July 17, 2024

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Thiazide-type diuretics as a class differ from the loop diuretics in that they have a longer duration and site of action. Additionally, thiazides are so-called low-ceiling diuretics, because the maximal response is reached at a relatively low dose.

July 16, 2024

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Loop diuretics, including the most commonly used furosemide and torsemide, inhibit the Na+/K+/2Cl- cotransporter associated with the transport of chloride across the lining cells of the ascending limb of the loop of Henle.

July 15, 2024

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Thiazide-type diuretics inhibit the reabsorption of sodium and chloride in the more distal part of the nephron. This distal cotransporter is insensitive to loop diuretics. Oral formulations produce a diuresis within 1 to 2 hours.

July 14, 2024

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Diuretics alter physiologic renal mechanisms to increase the flow of urine with greater excretion of sodium or natriuresis. This results in a wide range of effects on BP. Moreover, thiazide-type diuretics also result in mild vasodilation.

July 13, 2024

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Ranolazine reduces angina without any significant reductions in heart rate, BP, or rate-pressure product during exercise and is hemodynamically neutral, thus making it a useful therapeutic option in patients who are at risk of hypotension.

July 12, 2024

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Ranolazine is an inhibitor of sodium channel influx during repolarization. This reduces intracellular sodium concentrations, which, in turn, results in a reduction in oxygen consumption and improvement in angina symptoms.

July 11, 2024

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
The major advantages of amlodipine are (1) the slow onset of action and the long duration of activity and (2) the vast experience with this drug in hypertension. It was the first of the longer-acting “second-generation” calcium channel blockers.

July 10, 2024

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Typically, diltiazem side effects of the standard preparation are few and limited to headaches, dizziness, and ankle edema in approximately 6-10% of patients. With high-dose diltiazem (360 mg daily), constipation may also occur.

July 9, 2024

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
The functional and refractory periods are prolonged by diltiazem so that diltiazem is approved for termination of an attack of supraventricular tachyarrhythmia and for the rapid decrease of the ventricular response rate in atrial flutter or fibrillation.

July 8, 2024

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Verapamil inhibits the hepatic CYP3A isoenzyme, and therefore potentially increases the blood levels of atorvastatin, simvastatin and lovastatin, which are all metabolized by this isoenzyme.

July 7, 2024

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
For patients with Prinzmetal’s variant angina, therapy is based on calcium channel blockers, including verapamil, and high does may be needed. Abrupt withdrawal of verapamil may precipitate rebound angina.

July 6, 2024

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
In chronic stable exertional angina, verapamil acts by a combination of afterload reduction and a mild negative inotropic effect, plus reduction of exercise-induced tachycardia and coronary vasoconstriction.

July 5, 2024

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Oral verapamil takes 2 hours to act and peaks at 3 hours. The elimination half-life is usually 3 to 7 hours but increases significantly during chronic administration and in patients with liver or advanced renal insufficiency.

July 4, 2024

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Verapamil inhibits the action potential of the upper and middle regions of the AV node where depolarization is calcium mediated. Verapamil thus inhibits one limb of the reentry circuit, believed to underlie most paroxysmal SVTs.

July 3, 2024

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Calcium channel blockers “block” the entry of calcium through the calcium channel in both smooth muscle and myocardium, so that less calcium is available to the contractile apparatus. The result is vasodilation and a negative inotropic effect.