3B: Cardiac Meds

Question 1

When do thrombolytic agents have to be given?

Answer 1

Within 4-12 hours of symptom onset

Question 2

What is the use of Streptokinase?

Answer 2

Acute MI to reestablish coronary blood flow

Question 3

What is the action of Streptokinase?

Answer 3

Facilitate clot disolution

Question 4

What are the adverse effects of Streptokinase?

Answer 4

Hemorrhage

Question 5

What is the use of Recombinant tPA and Retrovase?

Answer 5

Acute MI (same as Streptokinase)

Question 6

What is the action of Recombinant tPA and Retrovase?

Answer 6

Facilitate clot disolution (same as Streptokinase)

Question 7

What is the adverse effect of Recombinant tPA and Retrovase?

Answer 7

Hemorrhage (same as Streptokinase)

Question 8

What is the use of Heparin?

Answer 8

Prevent and treat thromboembolism

Question 9

What is the action of Heparin?

Answer 9

Inhibit clot formation

Question 10

What are the adverse effects of Heparin?

Answer 10

Hemorrhage and hemarthosis

Question 11

What is the duration of a Heparin perscription?

Answer 11

Short term - given via IV or subcutaneous shot

Question 12

What is the use of Coumadin?

Answer 12

Prevent and treat thromboembolism (same as Heparin)

Question 13

What is the action of Coumadin?

Answer 13

Block vitamin K and other clotting agents

Question 14

What are the adverse effects of Coumadin?

Answer 14

Hemorrhage, hemarthosis

Question 15

What is the duration of a Coumadin perscription?

Answer 15

Long term

Question 16

How are Heparin and Coumadin dosing monitored?

Answer 16

Clotting times

Question 17

What is PT?

Answer 17

Prothombin time

Question 18

What is the normal value of PT?

Answer 18

12-15 seconds

Question 19

What does PT measure?

Answer 19

Extrinsic and pathway means of clotting

Question 20

What is PTT?

Answer 20

Partial Thromboplastin Time

Question 21

What is the normal value for PTT?

Answer 21

30-70 seconds

Question 22

What does PTT measure?

Answer 22

Intrinsic and pathway means of clotting

Question 23

What is the International Normalized Ratio?

Answer 23

Measures the difference between PTT and PT

Question 24

What is the normal value for the International Normalized Ratio?

Answer 24

2-3 ng/L for prophylactic treatment

Question 25

What is the use of Lovenox, Xarelto, and Eliquis?

Answer 25

Prevent and treat thromboembolism

Question 26

What is the action of Lovenox, Xarelto, and Eliquis?

Answer 26

Deactivates thrombin to prevent fibrin clot

Question 27

What are the adverse effects of Lovenox, Xarelto, and Eliquis?

Answer 27

Small chance of hemorrhage

Question 28

Are PT and INR needed for Lovenox, Xarelto, and Eliquis?

Answer 28

No - do not affect clotting times

Question 29

What is the use of Aspirin, Plavix, and Effient?

Answer 29

Prevent clot formation, does not thin

Question 30

What is the action of Aspirin, Plavix, and Effient?

Answer 30

Prohibit platelet induced thrombus

Question 31

What are the adverse effects of Aspirin, Plavix, and Effient?

Answer 31

Mild gastric irritation

Question 32

What is the general function of all calcium channel blockers?

Answer 32

Less excitability

Question 33

What are the calcium channel blockers?

Answer 33

Cardizem, Procardia, Cardene, Norcasc, Verapimil

Question 34

What is the use of calcium channel blockers?

Answer 34

HTN, myocardial ischemia, coronary artery spasm, angina, atrial tachycardia, diastolic dysfunction

Question 35

What is the action of calcium channel blockers?

Answer 35

Inhibit calcium influx into cardiac and smooth muscle, prevents vasoconstriction, reduces myocardial contractility, and slows conduction

Question 36

What are the adverse effects of calcium channel blockers?

Answer 36

Bradycardia, orthostatic hypotension, peripheral edema

Question 37

What is the use of Lasix?

Answer 37

Reduce fluid overload in CHF, HTN, and other edema

Question 38

What is the action of Lasix?

Answer 38

Increase renal excretion of fluid and electrolytes

Question 39

What are the adverse effects of Lasix?

Answer 39

Hypokalemia and fluid depletion that may cause ectopic arrhythmias, hypotension, gastric disturbances

Question 40

What are the two functions of cardiac glycosides?

Answer 40

1. Positive inotropic effect 2. Dromotropic effect (slows conduction at AV node to allow increased filling time)

Question 41

What is the use of Digitalis and Digoxin?

Answer 41

CHF, atrial arrhythmias, a-fib secondary to AV node delay

Question 42

What is the action of Digitalis and Digoxin?

Answer 42

Improves myocardial contractility by increasing calcium concentrations, reducing end diastolic pressure, decreased AV nodal conduction to allow greater filling time

Question 43

What are the adverse effects of Digitalis and Digoxin?

Answer 43

Digitalis toxicity including GI disturbances, CNS disturbances, fatigue, ST segment depression, arrhythmia, PVCs, VT, bradycardia

Question 44

What are the sympathetic stimulators?

Answer 44

Dobutamine and dopamine

Question 45

What is the use of Dobutamine and Dopamine?

Answer 45

Post cardiac event, in ICU

Question 46

What is the function of Dopamine?

Answer 46

Increase CO and BP, good for CHF with resultant hypotension

Question 47

What is the function of Dobutamine?

Answer 47

Increased Ca+ in cell which increases SA node firing, AV node conduction, contractility

Question 48

What is the action of Dobutamine and Dopamine?

Answer 48

Prolong the effect of sympathetic action and increase myocardial contraction and BP

Question 49

What are the adverse effects of Dobutamine and Dopamine?

Answer 49

CP and feelings of dyspnea

Question 50

What should you be cautious with Dobutamine and Dopamine?

Answer 50

Wean off ASAP because they can cause receptor desensitization