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NURS 2514 > Cardiac 2 drugs > Flashcards

Cardiac 2 drugs Flashcards

1
Q

Drugs to manage heart failure

A

Diuretics
Inhibitors of RAAS
Beta-Adrenergic Blockers
Cardiac Glycosides
SGLT-2 Inhibitors

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2
Q

Drugs to manage dysrhythmias

A

Beta-Adrenergic Blockers
Calcium Channel Blockers
Potassium Channel Blockers

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3
Q

Definition of heart failure

A

Syndrome in which the heart is unable to pump sufficient blood to meet metabolic needs of tissue

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4
Q

What is heart failure characterized by?

A

Inadequate tissue perfusion (fatigue, SOB, exercise intolerance)
Volume overload (venous distension, peripheral/ pulmonary edema)

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5
Q

General objectives when treating heart failure

A
  1. Identification of underlying cause
  2. Correct Na and water retention & volume overload
  3. Reduce cardiac workload
  4. Improve myocardial contractility
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6
Q

What is the most effective diuretic?

A

Furosemide (Lasix)

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7
Q

MOA of furosemide (Lasix)

A

Acts on loop of Henle to block reabsorption of Na and Cl, preventing passive reabsorption of water

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8
Q

Indications for furosemide (Lasix)

A

Situations that require rapid or massive removal of fluid ex. pulmonary edema, edema of hepatic, cardiac, or renal cause, HTN

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9
Q

Adverse effects of furosemide (Lasix)

A

Hyponatremia, hypochloremia, dehydration, dry mouth, thirst, oliguria, excessive weight loss, hypotension, hypokalemia, otoxotoxicity

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10
Q

Hydrochlorothiazide MOA

A

Blocks reabsorption of Na and Cl in distal convoluted tubule, causing water to be retained. Maximum diuresis considerably lower than loop diuretics

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11
Q

Indications for hydrochlorothiazide

A

Hypertension, edema (mild to moderate HF)

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12
Q

Hydrochlorothiazide adverse effects

A

dehydration*, dry mouth, thirst, oliguria, excessive weight loss,

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13
Q

Spironolactone MOA

A

Blocks actions of aldosterone in distal nephron. Maximum diuresis considerably lower than loop and thiazide diuretics. Delayed effect up to 48 hours

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14
Q

Spironolactone indication

A

Hypertension, edema, HF (decreased mortality)

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15
Q

Spironolactone adverse effects

A

Hyperkalemia (never use if K > 5, caution with ACE inhibitors, ARBS), can have endocrine effects (gynecomastia, impotence, menstrual irregularities)

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16
Q

Results of using diuretics

A

Lowers blood volume
Results in:
Lowered preload (venous pressure)
Lowered pulmonary edema
Lowered peripheral edema

17
Q

Big idea of ACE inhibitor Captopril

A

Work on RAAS
Decreases BP (monitor)
Can cause K retention (monitor)
Side effects: cough/ angioedema

18
Q

Results from Captopril

A

Vasodilation, lowered blood volume, lowered cardiac remodeling

19
Q

Big idea of using Angiotensin II receptor blockers Losartan (Cozaar)

A

Works on RAAS (different than ACE)
Lowers BP (monitor)
S/E: angioedema
Doesn’t cause cough as frequently as ACE
2nd line of drug for HF

20
Q

Angiotensin receptor neprilysin inhibitor drug example

A

Sacubitril/ Valsartan (Entresto)

21
Q

Sacubitril/ Valsartan (Entresto) MOA

A

Sacubitril - inhibits neprilysin leading to increased natriuretic peptides; induces vasodilation and natriuresis. Valsartan - ARB

22
Q

Sacubitril/ Valsartan (Entresto) big idea

A

Combo drug
Lowers blood pressure
Watch for dehydration and electrolyte imbalance, renal failure

23
Q

Metoprolol (Lopressor) SR (Sustained release) big idea

A

Slows heart rate, decreases BP, decreases contractility (less work for the heart) *If you slow the heart too much can tip into heart failure when CO drops below metabolic demands

24
Q

Adverse effects of metoprolol (Lopressor)

A

Hypotension, dizziness, signs of HF (dyspnea, crackles, weight gain, peripheral edema)

25
Q

Drug example of cardiac glycosides

A

Digoxin

26
Q

Digoxin big idea

A

Increased force of contraction, decreased heart rate
SE: dysrhythmias (esp with decreased K, bradycardia, hypotension, GI disturbances)

27
Q

Metoprolol (Lopressor) & Diltiazem MOA

A

Decreases movement of Ca into cells

28
Q

Metoprolol (Lopressor) & Diltiazem results

A

Decreased contractility, decreased AV conduction, decreased automaticity in SA node

29
Q

Indication for metoprolol (Lopressor) & Diltiazem

A

Afib

30
Q

Potassium channel blocker drug example

A

Amiodarone

31
Q

Amiodarone MOA

A

Prolongs the effective refractory period (ERP is time during which cell is unable to respond to excitation and to initiate a new action potential)

32
Q

Amiodarone additional cardiac effects

A

Decreased SA automaticity, decreased contractility, decreased AV conduction

33
Q

Amiodarone adverse effects

A

Increased arrhythmias, pulmonary toxicity, thyroid toxicity, liver toxicity

34
Q

Antidysrhythmic summary

A

These 2 drug BB, CCB, Amio all slow the movement of ions through gated channels in cardiac cells. This has the overall effect of slowing conduction which is helpful in controlling or converting arrhythmias. Risk for blood clots (Warfarin & Apixaban are used). Amio has unique side effects

NURS 2514 (14 decks)

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