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NCLEX > Cardiology > Flashcards

Cardiology Flashcards

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1
Q

What drugs are used in HTN emergencies and ICU settings?

What are important s/e?

A

Direct Acting Vasodilators: Hydralazine; Nipride (Nitroprusside; ET for pulmonary vasodilation)

S/e: REFLEX TACHYCARDIA, syncope, hypotension, headache

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2
Q

What is the 1st line of tx for HTN?

  • MOA
  • Characteristics
  • Common drug (1)
A

Diuretics lower BP by increasing urine output.
- Furosemide (Lasix)

s/e:

  • Ototoxic (hearing/vision loss)
  • Nocturia
  • Dehydration
  • High drug-drug interactions

*Monitor electrolyte levels (hyperglycemia, hypo/hyperkalemia, hyponatremia)

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3
Q

Hydrocholorothiazide (HCTZ)

A

Thiazide: blocks reabsorption of Na, Cl, K @Distal convoluted tubule
- Caffeine + ETOH enhances its hypotensive effects

s/e:

  • Hyponatremia
  • Hypokalemia
  • Hyperglycemia (insulin resistance)
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4
Q

Cholorothiazide (Diuril)

A

Thiazide: blocks reabsorption of Na, Cl, K @Distal convoluted tubule

Caffeine + ETOH enhances its hypotensive effects

s/e:

  • Hyponatremia
  • Hypokalemia
  • Hyperglycemia (insulin resistance)
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5
Q

Metolazone (Zaroxolyn)

A

Thiazide: blocks reabsorption of Na, Cl, K @Distal convoluted tubule
- Caffeine + ETOH enhances its hypotensive effects

s/e:

  • Hyponatremia
  • Hypokalemia
  • Hyperglycemia (insulin resistance)
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6
Q

Spironolactone (Aldactone)

- t1/2?

A

K-sparing: blocks renal aldosterone receptors @Distal tubule
- Long t1/2: 1-2 days

s/e: hyperkalemia

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7
Q

What circumstances are Mannitol (Osmitrol) / Isosorbide typically used in?

What class of drugs are they? What is their MOA?

A

Osmotic diuretics
Tx for cerebral edema + intraocular HTN

  1. Pulls water into renal circulation
  2. Inhibits Renin release
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8
Q

What drug class does Labetalol belong to? What is it used to treat?

A 
Adrenergic antagonist (antihypertensive)
Tx: Pre-eclampsia
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9
Q

What is the recommended therapeutic dose for Ginseng?

A

20-30 mg/day

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10
Q

Losartan (Cozaar)

A

ARB

s/e: hypotension

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11
Q

Hyazaar HCT

Cosart-H

A

Thiazide + ARB combo

Tx: HTN and HF

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12
Q

Aldactazide - what drug combo is it? Why is it a good option for HTN tx?

A

K+ sparing and Thiazide combo

  • Balances out K+
  • Excellent maintenance HTN therapy
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13
Q

Ibesartan (Avapro)

A

ARB

s/e: hypotension

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14
Q

What are first line medications for HF? What are the s/es?

A

ACE inhibitors
s/e: severe hypotension

  • Enalapril (Vasotec)
  • Captopril
  • Monopril
  • Ramipril (Altace)
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15
Q

Nifedipine (Adalat)

A

CCB: vascular selective

s/e:

  • Dizziness, flushing, hypotension
  • Reflex tachycardia
  • Peripheral edema
  • Dysrhythmias
  • Exacerbation of HF
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16
Q

Amlodipine (Norvasc)

A

CCB: vascular selective

s/e:

  • Dizziness, flushing, hypotension
  • Reflex tachycardia
  • Peripheral edema
  • Dysrhythmias
  • Exacerbation of HF
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17
Q

Verapamil (Isoptin)

A

CCB: cardio selective

s/e:

  • Dizziness, flushing, hypotension
  • Reflex tachycardia
  • Peripheral edema
  • Dysrhythmias
  • Exacerbation of HF
18
Q

Diltiazem (Cardizem)

A

CCB: cardio selective

s/e:

  • Dizziness, flushing, hypotension
  • Reflex tachycardia
  • Peripheral edema
  • Dysrhythmias
  • Exacerbation of HF
19
Q

Prazosin and Phentolamine

A

Alpha receptor blockers (adrenergic antagonist)

= peripheral vasodilation

20
Q

What is the normal fx of Alpha-1 adrenergic receptors?

A

PERIPHERAL VASOCONSTRICTION

  • Dilate pupils
  • Increase closure of internal urinary sphincter
  • Stimulate secretions (salivary glands)
21
Q

What is the normal fx of Alpha-2 adrenergic receptors?

