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Pharmacology HOSA > Cardiovascular Drugs > Flashcards

Cardiovascular Drugs Flashcards

1
Q

Cardiotonic and inotropic indication

A

Used on people that still have symptoms after using ACE inhibitors, diuretics and beta blockers, but can be used in acute situations of heart failure, however their use is decreasing. Used for heart failure and atrial fibrillation

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2
Q

Cardiotonic/inotropic ex

A

Digoxin, ivabradine, milrinone (inotropic), amrinone

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3
Q

Cardiotonic/inotropic considerations

A

Stop if low blood pressure, monitor blood pressure and heart rate, caution in patients with electrolyte imbalance

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4
Q

Left ventricular heart failure symptoms

A

Decreased cardiac output, orthopnea, moist cough, frothy pink sputum, dyspnea, decreased ejection fraction

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5
Q

Right ventricular heart failure symptoms

A

Neck vein distension, peripheral edema, weight gain, haptic engorgement, nocturia

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6
Q

Cardiotonic/inotropic side effects

A

Arrhythmia, weakness, drowsy, visual disturbances, arrhythmias, anorexia, nausea

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7
Q

Cardiotonic/inotropic aren’t for people with

A

Ventricular failure, fast heart rate, cardiac tamponade, AV block, digoxin toxicity, restrictive cardiomyopathy

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8
Q

Cardiotonic/inotropic: what to monitor

A

Edema, weight gain, lung sounds, jugular veins for distension, sputum, electrolytes, renal function

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9
Q

Cardiotonic/inotropic signs of digoxin toxicity

A

Anorexia (usually the first sign), nausea, vomiting, diarrhea, weakness, lethargy, headache, drowsiness, visual disturbances, confusion, disorientation, delirium, changes in pulse rate them, electrocardiograph changes, Bradycardia, tachycardia, premature ventricular contractions

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10
Q

Cardiotonic/inotropic administration

A

IM or IV, and also give potassium supplement

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11
Q

Cardiotonic/inotropic toxicity antidote

A

Digibind

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12
Q

Anticoagulants indications

A

Prevention and treatment of DVT, prevention and treatment of atrial fibrillation with embolization, prevention and treatment of PE, adjuvant treatment of MI, prevention of thrombus formation after valve replacement surgery

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13
Q

Anticoagulants ex

A

Warfarin (oral, most common), heparin (available in low weight, mid of other drugs)

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14
Q

Anticoagulants side effects

A

Nausea, abdominal cramps, alopecia, urticaria, hepatitis, diarrhea, jaundice, thrombocytopenia, blood dyscrasias, bleeding (most common)

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15
Q

Anticoagulants are not for people with

A

Active bleeding (except when caused by DIC), TB, leukemia, high BP, ulcers, renal or hepatic disease, pregnancy (oral is cat X, and parenteral is cat C), hemorrhagic disease, lactation, aneurysms, recent eye or CNS surgery

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16
Q

Anticoagulants interactions

A

Aspirin, acetaminophen, NSAIDs, chloracne hydrate, some antibiotics, some GI drugs

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17
Q

Anuria

A

Cessation of urine production

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18
Q

Azotemia

A

Absence of urine production

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19
Q

Diuresis

A

Production of urine

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20
Q

Edema

A

Accumulation of a excess water in the body

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21
Q

Gynecomastia

A

Male Breast enlargement

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22
Q

Hyperkalemia

A

Increase in potassium levels in the blood

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23
Q

Hypokalemia

A

Low blood potassium level

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24
Q

Hypertension is frequently treated by

A

Antihypertensive drug and a diuretic (loop or thiazide)

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25
Q

Diuretics MOA

A

Altering the excretion or reabsorption of electrolytes (sodium and chloride) in the kidney,

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26
Q

Loop diuretics MOA

A

Inhibit reabsorption of sodium and chloride in the distal and proximal tubules in the kidney and in the the loop of henle

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27
Q

Thiazide diuretics MOA

A

Inhibit the reabsorption of sodium and chloride ions in the ascending portion of the loop of henle and the early distal tubule of the nephron. Sodium, chloride, and water are excreted

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28
Q

Potassium sparing diuretics MOA

A

Blocking reabsorption of sodium in the kidney tubules, reducing the excretion of potassium

