CCRN Meds

Question 1

Pharmacodynamics of Alpha Adrenergic Drugs?

Answer 1

causes Arterial vasoconstriction

Question 2

Pharmacodynamics of Alpha Blockers

Answer 2

Arterial vasodilation.

When thinking Alpha, think ARTERIAL

Question 3

Beta 1 Adrenergic Drugs

Answer 3

stimulates the heart

Question 4

Beta 2 adrenergic and beta 2 agonists rugs

Answer 4

Stimulates the lungs, bronchodilators

Question 5

Caution about beta adrenergic blockers?

Answer 5

neg inotropes and can mask signs of hypoglycemia

Question 6

Type: phenylephrine

Answer 6

alpha adrenergic drugs

Question 7

Type: norepinephrine

Answer 7

alpha adrenergic drugs.

Question 8

What drugs increases serum digoxin

Answer 8

amiodarone, ahminoglycosides, captopril, carvedilol, diltiazem, esmolol, ibuprofen, quinidine, verapamil

Question 9

Nitroprusside action?

Answer 9

Decreases preload and afterload

Question 10

Signs of nitroprusside toxicity?

Answer 10

hypotension OR increase dose to control BP, confusion, agitation, N/V, twitching

Question 11

What do nitrates do?

Answer 11

dilate veins andarteries

- not admin with erection enhancing medication, may cause severe hypotension

Question 12

Amiodarone may do what to EKG?

Answer 12

Prolong QT, lowers HR

Question 13

What med would be used for SBradycardia?

Answer 13

Atropine 0.5mg IV repeated in 5 min intervals up to 3mg and transcutaneous pacemaker.

Question 14

Caution of Atropine usage?

Answer 14

Ensure adequate tissue perfusion to vital organs. Accidental overdoses will need hemodynamic support until metabolized and excreted

Question 15

Med for afib RVR?

Answer 15

CC blockers like IV diet, or beta blockers. Dilt is admin bolls of .25mg/kg given over a min, followed by second dose.
A/C, INR 2-3

Question 16

Med for sinus tachycardia?

Answer 16

Adenosine. 6mg rapid bolus, followed by 12 mg after 1-2 min.
Drug can cause brief systolic as SA/AV node is rest from reentry and NSR return.

Question 17

Tx for narrow supraventriciular tachycardia? How come it can cause asystole?

Answer 17

Tx amiodarone bolus of 150mg over 10 min, followed by initiation of a continuous infusion at 1mg/min. Could attempt synchronized cardioversion if pt is hemodynamically stable. If pt is hemodynamically unstable, immediate defibrillation is required. Can lead to Torsades de pointes.

Question 18

Torsades is a type of ventricular tachycardia that shows polymorphous origination. Tx?

Answer 18

IV MgSO4 1-2 grams over 30-60seconds. Can repeat 5-15min.

Question 19

How are ventricular/wide tachycardias treated?

Answer 19

Vagam maneuvers. Adenosine and CC blockers can be even for a symptomatic rhythm.

Question 20

How should you treat V fib?

Answer 20

immediate CPR and or defibrillation. Rhythm should be confirmed and pulses checked.

Question 21

How would you tx systole?

Answer 21

epinephrine or vasopressin.

Epinephrine is administered 1 mg IV every 5 min until return of rhythm. Vasopressin 40 u is given as a one time dose in replacement for 1 or 2 dose of epinephrine. Cont CPR should be continue with freq pulse checks to ensure adequate compressions. Pt will need intubation if not immediately converted to ensure adequate oxygenation

Question 22

What are beta blockers affect on the body?

Answer 22

reduce heart rate and contractility, while increasing diastolic filling pressures. (atenolol, metoprolol, esmolol, labetalol). Drugs should be not be withdrawn rapidly to prevent rebound effects like unstable angina, HTN, and MI.

Question 23

How do ACEI meds work? Name two meds

Answer 23

Angiotensin converting enzyme inhibitors causes vasodilation and afterload reduction, decreased L ventricular workload. Drugs block conversion of angiotensin I to angiotensin II. i.e captopril and enalapril. Complication is hypotension, esp in volume depleted pt.

Question 24

What does ACEI stand for?

Answer 24

Angiotensin concerting enzyme inhibitors.

Question 25

How does ARB work?

Answer 25

Angiotensin II receptor blockers works similarly to ACEIs. Primary func is to blocks the effects of angiotensin II (a potent chemical that causes the vessels to contract). The vessels dilate and reduces BP. Meds: losartan, irbesartan, valsartan. Hf and HTN responds well to ARB. Can also be used to prevent renal failure.

Question 26

ARBs stand for?

Answer 26

Angiotensin II receptor blockers

Question 27

ARB med examples?

Answer 27

Losartan, irbesartan, valsartan

Question 28

Function of inotropics?

Answer 28

improve cardiac contractility

Question 29

Inotropic pathophys? what happens to electrolytes?

Answer 29

Func to improve cardiac contractility. So improved CO by decreased filling pressures.
Digoxin is a cardiac glycoside, regulates HR and classified as a weak inotrope. Although it’s a positive inotrope that strengthens the heart beat by increasing the amount of calcium in the heart’s cells. Med draws potassium and sodium into the cells, which prevents the Ca from leaving the cells.
Dobutamine is another example. Milrinone directly relaxes vascular smooth muscle and increases myocardial contractility. Most inotropes cause tachycardia.