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ADH 1 > ADH 3; Dysrythmias,Rx anti-anginals/lipidemics/dysrhythmias > Flashcards

ADH 3; Dysrythmias,Rx anti-anginals/lipidemics/dysrhythmias Flashcards

1
Q

What do Nitrates do?

A

VASODILATION; relax smooth muscles in blood vessles; BP
decrease afterload (diastolic)
decrease preload/resistance (systolic)

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2
Q

Nitrates; PT teaching for…
Sublingual
Transdermal
PO

A

Sublingual - should fizzle/tingle, if inactive, new prescription
Transdermal - gloves* take off oldpatch, rotate sites, plain skin (no hair/scars) ON/OFF 12 hrs
PO - take on an empty stomach

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3
Q

Nitrates; WWND??

A

check BP
watch for O/H
HOLD if systolic is below 100; document & call Dr
head aches; admin NSAIDS - Aspirin or Analgesic - Tylenol

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4
Q

Nitrates; avoid…

A

NO ETOH or Viagra!!!

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5
Q

What do Calcium Channel Blockers do??

3

A

DEC intracellular calcium & promotes VASODILATION

DEC afterload/workload ofheart

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6
Q

CCB; WWND?? check/monitor

A

check BP, HR, RR, lung sounds
Monitor EKG
check bowels

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7
Q

CCB; may…

CCB WILL NOT

A

WORSEN contractions causing HF/arrythmias
cause CONSTIPATION
WILL NOT RELIEVE AN ACUTE ATTACK

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8
Q

CCB; Cardizem is to manage what arrythmias? 4

slows heart

A

S-Tach
SVT
A-Fib
A-Flutter

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9
Q

What do Beta Blockers do??

A

Block SNS/vasoconstriction
to DEC cardiac workload

SLOW HR
DEC contractions
DEC O2 requirements

WILL NOT PREVENT AN ACUTE ATTACK; need Nitroglycerine

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10
Q

Beta Blockers; given for…

& what arrythmias? 4

A

Angina, Hypertension
prevents SVT, V-fib
also for A-fib, A-flutter

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11
Q

Beta Blockers; WWND??

A

check HR, RR, O2; X asthma, COPD
BP (hold if under 50)
BG (mask hypoglycemia)

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12
Q

BB; (loPRESSor) Lopressor controls…

how would you admin??

A

controls ventricle rate

5mg IV push

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13
Q

Reductase Inhibitors/Statins; WDTD?

Drugs

A

block enzymes HMG-CoA; lowers cholesterols

ZOCOR

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14
Q

Reductase/Statins; Monitor…

A 
LFTs (activates in liver)
Muscle weakness/CRAMPS/Rhabdomyolysis
CPK levels (tissue injury)
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15
Q

Reductase/Statins; PT teaching & Drug Interactions

A

Take in evening (when you make lipids)
Avoid ETOH
D/I: erythromyocin (abx for skin/acne), grapefruit juice - inc risk of myopathy

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16
Q

Bile Acid Sequestrants; Questran

WDTD?

A

Bind with bile acids in interstitial lumen to lower LDL

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17
Q

Bile Acid Sequestrants;Questran

PT teaching - drug interactions

A

THERE ARE A LOT!! decreases absorption of other medications, TAKE 1 HR BEFORE or 4-6 HRS AFTER

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18
Q

Bile Acid Sequestrants;Questran

preparation/WWND?

A

Mix powder with 120-180 ml of any liquid

Monitor bowel function; can cause constipation

19
Q

Cholesterol Absorption Inhibitors; Zetia

WDTD?