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29
Q

Potassium sparing diuretics ex

A

Spironolactone,

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30
Q

Spironolactone MOA

A

Antagonize the action of aldosterone, sodium and water are excreted

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31
Q

Osmotic diuretics MOA

A

Increase the density of the filtrate in the glomerulus, sodium and chloride excretion is increased

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32
Q

Carbonic anhydride inhibitors MOA

A

Sulfonamides, Without bacteriostatic action that inhibit carbonic anhydride enzymes, and result in the excretion of sodium, potassium, bicarbonate, and water

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33
Q

Diuretics uses

A

Edema associated with heart failure, corticosteroid/estrogen therapy, cirrhosis of the liver, hypertension, renal disease (acute failure, renal insufficiency, nephrotic syndrome), cerebral edema, acute glaucoma, increased intraocular pressure, seizures, altitude sickness

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34
Q

Spironolactone use

A

Male to female hormonal therapy for gender dysphoria

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35
Q

Ethacrynic acid use

A

Short term managemtn of ascites caused by a malignancy, idiopathic edema, or lymphedema

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36
Q

Diuretics: what to do if the patient is at risk for potassium loss

A

Use potassium sparing diuretics in place of or with other diuretics

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37
Q

Diuretics neuromuscular system side effects

A

Dizziness, lightheadedness, headache, weakness, fatigue

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38
Q

Diuretics cardiovascular system side effects

A

Orthostatic hypotension, electrolyte imbalances, glycosuria

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39
Q

Diuretics GI system side effects

A

Anorexia, nausea, vomiting

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40
Q

Diuretics general side effects

A

Rash, photosensitivity, hypokalemia

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41
Q

Hypokalemia signs

A

Extremity paresthesias (numbness or tingling), or flaccid muscles

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42
Q

Potassium sparing diuretics side effects

A

Hyperkalemia

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43
Q

Potassium sparing diuretics: Hyperkalemia is most likely to occur in

A

Inadequate fluid intake and urine output, diabetes, renal disease, elderly, severely ill

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44
Q

Spironolactone side effects

A

Gynecomastia, which is related to both dose and duration of treatment

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45
Q

Diuretics contraindications

A

Electrolyte imbalances, severe kidney or liver dysfunction, anuria

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46
Q

Mannitol contraindications

A

Active intracranial bleeding (except during craniotomy)

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47
Q

Potassium sparing diuretics contraindications

A

Hyperkalemia, pediatric patients

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48
Q

Diuretics precautions

A

Renal dysfunction , pregnancy (cat C), lactation

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49
Q

Pregnancy cat B diuretics

A

Ethacrynic acid, torsemide, isosorbide, amiloride, triamterene

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50
Q

Thiazide diuretics pregnancy cat

A

B

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51
Q

Benzthiazide pregnancy cat

A

C

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52
Q

Methyclothiazide pregnancy cat

A

C

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53
Q

Thiazide diuretics precautions

A

Gout, liver disease, systemic lupus erythematosus, diarrhea, cross sensitivity with sulfonamides, sensitive to tartazine (can cause allergic type reactions or bronchial asthma)

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54
Q

Loop diuretics precautions

A

Gout, liver disease, systemic lupus erythematosus, diarrhea, cross sensitivity with sulfonamides,

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55
Q

Potassium sparing diuretics precautions

A

Liver disease or diabetes

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56
Q

Carbonic anhydride inhibitors interactions

A

Primodone decreases diuretic effectiveness

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57
Q

Loop diuretics interactions

A

I solas tin and aminoglycosides increase risk of ototoxicity, anticoagulants and thrombolytics increase risk of bleeding, digitalis increases risk of arrhythmias, increased risk of lithium toxicity, hydantoins decrease diuretic effectiveness, NSAIDs and salicylates decrease diuretic effectiveness

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58
Q

Potassium sparing diuretics interactions

A

ACE inhibitors and potassium increase risk for Hyperkalemia, NSAIDs, salicylates, and anticoagulants decrease diuretic effectiveness, increased risk of allopurinol hypersensitivity, increased effectiveness of anesthetics, antineoplastics extend leukopenia, and antidiabetics cause hyperglycemia

