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Pharm > Cardio and Renal > Flashcards

Cardio and Renal Flashcards

1
Q

HDL

A

helps rid your body of excess cholesterol so it’s less likely to end up in your arteries, does so by taking fat from your blood to your liver

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2
Q

LDL

A

“bad cholesterol” because it takes cholesterol to your arteries, where it can collect in your artery walls

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3
Q

good triglyceride level

A

below 150 mg/dl

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4
Q

good LDL level

A

below 100 mg/dl

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5
Q

good cholesterol level

A

less than 200 mg/dl

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6
Q

good HDL level

A

above 60 mg/dl

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7
Q

medications to treat high cholesterol

A

-Statins (HMG-CoA inhibitors)
-Bile Acid Resin
-Nicotinic Acid (Niacin)
-Fibric Acid Agents
-Cholesterol Absorption
Inhibitors

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8
Q

what’s HMG-CoA reductase?

A

the critical enzyme in the biosynthesis (production) of cholesterol

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9
Q

atorvastatin

A

*statin
*MOA: inhibits HMG-CoA reductase/lowers cholesterol
Adverse: HA, fatigue, muscle/joint pain (rhabdo) and heartburn
**watch for rhabdo, liver function
*take in PM & NOT w/ grapefruit juice

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10
Q

what’s Rhabdomyolysis?

A

when damaged muscle tissue releases its proteins and electrolytes into the blood
**These substances can damage the heart and kidneys
**watch for complaints of muscle aches/pains

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11
Q

nursing interventions for statins

A

*Monitor for joint and muscle pain.
*Monitor liver function labs (ALT and AST).
*Monitor client alcohol consumption
*Monitor cholesterol and triglyceride levels.
*Monitor client dietary compliance.
*Do not administer with grapefruit juice

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12
Q

1 choice to treat high cholesterol

A

statins

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13
Q

bile acids: prototype, etc

A

*cholestyramine (Questran)
*MOA: bind with bile acids, increasing cholesterol excretion in stool
*Use: lower cholesterol
*Adverse: GI tract, (bloating and constipation), can bind other drugs increasing potential for drug–drug interactions

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14
Q

nursing implications of bile acids

A

*GI side effects (bloating and constipation)
*Take an hour before or 4 hours after other meds because of absorption
*bile acids need to be mixed with a LOT of water (60-180 ml) so not for someone on a fluid restriction/unable to drink

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15
Q

nicotinic acid, prototype etc

A

*niacin (B3)
*for those allergic to, or unable to tolerate, statins
*Need high doses, 2-3 g/day
*Decreases VLDL & LDL, increases HDL
*Adverse: Flushing/hot flashes, GI upset. *Interventions: ASA 30 minutes prior to prevent flushing

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16
Q

fibric acids/fibrates prototype, etc

A

*gemfibrozil (Lopid)
*MOA: unknown
*Use: high cholesterol
*Adverse: GI distress, watch for bleeding with patients on anticoagulants, flu-like sx

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17
Q

nursing implications of fibric acids/fibrates

A

*Take with food to prevent GI distress
*Increases risk of bleeding if used with Coumadin.
*Avoid concurrent use with statins (increased risk of rhabdo)

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18
Q

General Cholesterol Medication Information

A

-Should be discontinued during pregnancy.
-Take medication in PM
-Monitor liver and renal function.
-Low fat, high fiber diet.
-Side Effects: Muscle aches, hepatotoxicity, myopathy, rhabdomyolysis, peripheral neuropathy

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19
Q

kidneys secrete what?

A

*Renin - B/P regulation
*Erythropoietin - stimulate RBC production
*Calcitriol - active form of vitamin D for bone homeostasis

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20
Q

diuretics decrease the preload or the afterload?

A

preload

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21
Q

how to diagnose renal failure

A

*Urinalysis
*Serum creatinine
*Diagnostic imaging
Renal biopsy
**Glomerular filtration rate (GFR)

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22
Q

What’s GFR?

