0)
22.3 [Shock Drugs](#page-666-0)
**INTRODUCTION** Cardiac emergencies are life-threatening events that can include acute myocardial infarction, unstable angina, and acute dysrhythmias (abnormal heart rhyth... | {
"Header 1": "CHAPTER 22 Cardiac Emergency and Shock Drugs",
"Header 2": "**CHAPTER OUTLINE**",
"token_count": 270,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
The primary responsibility of the heart is to generate **cardiac output**. Cardiac output (CO) is a function of heart rate (HR) and stroke volume . Normal resting cardiac output is 4–5 L/min. Heart rate is the
number of times the heart beats per minute. Stroke volume is the amount of blood pumped out of the left vent... | {
"Header 1": "CHAPTER 22 Cardiac Emergency and Shock Drugs",
"Header 2": "**Cardiac Emergencies**",
"token_count": 419,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
The heart, just like every other organ in the body, needs oxygen and nutrients to survive. Cardiac tissue receives oxygenated blood from coronary arteries, which branch off from the aorta [\(Figure 22.2](#page-637-0)). However, the coronary arteries may become occluded due to various causes, with atherosclerosis, ather... | {
"Header 1": "CHAPTER 22 Cardiac Emergency and Shock Drugs",
"Header 2": "**Cardiac Emergencies**",
"Header 3": "**Acute Myocardial Infarction**",
"token_count": 363,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
**Angina** is the medical term for chest pain caused by cardiac ischemia. Angina occurs when the heart is not getting enough blood flow. There are two types of angina: stable and unstable. Stable angina (discussed in [Antihypertensive](#page-528-1) [and Antianginal Drugs\)](#page-528-1) occurs when the heart needs more... | {
"Header 1": "CHAPTER 22 Cardiac Emergency and Shock Drugs",
"Header 2": "Videos on Coronary Artery Disease",
"Header 3": "**Unstable Angina**",
"token_count": 229,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
It is important to understand cardiac conduction in order to understand **dysrhythmias**. The heart is truly amazing in that it has the ability to generate electrical impulses. The sinoatrial (SA) node generates impulses that travel through the conduction tissue and stimulate the myocytes to contract. Each impulse leav... | {
"Header 1": "CHAPTER 22 Cardiac Emergency and Shock Drugs",
"Header 2": "Videos on Coronary Artery Disease",
"Header 3": "**Dysrhythmias**",
"token_count": 338,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
All cells in the body require oxygen to make adenosine triphosphate (ATP), which is the primary source of energy that cells use. This process is called aerobic metabolism. Most cells in the body can produce a limited amount of ATP anaerobically (without oxygen), but if oxygen is not eventually present, the cells cannot... | {
"Header 1": "CHAPTER 22 Cardiac Emergency and Shock Drugs",
"Header 2": "Signs and Symptoms of Acute Myocardial Infarction",
"Header 3": "**Shock**",
"token_count": 618,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
**Anaphylaxis** occurs when the immune system has an overwhelming response to a foreign substance that is not usually harmful to most people. Examples of this type of substance include food and insect stings. In a typical allergic response, the immune system releases inflammatory mediators that cause local vasodilation... | {
"Header 1": "CHAPTER 22 Cardiac Emergency and Shock Drugs",
"Header 2": "Signs and Symptoms of Acute Myocardial Infarction",
"Header 3": "**Anaphylactic Shock**",
"token_count": 267,
"source_pdf": "datasets/websources/Med_v1/med_textbook/Pharmacology-WEB.pdf"
} |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.