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59
Q

Dehydration signs

A

Thirst, poor skin turgor, dry mucous membranes, weakness, dizziness, fever, low urine output

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60
Q

Hyponatremia signs

A

(Excessive sodium loss), cold and clammy skin, decreased skin turgor, confusion, hypotension, irritability, tachycardia

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61
Q

Hypomagnesemia signs

A

Leg and foot cramps, hypertension, tachycardia, neuromuscular irritability, tremor, hyperactive deep tendon reflexes, confusion, visual or auditory hallucinations, paresthesias

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62
Q

Hypokalemia signs

A

Anorexia, vomiting, muscle twitching, depression, confusion, bradycardia, impaired thought process, drowsiness

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63
Q

Hyperkalemia signs

A

Irritability, anxiety, confusion, muscle cramps, numbness, tingling, nausea, diarrhea, arrhythmias, flaccid paralysis

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64
Q

Loop diuretics ex

A

Bumetanide, ethacrynic acid, furosemide, torsemide

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65
Q

Potassium sparing diuretics ex

A

Amiloride, spironolactone, triamterene,

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66
Q

Thiazide diuretics ex

A

Chlorothiazide, chlorthalidone, hydrochlorothiazide, indapamide, metolazone, methyclothiazide

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67
Q

Carbonic anhydrase inhibitors ex

A

Acetazolamide, methazolamide

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68
Q

Osmotic diuretics

A

Glycerin, isosorbide, mannitol, urea

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69
Q

Atherosclerosis

A

Disease characterized by deposits of fatty plaques on the inner walls of arteries

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70
Q

Catalyst

A

Substance that accelerates a chemical reaction without itself undergoing a change

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71
Q

Cholecystitis

A

Inflammation of gallbladder

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72
Q

Cholelithiasis

A

Stones in gallbladder

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73
Q

Cholesterols

A

Fat like substance produced mostly in the liver of animals

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74
Q

High density lipoproteins (HDLs)

A

Macro (big) molecules that carry cholesterol from the body cells to the liver to be excreted

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75
Q

Hyperlipidemia

A

Increase in the lipids in the blood

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76
Q

Lipid

A

Group of fats or fat-like substances

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77
Q

Lipoprotein

A

Macromolecule consisting of lipid, and protein; how fats are transported in the blood

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78
Q

Low density lipoproteins

A

Macromolecules that carry cholesterol form the liver to the body cells

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79
Q

Risk evaluation and mitigation strategies

A

(REMS) a program of the FDA designed to monitor drugs that have a high risk compared to benefit ratio

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80
Q

Rhabdomylosis

A

Condition in which muscle damage results in the release of muscle cell contents into the bloodstream

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81
Q

Statins (HMD-CoA reductase inhibitors)

A

Common name fro drugs that inhibit the manufacture or promote the breakdown of cholesterol

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82
Q

Triglycerides

A

Types of lipids that circulate in the blood

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83
Q

Xanthomas

A

Yellow deposits of cholesterol in tendons and soft tissues

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84
Q

Uncontrollable risk factors of hyperlipidemia

A

Age (men older than 45 and women older than 55), gender (LDL increases in women after menopause), family history of heart disease

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85
Q

Hyperlipidemia controllable factors

A

Diet, weight, ohycial inactivity

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86
Q

HMG-CoA reductase inhibitors MOA

A

Inhibit the manufacture of cholesterol, or promote breakdown of cholesterol, LDLs, and serum triglycerides

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87
Q

Statins uses

A

Hyperlipidemia, primary prevention of coronary events, secondary prevention of cardiovascular events

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88
Q

Statins side effects nature

A

Mild, transient, well tolerated

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89
Q

Statins side effects

A

Headache, dizziness, insomnia, memory and cognitive impairment, flatulence, abdominal cramps, constipation, nausea, hyperglycemia in non diabetic patients

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90
Q

Statins contraindications

A

Serious liver disorders, pregnancy (cat X), lactation, can elevate serum glucose and HbA1c levels in people with diabetes risk

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91
Q

Statins precautions

A

Alcoholism, non alcohol related liver disease, acute infection, hypotension, trauma, endocrine disorder, visual disturbances, myopathy

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92
Q

Rosuvastatin side effects

A

Severe muscle toxicity in people taking cyclosporine, Asian people, and with severe renal insufficiency

