July 23, 2024

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Higher doses of dihydropyridine calcium channel blockers often result in some degree of edema, and can additionally cause flushing, headache and tachycardia. Lower extremity edema is the most commonly observed of these side effects.

July 22, 2024

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Calcium channel blockers act primarily to reduce peripheral vascular resistance and, within the renal vasculature, produce natriuresis by increasing renal blood flow, dilating afferent arterioles and increasing glomerular filtration pressure.

July 21, 2024

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Calcium channel blockers impede the movement of extracellular calcium through ion-specific channels within the cell wall. This ultimately reduces calcium flux inward, which results in arterial dilation via smooth muscle relaxation.

July 20, 2024

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Metolazone is a powerful thiazide diuretic with a quinazoline structure. An important advantage of metolazone is efficacy even despite decreased kidney function and is usually used in concert with loop diuretics for edema management.

July 19, 2024

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Thiazide-like and thiazide diuretics can be very different pharmacokinetically. Compared to hydrochlorothiazide, chlorthalidone has a considerably longer half-life, approximately 40-60 hours and a larger volume of distribution.

July 18, 2024

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Among thiazide-type diuretics, hydrochlorothiazide is the most widely used. It has a bioavailability ranging from 60% to 80%. Its absorption may be decreased in heart failure and/or chronic kidney disease.

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.