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Pharmacology > Cardiac Meds > Flashcards

Cardiac Meds Flashcards

1
Q

When do pt need diuretics?

A

When they require a reduced fluid circulation

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2
Q

Are diuretics often given by themselves?

A

No they are usually given with antihypertensive meds

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3
Q

Which diuretics have risk for hypokalemia?

A

Loop diuretics, thiazide and related diuretics
Because they make potassium excreted in urine

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4
Q

Loop diuretics ex?

A

Furosemide (Lasix)

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5
Q

Thiazide and related diuretics ex?

A

Hydrochlorothiazide

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6
Q

Furosemide class?

A

Loop diuretics

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7
Q

Hydrochlorothiazide class?

A

Thiazide and related diuretics

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8
Q

What do potassium-sparing diuretics do?

A

Reduce secretion of K from kidney

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9
Q

Potassium-sparing diuretics ex?

A

Spironolactone

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10
Q

Spironolactone class?

A

Potassium-sparing diuretics

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11
Q

What do loop diuretics do?

A

Inhibit Na and Cl

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12
Q

What is the first drug in tx for new onset of hypertension?

A

Hydrochlorothiazide

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13
Q

What do you need to make sure to do before giving diuretics?

A

Get electrolytes under control!

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14
Q

What does osmotic diuretics do?

A

Osmotic means water
Prevents reabsorption of water, increase urine, increase Na and Cl absorption

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15
Q

Osmotic diuretics ex?

A

Mannitol

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16
Q

Mannitol class

A

Osmotic diuretics

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17
Q

what are pt taking thiazide diuretics at risk for? (Not hypokalemia)

A

Gout attacks b/c it increase urate in body

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18
Q

Which diuretics can cause hypokalemia?

A

Loop diuretics and thiazide diuretics

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19
Q

Which diuretics can cause hyperkalemia?

A

Potassium-sparing diuretics

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20
Q

What hormone affect can spironolactone cause in males?

A

Gynecomastia b/c it blocks male sex hormone

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21
Q

Can you take diuretics with food/milk?

A

Yes

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22
Q

When should you take diuretics?

A

Early in the morning!

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23
Q

Can pt reduce fluid intake while on diuretics to reduce the need to urinate?

A

No!

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24
Q

Relations between cholesterol, triglycerides, and lipoproteins?

A

Cholesterol and triglycerides are not soluble in water, so need lipoproteins to help eliminate

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25
Q

What is LDL?

A

Low density lipoprotein
Harmful b/c it transports cholesterol to peripheral cells but discard the rest into bloodstream, causing atherosclerosis

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26
Q

What is HDL?

A

High density lipoprotein
Better b/c it takes cholesterol from peripheral cells to the liver to metabolize and excrete
Lower risk for atherosclerosis

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27
Q

What level of cholesterol and triglycerides is considered hyperlipidemia?

A

Cholesterol > 240
Triglycerides > 150

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28
Q

What do the statins help treat?

A

Hyperlipidemia
Prevent MI, stroke, and atherosclerosis

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29
Q

What do the statins do?

A

Inhibit manufacture and promotes breakdown of cholesterol

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30
Q

What is one serious adverse reaction of statins?

A

Leg pain/cramping and muscle ache/weakness
Because of rhabdomyolysis (breakdown of muscle and tissue)!

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31
Q

What kind of pt cannot take statins?

A

Diabetic b/c statins raise blood glucose

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32
Q

What do bile acid resins do?

A

Binds to bile acid, forms insoluble substance that cannot be absorbed in GI system, so you can poop it out

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33
Q

What are bile acid resins used for?

A

Hyperlipidemia
Gallstone when surgery is not recommended

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34
Q

Bile acid resins ex?

A

colestipol

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35
Q

colestipol class?

A

Bile acid resins

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36
Q

What are fabric acid derivatives (fibrates) used for?

A

Very high serum triglyceride levels
Reduce LDLs, cholesterol, and triglycerides

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37
Q

Fibric acid derivatives ex?

A

gemfibrozil

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38
Q

gemfibrozil class?

A

Fibric acid derivatives

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39
Q

When should pt take statins?

A

In the evening or at bedtime

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40
Q

What diet should pt have when taking statins?

