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Clinical > Cardiac Pharmo > Flashcards

Cardiac Pharmo Flashcards

1
Q 
Lipid Lowering Agents
Generic:
Class: 
Indication: 
Mechanism:
Contras:
Side effect: 
Nursing Care:
A

Generic:
‘Statins’ (simvastatin)

Class:
HMG-CoA reductase inhibitors

Indication:
- Hypercholestrolaemia

Mechanism:
- Inhibits HMG-CoA reductase, reducing cholesterol synthesis and increasing number of liver LDL receptors

Contras:

  • Liver disease
  • Pregnancy

Adverse:

  • Gastro upset
  • CNS symptoms (headache, dizziness)
  • Cataracts

Nursing care:

  • Avoid grapefruit
  • Avoid large amounts of alcohol
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2
Q

ACE Inhibitors

Generic: 
Class: 
Indications: 
Mechanism: 
Contras: 
Side Effect: 
Nursing Care:
A

Generic:
Class: ACE inhibitor
Indication:
- Hypertension, heart failure

Mechanism:

  • Prevents conversion of angiotensin I to Angiotensin II.
  • Results in reduced peripheral vascular resistance and descreased BP
  • Decreases aldosterone production, reduction sodium and water reabsorption

Averse:

  • Cough
  • Dizziness, headache, fatigue

Nursing care:

  • NSAIDs can interact and reduce efficiency
  • Avoid dehydration
  • Low salt diet
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3
Q

Anti-Anginal Agents

Generic: 
Class: 
Indications: 
Mechanism: 
Contras: 
Side Effect: 
Nursing Care:
A

Generic:
- GTN
‘trates’

Indication:

  • Angina
  • Manage acute pain and prevent further attacks

Mechanism:

  • Relaxes the smooth muscle causing vasoconstriction, decreases arterial pressure and cardiac output resulting in decreased myocardial O2 demand.
  • Dilates vessels

Nursing Care:

  • Tolerance can develop
  • Patient education re. dizziness
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4
Q

Calcium channel blockers

Generic: 
Class: 
Indications: 
Mechanism: 
Contras: 
Side Effect: 
Nursing Care:
A

Generic:
‘ines’
- Benzothiazepine
- Amoldopine

Indication:

  • Hypertension
  • Angina

Mechanism:

  • Impedes influx of calcium ions during depolarisation
  • Dilates coronary arteries to improve O2 supply

Contras:
- Patients with severe Hypotension

Adverse:

  • Bradycardia
  • Dizziness

Nursing Care:
- Grapefruit juice

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5
Q

Beta Blockers

Generic: 
Class: 
Indications: 
Mechanism: 
Contras: 
Side Effect: 
Nursing Care:
A

Indication:
- Angina, hypertension, heart failure

Mechanism:
- blocks beta 1 receptors, resulting in reduced HR, reduced force of contraction leading to reduces cardiac output and O2 demand

Adverse:

  • Bradycardia
  • Hypotension

Nursing care:

  • Note patient vital signs prior to admin
  • Can be contraindicated with asthma
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6
Q

Diuretics

Generic: 
Class: 
Indications: 
Mechanism: 
Contras: 
Side Effect: 
Nursing Care:
A

Class:

  • Thiazide ( hydrochlorothiazide)
  • Loop (furosemide)
  • Potassium sparing (spironolactone)

indication:
- Heart failure
- Hypertension

mechanism:
Thiazide:
- Reduces blood volume and arterial resistance

Loop:
- Lowers BP by reducing blood volume and promoting vasoconstriction

Potassium:
- Mild diuretic that conserves potassium, increases excretion of sodium.