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93
Q

Statins interactions

A

Macrolides, erythromycin and clarithromycin increase risk for severe myopathy or rhabdomylosis, amiodarine increases risk of myopathy, niacin increases risk of severe myopathy, protease inhibitors increase plasma levels of statins, verapmil increases risk of myopathy, and increased anticoagulant effect, additive effect with bile acid resins

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94
Q

Lovastatin contraindications

A

Grapefruit

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95
Q

Simvastatin contraindications

A

Grapefruit

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96
Q

PCSK9 inhibitors use

A

Genetic familial hyperlipidemia, or are at a very high risk for cardiovascular disease, and are given if diet changes and statins don’t work

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97
Q

PCSK9 inhibitors ex

A

Alirocumab, evolocumab

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98
Q

PCSK9 inhibitors administration

A

Subcutaneous once or twice a month, but are very expensive

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99
Q

PCSK9 inhibitors side effects

A

Possible cognitive adverse reactions

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100
Q

Bile acid resins MOA

A

Bind to bile acids to form an insoluble substance that can’t be absorbed by the intestine, forcing the liver to use more cholesterol and causing a decrease in cholesterol levels

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101
Q

Bile acid resins uses

A

Hyperlipidemia (When diet and exercise don’t work), gallstone dissolution in patients where surgery isn’t recommended

102
Q

Cholestyramine use

A

Pruritus associated with partial biliary obstruction

103
Q

Bile acid resins side effects

A

Constipation , aggravation of hemorrhoids, abdominal cramps, flatulence, and nausea, and increased bleeding tendencies related to vitamin K malabsorption and vitamin A and D deficiencies

104
Q

Cholestyramine interactions

A

Decreased effects of anticoagulants, loss of efficacy of thyroid and hypothyroidism with thyroid hormones,

105
Q

Bile acid resins interactions

A

Reduced absorption of fat-soluble vitamins (A, D, E, K) and folic acid. And a decreased serum level of or decreased GI absorption of NSAIDs, penicillin, tetracycline, niacin, digitalis glycosides, furosemide, thiazide diuretics, glipizide, hydrocortisone, methyldopa, propranolol

106
Q

Fenofibrate MOA

A

Reducing very low density lipoproteins and stimulating the catabolism of triglyceride rich lipoproteins, which decreases plasm triglycerides and cholesterol

107
Q

Gemfibrozil MOA

A

Increases the excretion of cholesterol in the feces, and reduced the production of triglycerides by the liver, lowering serum lipid levels

108
Q

Gemfibrozil use

A

Very high serum triglyceride levels who are at risk for abdominal pain and pancreatitis and when diet and exercise don’t work

109
Q

Fenofibrate use

A

Adjunctive treatment for reducing LDLs, total cholesterol, and triglycerides in patients with hyperlipidemia

110
Q

Fibric acid derivatives side effects

A

Nausea, vomiting, upset GI, diarrhea, cholelithiasis (if this is found they might discontinue), or cholecystitis

111
Q

Fibric acid derivatives contraindications

A

Significant hepatic or renal function, primary biliary cirrhosis, lactation

112
Q

Fibric acid derivatives precautions

A

Pregnancy (cat C)

113
Q

Fibric acid derivatives interactions

A

Enhanced effects of anticoagulants, statins increase risk of rhabdomylosis

114
Q

Gemfibrozil interactions

A

Decreased effects if cyclosporine, increased hypoglycemic effects of sulfonylureas

115
Q

Ezetimibe MOA

A

Inhibits absorption of cholesterol in the small intestine, leading to decrease of cholesterol in the liver

116
Q

Niacin use

A

Adjunctive therapy for lowering very high serum triglyceride levels in patients who are at risk for pancreatitis and for whom diet control doesn’t work

117
Q

Ezetimibe use

A

In combinations with other antihyperlipidemics in lipid-lowering treatments

118
Q

Misc antihyperlipidemics side effects

A

Nausea, vomiting, abdominal pain, diarrhea, flushing, warmth, itching, tingling

119
Q

Niacin contraindications

A

Active peptic ulcer, hepatic dysfunction, arterial bleeding

120
Q

Niacin precautions

A

Renal dysfunction, high alcohol consumption, unstable angina, gout, pregnancy (cat C)

