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B SL ext. > 1 Pharmacology of Angina > Flashcards

1 Pharmacology of Angina Flashcards

1
Q

Cxr

A

Measure size contour and positioning of heart

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2
Q

12 lead ekg

A

Electrical activity

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3
Q

Holter monitoring

A

Continuous ambulatory monitoring (regular activities in 24hr period)

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4
Q

Transtelephonic monioring

A

At home patient over the phone

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5
Q

Wireless mobile

A

Advantage over holter Lightweight can monitor 24/7 don’t have to use phone Only transmit when dysrhythmias detected

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6
Q

Cardiac dress testing

A

Determine presence of CAD and what’s causing chest pain

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7
Q

Exercise stress test

A

Treadmill or bike Ends at target hr or because of chest pain

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8
Q

Pharmacologic stress test 2 meds

A

Patient is disabled or unable to exercise Dipyridamole Adenosine Vasdialate artery to mimic exercise

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9
Q

Fake exercise 1med

A

Increases HR, contractility, BP increases demand of the heart

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10
Q

Nursing implementation for diagn test

A

No food 4hrs and avoid stimulants (coffee and drugs)

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11
Q

Echocardiogram

A

Non invasive ultrasound Examine shape size and motion. Also determine ejection infraction which is usually 50-70%

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12
Q

Transesophageal echocardiograph TEE

A

Ultrasound and endoscopy. Transducer attach to gastroscope goes onto esophagus to take pictures of posterior heart

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13
Q

Potential comps with TEE

A

Inspired swallowing airway Esophagus injury

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14
Q

Radionuclide imaging (Thallium scan)

A

Evaluated myocardial blood flow after iv injection of r.thallum 201 (tissue perfusion) Goes to the heart and lights up areas. Where thallimus taken up good blood flow , where it’s not bad blood flow

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15
Q

CT scan with contrast

A

Reveals calcium and fat deposits in arteries. Indicates blockage

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16
Q

PET SCAN

A

Severity of CaD by myocardial perfusion Radioisotopic Administer IV 3D image

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17
Q

Myocardial rupture What is it Treatment

A

Infarcts myocardial wall become thin and bulges during contracting then ruptures

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18
Q

Cardiac failure What does it do

A

Right or left ventricle fails as a pump resulting in back up of blood into tissues, vericera, and lungs

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19
Q

Cardiac arrest vs Mi How does cardiac differ

A

Sudden cessation of heart and circulation May have asychronized twitching during v. Fib Immediate loss of consciousness and no hear sounds

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20
Q

Cardiac rehab stages

A
  1. S/s call 911, meds , rest, follow up apt 2. After discharge outpt rehab 3x / week or more. Monitor during exercise and control risk factors 3. Long term output. Usually self directed. Maintain cardiac stability
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21
Q

Acute coronary syndrome ACS

A

Unstable angina- pain but no ECG or biomarker abnm Stemi- ST elevated in 2leads -significant heart damage NSTEMI- non ST elevated. High bio markers but no signage change ECG

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22
Q

Stool softeners

A

Docusatw -not strain bm

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23
Q

Beta Blockers (End in)

A

Olol

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24
Q

Calcium channel blockers End in 2 uncommon ones

A

ipine Verapamil Diltiazem

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25
Q

Nitrates med names 2 What they do

A

Nitroglycerin Isorbide dinitrate Sublingual

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26
Q

Beta Blockers (End in)

A

Olol

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27
Q

Calcium channel blockers End in 2 uncommon ones

A

ipine Verapamil Diltiazem

28
Q

Nitrates med names 2 What they do

A

Nitroglycerin Isorbide dinitrate Sublingual

29
Q

Beta blockers What they do

A

Block sites in heart in kids (protect them) to prevent sympathetic (stress) response Watch for response in asthma and COPD, DECREASES: HR, contractibility, CO slow conduction through AV node, release of renin

30
Q

Beta blocker Contraindication PC

A

Contraindicated Bradycardia

31
Q

Calcium channel blockers What do they do

A

Calms excitable and slows conduction and repolarization

32
Q

Calcium channel blockers Contraindications PC

A

Contraindicated with heart block low BP and HF PC hypotension, arrhythmia, HF, n/v Cns changes- dizzy weakness fatigue

33
Q

Nitrates What they do

A

Direct vasodilator Relax smooth muscle improves blood flow and oxygen by pooling blood in periphery Take sublingual or spray

34
Q

Nitrates Contraindications Side effects Instructions

A

Severe hypotension, severe anemia, head trauma, carebral hemorrhaging, renal and hepatic, use of erectile dysfunction med (decre med) Side effect- skin flush, pulsing headache, interact ETOH (incre hypotension) Instruct sit down before taking & >3

