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
Q

Danger of Nifedipine

A

Reduce ventricular contractility, worsening angina, avoid in HF

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26
Q

Nondihydropyridines

A

Diltiazem and Verapamil

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27
Q

3 uses for CCB

A

HTN, angina, Arrhythmia(supraventricular tachyarrhythmias)

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28
Q

CCB less effective on cardiac tissue

A

dihydropyridines(amlodipine and nifedipine), it works more on the peripheral system

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29
Q

SE of CCB

A

HA, peripheral edema, leg edema, bradycardia(due to AV node)

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30
Q

which CCB can cause AV block and worsening heart failure

A

NonDihydropyridines(diltiazem and verapamil)

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31
Q

which CCB causes flushing and which ones cause constipation

A

nifedipine. diltiazam and verapamil

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32
Q

SE of K++ sparing diuretics

A

hypokalemia, gynecomastia, sexual dysfunction

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33
Q

hydralazine MOA and SE

A

causes release of nitric oxide and increases HR

lupus like syndrome, pericarditis

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34
Q

inotropes

MOA and meds

A

increase cardiac output by increasing contractility and it also increases BP.
-dobutamine, dopamine, epi

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35
Q

chronotropes MOA and meds

A

alter HR.

  • positive: adrenaline
  • neg: digoxin
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36
Q

avoid what in WPW

A

adenosine

37
Q

meds to reduce mortality in CHF

A

BB with ACE

38
Q

ACE MOA and pts to use in

A

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
Q

ACE SE

A

angiodema, rash, leukopenia, HYPERkalemia

40
Q

ARB SE

A

leukopenia, rash, HYPERkalemia

41
Q

Avoid in cocaine users

A

BB

42
Q

What worsens claudication

A

BB

43
Q

Tx for HTN urgency

A

ACE, BB, Clonidine

44
Q

Tx for HTN emergency

A

Nitroprusside, Nicardipine, Labetolol

45
Q

avoid what in renal dysfunction patients

A

ACE

46
Q

B1

A

increase C.O. by raising HR by increasing impulse conduction, increases renin secretion

47
Q

B2

A

relax smooth muscle(including bronchials), increases renin secretion

48
Q

3 things BB do

A
  • reduce HR
  • reduce contractility
  • decrease renin production and this lowers plasma volume
49
Q

when to use BB(4)

A

HTN, angina, CHF, Post MI to prevent another MI

50
Q

BB SE (8)

A

bronchospasm, bradycardia, CHF exacerbation, impotence, fatigue, depression, N/V, hypoglycemia

51
Q

Alpha blockers do what

A

prevent sympathetic vasoconstriction

52
Q

SE of alpha blockers

A

postural hypoTN

53
Q

What does angiotensin II do?

A

vasoconstriction and stimulates aldosterone secretion causing kidneys to reabsorb more Na and water

54
Q

adenosine

A

slows conduction time through AV node, interrupts reentry pathways

55
Q

digoxin

A

direct action on cardiac muscle and indirect action of CV system

56
Q

Life threatening V tach or V fib

A

flecainide,propafenone (Na channel blocker)

57
Q

how do nitrates work

A

venodilation to decrease preload and O2. also coronary artery dilation to increase blood flow.

58
Q

dig toxicity (sx, test, tx)

A

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
Q

common arrthymia with dig toxicity

A

premature ventricular contractions; nothing specific

60
Q

med for Afib with low EF

A

digoxin; slows rate

61
Q

which heart failure is digoxin for

A

systolic! improves EF

62
Q

med for chronic Afib with concurrent CHF

A

digoxin

63
Q

contraindications to digoxin

A

Vfib and heart block

64
Q

statin

A

lower HDL and TG; inc LFT, myositis, warfarin potentiation

65
Q

fibrates (lipoprotein lipase stimulators) effect and SE

A

dec Tg and inc HDL; cholelithiasis, myositis, inc LFT, GI upset

66
Q

cholesterol absorption inhibitors(Ezetimibe) effect and SE

A

dec LDL; diarrhea, abd pain, maybe angiodema

67
Q

niacin effect and SE

A

inc HDL, dec LDL; flushing that be prevented with aspirin, paraesthesias, pruritis, inc LFT, GI pain

68
Q

bile acid resins(cholestyramine, colestipol, colesevelam) effect and SE

A

dec LDL; myalgias, constipation, LFT abn, GI upset; can dec absorption of other drugs in small intestine

69
Q

CAD tx

A

statin, BB, aspirin right away

70
Q

BB 3 functions and se

A

Dec Bp, co, hr

Se: avoid in acute HF pts, BS, breathing issues

71
Q

BB 3 functions and se

A

Dec Bp, co, hr

Se: avoid in acute HF pts, BS, breathing issues

72
Q

Ace se

A

Angioedema, low K++

73
Q

Ace and aldosterone

A

Let’s body not hold onto water and sodium

74
Q

Ccb

A

Think Calcium “CONTRAcTS”
Relaxes blood vessels to bring more oxygen to the heart and decrease workload

75
Q

Cardiac glycoside

A

Help heart pump more effectively

Digoxin (lanoxin)

Uses calcium and sodium in cells to contract, improves circulation and decrease edema in body

76
Q

Digoxin on HR…

Use on who

Avoid in who

A

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
Q

Safe digoxin level

SE 4

Toxicity SE/causes

A

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
Q

Diuretics used in what 4 cases

A

Htn, hrt failure, edema, CKD

79
Q

Loops suffix

Moa /location

K++

A

Nide and mide

Inhibits reabsorption of sodium and chloride in proximal/distal tubules, loop of henle

K wasting

80
Q

How to take potassium PO

IV

A

With a full glass of water in a meal to prevent G.I. upset 

Infusion pump and diluted if doing IV 

81
Q

How do you administer for furosemide 

A

IV, slowly to prevent ototoxicity 

82
Q

Moa thiazide

A

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
Q

What med can cause hyperuricemis?

A

Thiazide

84
Q

What to avoid if your patient has a sulfa allergy 

A

Thiazide

85
Q

What 2 meds block aldosterone

A

Ace and spirinolactone

86
Q

Foods high in k++

A

Green, leafy vegetables, tomatoes, raw carrots, orange juice, bananas, lemon, and limes

Salt substitutes 

87
Q

Osmotic, diuretic mode of action

A

Increase the thickness of the filtrate =
So that water cannot be re-absorbed into the bloodstream 

88
Q

Osmotic, diuretic name and uses

A

Mannitol
Used to decrease swelling and pressure. Treat cerebral edema and decrease intraocular pressure. 

89
Q

Three nursing considerations for the osmotic mannitol

A

Only given IV
Solution may crystallize so check it prior
Perform neural assessments