121
Q

Ezetimibe contraindications

A

Pregnancy and lactation

122
Q

Mipomersen use

A

When TLC, statins, and adjuvant Drugs don’t lower LDL levels in people with genetic disorders, but carry severe hepatic Side effects, and are only prescribed as part of REMS

123
Q

Lomitapide use

A

When TLC, statins and adjuvant Drugs don’t lower LDL in people with a genetic disorder, but they have severe hepatic reactions, and are only prescribed as a part of REMS

124
Q

Severe hyperlipidemia signs

A

Xanthomas

125
Q

Bile acid resins elderly considerations

A

Elderly prone to constipation

126
Q

Statins ex

A

Atorvastatin, fluvastatin, lovastatin, pitavastatin, pravastatin, rosuvastatin, simvastatin

127
Q

PCSK9 inhibitors ex

A

Alirocumab, evolocumab

128
Q

Bile acid resins ex

A

Cholestyramine, colestipol, colesevelam

129
Q

Fibric acid derivatives ex

A

Fenofibrate, gemfibrozil

130
Q

Angina

A

Acute pain in the chest resulting from decreased blood supply to the heart muscle

131
Q

Buccal

A

Space in the mouth between the gum and the cheek in either the upper or lower jaw

132
Q

Pulmonary arterial hypertension (PAH)

A

High blood pressure in the pulmonary artery (heart to lungs), which can result in heart failure if not treated

133
Q

Sublingual

A

Under tongue

134
Q

Primary treatment for angina

A

CCBs

135
Q

How to treat PAH

A

Peripheral vasodilator

136
Q

Nitrates MOA

A

Relaxes the smooth muscle layer of blood vessels, increasing the lumen of the artery or arteriole, and increases the amount of blood flowing through the vessels

137
Q

What do CCBs do to the heart

A

Slow conduction velocity of the cardiac impulse, depress myocardial contractility, dilate coronary arteries and arterioles, which deliver more oxygen to cardiac muscle

138
Q

Antianginal drugs use

A

Relieve pain of acute anginal attacks, prevent angina attacks, treat chronic, stable angina pectoris

139
Q

Nitrates use

A

Relieve symptoms when an anginal attack happens

140
Q

CCBs as an antianginal drug use

A

Prevent angina from occurring (take on a regular basis)

141
Q

Nitroglycerin use

A

Control perioperative hypertension associated with surgical procedures (IV)

142
Q

Verapmil use

A

Cardiac arrhythmias, and affects conduction system of the heart

143
Q

CCBs side effects nature

A

Not usually serious and don’t require discontinuation

144
Q

Nitrates side effects

A

Sever headache, dizziness, weakness, restlessness, hypotension, flushing, rash

145
Q

Sublingual nitroglycerin side effects

A

Local buringin or tingling

146
Q

Transdermal nitroglycerin side effects

A

Contact dermatitis

147
Q

Nitrates side effects nature

A

In many cases, prolonged use causes side effects to lessen, however in other cases, adverse reactions can become more severe, so dose is lowered, until it can be slowly increased

148
Q

Nitrates contraindications

A

Severe anemia, closed angle glaucoma, postural hypertension, head trauma, cerebral hemorrhage, constrictive pericarditis, people taking phosphodiesterase inhibitors

149
Q

Sublingual nitrates contraindications

A

Early myocardial infarction

150
Q

Transdermal nitrates contraindications

A

Allergy to adhesives

151
Q

Nitrates precautions

A

Severe hepatic or renal disease, severe head trauma, hypothyroidism

152
Q

Peripheral vasodilation drugs contraindications

A

Pregnancy

153
Q

Nitrates interactions

A

Aspirin increases nitrate serum concentrations, CCBs increase orthostatic hypotension, dihydroergotamine increases risk of hypertension and decreases antianginal effect, decreased effect of heparin, phosphodiesterase inhibitors and alcohol can cause severe hypotension and cardiovascular collapse

154
Q

Nitrates ex

A

Isosorbide, nitroglycerin,

155
Q

Misc antianginal drugs ex

A

Ivabradine, ranolazine, nimodipine

156
Q

Peripheral vasodilator ex

A

Hydralazine, minoxidil, nitroprusside

157
Q

Drugs used for PAH

A

Ambrisentan, bosentan, epoprostenol, iloprost, macitentan, riociguat, treprostinil,