A

PERIPHERAL VASOCONSTRICTION

  • Decrease GI motility
  • Decrease smooth m. motility
  • Contract male genitalia during ejaculation
22
Q

What drug class do Atenolol*; Propranolol**; Metoprolol belong to?

A

Beta blockers (stimulate heart)

  • Atenolol - vasodilation
  • *Propranolol - antiarrhythmic
23
Q

What is the normal fx of beta-1 receptors?

A

Cardiac muscle

  • Increase myocardial activity
  • Increase HR
  • Increase renin release
24
Q

What is the normal fx of beta-2 receptors?

A

Smooth muscle in BVs, bronchi

  • Vasodilation/Bronchodilation
  • Increase glycogenolysis in muscle + liver = Incease glucagon release from alpha cells (pancreas)
25
Q

Lopressor HCT

A

Diuretic + Adrenergic antagonist

26
Q

Clonidine; Methyldopa**

Tx?

A

Centrally-acting Alpha-2 Adrenergic Agonist

  • NOT 1st line of HTN therapy
  • *Methyldopa = prodrug

Tx: RESISTANT HTN

s/e:

  • Hypotension
  • Headache
27
Q

What effects do anti-arrhythmic medications often induce?

A
  1. Slow conductivity b/w nodes + fibres

2. Synchronized cardial aversion (letting the heart restart by stopping all activity momentarily)

28
Q

What is atrial fibrillation?
What are the clinical presentations? (3)
What is the tx protocol?

A

Blood stasis so heart can’t complete systole

Presentations:

  • Irregular HR
  • Clot formation/Coagulation
  • Altered Q

Tx protocol:

  1. Assess cardiac fx
  2. Meds: epinephrine > CCB (CS) > Beta blockers
29
Q

MOA of Centrally-acting Alpha-2 Adrenergic Agonists?

Tx for _____?

A

Directly stimulates CNS Alpha-2 receptors in vasomotor centre.

Decreases presynaptic Ca levels > Inhibits release of NE > Net decrease in sympathetic tone in BV

Tx: RESISTANT HTN

30
Q

List the classes of drugs used to treat hypertension.

A
  • Direct acting vasodilators
  • Duretics
  • Renin-Angiotensin: ACE inhibitors, ARBs
  • CCB
  • Adrenergic antagonists
  • CA A2 Adrenergic agonists
31
Q

What are centrally-acting Alpha2 Adrenergic Agonists used to treat? What is the MOA?

A

Resistant HTN

MOA: stimulates CNS alpha2 receptors in vasomotor centre directly

32
Q

What is dilated cardiomyopathy?

What is its treatment?

A

It is when the ventricle stretches and thins out, impairing the heart’s contractility.

Treatment

  • If low CO = Acute HF tx
  • If long term = heart transplant
33
Q

What are the mechanisms of anti-arrhythmics? (3)

A
  1. slow SA-AV node conduction
    - Digoxin
  2. Depress ectopy (abnormal heartbeats) @ ventricular level
  3. Enhance normal AV conduction
    - Lidocaine (Na channel)
    - Amiodarone (K channel)
34
Q

What is SVT and what are the treatments for it?

A

Type of arrhythmia where a group of abnormally rapid heartbeats start in the atrias d/t issues with electrical system

Treatment:

  1. Cardioversion (vagal manuvers)
  2. Adenosine (inhibits cerebral synapse at receptors; sedative)
  3. Anti-arrhythmics
35
Q

Which class of drugs do the following belong to?

  • Lidocaine
  • Amiodarone
  • Adenosine
A

Anti-arrhythmics

  • Lidocaine (Na channel)
  • Amiodarone (K channel)

Sedative
- Adenosine (used for SVT tx)

36
Q

Abdominal Aortic Aneurysm

A

A bulge formed in a distended aorta d/t weak vessel wall.

Sx:
- Often asymptomatic
- Bruits*
- Back + abdomen pain (esp if ruptured = hypovolemic shock)

37
Q

Aortic Dissection

A

A tear in the aorta intima, creating a false lumen that blood pools into

If ruptures = cardiac tamponade

Type A (heart and above)
- progresses quickest
- Significant change in SBP in arms

Type B (below heart)

Tx: lower HR first, then lower BP (or else reflexive tachycardia)

38
Q

Cardiac tamponade
- Signs (4)

A

Blood pools in pericardium sac

Sx:
1. Narrow PP
2. Muffled heart sounds
3. Hypotension
4. JVP distention

39
Q

Pulsus paradoxus

A

When SBP decreases with inspiration caused by cardiac tamponade

ABNORMAL = >10mmHg difference in pressure

40
Q

How to measure orthostatic hypotension?

A

Wait 2-5 min b/w each position.

Tell HCP if SBP difference is >20mmHg
DBP difference is >10mmHg

NCLEX (19 decks)

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