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ADH 1 > ADH 3; CHF/shock Rx, Anticlot Rx > Flashcards

ADH 3; CHF/shock Rx, Anticlot Rx Flashcards

1
Q

Inotropes

Digoxin; used for? what does it do?

A

positive inotropic effect; INC contractility of heart

HF also hypotensive A-fib

  • strengthens myocardial contraction
  • slows impulse conduction of SA & AV nodes
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2
Q

Digoxin is used for…

levels, antidote

A

(0.5 - 2.0) if high, hold dose

Digi-bind

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3
Q

Digoxin risk factors
3 (think eldery)
3 (electrolytes)

A 
impaired renal function
drug interactions (antidysrhythmics)
hypothyroidism
hypokalemia (3.5 5) need K for Dig to work!
hypercalcemia (8.5- 10.5)
hypomagnesium (1.8- 2.5)
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4
Q

Digoxin side effects

A

GI: N/V/A/D
CNS: dizziness, h/a,confusion, blurred vision, halos
CV: bradycardia, heart block, arrhythmia

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5
Q

Digoxin

WWND?

A
  • take HR for 1 min; monitor
  • check K/Mg levels
  • check Dig levels
  • I/O’s daily weights; INC weight
  • RR, lung sounds
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6
Q

Digoxin

PT teaching?

A
  • check pulse/HR
  • don’t double up
  • s/s toxicity
  • f/u blood work
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7
Q

Inotropes

Primacor, used for? therapeutic effect?

A

in combination w/other inotropes for short-term CHF/shock MGMT

  • Therapeutic effect: INC cardiac output
  • DEC systemic vascular resistance w/o INC HR/O2 demand
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8
Q

Primacor

DOSE

A
  • WT base drug, need to know WT
  • IV bolus 50 mcg/kg over 10 min
    (0. 375 - 0.75 mcg/kg/min)
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9
Q

Primacor

WWND?

A

hypotension, monitor BP

thrombocytopenia, monitor PPT for low levels

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10
Q

Diuretics; 3 classes used for

A

CHF, hypertension, renal/liver dz (ascites), pulmonary edema

  • Loop diuretics
  • Thiazides
  • Potassium sparing
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11
Q

Loop Diuretic; Lasix (POTENT diuretic)

used for?…works by…?

A
  • CHF, hypertension, pulmonary edema
  • inhibits Na & Cl reabsorption in loop of Henle
  • INC renal excretion of water & electrolytes
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12
Q

Loop Diuretic; Lasix

Nx 6

A
  • need K supplement
  • check BP prior to admin, hold if too low
  • give in AM to allow PT to urinate during day
  • monitor BUN/creatinine
  • Na & K levels
  • fluid statux, I/Os
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13
Q

Loop Diuretic; Lasix
what are some risks?
3

A

hypotension
elderly at risk for falls
tinnitus/ottotoxicity

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14
Q

Thiazides; Hydrochlorothiazide

works by…

A
  • INC excretion of Na & H2O by inhibiting enzymes (Na, K, Cl) reabsorption in the distal tubule
  • relaxes arteries
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15
Q

Thiazides; Hydrochlorothiazide

Nx (same as loop diuretic) +2

A
  • check BP

- can increase uric acid levels

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16
Q

Potassium Sparinc Diuretics; Aldactone

WEAK diuretic in adjuct to loop diuretics

A

-inhibits Na reabsorption in kidney while saving K & hydrogen ions

17
Q

Potassium Sparinc Diuretics; Aldactone

WWND? 3

A
  • monitor renal funtion; PT in renal failure cannot recieve this drug
  • watch potassium diet
  • no supplement/salt substitutes
18
Q 
Adrenergic drugs (heavy hitters)
WDTD?
A
  • mimic SNS
  • INC cardiac output
  • watch for hypokalemia due to increased UR output
19
Q

Dopamine; dose related/WT base drug:
low dose
mod dose
high dose

A

low dose = renal dilation, helps perfuse kidneys
mod dose = INC cardiac contractility, promotes vasodilation
higher dose= causes vasoconstriction (for shock - hypotension)

20
Q

Dopamine works by…

A

acts on Beta 1 (heart) & Alpha receptors resulting in vasoconstriction & INC myocardial contractility

21
Q

Dopamine

WWND? 3, may cause…

A

NECROSIS, assess IV frequently *central line ideal
monitor HR (tachycardia), EKG (arrhythmias)
watch for s/s of angina/chest pain, hypotension

22
Q

Dobutamine works by…2

WT base drug

A
  • stimulates Beta1 receptors (heart)

- INC cardiac contractility & CO

23
Q

Dobutamine given for…2

symptom of…

A

usually short-term for acute decompensated HR & cardiogenic shock

symp of SOB at rest

24
Q

Dobutamine:
side effects
toxicity

A
  • can develop premature ventricular contractions
  • Necrosis (same as dopamine)
  • GI: N/V/D/A (same as Dig)
25
Q

Dobutamine

Nx 2

A

WT, I/O
RR, lung sounds
(same as Dig???)

26
Q

Levophed (norepinephrine) given…

dose

A

short-term for hypotensive shock

8-12 mcg/min

27
Q

Levophed (norepinephrine)
mechanics
theraputic

A
  • stimulate alpha & beta1 receptors
  • causes vasoconstriction INC BP
  • myocardial stimulation INC CO
28
Q

Levophed (norepinephrine)

  • possible side effects
  • WWND?
A
  • very powerful vasoconstrictor; DEC blood flow to non vital organs
  • h/a w/hypertension
  • check peripheral pulse/warmth/color
29
Q

MISC; Natrecor
synthetic version of…
therapeutic

A
  • BNP (promotediureses & DEC preload/afterload)

- INC blood & O2 to heart

30
Q

Natrecor
used for?
dose?

A
  • stage 4 heart failure
  • 2 mcg/kgbolus followedby0.01 mcg/kg/min
  • Monitor RR, WT, I/O

ADH 1 (3 decks)

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