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TERM 2 N1261 KNLG 1 > CARDIAC DRUGS > Flashcards

CARDIAC DRUGS Flashcards

1
Q

What is the purpose of inotropic drugs?

A

Affect myocardial contractility

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2
Q

What is the purpose of chronotropic durgs?

A

Affect heart rate

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3
Q

What is the purpose of dromotropic drugs?

A

Affect speed of electrical conduction in the heart

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4
Q

Which group of drugs end with the suffix -pril?

A

ACE (angiotensin-converting enzyme) inhibitors

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5
Q

Which group of drugs end with the suffix -sartan

A

ARBs (angiotensin II receptor blockers)

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6
Q

Which group of drugs end with the suffix -lol

A

Beta blockers

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7
Q

What do beta blockers do?

A

Prevent stimulation of heart by catecholamines; causes reduced heart rate, conduction, and contractility

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8
Q

What are the effects of angiotensin II?

A

Vasoconstriction, aldosterone secretion

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9
Q

What does aldosterone do?

A

Stimulate sodium and water resorption to increase blood pressure

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10
Q

Define ejection fraction

A

Amount of blood ejected from the heart with each contraction

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11
Q

Define left ventricular end diastolic volume

A

Amount of blood in the ventricle just before contraction

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12
Q

What is a normal ejection fraction?

A

65%

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13
Q

Why is kidney failure related to heart failure?

A

Blood supply to kidney is decreased in heart failure, increasing presence of waste products in blood

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14
Q

What clinical manifestation may indicate cardiac glycoside toxicity?

A

Flickering lights or halos around lights

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15
Q

What lab result may indicate digoxin toxicity?

A

Elevated potassium

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16
Q

What adverse cardiac effect is most likely to occur with IV milrinone?

A

Ventricular dysrhythmia

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17
Q

Name 3 therapeutic effects of phosphodiesterase inhibitors

A
  1. Positive inotropic effects
  2. Vasodilation
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18
Q

Name an example of a phosphodiesterase inhibitor

A

Milrinone

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19
Q

Name an example of a cardiac glycoside

A

Digoxin

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20
Q

Milrinone is contraindicated in which 3 conditions?

A

Aortic or pulmonary valve disorder, diastolic heart failure

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21
Q

Which 5 assessments should be performed in clients taking positive inotropic drugs?

A

Apical pulse, lung sounds, daily weights, serum electrolytes, and RBC count

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22
Q

What is the therapeutic range of digoxin?

A

0.5-1 ng/mL

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23
Q

What digoxin level may indicate toxicity?

A

Higher than 2.4 ng/mL

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24
Q

Which drugs are considered inodilators?

A

Phosphodiesterase inhibitors

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25
Q

Digoxin should NOT be taken with which foods?

A

Wheat bran and dairy

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26
Q

What drug is contraindicated with ACE inhibitors?

A

Potassium chloride.

ACE inhibitors block the conversion of angiotensin and therefore aldosterone production. Aldosterone is responsible for potassium excretion, so taking potassium can result in hyperkalemia.

27
Q

What lab test should be checked before administering eplerenone?

A

Serum electrolytes, because it is a potassium sparing diuretic.

28
Q

Which calcium channel blocker is used to prevent cerebral artery spasms after a subarachnoid hemorrhage?

A

Nimodipine, because it crosses the blood-brain barrier

29
Q

Which 2 classes of antihypertensives do Black people respond best to?

A

Diuretics and calcium channel blockers

30
Q

What is the classification of labetalol hydrochloride?

A

Dual action alpha1 and beta blocker

31
Q

What group of anti-anginal drugs includes nitroglycerine and isosorbide?

A

Nitrates

32
Q

Name 5 kinds of diuretics

A
  1. Carbonic anhydrase inhibitors (CAIs)
  2. Loop diuretics
  3. Osmotic diuretics
  4. Potassium-sparing diuretics
  5. Thiazide and thiazide-like diuretics
33
Q

What is the purpose of carbonic anhydrase?

A

Makes hydrogen ions that body exchanges for sodium and water that are resorbed back into blood.

34
Q

What is another therapeutic effect of CAIs?

A

Increase oxygenation during hypoxia.

35
Q

What is a negative effect of CAIs?

A

Elevation of blood glucose.

36
Q

What is an example of a CAI?

A

Acetazolamide

37
Q

What is the action of loop diuretics?

A

Block chloride resorption and secondarily sodium resorption

38
Q

What is an example of a loop diuretic?

A

Furosemide (Lasix)

39
Q

What is the action of osmotic diuretics?

A

Increases osmotic pressure in filtrate to pull fluid into renal tubules from tissues and inhibit tubular resorption.

40
Q

What is an example of an osmotic diuretic?

A

Mannitol

41
Q

What is the action of potassium sparing diuretics?

A

Block aldosterone receptors to block resorption of sodium and water.

42
Q

What are 2 examples of a potassium sparing diuretics?

A
  1. Spironolactone
  2. Triamterene
43
Q

What are 2 actions of thiazide and thiazide-like diuretics?

A
  1. Inhibits resorption of sodium, potassium, and chloride to result in osmotic water loss.
  2. Direct relaxation of arterioles to reduce peripheral vascular resistance (afterload)
44
Q

What are 2 examples of thiazide and thiazide-like diuretics?

A

Hydrochlorothiazide, metolazone

45
Q

Which group of drugs may interact with loop diuretics?

A

NSAIDs

46
Q

What is an adverse event associated with loop and thiazide diuretics?

A

Decreased serum potassium

47
Q

What lab result would be concerning in a patient taking spironolactone?

A

Hyperkalemia (higher than ~5.2)

48
Q

What is a negative effect of thiazide diuretics?

A

Elevated blood glucose

49
Q

When should loop diuretics be taken?

A

At the same time every morning

50
Q

What adverse events associated with loop diuretics are directly linked to patient safety?

A

Orthostatic hypotension, muscle weakness, dizziness

51
Q

What drug group may cause ototoxicity if taken with furosemide?

A

Aminoglycosides

52
Q

Why would a physician prescribe spironolactone and furosemide together?

A

Promotes diuresis but prevents hypokalemia

53
Q

Name 3 foods that are a source of potassium

A

Potatoes, meats, bananas

54
Q

What are 3 common adverse events related to potassium sparing diuretics?

A

Hyperkalemia, dizziness, headache

55
Q

Which laboratory test result is a common adverse effect of furosemide?

A

Hypokalemia

56
Q

Why would a health care provider prescribe furosemide for a patient with a history of renal insufficiency?

A

Furosemide continues to be effective even in impaired renal function

57
Q

Why is mannitol contraindicated in patients with anuria?

A

Mannitol does not influence urine production, it only increases existing urine output.

58
Q

If the patient asks about taking potassium supplements with spironolactone, what should the nurse say?

A

Spironolactone is potassium sparing, so no need to take supplements.

59
Q

What is the diuretic used for pulmonary edema?

A

Furosemide

60
Q

What is a possible adverse effect from taking triamterene?

A

Hyperkalemia

61
Q

What is a common symptom of hypokalemia?

A

Muscle weakness

62
Q

What are three indications for acetazolamide?

A
  1. Open angle glaucoma
  2. High altitude sickness
  3. Edema associated with heart failure
63
Q

Explain the action of ARBs

A

Vasodilation

64
Q

Explain the action of cardiac glycosides

A

Inhibits sodium-potassium adenosine triphosphatase pump to cause increase in intracellular sodium and calcium concentration; Increased contractility, decreased heart rate, decreased conduction

TERM 2 N1261 KNLG 1 (3 decks)

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