Intravenous drip photosensitive Topical ointment slow onset Cover in plastic

Intravenous drip photosensitive topical ointment slow

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•Intravenous: drip, photosensitive •Topical ointment: slow onset. Cover in plastic wrap or tape. Do not massage. •for chest pain at home instruct patient: stop activity, take first dose, wait 5 minutes, if no relief call 911, take second dose, wait five minutes, take third dose. •Headache: dilates cerebral blood vessels. Give aspirin or Tylenol •Orthostatic hypotension: Check BP before giving Reflex tachycardia : sudden drop in blood pressure and increase in heart rate. Administer beta blocker. •Tolerance. Make sure to remove patches q12 •PDE5 drugs can cause severe hypotension (sildenafil, -afil) •grapefruit juice •antihypertensive medications •alcohol •hypersensitivity to nitrates •anemia, closed angle glaucoma, traumatic head injury increases intracranial pressure •kidney or liver dysfunction hyperthyroidism Antianginal agent Ranolazine •lowers cardiac oxygen demand and thereby improves exercise tolerance and decreases pain QT prolongation •elevated BP •Quinidine (therapeutic value 2-5) and sotalol can further prolong WT interval •digoxin increased serum levels of digoxin •simvastatin increased serum levels of simvastatin Medications affecting cardiac rhythm Class 1 Sodium Channel blockers Procainamid e slows cardiac conduction velocity Systemic lupus : fever, painful and swollen joints, butterfly shaped rash on face. Give NSAID •Neutropenia and thrombocytopenia: Monitor for infection and bleeding •Cardiotoxicity: widened QRS vfib cardiac arrest. Monitor therapeutic levels. •↓BP, ↓HR •Procainamide therapeutic level:4-8 Lidocaine •carefully read label for route and additives •loading dose: 1mg/kg IVP •maintenance dose: 1-4mg/minute IV drip •therapeutic value: 1.5-5 •CNS: drowsiness, altered mental status, paresthesia, seizures •Respiratory arrest •Stokes-Adams syndrome •Wolff-Parkinson-White Syndrome •Severe heart block Propafenone •monitor RR •↓HR, ↓BP •heart failure •dizziness, weakness bronchospasm Class 2 Beta-adrenergic blockers Propranolol prevents sympathetic nervous system stimulation of the heart Class 3 Amiodarone •prolong the action potential and •ACLS dosage: First: 300mg. Second: •pulmonary toxicity
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Potassium channel blockers refractory period of the cardiac cycle •ventricular dysrhythmia 150mg •sinus bradycardia and AV block •↓BP ↓HR visual disturbances : photophobia, photosensitivity, blurred vision blindness •liver dysfunction/hepatotoxic •hypothyroidism •GI disturbances blue-grey discoloration to skin •phlebitis with IV Class 4 Calcium channel blockers •prolongs cardiac conduction, depresses depolarization and decreases oxygen demand of the heart Other Digoxin •↓BP, ↓HR •dyspnea •vasodilation Adenosine •resets the SA node and starts a new rhythm •given for SVT (HR >150) •dosage: 6mg then 12mg then if needed another 12mg •half life of drug is 8 seconds, so the medication needs to be pushed as
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  • Spring '15
  • Angiotensin II receptor antagonist, •Orthostatic hypotension

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