158
Q

Aggregate

A

Clumping of blood element

159
Q

Embolus

A

Thrombus that detaches from a blood vessel wall and travels through the bloodstream

160
Q

Fibrolytic

A

Drug the dissolves clots already formed within blood vessel walls

161
Q

Hemostasis

A

Complex process by which fibrin forms and blood clots

162
Q

Lysis

A

Dissolution and destruction of cells

163
Q

Petechiae

A

Pinpoint sized red hemorrhagic spots on the skin

164
Q

Prothrombin

A

Substance that is essential for the clotting if the blood, clotting factor 2

165
Q

Thrombolytic

A

Drug that helps to eliminate blood clots

166
Q

Thrombosis

A

Formation of a blood clot

167
Q

Thrombus

A

Blood clot

168
Q

Direct thrombin inhibitors (DTIs) ex

A

Dabigatran (oral), argatroban, bivalirudin,

Desirudin

169
Q

LMWH ex

A

Dalteparin, enoxaparin

170
Q

oral anticoagulants ex

A

Apixaban, edoxaban, rivaroxaban, rivaroxaban, warfarin

171
Q

How did DTIs compare to heparin and warfarin

A

Don’t have the difficult management properties of heparin or warfarin

172
Q

LMWHs side effects nature

A

Produce very stable responses, and lab monitoring isn’t needed

173
Q

Apixaban use

A

Prevent DVT in people with hip, knee, or abdominal surgeries

174
Q

Edoxaban use

A

Prevent DVT in people undergoing hip, knee, or abdominal surgeries

175
Q

Rivaroxaban use

A

Prevent DVT in people undergoing hip, knee, or abdominal surgeries

176
Q

Fondaparinux use

A

Prevent DVT in people undergoing hip, knee, or abdominal surgeries

177
Q

Warfarin MOA

A

Interferes with the manufacturing of vitamin K dependent clotting factors by the liver, resulting in the depletion of clotting factors 2, 7, 11 and 10

178
Q

Heparin MOA

A

Inhibits the formation of fibrin clots, inhibits the conversion of fibrinogen to fibrin and inactivated several of the factors necessary for the clotting of blood, can’t be taken orally

179
Q

LMWHs MOA

A

Inhibit clotting reactions by binding to antithrombin 3, which inhibits synthesis factor X and the formation of thrombin (no effect in existing clots)

180
Q

DTIs MOA

A

Directly inhibit thrombin, and don’t require a cofactor to exert effect

181
Q

Parenteral anticoagulants use

A

Prevention of postoperative DVT and PE in people undergoing major surgery, prevention of clotting in heart and arterial surgery, prevention of a repeat cerebral thrombosis in people who have had stroke, treatment of coronary occlusion, acute MI, peripheral arterial embolism, disseminated intravascular coagulation (DIC), maintaining latency of IV catheters (low dose)

182
Q

Warfarin risk

A

Narrow therapeutic window, significant risk of hemorrhage

183
Q

Subcutaneous heparin side effects

A

Local irritation

184
Q

Anticoagulants allergic reaction signs

A

Fever, chills, asthma like reaction

185
Q

LMWHs contraindications

A

People allergic to pork

186
Q

Anticoagulants precautions

A

Fever, heart failure, diarrhea, diabetes, malignancy, hypertension, renal or hepatic disease, psychoses, depression

187
Q

Apixaban administrating considerations

A

Monitored by REMS, because a chance of stroke with discontinuation

188
Q

Apixaban interactions

A

Grapefruit will increase serum levels

189
Q

Rivaroxaban interactions

A

Grapefruit increases serum levels

190
Q

Anticoagulants interactions

A

Aspirin, acetaminophen, NSAIDs, chloracne hydrate, penicillin, aminoglycosides, isoniazid, tetracyclines, cephalosporins, beta blockers, loop diuretics, disulfiram, and cimetidine increase risk of bleeding and oral contraceptives, barbiturates, diuretics and vitamin K decrease anticoagulant effectiveness, spinal anesthesia or spinal punctures can cause spinal or epidural hematoma formation, which can lead to paralysis

