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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
Q

CLASS 3 Potassium channel blocker; work by

A

prolonging phase 3 of action potential

26
Q

Class 4 Calcium channel blockers

A

in membrane

27
Q

CLASS 1

A

DEC conduction & velocity; slow impulses in atria & ventricle
SUPPRESS automaticity
INC recovery time

28
Q

CLASS 1
A.
B.
C.

A

CLASS 1
A. Quinidine
B. Lidocaine
C. Rythmol

29
Q

CLASS 1 A - Quinidine

used for what arrhythmia?

A

PAC/PVC
A-Fib
V-Tach

30
Q

CLASS 1 A - Quinidine
LEVELS?
TOXICITY? s/s

A 
(2 - 5mcg/ml)
TOXICITY S/S
-visual disturbances
-headache
-dizzy
-widening QRS
-arrhythmias, ectopic beats (SVT)
-30 - 35% diarrhea, stomach cramping
31
Q

CLASS 1 A - Quinidine

WWND? PT teaching?

A

Take apical rate
Monitor EKG
PT- avoid ant acids; needs acidic environment

32
Q

CLASS 1 B.- Lidocaine…MGMT of??

A

MGMT of acute ventricle arrhythmias
PVC
V-Tach - w/pulse
prevents V-Fib

33
Q

CLASS 1 B.- Lidocaine
LEVELS?
WWND?

A

1.5 - 6mcg/ml
Monitor for CNS symptoms; dizzy, slurred speech
Seizure precautions!

34
Q

CLASS 1 C - Rhythmol PO…works by??
MGMT of??

“you’re tachy & i hate you” - School of Rhythmol

A

prolonging AV node refractory period
life threatening ventricular arrythmias (tachydysrythmias)
also A-Fib/A-Flutter

35
Q

CLASS 2 Beta Blockers

A

Slows SNS
DEC SA node activity
Eliminate/DEC atrial ectopicfoci stimulation
DEC ventricular contraction

36
Q

CLASS 2 Beta Blockers; Lopressor..controls?

DOSE

A

controls ventricular rate of A-fib/A-flutter

5mg IV push

37
Q

CLASS 3 Potassium channel blockers

A
  • blocks potassium channels in purkinje fibers & ventricular muscle
  • prolongs refractory period/delay repolarization
38
Q

CLASS 3 Potassium channel blockers:

Amiodarone IV/drip for the DEAD, Amidead?

A

Drug of choice for treating V-fib (dead) & pulseless V-tach (dead)

39
Q 
CLASS 3 Potassium channel blockers: Amiodaron
Nx implementations (7)
Rx, L-T-P-N-E
A 
Respiratory toxicity; pulmonary fibrosis - assess for cough/SOB,routine CXR
Coumadin
Digoxin toxicity
LFT
Hyper/Hypo Thyroid
Neuro effects
Photosensitivity
Eye exams/EKG
40
Q

CLASS 4 Calcium channel blockers

A

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
Q

CLASS 4 Calcium channel blockers
Cardizem
DOSE (2)
WWND?

A

Controls ventricular reate in A-fib/A-flutter
25mgIV bolus OR 5-15mg/hr drip
Monitor rate, rhythm

42
Q

Adenosine
given for?
works by?
admin?

A

acute treatment of PSVT
slows electro-conduction though AV node
short acting - rapid IV push, 6mg, 6mg, 12mg

43
Q

Atropine Sulfate

given for?

A

Bradycardia; HR <60 w/dizziness, groggy, pale

IV push: 0.5 - 1 IV every 3 - 5min

44
Q

Magnesium Sulfate

A

Torsades de pointes

IV push: 1 - 2 gm over 2min

ADH 1 (3 decks)

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