A

Low fat/saturated fat

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41
Q

Can you drink grapefruit juice when taking statins?

A

No!

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42
Q

When should pt take bile acid resins?

A

Before meals

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43
Q

what is DASH diet?

A

Used for hypertensive pt
Low saturated fat and cholesterol
Rich in fruits, vegetables, and low-fat dairy food
Whole grain, poultry, fish, and nuts
Reduce fats, red meats, sweets, and sugared beverage

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44
Q

What do beta blockers do?

A

Decrease hr and bp

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45
Q

Centrally acting antiadrenergic drugs ex?

A

Clonidine

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46
Q

Peripherally acting antiadrenergic drugs ex?

A

Doxazosin

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47
Q

Calcium channel blockers ex?

A

Amlodipine, diltiazem

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48
Q

ACE inhibitors ex?

A

Lisinopril

49
Q

Clonidine class?

A

Centrally acting antiadrenergic

50
Q

Doxazosin class?

A

Peripherally acting antiadrenergic

51
Q

Amlodipine class?

A

Calcium channel blocker

52
Q

Diltiazem class?

A

Calcium channel blocker

53
Q

Lisinopril class?

A

ACE inhibitors

54
Q

What do you need to check before giving antihypertensive drugs?

A

bp and hr

55
Q

What is one expected finding on pt who are taking ACE inhibitors?

A

Dry, nonproductive cough

56
Q

What do calcium channel blockers do?

A

Relax and open vessels

57
Q

How do calcium channel blockers work?

A

They block the calcium ions to reduce contraction of heart and smooth muscle, relax and open vessels
Cardiac and smooth muscle contraction rely on calcium!

58
Q

How to discontinue beta blockers?

A

Taper off

59
Q

What is a severe side effect of antihypertensive drugs?

A

Rhabdo

60
Q

What do antianginal drugs do?

A

Relieve chest pain, decrease pressure by dilating coronary arteries, increase blood supply to myocardium

61
Q

How do beta-blockers help with angina?

A

Reduce hr and contractility, and decrease O2 demand

62
Q

How do calcium channel blockers help with angina?

A

Reduce the calcium available for transmission of nerve impulse, increase O2 to heart, decrease workload

63
Q

What do nitroglycerin do?

A

Dilate blood vessels, increase flow, decrease bp

64
Q

How should pt take nitrate?

A

3 dose max with 5 min apart

65
Q

What to do when 3 dose of nitrates doesn’t relieve chest pain?

A

Call 911 immediately

66
Q

What is one common side effect of antianginal meds?

A

Hypotension

67
Q

What data do you need to collect before administering antianginal meds?

A

bp and pulse

68
Q

What respiratory disorders is beta blockers contraindicated in?

A

Asthma and emphysema

69
Q

What should you do after applying topical nitro ointment?

A

Measure the inches of ointment that is being applied for dosage documentation

70
Q

What are anticoagulants used for?

A

Prevent blood clot
Usually used prophylactically for high risk pt

71
Q

Do anticoagulants have affect on existing clots?

A

No, but it can prevent future clots

72
Q

What are anticoagulants also called?

A

Blood thinners
But they don’t thin the blood, just prevents clots

73
Q

Warfarin class

A

Anticoagulant

74
Q

How long does it take for warfarin to take effect?

A

1.5-3 days

75
Q

Dalteparin (Fragmin) class

A

Anticoagulant
Low molecular weight heparin

76
Q

Enoxaparin (Lovenox) class

A

Anticoagulant
Low molecular weight heparin

77
Q

Apixaban (Eliquis) class

A

Anticoagulant

78
Q

What should you do if pt have an order for anticoagulants but they have thrombocytopenia?

A

Call the provider b/c pt is already lacking clotting factors (platelets)

79
Q

Is heparin given orally?

A

No

80
Q

Why is heparin not given orally?

A

Because they will get inactivated by gastric acid

81
Q

What is the antidote for heparin?

A

Protamine sulfate

82
Q

What precaution should pt taking anticoagulants be on?

A

Bleeding precaution

83
Q

What do antiplatelet drugs do?

A

Decrease ability of platelets to stick together

84
Q

Difference between anticoagulants and antiplatelets?