A

*glomerular filtration rate
*Best marker for estimating renal function
*Measure volume of filtrate passing through Bowman’s capsule per minute

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23
Q

furosemide (Lasix)

A

*loop diuretic for hypertension
*-ide
*MOA: block reabsorption of Na & Cl in loop of Henle
*K+ WASTING
*Adverse: electrolyte imbalances, dehydration and hypotension.
monitor K+, B/P, HR and kidney function
**Can cause transient deafness pushed fast

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24
Q

hydrochlorothiazide

A

*thiazide and thiazide-like diuretics
*–thiazide
*K+ WASTING
*Use: hypertension
*Less effective than loop diuretics
*Not effective w/ severe renal failure
*Adverse: electrolyte imbalances (loss of K+ & Na+) so WATCH LEVELS

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25
Q

spironolactone

A

*potassium sparing diuretics
Advantage: diuresis w/out affecting K+ levels
**Watch for hypERkalemia

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26
Q

sodium levels should be…

A

135-145 mEq/L

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27
Q

too much or too little NA+ can cause….

A

SEIZURES

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28
Q

potassium levels should be…

A

3.5-5.0 mEq/L

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29
Q

potassium supplement

A

*potassium chloride (KCl)
*use: to treat hypokalemia
*Adverse: GI irritation (so give with food), hyperkalemia
*contraindicated in patients with chronic renal failure or those taking potassium-sparing diuretics

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30
Q

calcium levels should be…

A

8.5-10.5 mEq/L

31
Q

signs of hypercalcemia

A

bones, stones, abdominal groans, psych overtones

32
Q

signs of hypocalcemia

A

Muscle spasms, cramps, abdominal pain and convulsions. Facial spasms

33
Q

Acidosis: pH below/above _____
Alkalosis: pH below/above _____

A

acidosis = excess acid (pH < 7.35)

alkalosis = excess base (pH > 7.45)

34
Q

To treat alkalosis or acidosis need to know _________

A

the cause

35
Q

what drugs treat hypertension?

A

*primary
-Diuretics
-ACE inhibitors (RAAS)
-ARBs (RAAS)
-Direct renin inhibitors
(RAAS)
-CCBs
*secondary
-Beta-adrenergic receptor
blockers (in heart)
-Alpha1-adrenergic receptor
blockers (in arterioles)
-Alpha2-adrenergic agonists
-Direct-acting vasodilators
-Peripherally acting
adrenergic neuron blockers

36
Q

what’s ACE stand for?

A

Angiotensin-converting enzyme (ACE) inhibitors

37
Q

what’s ARB stand for?

A

Angiotensin receptor blockers (ARBs)

38
Q

what’s CCB stand for?

A

Calcium channel blockers (CCBs)

39
Q

RAAS drugs and what do they do?

A

*ACES
*ARBS
*Direct renin inhibitors
**dilate arteries

40
Q

enalapril

A

*ACE inhibitor
*-aPRIL
*MOA: vasodilates
*avoid salt substitute! (We’re watching k+ levels)

41
Q

drugs to terminate or prevent dysrhythmias

A

*Sodium channel blockers
*Beta-adrenergic blockers
*Potassium channel blockers
*Calcium channel blockers
*Miscellaneous antidysrhythmic drugs

42
Q

propranolol

A

*AKA beta blockers
*MOA: slows <3, antidysrhythmic
*Adverse: bradycardia, hypotension, bronchospasm, HYPERglycemia
*hold if apical pulse is less than 60!

43
Q

lidocaine

A

*sodium channel blockers prototype
*-cain-
*MOA: Largest group of antidysrhythmics
*Adverse: New dysrhythmia or worsen existing one, Lupus effect, N/V, ab pain, headache, CNS effects
*numbness and tingling indicates overdose

44
Q

potassium channel blockers

A

*amiodarone-banana phone
*MOA: antidysrhythmic
*Adverse: potentially fatal pneumonia-like syndrome, elevated liver enzymes, thyroid dysfunction, skin discoloration, bradycardia, hypotension
*Adverse: New dysrhythmias or worsen existing ones

45
Q

calcium channel blockers, prototype etc.

A

*verapamil
*MOA: antidysrhythmic
Adverse: bradycardia, hypotension, headache, flushed skin, constipation
**watch for reflex tachy!

