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Pharmacology > Cardiovascular system drugs > Flashcards

Cardiovascular system drugs Flashcards

1
Q

Normal Blood pressure

A

SBP: < 120
DBP: <80

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2
Q

Elevated blood pressure

A

SBP: 120-129
DBP: <80

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3
Q

Prehypertension (Stage I)

A

SBP: 130-139
DBP: 80-89

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4
Q

Hypertension (Stage II)

A

SBP: > 140
DBP: >90

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5
Q

Hypertensive Crisis

A

SBP: >180
DBP: >120

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6
Q

Diuretic types

A

Loop: Furosemide, bumetanide
Potassium-sparing: spironolactone
Thiazide: Hydrochlorothiazide

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7
Q

Furosemide adverse effects

A

Electrolyte imbalance: hyponatremia, hypokalemia, hypochloremia
Ototoxicity: hearing (tinnitus) or balance problems
Hypotension
Hyperglycemia
Hyperuricemia is (Increased uric acid levels) w/ possible gouty arthritis

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8
Q

Hydrochlorothiazide therapeutic use

A

Used with other drugs, treat heart failure
Treats cirrhosis of the liver and renal failure
Treats hypertension

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9
Q

Hydrochlorothiazide (HCTZ) adverse effects

A

Electrolyte imbalance: Hypokalemia, hypochloremia, hyponatremia
Hyperglycemia (especially in diabetic patients)
Hyperuricemia (along with gouty arthritis)

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10
Q

Spironolactone adverse effects

A

Hyperkalemia (because of decreased excretion of potassium)
Menestral irregularities: abnormal hair growth, deepening of the voice, gynecomastia (growth of breast tissue)

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11
Q

Atenolol adverse drug effects

A

Bradycardia (due to blockade of Beta 1)
Heart failure: shortness of breath, edema, coughing at night
Rebound excitation causing angina pain or MI w/ Sudden withdrawal of beta blocker in client with CHD

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12
Q

Carvedilol adverse effects

A

-Dizziness, hypotension
-Bradycardia due to blockage of Beta 1 receptor (lead to reduced cardiac output)
-Postural hypotension
-Exacerbation of asthma (airways are swollen and inflamed)

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13
Q

Angiotensin-converting Enzyme (ACE) inhibitors examples

A

Captopril
Benazepril
Lisinopril
Enalapril

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14
Q

Captopril adverse effects

A

Severe hypotension following first dose (most likely in clients taking diuretics, w/ high BP)
Dry nonproductive cough due to increase in bradykinin
Rash & report of metallic taste in mouth
Angioedema (swelling of mouth, throat)
Hyperkalemia
Neutropenia (decrease in WBC with increase of infection)

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15
Q

Angiotensin II Receptor Blockers

A

Losartan
Valsartan

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16
Q

Losartan adverse reactions

A

Angioedema (occurs less than ACE)
Headache, hypotension, dizziness, insomnia
Fetal injury

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17
Q

Atorvastatin adverse reactions

A

Myopathy: pain in muscle, which can progress to rhabdomyolysis: breakdown of muscle protein caused by kidney damage
Hepatotoxicity: anorexia, nausea, vomiting, jaundice

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18
Q

Digoxin adverse effects

A

Cardio toxicity leading to bradycardia
Hypokalemia increases toxicity
Manifestations of toxicity
- Vincent Van Gough (colored vision, halo vision, flickering lights
- anorexia, nausea, vomiting, diarrhea

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19
Q

Heparin adverse effects

A

Bleeding and heparin toxicity
- petechiae, ecchymosis
-bleeding mucous membrane or gum
-Hematuria
-Melena

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20
Q

Heparin antidote

A

Protamine sulfate

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21
Q

Anti-platelet examples

A

Aspirin (ASA)
Clopidogrel

22
Q

Anti-platelet adverse effects (ASA, Clopidogrel)

A

Prolonged bleeding time, thrombocytopenia
Tinnitus, hearing loss (ASA)
Nausea, vomiting, dyspepsia (indigestion)
GI bleed

23
Q

Warfarin adverse effects

A

Bleeding and warfarin toxicity or overdose
Any bleeding —> stop drug immediately

24
Q

Warfarin antidote

A

Vitamin K

25
Q

Enoxaparin

A

Low-molecular weight heparin (LMWH)
Injectable only
Prefilled syringes (do not expel air bubble)
Usually given after surgery