191
Q

Antiplatelet Drugs MOA

A

Decrease the platelets ability to stick together in the blood, forming a clot

192
Q

Aspirin MOA as an antiplatelet

A

Prohibit the aggregation of platelets for the lifetime of the platelet

193
Q

Adenosine diphosphate receptor blockers (ADP blockers) MOA

A

Alter the platelet cell membrane, preventing aggregation

194
Q

Glycoprotein receptor blocker MOA

A

Prevent enzyme production, inhibiting platelet aggregation

195
Q

Antiplatelet use

A

Risk for acute coronary syndrome, MI, stroke, and intermittent claudication

196
Q

Antiplatelet side effects

A

Palpitations, bleeding, dizzy, headache, nausea, diarrhea, constipation, dyspepsia

197
Q

Antiplatelet Drugs contraindications

A

Pregnancy, lactation, heart failure,active bleeding, thrombotic thrombocytopenic purpura (TTP)

198
Q

Antiplatelets precautions

A

Elderly, pancytopenic people, renal or hepatic impairment

199
Q

Antiplatelet pregnancy cat

A

C

200
Q

Clopidogrel pregnancy cat

A

B

201
Q

What to do if TTP is diagnosed

A

Stop antiplatelet treatment immediately

202
Q

Antiplatelets interactions

A

Aspirin and NSAIDs increase risk of bleeding, increased effectiveness of macrolides, decreased digoxin serum levels, increased phenytoin serum levels

203
Q

Thrombolytic Drugs MOA

A

Break down fibrin clots by converting plasminogen to plasmin (will have an effect on existing thrombus)

204
Q

Thrombolytic Drugs uses

A

Acute stroke or MI by lyis of blood clots in coronary arteries, blood clots causing pulmonary embolism and DVT, suspected occlusion in central venous catheters

205
Q

Thrombolytic Drugs side effects

A

Bleeding, can be internal in GI tract, genitourinary tract and brain, bleeding can also be external and seen where skin is broken (venipuncture sites and recent surgical wounds), allergic reactions

206
Q

Thrombolytic Drugs contraindications

A

Active bleeding, history of stroke, aneurysm, recent intracranial surgery

207
Q

Thrombolytic Drugs precautions

A

Recently undergone major surgery (within 10 days), stroke, trauma within the last 10 days, vaginal or C-section delivery, GI bleeding, hypertension, diabetic retinopathy, significant possibility of bleeding, taking oral anticoagulants

208
Q

Thrombolytic Drugs pregnancy cat

A

C

209
Q

Urokinase pregnancy cat

A

B

210
Q

Thrombolytics interactions

A

When given with drugs that prevent blood clots (aspirin, dipyridamole, anticoagulant), there is an increased risk of bleeding

211
Q

Parenteral anticoagulants ex

A

Heparin, fondapurinux

212
Q

Antiplatelet ex

A

Abciximab, anagrelide, cilostazol, clopidogrel, dipyridamole, eptifibatide, prasugrel, ticagrelor, ticlopidone, tirofiban, vorapaxar

213
Q

Thrombolytic ex

A

Alteplase, reteplase, tenecteplase,

214
Q

Anticoagulant antagonists use

A

Treats heparin/warfarin overdose

215
Q

Anticoagulant antagonists ex

A

Phytonadione, protamine, idarucizumab

216
Q

Atrial fibrillation

A

Quivering of the atria if the heart

217
Q

Cardiac output

A

Volume of blood discharged from the left or right ventricular per minute

218
Q

Digitalis toxicity

A

Toxic drug effects from te administration of digoxin

219
Q

Heart failure

A

Condition in which the heart can’t pump enough blood to meet the tissue needs of the body

220
Q

Left ventricular dysfunction

A

Conduction in which fluids back up previous to the left ventricle of the heart and is characterized by shortness of breath, and moist cough in heart failure

221
Q

Neurohormonal activity

A

In heart failure, increased secretions of epinephrine and norepinephrine, resulting in arteriolar vasoconstriction, tachycardia, myocardial contractility, resulting in a worsening of heart failure and reduced ability of the heart to contract effectively

