Remake of Sarah 2pm Week 3 HNN215 Week 3 Padlet by https://padlet.com/sarahd59/18qal72y627oqa68 Management of patients experiencing cardiovascular symptoms (1) en-us 2023-03-16 09:13:30 UTC 2023-04-05 02:29:49 UTC hello@padlet.com Significant drug-drug interactions??? sarahd59 https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086004 How / why does it occur?
What are they and what signs and symptoms would we see?
What do we as nurses do;
- prevent and/ or manage these?]]> 2023-03-16 09:13:30 UTC https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086004 Case Scenario sarahd59 https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086005 2023-03-16 09:13:30 UTC https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086005 Compare and contrast the significant risks for each of the drug classes sarahd59 https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086006 What were your significant risks? Why are they significant?
Do you understand the MoA of how the patient might develop the risk?
Did you need to go and look them up again? ]]> 2023-03-16 09:13:30 UTC https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086006 Scenario continued sarahd59 https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086007 2023-03-16 09:13:30 UTC https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086007 Part 2??? sarahd59 https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086008 This will be added once we get to it :)]]> 2023-03-16 09:13:30 UTC https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086008 sarahd59 https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086009 2023-03-16 09:13:30 UTC https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086009 Consider??? sarahd59 https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086010 Note: Always consider:
Is there anything in the patient's condition/ past history that may increase the risks?]]> 2023-03-16 09:13:30 UTC https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086010 Group 1 sarahd59 https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086011 Temazepam

MOA: 
Benzodiazepines potentiate the inhibitory effects of GABA throughout the CNS, resulting in anxiolytic, sedative, hypnotic, muscle relaxant and antiepileptic effects.

Indications for use: Short-term treatment for Insomnia

Nursing considerations: Consideration of the pts. vital signs (RR) since it causes respiratory depression. 
- Increased risk of oversedation, falls, memory, confusion, ataxia due to the pat being on the elderly side.

Drug/Drug interaction: Metabolism of temazepam can be decreased when combined with Amiodarone 

Signs and Symptoms: Drowsiness, over-sedation, headache, hypotension, respiratory depression, confusion.
]]> 2023-03-16 09:13:30 UTC https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086011 sarahd59 https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086012 2023-03-16 09:13:30 UTC https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086012 Group 4 sarahd59 https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086013 the benefits of a loading dose is that is gets the drug to a therapeutic range quicker then what normal dosing of a drug does. 
as amiodarone medication can take longer time periods to reach therapeutic levels a loading dose gets the drug to work quickly and effectively (orally). 
IV amiodarone 
Loading, IV 5 mg/kg over 20 minutes – 2 hours.
Maintenance, IV 15–20 mg/kg over 24 hours (maximum 1.2 g in 24 hours); begin oral treatment as soon as possible, overlapping oral and IV treatment by up to 2 days.



]]> 2023-03-16 09:13:30 UTC https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086013 Group 2 sarahd59 https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086014 Amiodarone

MOA: 
Decreases sinus node and junctional automaticity, slows atrioventricular (AV) and bypass tract conduction and prolongs refractory period of myocardial tissues (atria, ventricles, AV node and bypass tract); also has weak beta-blocker activity.

Indications: 
Treatment and prophylaxis of serious tachyarrhythmias refractory to other treatment, including ventricular tachycardia, AF and SVT

Nursing considerations:
- Check patient allergies
- Understand their baseline vital sign readings
- You'll want to monitor the EKG continuously during IV amiodarone infusion and initiation of PO therapy. Amiodarone can cause pulmonary toxicity and ARDS, so monitor your patient's respiratory status carefully. Patients taking amiodarone long-term should get regular chest x-rays and pulmonary function tests.

Drug-drug interactions: 
- Amiodarone has a very long half-life and it may take weeks to months before an interaction fully develops; when it is stopped interactions may continue for weeks to months.

- Amiodarone may increase metoprolol’s concentration, increasing the risk of severe bradycardia; consider using a low dose to start metoprolol treatment, and monitor carefully.


