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cardio and pulm > cardio meds > Flashcards

cardio meds Flashcards

1
Q

what is mild HTN BP

A

140-149/90-99

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2
Q

FIRST LINE tx for most HTN

A

thiazide

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3
Q

thiazide MOA

A

Lower plasma volume by dec Na resorption at distal convuluted tubule by inhibiting Na/Cl transporter

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4
Q

Diuretics MOA

A

remove excess water and Na; dec amt of fluid flowing through blood vessels to reduce pressure on vessel walls

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5
Q

first line medications list tx for htn

A

thiazide, ccb, ace/arbs

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6
Q

thiazide and calcium

A

increase Ca reabsorption and lower urinary Ca excretion(good for kidney stones)

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7
Q

Electrolyte effect of thiazide

A

hypokalemic metabolic alkalosis, hyponatremia, decreased Mg;
HYPER(G-L-U-C): glycemina, lipidemia, uricemia, calcemia)

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8
Q

FIRST LINE tx for mild HTN

A

Diuretics

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9
Q

Contraindications to thiazides(5)

A

HypoTN, Sulfur allergy, gout, renal failure, hypokalemina, careful in diabetics

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10
Q

loop MOA

A

act on ascending loop of henle inhibiting Na/K++/Cl transporter

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11
Q

where is most of the Na reabsorbed

A

loop of henle

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12
Q

Electrolyte effect of Loops

A

hyperuricemia, decrease K++, Mg, Ca

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13
Q

good and bad side of using Loops

A

Powerful but short acting

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14
Q

Good med for acute pulm edema with renal failure

A

loop

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15
Q

SE of loops

A

ototoxicity but it is reversible

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16
Q

2 MOA of K++ sparing diuretics

A

Block Na exchange sites; and aldosterone antagonists which prevent specific proteins from being created that are part of the Na K++ exchange pump

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17
Q

when to use K++ sparing diuretics

A

SECOND line with another med for acute pulm edema or CHF

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18
Q

Electrolyte effect of K++ sparing diuretics

A

hyperuricemia and dec Mg

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19
Q

FIRST line treatment as monotherapy or with thiazides, ACE/ARB for HTN regardless of age or race

A

CCB

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20
Q

CCB MOA

A

Block Ca channels in blood vessels and cardiac muscle; this prevents Ca from entering the cells reducing muscle contractility–leading to vasodilation and decreased cardiac contractility

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21
Q

What reduces AV node conduction therefore HR; and also reduces aldosterone production

A

CCB

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22
Q

Dihydropyridine

A

CCB(Nifedipine and Amlodipine)

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23
Q

Dihydropyridine MOA

A

Peripheral Vasodilation w/out affecting HR or rate control.

