Cardiac & Respiratory Drugs Flashcards

1
Q

Class of drugs that digoxin falls under

A

Cardiac glycosides

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2
Q

use of digoxin

A

Helps the heart beat slower and stronger

Decrease HR; increase force of contraction

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3
Q

Signs of digoxin toxicity

A

Anorexia, halos around lights, flashes of light, weight loss, n/v

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4
Q

Nursing considerations for patients on Digoxin

A

Assess digoxin levels due to narrow TI, monitor K+ levels, assess apical pulse for 1 full minute and if HR is <60 bpm then hold meds.

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5
Q

Uses and side effects of nitroglycerine

A

Tx angina (not getting enough O2 & blood to the heart)
Low blood pressure
HA

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6
Q

Quick acting nitroglycerine

A

Sublingual tabs
Translingual sprays
For suspected heart attack
Severe pain & SOB

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7
Q

slow acting nitroglycerin

A
Nitro-Bid (patch)
Nitro ointments
SR tablets
Daily doses to prevent angina
Considered a prophylactic
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8
Q

Nursing implications for persons taking nitroglycerin

A
  • monitor BP
    Rise slowly, assess pain level (main thing to monitor for effectiveness); keep med on person at all times, discard opened bottle after 3 months, protect from light
    A- avoid alcohol
    N- note BP & apical pulse before admin
    G- given to relax the vascular smooth muscle
    I- indicated in angina
    N- note for orthostatic hypotension
    A- advise client to seek medical assistance if pain i unrelieved after 3 doses with 5 min interval
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9
Q

True or false all diuretics get rid of sodium

A

True

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10
Q

What are the different types of antihypertensive drugs?

A

Ace Inhibitors
Beta Blockers
Calcium channel blockers (calcium antagonists)
ARBS

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11
Q

Nursing considerations for persons taking antihypertensives?

A

Avoid alcohol, hot tubs, & saunas because it can cause vasodilation
Advise them to limit sodium and fried foods

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12
Q

ACE inhibitors end in:

A

-pril

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13
Q

Beta blockers end in?

A

-olol

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14
Q

List four types of ace inhibitors

A

Captopril (capoten)
Lisinopril (zestril)
Enalapril (vasotec)
Quinapril (accupril)

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15
Q

Uses of ACE inhibitors

A

HTN, HF, & post MI

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16
Q

Side effects and adverse reactions of ace inhibitors

A

Postural hypotension,
fatigue *
renal insufficiency,
dry, non productive cough*

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17
Q

Examples of calcium antagonists (calcium channel blockers)

A

Calanisoptin (Verampamil)
Cadizem (Diltiazem)
Procardia (Nifedipine)

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18
Q

Action of Beta 1 blockers

A

Acts on the heart
Will act like an anticholinergic
Decrease the excitability of the heart, workload and O2 consumption and lower blood pressure

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19
Q

Action of Beta 2 blockers

A

Will act on the lungs
Will act like an anticholinergic
Cause bronchodilation

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20
Q

ARBs

A

-sartan drugs

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21
Q

Examples of sartans

A

Valsartan
Irbesartan
Candesartan

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22
Q

Interactions to be aware of for persons taking -sartans

A

NSAIDS (decrease the effects)

Diuretics (cause hypotension)

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23
Q

Nursing considerations for persons taking ARBs (sartan) drugs

A

Administer without regard to meals
Review renal function tests
Salt substitutes or potassium supplement should not be used because they will increase potassium levels

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24
Q

Types of Diuretics

A

thiazide, loop, potassium sparing, osmotic diuretics

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25
Q

Thiazide diuretics and loop diuretics are:

A

Potassium wasting diuretics

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26
Q

Give an example of a loop diuretic and its use

A

Furosemide (Lasix)
Bumetanide
Used to treat CHF and HTN

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27
Q

Example of potassium sparing diuretic

A

Aldactone (spironolactone)

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28
Q

Give an example of an osmotic diuretic. When might it be used?

A

Mannitol
Used for acute renal failure, edema, increased intracranial pressure,
Also used to decrease intraocular pressure

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29
Q

side effects of osmotic diuretics

A

HA, confusion, tachycardia

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30
Q

Interactions of osmotic diuretics

A

Digoxin- increases the toxicity

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31
Q

Nursing considerations for persons taking diuretics (loop)

A

Monitor orthostatic hypotension
Hypokalemia (loop) (hyperkalemia if taking a potassium sparing diuretic)
Give in the morning
Know potassium levels before giving
Know fluid status: body weight, I&Os
Assess for allergies to sulfa or thiazide (loop)
Monitor for tinnitus and hearing loss (loop)

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32
Q

General Side effects and adverse reactions of diuretic drugs

A

Fluid & electrolyte imbalances
CNS effects
GI effects

33
Q

Patient teaching for all antihypertensive drugs

A
Decrease salt intake
Exercixe 
Stress management 
Dont abruptly stop taking
Consult HCP before taking OTC or herbal meds
Avoid alcohol, hot tubs, and saunas 
Monitor bp 
Avoid straining during bowel movements 
May cause impotence- don't stop taking meds just because of this
34
Q

Route and action of Heparin

A

IV or IM; rapid acting
Prolongs clotting time;
interferes with the activation of fibrin & fibrinogen from thrombin and keeps the clots from forming

