Cardiovascular Flashcards
What is the prototype for Direct Renin Inhibitor
Aliskiren
In what patient is DRI contraindicated?
Diabetics taking ARBs and Pregnant Patients
What is Aliskiren typically prescribed for?
patients with hypertension
When giving a patient Aliskiren in pellets what is important patient education
do NOT crush or chew
What lab values should be monitored when a patient is taking Aliskiren
Sodium and Potassium levels
Whats the major adverse effects when taking Aliskiren
- Hypotension
-Angioedma - Hyperkalemia
-Hyponatremia
What the major adverse effects when taking Aliskiren
- Hypotension
-Angioedma - Hyperkalemia
-Hyponatremia
What is the MOA of an ACE inhibitor
Blocks angiotensin 1 from converting into angiotensin 2 causing vasodilation. Blockage of aldosterone causing sodium and water excretion
Which patients would likely be presecribed ACE inhibtors
Hypertension
Heart Failure
Diabetic Neuropathy
In what patient is ACE inhibtors contradicted in and what is their black box warning
Pregnant patients
Can cause fetal harm or death
What is ACE inhibitors prototype?
Captopril
Adverse side effects of captopril?
Cough
Neutropenia
Proteinuria (protein in urine)
Angioedema
What kind of toxicity can come from ACE inhibitors?
Lithium toxicity
What is the MOA of angiotensin II receptor blocker
Block angiotensin II produce vasodilation and vascular resistance
In what patients would you administer ARB’s?
Diabetics for neuropathy and patients wiht hypertension
A patient taking ARB’s must do what before stopping this medication?
Receive permission from their provider
ARBS black box warning
No indicated to use during pregnancy
What is ARBS prototype
Losartan
What adverse side effects can losatran cause ?
Hypotension
Hyperkalemia
Protienuria
What is aldostrone antagonist MOA
Blocks receptors for aldestrone
In what case would you administer Epleronone
Heart failure and hypertension
What is Aldosterone antagonist prototype
Eplerenone
In what situation Aldosterone antagonist be given?
Heart failure and hypertension
After giving captopril what theraputic effects will you expect to see?
Dcresed BP and fluid volume
What is Beta 1 antagonist prototype
Metoprolol
Before administering metoprolol what must be checked
apical pulse rate , must be greater than 60
MOA of beta I blocker and what a higher dose can cause
Beta I receptors in the heart and will affect beta two receptors in the lungs in high doses
After giving metoprolol what effects do you expect to see?
Decreased HR and decreased BP
Adverse side effects of metoprolol
hypotension and worsening heart failure
What is the MOA for calcium channel blockers
slow influx of calcium ions in the heart, relaxing smooth muscle to cause vasodilation
In what patients would you consider administering calcium channel blockers
patients experiencing tachycardia, dyrthimias, hypertension and angina
A patient taking a Diltiazem should follow what medication regimen?
Take at the same time daily
In what ways can Diltiazem be administered?
PO,IV
After giving Diltiazem what effects do you want to see in your patient?
The reduced workload of heart(heart slows down_)
Increase perfusion to the heart
Adverse affects of Diltiazem? (4)
Worsening first degree heart block
Worsening heart failure
Syncope
Edema
What patients would benefit from alpha 2 agonist
Hypertension , and ADHD
MOA of alpha 2 agonist
vasodilation causing decreased BP , increased blood flow to kidneys , and decreased afterload
Patients taking Clonidine should aviod ?
Alcohol and other CNS depressants
A patient who stops clonidine abruptly may experience what?
Rebound hypertension
What adverse side effects are seen with Clonidine
sedation and rebound hypertension
Alpha 2 agonist prototype?
Clonidine
What is the prototype for vasodilators ?
Hydralazine
MOA for hydralazine?
UNKNOWN
What would you administer hydralazine for ?
In patients with hypertension
Hydralazine can cause what other health issues?
Autoimmue SLE(LUPUS)
What should patients be aware of while taking hydralazine?
Monitor weight , asses for edma
Adverse effects of hydralazine
Nasal congestion, disorentation ,tremors/tingling
After taking hydralazine what do you want to see in your patient?
decrease peripheral vascular resistance and decreased cardiac workload
What is the prototype for Antianginal nitrates
Nitroglycerin
What would you educate your patient on prior to administering nitroglycerine
-Do NOT smoke while taking this medication
-Sit down while taking this medication
- Store in a dark air tight container
-DO NOT crush or chew this medication
What is the MOA of nitroglycerin?
