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ABSN > cardiac pharm - E3 > Flashcards

cardiac pharm - E3 Flashcards

1
Q

beta blockers

A

“olo”
-take BP every time before giving and hold + contact HCP if HR is less than 60 or systolic BP is less than 100
-vasodilation
-can mask hypogly by preventing tachycardia which is one of the main signs of hypogly

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2
Q

calcium channel blockers

A

“dipine”
-decreased contractility & conductivity of the heart as well as lowers the demand for oxygen (vasodi)
-best for AA d/t lack of angioedema seen w/ ACEs

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3
Q

statins

A

“statin”
-reduces the amount of cholesterol made by the liver and then the liver makes more LDL receptors
-myopathy, rhabdo & hepatotoxicity

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4
Q

ACE

A

“pril”
-Blocks angiotensin converting enzyme (ACE) which inhibits production of angiotensin 2 (a power vasoconstrictor)
-first dose hyponten
-do not give to pregnant women, risk for hyperK+ & neutropenia
COUGH

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5
Q

what class is nitroglycerin

A

Organic nitrates

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6
Q

Organic nitrates MOA

A

Dilates veins (both large & small vessels but primarily in the venous system) & decreases preload

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7
Q

nitroglycerin indications

A

angina

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8
Q

nitroglycerin SE

A

(related to vasodilation) HA, hypotension & dizziness, reflex tachycardia

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9
Q

nitroglycerin nursing considerations

A

Severe hypotension when taken w/ sindenafil, antihypertensices & alcohol

Can develop tolerance quickly -> only take as many as needed until pain goes away

Fall precautions

Do not exceed 3 doses

Long acting has to be tapered & it is a 1 time dose -> if pain is still present take another form but not another long acting

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10
Q

if you take Nitroglycerin and in 5 minutes pain doesn’t resolve, what do you do

A

If taken and no relief in 5 mins, call 911 (can take another one but have to call)

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11
Q

what drugs can be used to treat stable angina

A

beta blockers, CCB, Statins, aspirin, nitrates and ranolazine

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12
Q

nitrostat

A

route: sublingual
type: rapid acting
comments: put underneath tongue, repeat q5 min x as needed
use: active angina

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13
Q

transderm-nitro

A

route: skin patch
type: short acting
comments: apply to chest or thigh area daily
use: active angina

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14
Q

nitro bid

A

route: ointment
type: short acting
comments: apply 1-2in to chest or thigh area
use: active angina

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15
Q

lsosorbide

A

route: sublingual or oral
type: long acting
comments: tolerance builds up over time
use: for prevention of angina attacks

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16
Q

what class is ranolazine

A

anti anginals

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17
Q

anti anginals MOA

A

unknown

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18
Q

ranolazine indication

A

angina

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19
Q

ranolazine SE

A

HA
Dizziness
Nausea
Constipation

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20
Q

ranolazine nursing consideration

A

Can prolong QT interval

Caution if pt has acute renal failure or liver cirrhosis

CYP340 inhibitor-> avoid grapefruit and other meds that are inhibitors

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21
Q

ARBs

A

“satan”
-Block the action of angiotensin 2 after it is formed causing vasodilation
-cannot give to pregnant women pt is required to use contraception

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22
Q

warfarin

A

anti coag

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23
Q

what class are Sacubitril / valsartan

A

angiotensin receptor neprilysin inhibitor (ARNI) – RAAS inhibitors

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24
Q

ARNI – RAAS inhibitors MOA

A

Decreases preload & after load, suppresses aldosterone, and favorably impact cardiac remodeling

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25
Q

Sacubitril / valsartan indications

A

heart failure

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26
Q

Sacubitril / valsartan SE

A

Increased potassium levels
Hypotension
cough

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27
Q

Sacubitril / valsartan nursing considerations

A

Use highest dose possible

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28
Q

what are the RAAS inhibitors for heart failure

A

ACE
ARBs
ARNI
never use all 3 together, have to just pick 1

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29
Q

what class is carvedilol

A

beta blocker

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30
Q

beta blocker MOA (for heart failure)

A

decreases heart rate, contractility and afterload
Protects against SNS activation and dysrhythmias, reverses cardiac remodeling

31
Q

Carvedilol indication

A

heart failure

32
Q

Carvedilol SE

A

Fluid retention or worsening HF
Fatigue
Hypotension
Bradycardia

33
Q

Carvedilol nursing consideration

A

Hold if systolic is <100 or HR is <60

34
Q

what class is Dapaglifozin

A

SLG2 inhibitors

35
Q

SLG2 inhibitor MOA

A

Not well understood for HF -> thought to help w/ ventricular unloading through natriuresis / osmotic diuresis w/o actually depleting volume like traditional diuretics & may affect cardiac metabolism/bioenergetis

