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Pharmacology > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

What three components comprise Total Cholesterol?`

A

LDL, HDL, Triglyceride

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2
Q

What are HDL and LDL, what do they do?

A

High Density Lipoprotein: Removes cholesterol from plaque

Low Density Lipoprotein: Adds cholesterol to plaque

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3
Q

What are statins?

A

HMG-CoA reductase inhibitors

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4
Q

What do statins do?

A

Inhibitor HMG-CoA reductase which leads to a reduction in cholesterol synthesis. This stabilises plaque and reduces the incidence of heart attacks and cardiovascular disease

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5
Q

Statin side effects

A

Constipation, abdo pain, nausea, increased risk of type 2 diabetes. Contraindicated with renal impairment

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6
Q

Statin nursing considerations

A

Check serum lipid levels and instruct the patient not to drink alcohol to further damage their liver

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7
Q

How do bile sequestrants lower cholesterol?

A

Cholesterol is a major precursor to bile salts. Bile acid sequestrants are binding agents that bind cholesterol containing bile acids in the intestine and prevent them from being absorbed. This increases LDL receptor activity promoting hepatic uptake and subsequent breakdown of plasma LDL hence lowering plasma cholesterol concentration

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8
Q

Bile acid sequestrant side effects

A

GI symptoms

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9
Q

What are the four main types of drugs that treat angina?

A

Direct-acting vasodilators, organic nitrates, calcium channel blockers, potassium channel activators

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10
Q

GTN action

A

Relaxes smooth muscle causing vasodilation of peripheral veins and arteries. At large doses arterial dilation occurs also

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11
Q

GTN side effects

A

Throbbing headache, orthostatic hypotension, nausea, vomiting, brachycardia

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12
Q

GTN nursing considerations

A

Resolve hypovolaemia before administration to decrease profound hypotension. Advise patient to sit or lie still to avoid dizziness

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13
Q

How do beta blockers work?

A

They provide beta-adrenergic sympathetic inhibition, hence reducing the body’s response to adrenaline which results in reduction in heart rate, slowed conduction of impulses, decreased blood pressure and reduced cardiac contractility

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14
Q

What causes Angina?

A

Reduced oxygenation of the myocardium

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15
Q

Beta blockers nursing considerations

A

Drop in HR and BP. Can mask symptoms of hypoglycaemia

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16
Q

Name three calcium channel blockers

A

Amlodipine, Verapamil, Diltiazem

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17
Q

What suffix indicates a beta blocker?

A

lol

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18
Q

What does GTN stand for?

A

Glyceryl trinitrate

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19
Q

How do calcium channel blockers work?

A

They inhibit the calcium channels in smooth muscle of the vasculature responsible for muscle contraction. This results in vasodilation

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20
Q

Calcium channel blocker interactions

A

Serum levels may be increased by grapefruit juice. Great caution should be used in conjunction with beta blockers and it may enhance hypotensive effects

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21
Q

Calcium channel blockers nursing considerations

A

Check BP and HR before administration

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22
Q

What 7 drugs are use used to treat unstable angina?

A

Oxygen, GTN, Morphine, Aspirin, Beta-blockers, ACE inhibitors, Anti-coagulants such as heparin

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23
Q

How does aspirin treat angina?

A

It blocks the cyclooxygenase enzyme in the inflammatory pathway which is responsible for platelets aggregation and vasoconstriction.

24
Q

Aspirin side effects

A

Increased RESP rate, GI symptoms, liver toxicity, increased bleeding risk

25
Q

Aspirin nursing considerations

A

Take with food to avoid GI upset and check for signs of gastric irritation. Shouldn’t be taken within 7 days of an invasive procedure

26
Q

How does morphine treat angina?

A

It has strong opioid effects on mu receptors. It reduces preload by decreasing venous return because of venodilation. As well as being a potent analgesic

27
Q

Morphine nursing considerations

A

Check BP prior to administration as it can cause hypotension when given intravenously. Keep a close eye on RESP vitals as overdose can cause respiratory depression

28
Q

How do ACE inhibitors work?

