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VEEB > Cardio System(Pharm) > Flashcards

Cardio System(Pharm) Flashcards

1
Q

Nitroprusside(Nipride)

A

-Nitroprusside(Nipride)

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2
Q

Dopamine(Intropin)

A

-Dopamine(Intropin)

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3
Q

Epinephrine(Andrenalin)

A

-Epinephrine(Andrenalin)

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4
Q

Warfarin Na(Coumadin)

A

-Warfarin Na(Coumadin)

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5
Q

Amlodpine(Norvasc)

A

-Amlodpine(Norvasc)

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6
Q

Lisinopril(Prinivil)

A

-Lisinopril(Prinivil)

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7
Q

Captopril(Capoten)

A

-Captopril(Capoten)

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8
Q

Amiodarone Cl(Cordarone)

A

-Amiodarone Cl(Cordarone)

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9
Q

Ticlopidine(Ticlid)

A

-Ticlopidine(Ticlid)

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10
Q

Clopidogrel(Plavix)

A

-Clopidogrel(Plavix)

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11
Q

Simvastatin(Zocor)

A

-Simvastatin(Zocor)

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12
Q

Digoxin(Lanoxin)

A
  • Digoxin(Lanoxin)
  • cardiac glycoside
  • cardiotonic
  • po,im,iv
  • loading dose(0.5-1.25 every 6-8hrs initially
  • maintenance dose(0.125-0.25mg daily)
  • 0.8-2.0ng theraputic dig level
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13
Q

Procainamide(Pronestyl)

A

-Procainamide(Pronestyl)

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14
Q

Lidocaine(Xylocaine)

A

-Lidocaine(Xylocaine)

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15
Q

Isosorbide(Isordil)

A
  • Isosorbide(Isordil)
  • NItrate drug
  • coronary vasodilator
  • po,chewable,sublingual
  • sublingual-under tongue, dont drink,smoke,eat after
  • taking on empty stomach
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16
Q

Propanolol(Inderal)

A

-Propanolol(Inderal)

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17
Q

Dilitiazem(Cardizem)

A

-Dilitiazem(Cardizem)

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18
Q

Nifedipine(Procardia)

A

-Nifedipine(Procardia)

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19
Q

Verapamil(Isoptin)

A

-Verapamil(Isoptin)

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20
Q

Methyldopa(Aldomet)

A

-Methyldopa(Aldomet)

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21
Q

Enoxaprin(Lovenox)

A

-Enoxaprin(Lovenox)

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22
Q 
Cardiac Glycosides(Cardtiotonics) ACTION:
DIGOXIN
A

action:

  • act directly on the myocardium to slow down conduction and increase the force of myocardial contraction
  • increase cardiac output through positive inotropic activity
  • decrease conduction velocity through the SA/AV nodes
  • result increase efficency and improved contraction of the heart muscle
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23
Q

Cardiac Glycosides(Cardtiotonics)
DIGOXIN
INDICATION:

A

indication:

  • heart failure
  • atrial fibrilation
  • supraventricular tachycardia
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24
Q

Cardiac Glycosides(Cardtiotonics)
DIGOXIN(LANOXIN)
Route/Dose:

A

-po,im,iv
-digitalization: a series of doses given until the drug begins to exert full therapeutic effect
Dose:
-loading dose: 0.5-1.25mg every 6 to 8hrs initally
-maintainance dose: 0.125-0.25mg daily
-Theraputic dig level: 0.8-2.0ng
-over 2.0 is toxic

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25
Q

Cardiac Glycosides(Cardtiotonics)
DIGOXIN
Side effect:

A

Gi: early signs=N&V, anorexia,diarrhea

Neuro: headache,facial pain,apaty,drowsiness,disorientation,confusion,mental depression,delirium, convulsion

Visual: blurred,galo,diplopia,colored vision,yellow vision

Cardiac: bradycardia,tachycardia,extra systole,extra beats,atrial fibrilation and flutter

early signs of toxicity=nausea,vomitting, anorexia,diarrhea

later signs of toxicity=changes in mental status

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26
Q

Early signs of toxicity(Digoxin)