36
Q

Dapaglifozin indication

A

Heart failure
Diabetes

37
Q

Dapaglifozin nursing considerations

A

Helps decrease readmissions, mortality and morbidity

38
Q

diuretics in HF

A

-100% symptom relief w/ no survival benefit
-can cause hypoK & hypotension
-risk for digoxin toxicity

39
Q

what class is Digitalis

A

Cardiac glycosides

40
Q

Cardiac glycosides MOA

A

Inhibits sodium potassium ATP pump causing calcium to collect within the cells of the heart helping to increase myocardial contractility

Increases blood flow to the kidney helping with excretion of sodium & water, decreases sympathetic action and increases parasympathetic action
which all decrease HR

think potassium

41
Q

Digitalis indications

A

heart failure

42
Q

Digitalis SE

A

Cardiac dysrhythmias
Digitalis toxicity

43
Q

Digitalis nursing considerations

A

2nd line med d/t risk for dysrhythmias

Toxicity occurs with the combo of digoxin and diuretics (which all HF pts are on) -> periodic monitoring of levels

take apical pulse for 1 min Hold med if pulse is <60

monitor cardiac rhythm & serum K+ levels

44
Q

antidote for digitalis

A

digoxin immune fab (digibind) given IV

45
Q

what drugs are for rate and rhythm control

A

CCB, amiodarone, adenosine, atropine and dofetilide

46
Q

what class is amiodarone

A

Antidysrhythmic

47
Q

amiodarone MOA

A

Prolongs the action potential duration and the effective refractory period in all cardiac tissues; blocks alpha and beta adrenergic receptors in the SNS

48
Q

amiodarone indication

A

PSVT
Ventricular dysrhythmias
Afib w/ RVR

49
Q

amiodarone SE

A

Lots of effects
pulmonary toxicity (fatal in 10% of pt)
Thyroid alterations
Corneal microdeposits

50
Q

amiodarone nursing considerations

A

Lipophilic so can be concentrated in adipose tissues

Caution w/ people with thyroid/iodine problems

BBW: pulmonary toxicity, hepatotoxicity, and pro arhythmic effects

Interacts w/ digoxin (inc levels by 50%) & warfarin (inc INR by 50-100%)

Extremely long half life, can take 2-3 months to clear

Contraindicated in people with severe bradycardia or heart blocks (a type of rhythm)

51
Q

what class is Atropine

A

Anticholinergic

52
Q

Atropine MOA

A

Poisons the vagus nerve; inhibits postganglionic acetylcholine receptors and direct vagolytic action

53
Q

Atropine indication

A

Symptomatic sinus bradycardia

54
Q

Atropine SE

A

Xerostomia
Blurry vision
Photophobia
Tachycardia
Flushing
Hot skin

55
Q

Atropine nursing consideration

A

Only works if brady is vagal induced (if sick heart problem then wont help but we usually don’t know the cause so always try)

Give it IVP ONLY for bradycardia, 1mg every 3-5 mins, 3mg max

Never give if not on cardiac monitoring

56
Q

what class is Adenosine

A

antidysrhythmic

57
Q

Adenosine MOA

A

Slows the conduction time through AV node

58
Q

Adenosine indication

A

PSVT
Sinus tachy

59
Q

Adenosine SE

A

very few

60
Q

Adenosine nursing consideration

A

Very short half life so may need multiple doses

Causes short burst of asystole until sinus rhythm returns

Only given IV -> 6mg IVP, if have no converted give 12mg IVP, can give a 3rd time 12mg IVP (always follow w/ rapid normal saline flush or 2 saline flushes)

61
Q

what class is Dofetilide

A

antidysrhythmic

62
Q

Dofetilide MOA

A

Selectively blocking the rapid cardiac ion channel carrying potassium currents

63
Q

Dofetilide indication

A

Conversion from afib/aflutter to NSR

64
Q

Dofetilide SE

A

Torsades (a deadly rhythm that needs CPR immediately)
SVT
Headache
Dizziness
Chest pain

65
Q

Dofetilide nursing considerations

A

Stay in the hospital w/ ECG monitoring due to risk of torsades (BBW)

don’t give pt w/ long QT intervals or other drugs that may prolong QT intervals

66
Q

what class is cilostazol

A

platelet inhibitor

67
Q

cilostazol MOA

A

platelet inhibitor and vasodilation

68
Q

cilostazol SE

A

headache, dizziness, diarrhea, abnormal stools, palpitations, peripheral edema

69
Q

cilostazol nursing considerations

A

metabolized by cytochrome P450

70
Q

cilostazol indication

A

peripheral vascular disease

71
Q

what class is pentoxifylline/trental

A

vascoactive agent

72
Q

pentoxifylline/trental MOA

A

relieves leg pain by increasing blood flow and oxygen through the blood vessels

73
Q

pentoxifylline/trental SE

A

N/v, dizziness

74
Q

what drugs can be used to rate control A.fib

A

beta blockers, CCB, digitalis, amiodarone
+Dofetilide

ABSN (145 decks)

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