A

Anticoagulants are for veins
Antiplatelets are for arteries

85
Q

What labs do you need for warfarin?

A

PT and INR

86
Q

If pt is taking warfarin, what should the normal range of PT and INR be?

A

PT: 11-13.5
INR: 2-3

87
Q

What is a PT blood test?

A

Prothrombin Time
See how long does it take blood to clot
Norm: 11-13.5 sec

88
Q

What is INR?

A

International Normalized Ratio
Test done with Prothombin Time for pt who are on warfarin
Norm: 2-3
Doctors use this to determine the right dose for pt

89
Q

What lab do pt need if they are on heparin?

A

aPTT

90
Q

What is aPTT?

A

Activated Partial Thromboplastin Time
See how long does it take for blood to clot after a substance is added to activate the clotting process

91
Q

What is the normal aPTT value for pt that are on heparin?

A

60-80 sec

92
Q

What is the normal value of aPTT for pt that are not on heparin?

A

30-40 sec

93
Q

What risk do thrombolytic drugs increase?

A

Bleeding

94
Q

What do thrombolytics do to the body?

A

Breaks down ALL the clots, not only the abnormal ones

95
Q

Alteplase recombinant (Activase) class

A

Thrombolytics

96
Q

Telecteplase (TNKase) class

A

Thrombolytics

97
Q

What foods do pt need to be aware of when taking blood thinners?

A

Foods high in Vitamin K b/c counteracts with the effects of blood thinners
Ex: leafy green vegetables, beans, broccoli, cabbage, cauliflower, cheese, fish, and yogurt

98
Q

What are pt at risk for during the first 3 months of tx if they are on anticoagulants/antiplatelets/thrombolytics?

A

Infection!

99
Q

How long before surgery should you stop taking aspirin?

A

7 days prior

100
Q

What herbs do pt need to avoid while taking blood thinners?

A

Garlic, ginger, and ginkgo b/c higher risk for bleeding

101
Q

What are cardiotonics?

A

强心剂
Increase heart muscle contraction
Increase blood flow
And hr decreases with stronger contraction to allow heart chambers to be filled with blood for contraction

102
Q

What do antiarrhythmics do?

A

Get heart back on regular rhythm

103
Q

Digoxin (Lanoxin) class

A

Cardiotonics

104
Q

Ivabradine (Corlanor) class

A

Cardiotonics

105
Q

Adverse reactions for cardiotonics

A

Visual disturbance: blurring, yellow halo
Digitalis toxicity: digoxin

106
Q

What is digoxin’s narrow therapeutic range?

A

0.8-2 mg

107
Q

What do beta-blockers do when used as antiarrhythmic agents?

A

Decrease excitability of heart, release renin to decrease hr and bp

108
Q

Amiodarone (Nexterone) class

A

Potassium channel blockers
Antiarrhythmic agents

109
Q

How do potassium channel blockers (amiodarone) work?

A

Binds with potassium ions to slow down overactive electric signals in the heart

110
Q

Verapamil (Calan) class

A

Calcium channel blockers
Antiarrhythmic agents

111
Q

How do calcium channel blockers work?

A

Dilate coronary and peripheral artery, decrease the force of cardiac contraction

112
Q

Severe side effects of calcium channel blockers?

A

Hepatotoxicity, MI, HF

113
Q

What is a common action of antiarrhyhmic agents?

A

Vasodilation

114
Q

What are some side effects of antiarrhythmic agents due to vasodilation?

A

Hypotension
Lightheadedness
Bradycardia

115
Q

What should pt monitor before taking antiarrhythmic agents?

A

Heart rate
Hold med if hr is irregular
(<60/>100)

116
Q

What food do pt need to eat while taking digoxin?

A

Foods high in potassium

117
Q

What can indicate digoxin toxicity?

A

Yellow halo visual disturbance

118
Q

What drugs do pt need to avoid while taking antiarrhythmic agents?

A

Antacids!
And nonprescription cough/cold/allergy/antidiarrheal/diet drugs

119
Q

Why does digoxin need potassium?

A

Because they bind to the same place on sodium-potassium pump, so if potassium is low, digoxin binds more freely and that increases the risk of digoxin toxicity

Pharmacology (25 decks)

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