Vasodilation and relaxation of smooth muscle to decrease the demand of the heart.
Why would a patient take nitroglycerin?
To relieve pain related to stable angina
How much nitroglycerine can a patient take in a 5 minute span?
3 SL every 5 minutes
What adverse side effect would you see in patient who is taking nitroglycerine
hypotension, palpations, headache
What is the prototype for Cardiac Glycoside
Digoxin
What is the patient teaching you would give before administering digoxin
s/s of digoxin toxicity, vison changes and pulse monitoring
What adverse side effects would you see in a patient taking digoxin
Bradycardia, Arrhythmia and gynecomastia
A patient experiencing afib or heart failure is most likely to be given what medication?
Digoxin
MOA of digoxin
influx of calcium into cardiac cells causing muscles to contract more effectively
What medication causes the force of the heartbeat to increase while decreasing the heart rate
Digoxin
In what population is antilipemic contraindicated?
Pregnant and breast feeding people
What is the HMG-Coa Inhibitor prototype?
Atovastatin (Lipitor)
What food item is not permitted while taking atrovastatin ?
grapefruits
What can both Ezetimibe and Atorvastatin cause?
Muscle spams ( rhabdomyolysis , myalgia)
What medication works in liver to reduces cholesterol synthesis reducing LDL cholesterol and inhibits HMG-CoA ?
Atorvastatin
What medication blocks the absorption of cholesterol in the small intestines
Ezetimibe
What medication(s) reduce LDL and treat hyperlipidemia
Atrovastatin and Ezetimibe
What food is not permitted while taking Ezetimibe
grapefruit
What diuretic is typically given to patients with heart failure as a maintenance medication?
Spironolactone (Potassium Sparing Diuretic )
Which diuretic can cause HYPERkalemia
Spironolactone
MOA for furosemide(lasix)
LOOP diuretic inhibiting absorption of Na and Cl in the loop of henie
What diuretic can cause ototoxicity
furosemide (lasix)
MOA for hydrochlorothiazide ?
promotes excretion of Na and water near the distal tubal
What is the prototype for Thiazide Diuretic
Hydrochlorothiazide
What diuretic can cause photosensitivity and not recommended for patients with anuria?
Hydrochlorothiazide
What diuretic improves pulmonary function in cystic fibrosis patient
Mannitol
Which diuretic is intended to reduce intracranial pressure and intraocular pressure
Mannitol
what brain injury can Mannitol NOT treat?
brain bleed
MOA for mannitol?
Elevates plasma osmolality causing water to flow FROM the brain
what is osmotic diuretics prototype
Mannitol
What do anti-arrhythmic do?
treat irregular heartbeats
Which anti-arrhythmic is a calcium channel blocker?
Diltiazem
A patient experiencing superventricular tachycardia is likely to be administered what medication?
Diltiazem
Diltiazem can cause what adverse effects?
The NEGATIVE inotropic effect? (decreasing the heart force), Worsen AV heart block
MOA of Diltiazem?
slowing the influx of calcium
what anti-arrhythmic is not permitted for patients who have had a MI 2nd or 3rd-degree heart block or sick sinus syndrome?
Diltiazem
Which anti-arrhythmic is the potassium channel blocker?
Amiodarone
MOA for Amiodarone
blocking potassium channels in cardiac cells
which anti-arrhythmic black box warning is pulmonary exacerbation , liver injury and heart block
Amiodarone -
which anti-arrhythmic is not indicated for pregnant women?
Amiodarone
what is sotalol black box warning?
can cause arrhythmias
which anti-arrhythmic MOA is to prolong the cardiac action potential?
Sotalol
What pt education is important before administering sotalol?
Can mask hypoglycemia and increasing cold sensitivity
a patient with a history of thrombocytopenia and myasthenia gravis should avoid what anti-arrhythmic?
Quinidine
which anti-arrhythmic is as sodium channel blocker?
Quinidine
MOA of quinidine
Slows conduction and prolongs depolarization by decreasing sodium influx
Adverse side-effect of Quinidine
Prolong QT interval and ventricular arrhythmia
how is adenosine given and what kind of situation would you use it in?
given bolus for EMERGENCY situations
which anti-arrhythmic slows conduction through AV node and restores sinus rhythm
Adenosine
a patient may experience extreme discomfort during the administration of what anti-arrhythmic medication?
Adenosine
Adverse side effects of Adenosine?
Prolong asystole
which anti-arrhythmic may cause a cease in the EKG for a few seconds?
Adenosine
what medication can affect other CYP450 inhibitors ?
Eplerenone