Contras:

  • NSAIDs
  • Hypotension

Adverse:

  • Hypotension
  • Dehydration
  • Hypokolaemia

Nursing Care:

  • Fluid and electrolyte balance to be treated
  • Monitor vitals
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7
Q 
Sinus Rhythm 
P Wave 
PR interval
QRS 
Rate 
T wave
A 
P Wave: Present, upright
PR interval: 0.12-0.2
QRS: Preceeded by normal P wave
Rate: 60-100
T wave: Present, upright
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8
Q

NSTEMI
ST Wave

What does T Wave inversion indicate:

A

ST Wave: Depressed or T Wave inversion
No Progression to Q Wave

T inversion = Ischaemia

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9
Q

STEMI
ST Wave

What does deep Q indicate
What does Elevated ST show

A

ST Wave: Elevated
Progression to deep Q

Elevated = Injury
Deep Q = Infarction/Necrosis

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10
Q

Afib
P wave
QRS

Patho
Clinical Manifestation
Ax & Mgmt

A

P Wave: Rate >300, not identifiable
QRS: Normal or wide
Rate: Variable, irregular

Patho:

  • SA node no longer the pacemaker
  • Impulse no longer originates in the SA but elsewhere in the atria, causing atria to quiver

Clinical Manifestations:

  • Palpitations
  • Altered conscious state
  • Chest pain
  • dizziness

Ax & Mgmt:

  • ECG
  • Echocardiogram
  • Medication (anti-arrhythmic)
  • Pacemaker
  • Catheter ablation
  • Lifestyle, including triggers
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11
Q

Sinus Tachycardia

A

> 100

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12
Q

Sinus Brady

A

< 60

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13
Q

V Tachy

P Wave
Patho
Causes:

A

P Wave: Absent or independent of QRS

patho: Impulse originates in ventricle

Causes: Aging, anaesthesia, ischaemic heart disease

Treatment: CPR & defibrillator

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14
Q

V Fib

P wave
Patho,
Causes

A

P Wave: Absent, not identifiable

Patho: Impulse originates in ventricles

Causes: Ageing, anaesthesia, ischaemic heart disease

Treatment: CPR, defibrillator

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15
Q

Asystole

Patho
Causes
Treatment

A

Patho: Not compatible with life
No electrical conduction or mechanical contraction

Causes: Profound ischaemia

Treatment: CPR

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16
Q

Pulseless electrical activity

A

PQRST: All variable
Patho: Depolarisation and depolarisation are not coupled

Causes: 
4Hs and 4 Ts
- hypovolaemia
- hypoxia 
-Hyper/hypothermia
  • Toxicity
  • Tension Pneumothorax
  • Tamponade
  • Thromboembolism
17
Q

Cardiac output equation

A

CO = HR x SV

18
Q

Ejection fraction equation

A

EF = (SV/end diastolic ventricular volume) x 100

19
Q

Left heart failure - reduced ejection fraction

patho
Clinical manifestations
Ax & mgmt

A

Patho: reduced ejection fraction

  • decreased contractility
  • unable to pump enough blood to meet demands of body
  • fluid builds in blood vessels, leaking into interstitial spaces of body and lungs

Clinical manifestations:

  • Dyspnoea (SOB)
  • Oedema
  • Fatigue
20
Q

Left heart failure - preserved ejection fraction

A

Patho:

  • impaired filling of left ventricle during diastolic phase
  • impaired diastolic relaxation, impairs ability to fill with blood

Clinical manifestations:

  • Dyspnoea (SOB)
  • Oedema
  • Fatigue
21
Q

Right Heart Failure
Patho:
Clinical manifestations:

A

Patho:

  • impaired contractility of right ventricle caused by increased pressure, volume overload or rhythm
  • Fluid builds in right atrium, liver, spleen, GIT and peripheries

Clinical Manifestations:

  • peripheral oedema
  • enlarged liver
  • weight gain
22
Q

Heart failure assessment and management

A

Assessment:

  • Health history and physical exam
  • Echo
  • Blood tests
  • ECG
  • X-rays

Management

  • Treat underlying cause
  • interprofessional
  • fluid restriction
  • pharmo
  • surgical
  • lifestyle, encourage movement

Clinical (11 decks)

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