35
Q

Uses of Heparin

A

Prevent DVT & pulmonary emboli

Used in persons at higher risk for strokes

36
Q

Side effects of heparin

A

Bleeding

37
Q

Nursing considerations for persons taking heparin

A

Monitor PTT due to narrow TI

Bleeding precautions

38
Q

Antidote for Heparin sodium

A

protamine sulfate

39
Q

Normal PTT vs. Ideal PTT on heparin

A

Normal is 60- 70 seconds

90- 175 seconds on heparin

40
Q

Route of administration of warfarin

A

Oral

41
Q

Nursing considerations for persons taking Warfarin

A

Advise against foods hight in vitamin K (will increase clotting risk)
Observe for bleeding
Check PT levels

42
Q

Normal PT levels vs. ideal PT levels on Coumadin

A

Normal is 10-14 seconds

Ideally 15- 35 seconds on Warfarin

43
Q

Antidote for Warfarin (Coumadin)

A

Vitamin K

44
Q

Antiplatelet drugs

A

Clopidogrel (Plavix)

Aspirin

45
Q

Uses of Clopidogrel (Plavix)

A

Used to decreased incidence of vascular clotting, MIs, stroke, & acute coronary syndrome

46
Q

Nursing implications for persons taking clopidogrel (Plavix)

A

Watch for skin disorders & flu-like symptoms
Caution with HTN, hepatic, & renal problems, hx of bleeding
Platelet counts before beginning & every 2 days for a week, then weekly

47
Q

Uses of aspirin

A

Anti-platelet aggregation
Anti- inflammatory
Anti-pain
Anti-pyretic

48
Q

Side effects and adverse reactions of aspirin

A

Tinnitus, stomach pain, GI bleeding, thrombocytopenia

49
Q

Contraindications/Precautions of Aspirin

A

Don’t take with heparin or warfarin

50
Q

lipid lowering drugs

A

Statins

51
Q

Antihistamines

A

Diphenhydramine (Benadryl)
Hydroxyzine (Vistaril)
Meclizine (Antivert)
Cetirizine (Zyrtec)

52
Q

Uses of antihistamines

A

Allergies & anaphylaxis
Anxiety & pain
Motion sickness & vertigo

53
Q

Side effects of antihistamines

First gen vs. second gen.

A

Drowsiness,
dryness (dry nose, throat, and mouth)
Urinary frequency
Hypotension

First gen have more side effects and are more likely to cause drowsiness

54
Q

Use of antitussives

A

For nonproductive cough

55
Q

Use of expectorants

A

Thins secretions so they can be coughed up

56
Q

Mucolytics

A

Breaks up mucus

57
Q

Antidote of acetaminophen toxicity

A

Mucolytics

58
Q

Management of Asthma

A
A - adrenergics (beta 2 agonists) (Albuterol) 
S - Steroids>>> reduce inflammation
T - Theophylline>>> oral bronchodilator
H - Hydration (IV)
M - Mask O2
A - Anticholinergics
59
Q

Examples of bronchodilators

A

Adrenaline

Theophylline

60
Q

Uses of Theophylline

A

Tx for chronic asthma & COPD

Prophylactic

61
Q

Side effects and adverse reactions of theophylline

A

(Same as bronchodilators)- n/v, anorexia, GI pain, GI bleeding, nervousness, dizziness, HA, irritability, cardiac dysrhythmias, tachycardia, palpitations, marked hypotension

62
Q

Nursing implications for theophylline

A

Monitor serum or plasma concentration
Avoid caffeine
NOT TO BE USED AS A RESCUE for asthma
Contraindicated in persons with seizure disorders

63
Q

Action of corticosteroids

A

Reduce inflammation by suppressing the immune system

64
Q

Corticosteroid drugs (examples)

A

Methylprednisolone (Solu-Medrol)
Dexamethasone (Decadron)
Prednisone (deltasone)

End in -one

65
Q

Side effects of corticosteroids

A

Edema, peptic ulcers, delayed wound healing, osteoporosis & infections.

66
Q

side effects of digoxin (similar to Digoxin toxicity)

A
Bradycardia
Dysthymia 
Anorexia
Visual disturbances (halos) 
Hypokalemia
67
Q

Examples of cardiac glycosides

A

Digoxin

Lanoxicaps

68
Q

antidote for digoxin

A

Digibind

69
Q

Commonly used nitrite drugs

A

Isorbide mononitrite
Nitroglycerine
Isorbidedinitrate

70
Q

Interactions of nitrite drugs

A

When used with ( ED drugs) viagra, cialis, levitra, alcohol, beta blockers

71
Q

Beta Blockers

A

-olol
Atenolol (tenormin)
Metoprolol (lopressor)
Propranolol (inderal)

72
Q

Side effects of beta blockers

A

Hypotension, decreased libido, wheezing

73
Q

Contraindications for beta blockers

A

Heart block
Bradycardia
Pulmonary edema

74
Q

Nursing implications for beta blockers

A

Monitor bp and P

Assess for chest pain

75
Q

Action of beta blockers

A

Dec hr
Dec force of contraction
Dec rate of av conduction

76
Q

Action of calcium channel blockers

A

reduces cardiac after load &
Reduces oxygen demand
All by dilating arterioles

77
Q

Contraindications of Diuretics

A

Allergies to sulfa drugs or thiazide

Anuria

78
Q

Side effects of loop diuretics

A

Hypotension, headache, dizziness, tinnitus, hearing loss, hypokalemia