26
Q

Manifestations of heart failure

A

Shortness of breath
Tachypnea, tachycardia
Edema of legs, ankle, and feet

27
Q

ACE inhibitors client teaching

A

Take on an empty stomach, or 1 hr before meals for adequate absorption
Notify HCP if cough develops
Refrain from potassium supplements
Report palpitations, muscle twitching, weakness
Report dry cough, rash or, metallic taste in mouth

28
Q

ACE inhibitors and ARBs client teaching

A

Change positions slowly
Impotence is expected (erectile dysfunction)
Monitor serum potassium and liver and kidney function
Avoid potassium and potassium containing salt substitutes

29
Q

ARB client teaching

A

Stop immediately if angioedema develops

30
Q

Beta-adrenergic examples

A

Cardio selective
Noncardioselective
Alpha & beta (noncardio selective)

31
Q

Cardioselective

A

Atenolol
Metoprolol

32
Q

Noncardioselective

A

Propranolol

33
Q

Alpha & Beta noncardioselective

A

Carvedilol
Labetalol

34
Q

ACE drug action

A

Inhibit RAAS
-produce vasodilation
-Inhibit aldosterone secretion

35
Q

Normal INR (International normalized ratio)

A

1.1 or below (what everyone’s level should be)

36
Q

Therapeutic INR

A

2-3x of the normal
(Because we want a longer bleeding time)

37
Q

Normal PT (prothrombin time)

A

11-12.5 seconds

38
Q

Therapeutic PT

A

1.5-2x of normal

39
Q

Warfarin Nursing implications

A

Assess the laboratory values
-platelets
-pt, aPTT, INR
Assess for history of abnormal bleeding conditions, baseline vital signs, medication history and allergies

40
Q

Normal platelet count

A

150,000-400,000 per UL

41
Q

Heparin Implications

A

Assess the laboratory values
Platelets
PT, aPTT, INR
History of abnormal bleeding, baseline vital signs, laboratory studies, medication history and allergies
VERIFY IV HEPARIN WITH ANOTHER NURSE
— USE INFUSION PUMP FOR CONTINUOUS INTRAVENOUS ADMINISTRATION
DO NOT MASSAGE INJECTION SITE TO PREVENT HEMATOMA
ROTATE SUBCUTANEOUS INJECTION

42
Q

Hydrochlorothiazide interventions

A

A client is at risk for hypokalemia if they are also taking digoxin (digitalis drug)
Potassium supplements may be added to drug regimen
Giving this drug with corticosteroids increases risk for hypoglycemia

43
Q

Hydrochlorothiazide administration

A

Give with food to minimize GI effect
Give by 3 pm to prevent nocturia and sleep loss

44
Q

Which diuretic drug is likely to be used initially for antihypertensive therapy
A. Loop diuretics
B. Osmotic diuretics
C. Thiazide diuretics
D. Potassium-sparing diuretics

A

C. Thiazide diuretics
Explanation: considered first-line drugs in the treatment of hypertension.

45
Q

Signs of potassium deficiency

A

Muscle weakness, anorexia, lethargy, hypotension, and confusion.

46
Q

Beta Blockers

A

Are given to patients after they have suffered an MI because of their cardio protective properties.
Ex: reduction of HR, decreased contractile force and a lesser impulse conduction

47
Q

Non cardio selective beta blocker (Carvedilol) contraindications

A

May precipitate bronchoconstriction, and or increased airway resistance making any pre-existing respiratory conditions such as asthma worse.
Severe unstable heart failure
Cardiogenic shock
Lactation/pregnancy

48
Q

Which beta blockers are used for the treatment of heart failure?

A

Carvedilol and metoprolol

49
Q

Furosemide (loop diuretic) interaction

A

Digoxin toxicity
Antihypertensives (can have additive hypotension effect)
Lithium
NSAIDs (decrease blood flow to the kidneys, reduces diuretic effect)

50
Q

Normal Potassium level

A

3.6-5.2 mEQ/L
If level drops below 3.5 mEQ/L, monitor the ECG and notify provider because client might require a potassium supplement

Pharmacology (5 decks)

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