A

nausea,vomitting,anorexia,diarrhea

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27
Q

Later signs of toxicity(Digoxin)

A

changes in mental status

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28
Q

Factors that predispose patient to digoxin toxicity

A
  • increase potassium
  • decrease potassium
  • decrease magnesium
  • renal impairment
  • recent mi and iv administration
  • hypothyrodism-slows metabolism
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29
Q

Treatment of digoxin toxicity

A

1-withdraw drug(hold med)
2-treat the dysrrythmia with dilantin
3-atropine for bradycardia

antidote for digoxine is digibind not first line choice b/c drug is life threatening

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30
Q

Digoxin(Lanoxin) Nursing implication

A
  • digoxin onset action 30min peak 2hrs, duration 2-6day
  • i/o-weight-examine extremities for edema
  • 2lbs per day or 5lbs per week must be recorded
  • B/P-respiration-sputum ausculate lungs
  • assess for jugular vein distention=fluid retention
  • assess apical heart rate one full minute
  • take same time each day
  • oral preparation w/o regards to meals
  • avoid antacid
  • decrease k levels, increase k levels
  • poorly absorbed IM
  • periodic EKG-electrolytes/kidney function
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31
Q

Digoxin(positive outcomes)Cardiac Glycosides(Cardtiotonics)

A
  • increase urine output
  • decrease weight
  • decreae edema
  • decrease SOB
  • decrease fatigue
32
Q

Digoxin(interactions)Cardiac Glycosides(Cardtiotonics)

A
  • antibiotics:macrolides,tetracycline
  • antifungal: ketoconozole
  • NSAIDs
  • Benzodiazepine: xanax
  • antiarrythmic-verapermil
  • antacids-kapectate
  • thyroid hormone
  • antileptics
  • oral aminoglycoside
  • antitubercular-rifampin
  • antineoplastic
33
Q

Phosphodiesterase Inhibitors(Action)
Amirone
Primacor

A
  • positive inotropic activity

- vasodilating properties

34
Q

Phosphodiesterase Inhibitors(indication)
Amirone
Primacor

A

-short term management of heart failure when digioxin doesnt work

35
Q

Phosphodiesterase Inhibitors(adverse reaction)
Amirone
Primacor

A
  • n/v
  • arrythmias
  • sudden death
  • not first line treatment
  • hypotension
36
Q

Phosphodiesterase Inhibitors(drugs)
amirone
primacor

A

amirone

primacor-20-30x stronger than amirone

37
Q

Atrial Natriuretic peptide hormone(ANP)

Action

A
  • inhibit the renin angiotension aldosterone system
  • binds w/ smooth vascular muscle-cause vasodilation
  • reduce intravascular fluid volume
38
Q

Atrial Natriuretic peptide hormone(ANP)(Indication)

A

-CHF w/ dyspnea at rest

39
Q

Atrial Natriuretic peptide hormone(side effect)

A
  • hypotension
  • decrease kidney function
  • drop in Bp
40
Q

Antiarrythmic drug

A
  • used to teat abnormal electrical activity in the heart.
  • act in different ways to diminish or obliterate arrhythmias
  • antiarrhythmic agents are divided into four classes/groups based on their similarity of their action
41
Q

Sodium Channel Blockers(CLass 1)

A

-blocks movement of sodium into myocardial cells
use:
-anesthetic like effect on myocardial cells
-ventricular tachy arrthymia
-used only in benefits outweigh the risk
-patient who are dying

Drug: Moriazine HCL(Ethnozine)

42
Q

Quinidine(Class 1A)(ACTION)

A

origin: cinchonobark
action: membrane stablizing effect on myocardial cells to decrease excitability

43
Q

Quinidine(Class 1A)(indication)

A

used for:

  • atrial and ventricular arrythmia
  • first line treatment for malaria
44
Q

Quinidine(Class 1A)(adverse effect)

A
  • cinchinism=effect cns=neurotoxicity=gi/neuro effect
  • gi: n/v, anorexia,diarrhea
  • cardiac: hypotension, vtach,vfib,embolism
  • hypersensitivity: mild to severe
  • bone marrow suppression
45
Q

