Nursing Pharmacology: 100 High-Yield
Notes, Q&A, and Summaries
Part 1: Cardiovascular Medications
1. Lisinopril (Prinivil)
Class: ACE Inhibitor
Mechanism: Inhibits ACE, blocking Ang I to Ang II conversion; results in
vasodilation.
Nursing Considerations:
Monitor BP, renal function, and potassium (risk of hyperkalemia).
Watch for dry, nagging cough.
Emergency: Angioedema (facial/airway swelling).
Black Box: Contraindicated in pregnancy.
2. Losartan (Cozaar)
Class: Angiotensin II Receptor Blocker (ARB)
Mechanism: Blocks Ang II receptors, preventing vasoconstriction.
Nursing Considerations:
Similar to ACE inhibitors but NO dry cough.
Monitor potassium and renal function.
Change positions slowly (orthostatic hypotension).
Black Box: Discontinue if pregnancy is confirmed.
3. Metoprolol (Lopressor)
Class: Beta-1 Selective Blocker
, Mechanism: Reduces heart rate and contractility.
Nursing Considerations:
Check apical pulse before admin (Hold if <60 bpm).
Can mask hypoglycemia symptoms (tachycardia) in diabetics.
Use cautiously in asthma.
Critical Alert: Do not stop abruptly (rebound hypertension).
4. Amlodipine (Norvasc)
Class: Calcium Channel Blocker (Dihydropyridine)
Mechanism: Arterial vasodilation.
Nursing Considerations:
Common side effect: Peripheral edema (not fluid overload).
Regular dental care (risk of gingival hyperplasia).
Change positions slowly.
5. Diltiazem (Cardizem)
Class: Calcium Channel Blocker (Non-dihydropyridine)
Mechanism: Slows AV node conduction, decreases cardiac workload.
Nursing Considerations:
Monitor for bradycardia and heart blocks.
Titrate based on ECG and cardiac response.
Avoid in sick sinus syndrome or heart block without a pacemaker.
6. Clonidine (Catapres)
Class: Central Alpha-2 Agonist
Mechanism: Reduces sympathetic outflow from the brain.
Nursing Considerations:
Common effects: Sedation, dry mouth.
High Alert: Severe rebound hypertension if stopped abruptly.
, Monitor BP and renal function.
7. Nitroprusside (Nipride)
Class: Vasodilator
Mechanism: Direct-acting vasodilator for hypertensive emergencies.
Nursing Considerations:
Critical Alert: Risk of cyanide toxicity with long-term or high-dose use.
Protect from light (wrap in opaque foil).
Monitor BP continuously (usually via arterial line).
8. Digoxin (Lanoxin)
Class: Cardiac Glycoside
Mechanism: Positive inotrope (increases contraction), negative chronotrope
(decreases HR).
Nursing Considerations:
Toxicity Signs: Yellow-green halos, nausea, vomiting, bradycardia.
Therapeutic range: 0.5 - 2.0 ng/mL.
Check apical pulse for 1 full minute (Hold if <60).
Low potassium (Hypokalemia) increases risk of toxicity.
9. Amiodarone (Cordarone)
Class: Antiarrhythmic (Class III)
Mechanism: Prolongs action potential and refractory period.
Nursing Considerations:
Critical Alert: Pulmonary toxicity (monitor for cough, dyspnea).
Monitor liver function and thyroid (contains iodine).
Avoid grapefruit juice.
10. Adenosine (Adenocard)
Class: Antiarrhythmic
Notes, Q&A, and Summaries
Part 1: Cardiovascular Medications
1. Lisinopril (Prinivil)
Class: ACE Inhibitor
Mechanism: Inhibits ACE, blocking Ang I to Ang II conversion; results in
vasodilation.
Nursing Considerations:
Monitor BP, renal function, and potassium (risk of hyperkalemia).
Watch for dry, nagging cough.
Emergency: Angioedema (facial/airway swelling).
Black Box: Contraindicated in pregnancy.
2. Losartan (Cozaar)
Class: Angiotensin II Receptor Blocker (ARB)
Mechanism: Blocks Ang II receptors, preventing vasoconstriction.
Nursing Considerations:
Similar to ACE inhibitors but NO dry cough.
Monitor potassium and renal function.
Change positions slowly (orthostatic hypotension).
Black Box: Discontinue if pregnancy is confirmed.
3. Metoprolol (Lopressor)
Class: Beta-1 Selective Blocker
, Mechanism: Reduces heart rate and contractility.
Nursing Considerations:
Check apical pulse before admin (Hold if <60 bpm).
Can mask hypoglycemia symptoms (tachycardia) in diabetics.
Use cautiously in asthma.
Critical Alert: Do not stop abruptly (rebound hypertension).
4. Amlodipine (Norvasc)
Class: Calcium Channel Blocker (Dihydropyridine)
Mechanism: Arterial vasodilation.
Nursing Considerations:
Common side effect: Peripheral edema (not fluid overload).
Regular dental care (risk of gingival hyperplasia).
Change positions slowly.
5. Diltiazem (Cardizem)
Class: Calcium Channel Blocker (Non-dihydropyridine)
Mechanism: Slows AV node conduction, decreases cardiac workload.
Nursing Considerations:
Monitor for bradycardia and heart blocks.
Titrate based on ECG and cardiac response.
Avoid in sick sinus syndrome or heart block without a pacemaker.
6. Clonidine (Catapres)
Class: Central Alpha-2 Agonist
Mechanism: Reduces sympathetic outflow from the brain.
Nursing Considerations:
Common effects: Sedation, dry mouth.
High Alert: Severe rebound hypertension if stopped abruptly.
, Monitor BP and renal function.
7. Nitroprusside (Nipride)
Class: Vasodilator
Mechanism: Direct-acting vasodilator for hypertensive emergencies.
Nursing Considerations:
Critical Alert: Risk of cyanide toxicity with long-term or high-dose use.
Protect from light (wrap in opaque foil).
Monitor BP continuously (usually via arterial line).
8. Digoxin (Lanoxin)
Class: Cardiac Glycoside
Mechanism: Positive inotrope (increases contraction), negative chronotrope
(decreases HR).
Nursing Considerations:
Toxicity Signs: Yellow-green halos, nausea, vomiting, bradycardia.
Therapeutic range: 0.5 - 2.0 ng/mL.
Check apical pulse for 1 full minute (Hold if <60).
Low potassium (Hypokalemia) increases risk of toxicity.
9. Amiodarone (Cordarone)
Class: Antiarrhythmic (Class III)
Mechanism: Prolongs action potential and refractory period.
Nursing Considerations:
Critical Alert: Pulmonary toxicity (monitor for cough, dyspnea).
Monitor liver function and thyroid (contains iodine).
Avoid grapefruit juice.
10. Adenosine (Adenocard)
Class: Antiarrhythmic
