Cardiovascular Medications & NCLEX Safety — Anticoagulants, Antianginals, Antihypertensives, and Pharmacology Review | Chapter 50: Saunders NCLEX-PN Review

Cardiovascular Medications & NCLEX Safety — Anticoagulants, Antianginals, Antihypertensives, and Pharmacology Review | Chapter 50: Saunders NCLEX-PN Review

Chapter 50 of Saunders Comprehensive Review for the NCLEX-PN® Examination (7th Edition) by Linda Anne Silvestri and Angela E. Silvestri delivers a comprehensive pharmacology review of cardiovascular medications. It outlines drug classifications, mechanisms of action, adverse effects, lab monitoring requirements, and NCLEX-priority nursing interventions to ensure medication safety in clinical practice.

Watch the lecture above for the complete medication breakdown, then review the detailed NCLEX study notes below.

Saunders NCLEX-PN Examination Review book cover

Anticoagulants & Antiplatelets

  • Warfarin: Monitor PT/INR; antidote is phytonadione (vitamin K)
  • Heparin & Enoxaparin: Monitor aPTT; antidote is protamine sulfate
  • Antiplatelets: Aspirin, clopidogrel—monitor for GI bleeding, bruising

Thrombolytics

  • Alteplase—administer within time window; contraindicated in active bleeding, recent surgery, or hemorrhagic stroke
  • Bleeding precautions and use of aminocaproic acid for reversal

Cardiac Glycosides

  • Digoxin—positive inotrope; monitor serum levels (0.5–2 ng/mL), watch for toxicity (nausea, vision changes, arrhythmias)
  • Increased toxicity risk with hypokalemia

Antihypertensives

  • Diuretics:
    • Thiazide (HCTZ)—monitor potassium
    • Loop (furosemide)—ototoxicity, electrolyte loss
    • Potassium-sparing (spironolactone)—risk of hyperkalemia
  • Alpha-blockers: Prazosin, doxazosin—orthostatic hypotension
  • Central sympatholytics: Clonidine, methyldopa—dry mouth, rebound hypertension
  • ACE inhibitors: Lisinopril—dry cough, hyperkalemia, angioedema
  • ARBs: Losartan—similar to ACE inhibitors but no cough

Antianginals

  • Nitrates (nitroglycerin)—sublingual, patch, or spray; monitor BP; prevent tolerance; safety with PDE-5 inhibitors

Beta Blockers & Calcium Channel Blockers

  • Beta blockers: Metoprolol, propranolol—bradycardia, bronchospasm, masks hypoglycemia
  • Calcium channel blockers: Diltiazem, verapamil—bradycardia, constipation, edema

Vasodilators

  • Hydralazine, nitroprusside—monitor for orthostatic hypotension; nitroprusside risk for cyanide toxicity

Lipid-Lowering Agents

  • Statins—monitor liver enzymes; report muscle pain (possible rhabdomyolysis)
  • Bile acid sequestrants, nicotinic acid—GI side effects, flushing (prevent with aspirin)

Nursing Safety Priorities

  • Lab monitoring—PT/INR, aPTT, electrolytes, liver function
  • Patient teaching—dose timing, side effect recognition, adherence
  • Drug interactions—avoid NSAIDs with anticoagulants, grapefruit juice with statins or calcium channel blockers
  • Emergency protocols for overdose or adverse reaction

Conclusion

This chapter equips NCLEX-PN candidates with essential cardiovascular pharmacology knowledge, emphasizing safe administration, patient education, and critical monitoring for medication side effects.

Subscribe to Last Minute Lecture for more NCLEX-focused lectures and study resources.

View the full Saunders Comprehensive Review for the NCLEX-PN® Examination (7th Edition) playlist here: Complete NCLEX-PN Review Playlist

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