35
Q

Short acting Acute attack nitrate

A

Amyl nitrate Nitro glycerin- take q 5min up

36
Q

Long acting nitrates Uses

A

Prevent angina Nitroglycerin ISO dinitrate ISO mononitrate

37
Q

Nitrate implication

A

Teach carry all times prevent ischemia Cool dark place Sit down prior to taking No swallow Contact Ems no chest relief after 3 tab Monitor BP prior to taking Take it in anticipation of any action bring it on

38
Q

Anti-platelet agents 2 meds What it does

A

Aspirin and thienopyrides Prevent platelet agreegation and thrombus that can cause clot

39
Q

Aspirin PC Dosage Teach

A

Risk for Gi upset and bleeding 81-325 mg daily Take daily even if taking other analgesics (acetominephen)

40
Q

Thienopyrides Effect 2meds

A

May take few days for effect May be giving with ASA –Grels Clopidogrel Prasugrel- (new used coronary events and intervention )

41
Q

Heparin How to give Implementation Range

A

Iv bolus or continuous drip titrated aPTT 70-100 Needs to be on own pump

42
Q

LMWH

A

Enoxaparin Dalteparin parin No lab monitoring

43
Q

Anticoagulant PC Precaution

A

Bleeding- low BP, hh, increase HR, bruising, pallor, urine and still Precautions: apply pressure to puncture site, NO IM INJ, avoid tissue trauma constrictive devices ( BP CUFF)

44
Q

Valsalva maneuver

A

Stimulate vagal response increase heart demand w bm and coughing

45
Q

Beta blockers What they do

A

Block sites in heart in kids (protect them) to prevent sympathetic (stress) response Watch for response in asthma and COPD, DECREASES: HR, contractibility, CO slow conduction through AV node, release of renin

46
Q

Valsalva maneuver

A

Stimulate vagal response increase heart demand w bm and coughing

47
Q

Anticoagulant PC Precaution

A

Bleeding- low BP, hh, increase HR, bruising, pallor, urine and still Precautions: apply pressure to puncture site, NO IM INJ, avoid tissue trauma constrictive devices ( BP CUFF)

48
Q

LMWH

A

Enoxaparin Dalteparin parin No lab monitoring

49
Q

Heparin How to give Implementation Range

A

Iv bolus or continuous drip titrated aPTT 70-100 Needs to be on own pump

50
Q

Thienopyrides Effect 2meds

A

May take few days for effect May be giving with ASA –Grels Clopidogrel Prasugrel- (new used coronary events and intervention )

51
Q

Aspirin PC Dosage Teach

A

Risk for Gi upset and bleeding 81-325 mg daily Take daily even if taking other analgesics (acetominephen)

52
Q

Anti-platelet agents 2 meds What it does

A

Aspirin and thienopyrides Prevent platelet agreegation and thrombus that can cause clot

53
Q

Nitrate implication

A

Teach carry all times prevent ischemia Cool dark place Sit down prior to taking No swallow Contact Ems no chest relief after 3 tab Monitor BP prior to taking Take it in anticipation of any action bring it on

54
Q

Long acting nitrates Uses

A

Prevent angina Nitroglycerin ISO dinitrate ISO mononitrate

55
Q

Short acting Acute attack nitrate

A

Amyl nitrate Nitro glycerin- take q 5min up

56
Q

Nitrates Contraindications Side effects Instructions

A

Severe hypotension, severe anemia, head trauma, carebral hemorrhaging, renal and hepatic, use of erectile dysfunction med (decre med) Side effect- skin flush, pulsing headache, interact ETOH (incre hypotension) Instruct sit down before taking & >3

57
Q

Nitrates What they do

A

Direct vasodilator Relax smooth muscle improves blood flow and oxygen by pooling blood in periphery Take sublingual or spray

58
Q

Calcium channel blockers Contraindications PC

A

Contraindicated with heart block low BP and HF PC hypotension, arrhythmia, HF, n/v Cns changes- dizzy weakness fatigue

59
Q

Calcium channel blockers What do they do

A

Calms excitable and slows conduction and repolarization

60
Q

Beta blocker Contraindication PC

A

Contraindicated Bradycardia

61
Q

Stable

A

E.g.: hurts when I go upstairs & stops when I lay down Consistent and relieves with rest or NTG

62
Q

Unstable

A

Increase in frequency and severity May not be relieved with ntg

63
Q

Intractable

A

Severe incapacitating chest pain

64
Q

Variant

A

Aka prinzmetal No precipitating factors Pain at rest With reversible ST segment elevation

65
Q

Silent ischemia

A

No pain but ecg changes More common with DM or elderly pts

B SL ext. (3 decks)

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