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ISPN 复习要点提示 22 心血管系统疾病与用药 （下）
日期：2020-03-18 21:10:35
Tips on How to Review for ISPN Examinations
22
Cardiovascular Disorders and Medications (Part 2)
心血管系统疾病及用药
Part 5
Cardiovascular medications
心血管系统用药
For review of cardiovascular medications, you need to know its indications and dosages, use, side and adverse effects, contraindications and cautions, interaction with other, and nursing considerations. Take warfarin sodium for example,
Warfarin sodium is orally used for long-term anticoagulation and is used mainly to prevent thromboembolic conditions such as thrombophlebitis, pulmonary embolism, and embolism formation caused by atrial fibrillation, thrombosis, myocardial infarction, or heart valve damage. (Indications, action)
Its adverse effects include abdominal pain, diarrhea, nausea and vomiting, hemorrhage, etc. Therefore, if the PT value is longer than 30 seconds and the INR is greater than 3.0 in a client receiving standard warfarin therapy, initiate bleeding precautions若标准华法林治疗患者PT时间长于30秒，INR大于3.0，启动出血预防措施. (Adverse effects, cautions)
It is contraindicated in patients hypersensitive to drug and in those with bleeding from the GI, GU, or respiratory tract, etc. (Contraindications)
It may increase bleeding with long-term therapy (more than 2 weeks) at high doses (morethan 2 g/day) of acetaminophen. (Drug-drug interaction)
Regularly monitor INR in all patients; consider more frequent INR monitoring in those at high risk for bleeding; withhold drug and call prescriber at once in the event of fever or rash; etc. (Nursing considerations)
Review the following drugs carefully,
A. Anticoagulants抗凝药
Anticoagulants prevent the extension and formation of clots by inhibiting factors in the clotting cascade and decreasing blood coagulability.抗凝药通过抑制凝血级联反应中的因子、降低血液凝固性，阻止凝块的形成和扩展。
1. Oral口服药
Warfarin sodium华法林钠, dabigatran etexilate mesylate甲磺酸达比加群酯, rivaroxaban利伐沙班, apixaban阿哌沙班
2. Parenteral非口服药
Argatroban阿加曲班, bivalirudin 比伐芦定, dalteparin 达肝素, desirudin地西芦定, enoxaparin依诺肝素, fondaparinux 磺达肝素, heparin sodium肝素钠
3. Substances to avoid with anticoagulants避免与抗凝药同时使用的物质
Allopurinol 别嘌醇, cimetidine 西米替丁, corticosteroids 皮质类固醇, green leafy vegetables and foods high in vitamin K 高维K绿叶蔬菜食物, nonsteroidal anti-inflammatory drugs 非固醇类抗炎药, oral hypoglycemic agents 口服降糖药, phenytoin苯妥英, salicylates水杨酸盐类, sulfonamides 磺胺类, ginkgo and ginseng (herbs) 银杏和人参(草药)
4. Side and adverse effects副作用和不利效应
Hemorrhage出血, hematuria血尿, epistaxis 鼻出血, ecchymosis瘀斑, bleeding gums牙龈出血, thrombocytopenia 血小板减少, hypotension低血压.
B. Thrombolytic Medications血栓溶解药
Thrombolytic medications are used early in the course of myocardial infarction (within 4 to 6 hours of the onset of the infarct) to restore blood flow, limit myocardial damage, preserve left ventricular function, and prevent death.血栓溶解药用于心肌梗死病程初期（梗死发作后4-6小时内）以恢复血流，限制心肌损坏，保护左室功能，防止死亡发生; also used in arterial thrombosis, deep vein thrombosis, occluded shunts or catheters, and pulmonary emboli. 还用于动脉血栓、深静脉血栓、分路或导管闭合及肺栓塞
上一篇：ISPN 复习要点提示 22 心血管系统疾病与用药 （上）
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