A

They prevent angiotensin I from converting into angiotensin II (which is a powerful vasoconstrictor). This reduces peripheral vascular resistance and blood pressure which reduces strain on the heart

29
Q

ACE inhibitor nursing considerations

A

Diuretic therapy must be stopped to prevent first dose hypotension. Monitor urine for protein, assess BP prior to administration

30
Q

How does Heparin work?

A

It prevents prothrombin converting into thrombin which provides rapid anticoagulation

31
Q

Heparin indications

A

Thromboembolic disorders such as DVT, and complications arising from heart and vascular surgery

32
Q

Heparin nursing considerations

A

Do not rub injection site as it can cause haematoma, rotate site regularly and monitor for signs of bleeding

33
Q

What is LMWH?

A

Low Molecular Weight Heparin

34
Q

How is LMWH different from normal Heparin?

A

It has increased bioavailability and provides an anticoagulant effect for longer. It’s also considered safer and requires less monitoring

35
Q

LMWH indications

A

Used prophylactically against thromboembolic complications before, during and after surgery

36
Q

LMWH nursing considerations

A

Should not be given IM. Regularly monitor platelet concentration throughout therapy and look for signs of bleeding

37
Q

What is Warfarin?

A

Vitamin K antagonist

38
Q

How does Warfarin work?

A

Interferes with vitamin K dependent synthesis of prothrombin which decreases the synthesis of vitamin K dependent anti-coagulation proteins

39
Q

Warfarin indications

A

Prevention and management of venous thrombosis and thromboembolism in atrial fibrillation

40
Q

Warfarin interactions

A

Interacts with alcohol and many other medications which reduces effectiveness. Caution if used with aspirin, Increased activity with cranberry juice

41
Q

Warfarin nursing considerations

A

Has a narrow therapeutic index and its effects are heavily effected by diet, drugs and disease. Takes 24-48 to take effect. Monitor PT and INR

42
Q

How do platelets form a thrombus?

A

They adhere to damaged endothelium and become activated. This draws other platelets which aggregate into a thrombus

43
Q

What are the two types of anti-platelet drugs?

A

P2Y12 inhibitors, Glycoprotein receptor inhibitors

44
Q

What is the gold standard therapy for ACS?

A

Percutaneous coronary intervention. It involves a small venous catheter with a balloon attached is used to widen arteries and remove the blockage

45
Q

What is the common name for fibrinolytic drugs?

A

Clot-busters

46
Q

Which conditions are thrombolytic drugs used for?

A

ST-segment elevation myocardial infarction, pulmonary embolism, acute ischaemic stroke, peripheral embolism, acute ischaemic stroke, peripheral arterial embolism and thrombose cannulae

47
Q

Which drugs are fibrinolytic?

A

Thrombolytic

48
Q

What are the contraindications for thrombolytic drugs?

A

Active internal bleeding, recent major trauma or surgery, recent cerebrovascular accident, bleeding disorder, haemorrhagic retinopathy, intracranial neoplasm, bacterial endocarditis, uncontrolled hypertension

49
Q

Which drug is an antidote to heparin?

A

Protamine Sulphate

50
Q

Which drug is antidote to warfarin?

A

Vitamin K

51
Q

What is AF?

A

Atrial Fibrillation. An irregular and often rapid heartbeat that that is out of rhythm between the upper and lower chambers in the heart

52
Q

How does Digoxin work?

A

It decreases heart rate and strengthens myocontractility by increasing the resting membrane potential of atrial tissue in the AV node

53
Q

Digoxin indications

A

Congestive heart failure, AF

54
Q

Digoxin side effects

A

Nausea, vomiting, abdo pain, arrhythmias, brachycardia

55
Q

Digoxin nursing considerations

A

Monitor BP and HR noting any new arrythmias. Monitor renal function and look for GI disturbances

56
Q

How do Class III antiarrhythmics work?

A

They prolong action potential duration and hence refractory period of atrial, nodal and ventricular tissues. This increases coronary blood flow by vasodilation

57
Q

Which part of the cardiac cycle do Class III antiarrhythmics prolong

A

QT interval, time taken for ventricular depolarisation and repolarisation

Pharmacology (7 decks)

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