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pharmacology > cardiac medications > Flashcards

cardiac medications Flashcards

1
Q

s/s of dig toxicity

A

nausea, vommiting, anorexia, bradycardia, visual disturbances, cardiac dysrythmias, yellow and green halos

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2
Q

pt on digoxin should do what?

A

take pulse daily, do not take if HR less than 60

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3
Q

normal serum dig

A

0.8-2.0

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4
Q

monitor potassium for (when taking dig)

A

hypokalemia

can lead to toxicity

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5
Q

do not give dig with ??

A

antacids, makes drug ineffective

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6
Q

antidote for dig toxicity

A

digoxin immuno fab

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7
Q

hypokalemia and dig

A

hypokalemia increases effects of drugs and can lead to toxicity

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8
Q

first time someone takes nitro what should you do?

A

have them laying when they take it then test for orthostatic hypotension

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9
Q

do not apply nitro patches or ointment where?

A

near pacemaker or ICD

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10
Q

withdrawal symptoms of ca channel blockers and beta blockers

A

reflex tachycardia

pain

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11
Q

common se of nitroglycerin

A

HA pt can take tylenol for HA

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12
Q

what do beta blockers do?

A

decrease HR and myocardial contractility

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13
Q

calcium channel blockers action

A

relax coronary artery spasm, relaxes coronary artery spasms, and relaxes peripheral arteries, decreases contractility in turn decreases oxygen demands
decrease afterload, decrease peripheral resistance, reduces workload of the heart

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14
Q

Nitro SL tablets may have

A

stinging or biting feel

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15
Q

sodium channel blockers

A

decreases sodium influx into cardiac cellls, which decreases the likelyhood of ectopic foci

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16
Q

when administering antidysrythmics what should be done?

A

IV push or bolus, monitor for hypotension, compare baseline ecg to ecg after drugs are administered

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17
Q

adverse effects of antidysrhythmics

A

dizziness, fainting, nausea, vomiting

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18
Q

tell patient on antidysrhythmics to avoid

A

alcohol, caffeine, tobacco

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19
Q

what lab results to monitor with beta blockers?

A

BUN creatnine GFR AST LDH

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20
Q

what can beta blockers cause in a trauma situation?

A

hypoglycemia

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21
Q

side effects/ adverse effects of beta blockers

A

dizziness, slow hr, changes in bp, palpitations, orthostatic hypotension, confusion, GI upset, constipation

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22
Q

monitor what with alpha-adrenergic receptor blockers?

A

urine output, less than 600 daily than contraindicated with renal damage
sudden marked decreased in bp and increased hr
daily wts, can lead to edema

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23
Q

how long does it take for AA receptor blockers to work?

A

up to 4 weeks

24
Q

side effects of AA blockers

A

dizziness, lightheadness, drowsiness, impotence, edema (fluid retention is an issue),

25
Q

African americans should take

A

AA blockers and Ca channel blockers, beta blockers are not typically effective

26
Q

asian patients are more susceptible to what?

A

effects of propanolol

27
Q

side effects of ACE inhibitors

A

angioedema, cough, dysgeusia, weakness, hyperkalemia, renal impairment

28
Q

nis for ACE inhibitors

A

BUN, creatnine, urine protein, bruising, petichae, bleeding
Teaching: avoid salt substitutes with K in them
rise slowly cause you can have orthostatic hypotension
how to take and record bp
report any occurrences of bleeding
report dizziness longer than a week
take with out food to increase absorption
food taste may diminish during first month of therapy
Hyperkalemia is possible

29
Q

african americans will not respond to an ace inhibitor unless

A

it is taken with a diuretic

30
Q

contraindications of warfarin

A

blood dyscrasia, peptic ulcers, cvas, hemophilia, severe hypertension

31
Q

therapeutic PT/INR

A

PT 1.25-2.5
INR 2-3
prosthetic heart valves- INR up to 3.5

32
Q

nursing assessment for a patient on heparin or warfarin

A

epistaxsis, hematuria, petechia, purpura, occult blood in stools

33
Q

antidotes for heparin and warfarin

A

heparin- protamine sulfate
Warfarin- Vit K
fresh frozen plasma

34
Q

teaching patients about warfarin and heparin

A

electric razor, PT and INR done regularly, medic alert card, do not smoke, if they do smoke may need to increase warfarin dosage, avoid herbal therapy, avoid large amounts of green leafy veggies, legumes, soybean,
increases effects- fish oils, green tea, chamomile, st johns wort, garlic, ginger, ETOH decreases effectiveness

35
Q

aspirin cannot be taken with

A

warfarin, suggest acetaminophen

36
Q

contraindications of thrombolytics

A

injury/head injury, CVA, hypertension, active bleeding, severe hypertension, anticoagulant therapy, report NSAIDS or aspirin

37
Q

nursing assessment of a patient on thrombolytics

A

decreased bp, increased hr
observe for signs of bleeding in mouth or rectum, hemorrhage, aminocaproic acid can be given as an intervention to stop bleeding

38
Q

monitoring vs/reactions of a pt on thrombolytics

A

q15 1st hr q30 for next 8hrs
s/s of allergic reactions
ecg for evidence of reperfusion, dysrythmias
avoid venipuncture (and arterial sticks)

39
Q

side effects of thrombolytics

A

lightheadness, dizziness, palpitations, nausea, puritis, urticaria

40
Q

desired cholesterol levels

A

150-200

41
Q

high risk cholesterol levels

A

greater than 240

42
Q

desired triglycerides

A

40-150

43
Q

high risk triglycerides

A

190

44
Q

LDL levels

A

100-160

45
Q

HDL levels

A

low risk: greater than 60

high risk: less than 35

46
Q

side effects of statins

A

GI disturbances, head aches, muscle cramps, fatigue

47
Q

labs with statins

A

monitor liver enzymes

48
Q

what else needs to be monitored for with statins?

A

eye exam, can cause cataracts

muscle cramping/weakness can be a sign of rhabdomylosis

49
Q

may take how long for statins to work?

A

up to a couple months

50
Q

people with what should not take gemfibrozil

A 
diabetes 
on anticoagulants (watch themselves for bleeding)
51
Q

side effects of niacin

A

vasodilatation- dizziness, fainting, flush (decreases w time)

52
Q

do not stop taking a statin

A

abruptly, can cause MI

53
Q

report to er if

A

muscle weakness
fever
tea like urine

54
Q

use of peripheral vasodilators

A

increase blood flow to an area, PVD

reassess blood slow to an area after dosage

55
Q

nursing interventions for peripheral vasodilators

A

monitor for orthostatic hypotension and tachycardia
may take 1.5-3.0 months to work
use with aspirin to prevent platelet aggregation

56
Q

side effects of cilostazol

A

flushing, h/a, dizziness

alcohol can potentiate this

pharmacology (4 decks)

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