222
Q

Positive inotropic activity

A

Increase in the force of cardiac contraction

223
Q

Right ventricular dysfunction

A

Condition in which fluid backs up previous to the right ventricle if the heart and is characterized by peripheral edema and venous congestion in heart failure

224
Q

Neurohormonal responses affecting heart failure

A

Increased secretion of the neurohormonal compensatory mechanisms, which results in increased secretion of the neurohormones, activation of the renin-angiotensin-aldosterone system (RAA), and remodeling of cardiac tissue

225
Q

Ventricular heart failure

A

Typically left side is affected first, followed by right ventricular involvement

226
Q

Heart failure symptoms

A

Left ventricular dysfunction, shortness of breath with exercise, dry, hacking cough or wheezing, orthopnea, restlessness, anxiety, right ventricular dysfunction, swollen ankles, legs or abdomen, anorexia, nausea, nocturia, weakness, weight gain, tachycardia, palpitations, fatigue or pain when performing normal activities, irregular heart rate, dizziness, conduction

227
Q

Digoxin is continued to be used for

A

Elderly who have been in the drug for many years, patients using symptoms after using other drugs, and in some cases of atrial fibrillation

228
Q

Ivabradine use

A

Slowly replacing digoxin to treat heart failure, and when used with a beta blocker, can reduce hospitalization

229
Q

milrinone use

A

Short term, acute management of heart failure when it isn’t controlled by digoxin

230
Q

Cardiotonic MOA

A

Increase cardiac output through positive inotropic activity, and slow conduction velocity through the AV node in the heart, don’t cure heart failure, but only control symptoms

231
Q

Ivabradine MOA

A

Blocks the If channel and inhibits the pacing of the SA node of the heart

232
Q

Milrinone MOA

A

Inotropic actions

233
Q

Digoxin side effects

A

Blurred or yellow halo around lights

234
Q

Ivabradine side effects

A

Increased brightness

235
Q

Cardiotonic precautions

A

Electrolyte imbalance, thyroid disorders, sever carditis, heart block, myocardial infarction, severe pulmonary disease, acute glomerulonephritis, and impaired renal or hepatic function

236
Q

Digoxin pregnancy cat

A

C, caution in pregnancy and lactation

237
Q

Ivabradine contraindications

A

Pregnant or lactating

238
Q

Cardiotonics interactions

A

Absorption slowed when taken with food, but if taken with high fiber meals, absorption is decreased, thyroid hormones require a larger dosage of digoxin, thiazide and loop diuretics increase risk of digoxin induced arrhythmia

239
Q

Digoxin interactions

A

Amiodarone, benzodiazepines, indomethacin, itraconazole, macrolides, propafenone, quinidine, spironolactone, tetracyclines, verapmil, and aminoglycosides increase serum digoxin levels (can lead to toxicity), and antacids, antineoplastics, charcoal, cholestyramine, neomycin and rifampin decrease serum digoxin levels

240
Q

Cardiotonics pediatric considerations

A

Drug is withheld if pulse in child is below 70, or if pulse in infant is below 90

241
Q

Who is at higher risk for digoxin toxicity

A

People with hypokalemia (on diuretics)

242
Q

Digoxin elderly considerations

A

Elderly ar more prone to digoxin toxicity, and conditions such as dementia can have similar signs to digoxin toxicity

243
Q

Action potential

A

Electrical impulse that passes from cel to cell in the myocardium of the heart and stimulates the fibers to shorten, causing the heart muscle to contract

244
Q

Depolarization

A

Movement of ions in a nerve cell from inside to outside and vice versa

245
Q

Myocardium

A

The striated, muscle tissue of the heart

246
Q

Polarization

A

Status of a nerve cell at rest, with positive ions on the outside of the cell membrane and negative ions in the inside

247
Q

Proarrhythmic effect

A

Creation of new arrhythmia or worsening of existing arrhythmia, resulting from administration of an antiarrhythmic Drug

248
Q

Refractory period

A

Quiet period between the transmission of nerve impulses along a nerve fiber

249
Q

Repolarization

A

Return of positive and negative ions to their original place in the nerve cell after an impulse has traveled along the nerve fiber

250
Q

Threshold

A

Any stimulus if lowest intensity that will give rise to a response in a nerve fiber

Pharmacology HOSA (37 decks)

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