Quinidine(Class 1A)(interaction)

A
  • anticoagulants: increase bleeding
  • antacid: decrease absorbtion
  • digoxin,betablock,ca chan bloc: increase cardiac depression
46
Q

Quinidine(Class 1A)(Nursing implication)

A
  • monitor apical pulse
  • po w/meals
  • avoid citrus
  • shell in stool-sustained release
  • iv test dose-supine position
  • monitor k level
  • monitor serum levels=2-6mcg
47
Q

Quindine drugs

A

Disopyramide

action: decrease rate of absorption
adr: atropine like
contraindication: atropine like
use: ventricular arrhythmia
dose: q6 100-150mg
atropine: treat bradycardia

procainamide
indication: first line drug of choice for vtach/vfib/pulselessness*
route:po,parental
dose:250-500mg
adr: cross sensitivity w/ procaine
gi irritation
drowsiness
dizziness
joint pain, butterfly rash(lupus like symptoms)
blood dyscaria
48
Q

Lidocaine(Xylocaine)-Class 1B(action)

A

action:increase threshold of myocardial cells. decrease myocardial excitability

49
Q

Lidocaine(Xylocaine)-Class 1B(indication)

A
  • premature ventricular contraction post mi

- dose 100mg bolus,then 400mg in 500ml d5w infuse mg/kg/min

50
Q

Lidocaine(Xylocaine)-Class 1B(adverse effects)

A
  • neurological-dizzy,drowsy,confusion
  • decrease heart rate
  • resp depression
  • gastrotoxic
51
Q

Mexiletin-class 1b

A

po lidocaine

  • all gastrotoxic
  • all neuro toxic
  • given po
52
Q

phenytoin(dilatin)-class 1b-

A

antriarrythmic/hydantoin/anti-convulsant

-only to treat digoxin induced arrhythmia

53
Q

Flecainidie-class 1C

A

action: decrease conduction in bundle of his and purkinjie fibers
indication: severe ventricular arrhythmia
route: po

54
Q

Beta Blockers-class 2

A

1st/2nd generation
-2nd generation more cardia selective=decrease bronco spasm incidences/decrease risk of adverse effect
action: reduce sympathetic excitation in the heart by blocking cardiac cell response to epinephrine
indication/use:supraventricular arrhrythmia

55
Q

Beta Blockers-class 2(drug)

A
  • propranolol hcl(inderal)-
  • 10mg 3x day TID
  • every 8hrs evenly spaced around the clock
  • treatment plan for migraine
  • indication: hypertension,angina,migraine,panic attack/stage freight, treat

-metoprolol tartrate(lopressor)

56
Q

Beta Blockers-class 2(side effect)

A
  • gi: n/v
  • resp: tachypnea, wheezing, dyspnea,broncospasm
  • cardiac: hypotension(inhibit renin-angiotension),bradycardia,cardiac arrhythmia,angina,chf
  • endocrine:hypoglycemia
  • reproductive-impotence
  • circulatory: Raynauds phenomenom=spasms in blood vessels effecting circulation
  • neuro-fatigue
  • skin: rash, purtitus
  • mood: mental depression
  • interaction: drugs that decrease b/p an pulse
  • contraindication: COPD,PVD, heart disease and diabetes
57
Q

Potassium Channel Blockers(action)

A

action: lengthen action potential of myocardial cells

58
Q

Potassium Channel Blockers(Drugs)

A

-Bretylium Tosylate-causes severe hypotension

  • Amiodarone HCL(cordarone)
  • vasodilating properties,decrease hr
  • decrease contractibility of left ventricle
  • negative inotropic
  • side effect-sandy eyes,discoloration of skin blue/gray,photosensitivity,hypotension,pulmonary toxicity
  • Adenosine(Adenocard)
  • natural chemical found in all cells
  • aides in transfer of energy
  • increase release of prostaglandins
  • decrease platale aggrgation(bleeding)
  • drug of choice for: SVT

-i/v protect from crystallization

59
Q

Calcium Channel Blocker(class 4)(action)

A
  • block ca uptake by myocardial cells
  • decrease force of contraction
  • decrease cardiac output
60
Q