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24
Q

Danger of Dihydropyridines

A

Reflex Tachycardia

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25
Danger of Nifedipine
Reduce ventricular contractility, worsening angina, avoid in HF
26
Nondihydropyridines
Diltiazem and Verapamil
27
3 uses for CCB
HTN, angina, Arrhythmia(supraventricular tachyarrhythmias)
28
CCB less effective on cardiac tissue
dihydropyridines(amlodipine and nifedipine), it works more on the peripheral system
29
SE of CCB
HA, peripheral edema, leg edema, bradycardia(due to AV node)
30
which CCB can cause AV block and worsening heart failure
NonDihydropyridines(diltiazem and verapamil)
31
which CCB causes flushing and which ones cause constipation
nifedipine. diltiazam and verapamil
32
SE of K++ sparing diuretics
hypokalemia, gynecomastia, sexual dysfunction
33
hydralazine MOA and SE
causes release of nitric oxide and increases HR lupus like syndrome, pericarditis
34
inotropes MOA and meds
increase cardiac output by increasing contractility and it also increases BP. -dobutamine, dopamine, epi
35
chronotropes MOA and meds
alter HR. - positive: adrenaline - neg: digoxin
36
avoid what in WPW
adenosine
37
meds to reduce mortality in CHF
BB with ACE
38
ACE MOA and pts to use in
help relax blood vessels by preventing formation of angiotensin(narrows vessels);inhibit bradykinin degradation and stimulate synthesis of vasodilating prostaglandins. good for DM, kidney pt, young white folk
39
ACE SE
angiodema, rash, leukopenia, HYPERkalemia
40
ARB SE
leukopenia, rash, HYPERkalemia
41
Avoid in cocaine users
BB
42
What worsens claudication
BB
43
Tx for HTN urgency
ACE, BB, Clonidine
44
Tx for HTN emergency
Nitroprusside, Nicardipine, Labetolol
45
avoid what in renal dysfunction patients
ACE
46
B1
increase C.O. by raising HR by increasing impulse conduction, increases renin secretion
47
B2
relax smooth muscle(including bronchials), increases renin secretion
48
3 things BB do
- reduce HR - reduce contractility - decrease renin production and this lowers plasma volume
49
when to use BB(4)
HTN, angina, CHF, Post MI to prevent another MI
50
BB SE (8)
bronchospasm, bradycardia, CHF exacerbation, impotence, fatigue, depression, N/V, hypoglycemia
51
Alpha blockers do what
prevent sympathetic vasoconstriction
52
SE of alpha blockers
postural hypoTN
53
What does angiotensin II do?
vasoconstriction and stimulates aldosterone secretion causing kidneys to reabsorb more Na and water
54
adenosine
slows conduction time through AV node, interrupts reentry pathways
55
digoxin
direct action on cardiac muscle and indirect action of CV system
56
Life threatening V tach or V fib
flecainide,propafenone (Na channel blocker)
57
how do nitrates work
venodilation to decrease preload and O2. also coronary artery dilation to increase blood flow.
58
dig toxicity (sx, test, tx)
Sx: N/V, confusion, arrhythmia, abd pain, weakness test: order serum digoxin, serum K++, renal function, EKG(ST seg depression) tx: digoxin antibody fragments and may activated charcoal
59
common arrthymia with dig toxicity
premature ventricular contractions; nothing specific
60
med for Afib with low EF
digoxin; slows rate
61
which heart failure is digoxin for
systolic! improves EF
62
med for chronic Afib with concurrent CHF
digoxin
63
contraindications to digoxin
Vfib and heart block
64
statin
lower HDL and TG; inc LFT, myositis, warfarin potentiation
65
fibrates (lipoprotein lipase stimulators) effect and SE
dec Tg and inc HDL; cholelithiasis, myositis, inc LFT, GI upset
66
cholesterol absorption inhibitors(Ezetimibe) effect and SE
dec LDL; diarrhea, abd pain, maybe angiodema
67
niacin effect and SE
inc HDL, dec LDL; flushing that be prevented with aspirin, paraesthesias, pruritis, inc LFT, GI pain
68
bile acid resins(cholestyramine, colestipol, colesevelam) effect and SE
dec LDL; myalgias, constipation, LFT abn, GI upset; can dec absorption of other drugs in small intestine
69
CAD tx
statin, BB, aspirin right away
70
BB 3 functions and se
Dec Bp, co, hr Se: avoid in acute HF pts, BS, breathing issues
71
BB 3 functions and se
Dec Bp, co, hr Se: avoid in acute HF pts, BS, breathing issues
72
Ace se
Angioedema, low K++
73
Ace and aldosterone
Let’s body not hold onto water and sodium
74
Ccb
Think Calcium “CONTRAcTS” Relaxes blood vessels to bring more oxygen to the heart and decrease workload
75
Cardiac glycoside
Help heart pump more effectively Digoxin (lanoxin) Uses calcium and sodium in cells to contract, improves circulation and decrease edema in body
76
Digoxin on HR… Use on who Avoid in who
Decease hr and bp Increase cardiac function and blood flow Use for htn, cardiac arrhythmias (afib), HRT FAILURE Avoid in MI and v fib
77
Safe digoxin level SE 4 Toxicity SE/causes
0.5-2 Dizzy, gi upset, worsening edema, rash (allergy or toxicity) Toxicity: vision changes, confusion, dizziness, N/V, bradycardia, fatigue Low k++, bad kidneys, elderly (low gfr)
78
Diuretics used in what 4 cases
Htn, hrt failure, edema, CKD
79
Loops suffix Moa /location K++
Nide and mide Inhibits reabsorption of sodium and chloride in proximal/distal tubules, loop of henle K wasting
80
How to take potassium PO IV
With a full glass of water in a meal to prevent G.I. upset  Infusion pump and diluted if doing IV 
81
How do you administer for furosemide 
IV, slowly to prevent ototoxicity 
82
Moa thiazide
Inhibit reabsorption of sodium and chloride on the acending loop of Henley  and early distal tubule K++ wasting must monitor Avoid in gout pts and sulfa allergys
83
What med can cause hyperuricemis?
Thiazide
84
What to avoid if your patient has a sulfa allergy 
Thiazide
85
What 2 meds block aldosterone
Ace and spirinolactone
86
Foods high in k++
Green, leafy vegetables, tomatoes, raw carrots, orange juice, bananas, lemon, and limes Salt substitutes 
87
Osmotic, diuretic mode of action
Increase the thickness of the filtrate = So that water cannot be re-absorbed into the bloodstream 
88
Osmotic, diuretic name and uses
Mannitol Used to decrease swelling and pressure. Treat cerebral edema and decrease intraocular pressure. 
89
Three nursing considerations for the osmotic mannitol
Only given IV Solution may crystallize so check it prior Perform neural assessments

cardio and pulm (24 decks)

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