Signs and symptoms:
- nausea & vomiting
- constipation
- anorexia
-
]]> 2023-03-16 09:13:30 UTC https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086014 Group 5 sarahd59 https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086015 2023-03-16 09:13:30 UTC https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086015 Group 3 sarahd59 https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086016 Metoprolol

MOA:
Metoprolol is a cardioselective beta-1-adrenergic receptor inhibitor that competitively blocks beta1-receptors with minimal or no effects on beta-2 receptors at oral doses of less than 100 mg in adults. It decreases cardiac output by negative inotropic and chronotropic effects.

Indications for use:
- High blood pressure
- Chest pain due to reduced blood flow to the heart (Angina)
- Tachyaahythmias 
- Prevention of migraine 
- Chronic heart failure 

Nursing considerations: 
- Monitoring blood pressure 
- Assess hypersensitivity 
- Monitor for side effects 

Signs and Symptoms:
- Bradycardia
- Hypotension
- Worsening of heart failure
- Nausea
- Diarrhoea 
- Bronchospasm
- Dyspnoea
- Cold extremitites 
- Fatigue 
- Dizziness 
- Abnormal vision
- Alteration of glucose 
- Hallucinations
- Insomnia
- Nightmares
- Heart block
- Rash
- Muscle cramp
- Nasal congestion 
- Hypersensitivity reaction 

Drug-Drug interactions
Lidocaine and Metoprolol= Metoprolol may reduce metabolism and increase risk of toxicity of lidocaine when it is used IV 
Amiodarone and Metoprolol= Amiodarone may increase metoprolos concentration, increasing the risk of severe bradycardia ]]> 2023-03-16 09:13:30 UTC https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086016 Group 2 sarahd59 https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086017 Due to the drugs nature of a long half life, initiating a loading dose in the beginning helps to achieve the therapeutic levels on the first dose, then maintenance to achieve these therapeutic levels can be achieved following. ]]> 2023-03-16 09:13:30 UTC https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086017 Group 4 sarahd59 https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086018 Amlodipine

MOA: act on coronary arteriolar smooth muscle to reduce vascular resistance and myocardial oxygen requirements, relieving angina symptoms. The blockage of calcium channels inhibits the influx of calcium ions in, the cell reducing depolarization of myocardial cells and reduction of myocardial contraction, due to its association with actin and myosin stimulation. 

Indications: hypertension, angina

Nursing considerations: ECG, vitals - BP, HR, due to vasodilation of blood vessels can cause headaches, pain levels of patient

Signs and Symptoms: respiratory depression, vasodilatory effects, hypotension, nausea/vomiting, peripheral oedema 

Drug-drug interaction: 
magnesium - increases the effects of IV magnesium sulphate and the risk of adverse effects 
enoxaparin - increases the toxicity of amlodipine]]> 2023-03-16 09:13:30 UTC https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086018 Group 3 sarahd59 https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086019 A loading does is a higher dose/quicker administration of a drug that may be given at the start of a course of treatment before dropping down to a lower maintenance dose. a loading dose is mainly used for drugs that are eliminated from the body slowly. drugs only need a lower or regular dose to maintain the therapeutic level. 

We would give a loading dose of amiodarone so we can control and lower his heart rate back to sinus rhythm as quick as possible and then continue with the infusion to help sustain regularity in heart rhythm ]]> 2023-03-16 09:13:30 UTC https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086019 Group 5 sarahd59 https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086020 Potassium/Magnesium 

MOA:

Indications for use:

Nursing considerations:

Drug-drug interactions:

Signs and Symptoms:]]> 2023-03-16 09:13:30 UTC https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086020 Loading doses sarahd59 https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086021 2023-03-16 09:13:30 UTC https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086021 Additional considerations sarahd59 https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086024 Something to consider : do we need to think about the patient's underlying condition such as renal function/ liver function when giving a loading dose? Or body weight? If so why??]]> 2023-03-16 09:13:30 UTC https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086024 Group 1 sarahd59 https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086025 Slow and wide distribution of amiodarone to tissue (fat, muscle, highly perfused organs) results in a requirement of long loading periods in an effort to accelerate the onset of drug activity. ]]> 2023-03-16 09:13:30 UTC https://padlet.com/sarahd59/18qal72y627oqa68/wish/2519086025