46
Q

Miscellaneous Antidysrhythmics: Ad_______

A

*adenosine
*MOA: resets the AV node which makes the heart stop
*Use: tachycardia
*Adverse: Creates new dysrhythmias or worsens existing ones
**Adenosine: facial flushing, dyspnea

47
Q

digoxin immune fab

A

*Digibind
*antidote for digoxin overdose
*adverse: hypokalemia

48
Q

digoxin

A

*Miscellaneous Antidysrhythmic
*MOA: increases contractility and slows down heart
*Use: heart failure
*Adverse: Creates new dysrhythmias or worsens existing ones
*SMALL MARGIN OF SAFETY
*if on dig, probably also on a loop diuretic (so, losing K+) = likely get dig toxicity

49
Q

Miscellaneous Antidysrhythmics: At_______

A

*atropine
*increases firing of SA node, speeds things up
*Used in bradycardia
*Monitor for dry mouth, blurred vision, photophobia, urinary retention, and constipation b/c it’s an ANTI-CHOLINERGIC

50
Q

can treat acidosis with _____ (but still need to look for cause to treat)

A

sodium bicarbonate

51
Q

ARBS

A

*angiotensin II receptor blockers
MOA: HTN, MI, <3 failure
*-artans
*losartan
*causes dilation
**monitor BP and K+ (ACE/ARBs can increase K+)
*s/s: headache, dizziness, facial flushing, hypotension, insomnia
*not to be used in 2nd/3rd tri

52
Q

Alpha blockers

A

*-sin sisters
*MOA: arterial dilation to decrease BP
*Doxazosin
*increased risk for hypotension and syncope
*monitor HR and BP
*take in PM to decrease SE
*dizziness, dyspnea, fatigue, HA, hypotension

53
Q

thrombolytics, prototype etc

A

*alteplase
*dissolve life-threatening clots (MI, CVA)
*abnormal bleeding; contraindicated in patients with bleeding disorder, recent trauma, or surgery

54
Q

aspirin

A

antiplatelet drug
*Used for MI (Mona: morphine, oxygen, Nitroglycerin, aspirin)

55
Q

BNP

A

*brain natriuretic peptide is an enzyme put out by your heart when it starts to stretch (BNP)
*lab we watch for congestive heart failure
*Normally it’s less than 100

56
Q

Dabigatran

A

*new anticoagulant
*Stop med 1-2 days before surgical procedures
*SE: Bleeding, GI discomfort.
**do not take missed dose within 6 hours of next dose, watch for GI bleeding, avoid NSAIDs, ASA

57
Q

Enoxaparin 1/2

A

*Low-molecular-weight Heparins
*anticoagulant
*watch platelets and PTT

58
Q

Dalteparin 2/2

A

*Low-molecular-weight Heparins
*anticoagulant
*watch platelets and PTT

59
Q

Digoxin toxicity

A

*Visual changes, anorexia, n/v, diarrhea, headache, drowsiness, irritability/confusion, bradycardia

60
Q

drugs to treat heart failure

A

1st: ACES
2nd: diuretic when your ADL’s are affected

61
Q

drugs to treat hypertension

A

1st: diuretic
2nd: ACES only after lifestyle changes have failed

62
Q

Epoetin alfa

A

*Erythropoietin Hematopoietic growth factors (hormone)
*stimulate RBC’s
*Adverse: HTN, HA

63
Q

anticoagulants

A

*heparin
*prevent thrombi from forming
*reversal agent: protamine sulfate

64
Q

how do drugs for dysrhythmias work?

A

by blocking calcium, sodium, potassium ions

65
Q

Vasodilator for Heart Failure

A

*Hydralazine
*for high BP, direct acting vasodilator
*Vasodilates & reduces symptoms of heart failure by decreasing cardiac workload
*watch for reflex tachycardia

66
Q

nitroglycerin

A

*for angina
*vasodilates
*can take 3 5-minutes apart then call 911
*#1 side effect is headache

67
Q

Phytonadione

A

*reversal agent for anticoagulants
*this is the generic name for Vitamin K
*it’s reversal agent: Warfarin

68
Q

Reversal agent for anticoaguants?

A

phytonadione

69
Q

reversal agent for heraprin

A

Protamine sulfate
**given if potassium is too high!

70
Q

Warfarin

A

*anticoagulant
*reversal agent: phytonadione
*watch PT and INR

71
Q

lab to watch for heparin and low-molecular weight heparins

A

PTT

72
Q

Sodium polystyrene sulfate

A

brings down potassium level by making you poop

73
Q

watch for with vasodilators

A

reflex tachy and drop of BP

74
Q

heparin

A

*anticoagulant, antithrombotic (prevention of thrombus formation)
*use extreme caution with hemorrhagic stroke
*monitor PTT levels
*Protamine sulfate is the antidote

Pharm (8 decks)

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