A

Inhibit absorption of CHL from small intestine

DEC total serum CHL

20
Q

Niacin Vit B3 (OTC); must be taken in HIGH doses

A

Inhibits release of free fatty acids
Removes triglycerides
DEC LDL

21
Q

Niacin Vit B3 (OTC); Monitor

A

LFTs; may cause liver insufficiency
INC in uric acid levels
FLUSHING; Aspirin, Ibuprofen

22
Q

CLASS 1
CLASS 2
CLASS 3
CLASS 4

A

CLASS 1 - Sodium channel blockers
CLASS 2 - Beta blockers
CLASS 3 - Potassium channel blockers
CLASS 4 - Calcium channel blockers

23
Q

CLASS 1 Sodium channel blockers; work by

A

blocking the sodium channels in the cell membrane during an action potential

24
Q

CLASS 2 Beta blockers; work by

A

causing depression of phase 4 of action potential

25
CLASS 3 Potassium channel blocker; work by
prolonging phase 3 of action potential
26
Class 4 Calcium channel blockers
in membrane
27
CLASS 1
DEC conduction & velocity; slow impulses in atria & ventricle SUPPRESS automaticity INC recovery time
28
CLASS 1 A. B. C.
CLASS 1 A. Quinidine B. Lidocaine C. Rythmol
29
CLASS 1 A - Quinidine | used for what arrhythmia?
PAC/PVC A-Fib V-Tach
30
CLASS 1 A - Quinidine LEVELS? TOXICITY? s/s
``` (2 - 5mcg/ml) TOXICITY S/S -visual disturbances -headache -dizzy -widening QRS -arrhythmias, ectopic beats (SVT) -30 - 35% diarrhea, stomach cramping ```
31
CLASS 1 A - Quinidine | WWND? PT teaching?
Take apical rate Monitor EKG PT- avoid ant acids; needs acidic environment
32
CLASS 1 B.- Lidocaine...MGMT of??
MGMT of acute ventricle arrhythmias PVC V-Tach - w/pulse prevents V-Fib
33
CLASS 1 B.- Lidocaine LEVELS? WWND?
1.5 - 6mcg/ml Monitor for CNS symptoms; dizzy, slurred speech Seizure precautions!
34
CLASS 1 C - Rhythmol PO...works by?? MGMT of?? "you're tachy & i hate you" - School of Rhythmol
prolonging AV node refractory period life threatening ventricular arrythmias (tachydysrythmias) also A-Fib/A-Flutter
35
CLASS 2 Beta Blockers
Slows SNS DEC SA node activity Eliminate/DEC atrial ectopicfoci stimulation DEC ventricular contraction
36
CLASS 2 Beta Blockers; Lopressor..controls? | DOSE
controls ventricular rate of A-fib/A-flutter | 5mg IV push
37
CLASS 3 Potassium channel blockers
- blocks potassium channels in purkinje fibers & ventricular muscle - prolongs refractory period/delay repolarization
38
CLASS 3 Potassium channel blockers: | Amiodarone IV/drip for the DEAD, Amidead?
Drug of choice for treating V-fib (dead) & pulseless V-tach (dead)
39
``` CLASS 3 Potassium channel blockers: Amiodaron Nx implementations (7) Rx, L-T-P-N-E ```
``` Respiratory toxicity; pulmonary fibrosis - assess for cough/SOB,routine CXR Coumadin Digoxin toxicity LFT Hyper/Hypo Thyroid Neuro effects Photosensitivity Eye exams/EKG ```
40
CLASS 4 Calcium channel blockers
blocks influx of calcium into the SA & AB nodes slows conduction DEC ventricular response to rapid A-Fib/A-Flutter ALT to Adenosine for PSVT
41
CLASS 4 Calcium channel blockers Cardizem DOSE (2) WWND?
Controls ventricular reate in A-fib/A-flutter 25mgIV bolus OR 5-15mg/hr drip Monitor rate, rhythm
42
Adenosine given for? works by? admin?
acute treatment of PSVT slows electro-conduction though AV node short acting - rapid IV push, 6mg, 6mg, 12mg
43
Atropine Sulfate | given for?
Bradycardia; HR <60 w/dizziness, groggy, pale | IV push: 0.5 - 1 IV every 3 - 5min
44
Magnesium Sulfate
Torsades de pointes | IV push: 1 - 2 gm over 2min

ADH 1 (3 decks)

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