Calcium Channel Blocker(class 4)(side effect)

A
  • same as beta blocker
  • hepatoxicity
    gi: n/v, PLUS SWOLLEN GUMS
  • resp: tachypnea, wheezing, dyspnea,broncospasm
  • cardiac: hypotension(inhibit renin-angiotension),bradycardia,cardiac arrhythmia,angina,chf
  • endocrine:hypoglycemia
  • reproductive-impotence
  • circulatory: Raynauds phenomenom=spasms in blood vessels effecting circulation
  • neuro-fatigue
  • skin: rash, purtitus
  • mood: mental depression
  • interaction: drugs that decrease b/p an pulse
  • contraindication: COPD,PVD, heart disease and diabetes
61
Q

Calcium Channel Blocker(class 4)(indication)

A

-use to treat (atypical)angina,hypotension,tachy-arrythmia

62
Q

Calcium Channel Blocker(class 4)(drugs)

A

Amlodipine(norvasc)-
Diltiazem HCL(cardizem)-
Nifedipine(Procardia)-
Verapamil(Calan)-used for SVT-AFIB

63
Q

Anticholinergic

A

-bradycardia
-prodysrhythmic effect of antiarrhythmic drug
drug used: atropine/anti-cholinergic
ADE: mad as hatter, red as a beat, blind as a bat, dry as bone
-elevated temp, confusion,blurry vision, flushed skin

64
Q

Antianginal/vasodilators

A

types: 1)peripheral2)coronary

a. nitrates b.beta blockers c.calcium channel blocker

65
Q

peripheral vaso dilators(action)

A
  • relax the smooth muscle layer of atrerial blood vessels
  • block alpha adrenegic receptors and stimulate beta adrenegic receptors
  • dilate vascular bed in the femoral blood vessels
  • inhibit platelet aggregation=risk for bleeding
66
Q

peripheral vaso dilators(indication)

A

-intermittent claudication,PVD,Raynauds disease or burgers disease

67
Q

peripheral vaso dilators(side effects)

A
  • lowbp=hypotension
  • every vasodilater has ability to drop bp
  • flushing,tingling,dizziness,nervousness,postual hypotention, tachycardia, gi irritation, orthostatic hypotension
68
Q

peripheral vaso dilators(interaction)

A

-betablockers-also hypertensive so cause greater hypertensive effect

69
Q

peripheral vaso dilators(nursing implication)

A
  • change in position slowly
  • stop smoking b/c contricts vessels
  • decrease cholesterol intake
  • decrease caffeine intake=vaso contrictor
  • caution pt with bleeding tendencies
  • footcare: assess peripheral circulation: color,temp,pulses,edema,pain,foster circulation,pedal pulse cap refill in toes
  • exercise to promote circulation
70
Q

Coronary vaso dilator

A

indication: angina pectoris
action: opens coronary blood vessels, decrease cardiac workload, decrease cardiac oxygen consumption,increase risk for edema

71
Q

Nitrate(coronary vasodilator)(Drug)

A

isosorbide dinitrate(isordil)-po, chewable,sublingual

  • taken on empty stomach
  • 1 before - 2hrs after
72
Q

Nitroglycerin(Sublingual)

A

ac. attack of angina pectoris
- take at 5min interval, if no relief call md and go back to hospital
- dose: 0.4mg
- pain disappear in 1-3 min
- throbbin headache indicates potency
- burning sensation under tongue=potency/freshness of drug
- drop BP, hypotension

73
Q

Nitroglycerin(lingual spray)

A
  • 60-200meter dose

- indication-ac attack,hypertension

74
Q

Nitroglycerin(patch)

A

-comes off at sleep to decrease tolerance

75
Q

Nitroglycerin(IV)

A

-emergency treatment for high bp,vhf,post mi, and hypertension during cardiac surgery

76
Q

Nitroglycein side effect/coranary vasodilator

A

3 H’s

Headache,Hypotension,Increarse heart rate

77
Q

Nitroglycein(interaction)

A
  • tobacco,cold,atropine

- viagra(vaso dilator causes futher dilation)

VEEB (25 decks)

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