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Pharm 201 > Chapter 25 and 28 > Flashcards

Chapter 25 and 28 Flashcards

1
Q

Coronary Artery Disease

A

Narrowing or occlusion of a coronary artery

Narrowing causes myocardial ischemia

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2
Q

atherosclerosis

A

Most common etiology of CAD

Caused by presence of plaque & inflammation

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3
Q

Nitrates

A 
Potent vasodilators (coronary arteries)
main treatment for angina
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4
Q

Nitrates action

A

relax arterial & venous smooth muscle

Reduces preload → decreases cardiac output and cardiac demand → myocardial oxygen demand

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5
Q

Nitrates adverse effects

A

Headache, dizziness, hypotension, flushing, rash

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6
Q

Avoid with nitrates

A

no alcohol

no viagra

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7
Q

Myocardial Infarction tx

A 
Nitrates
Beta-blockers
Thrombolytics
Asprin
Statins for hyperlipidemia
ACE inhibitors 
Platelet Aggregation Inhibitors
Heparin drip
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8
Q

Hematopoiesis

A

Process of blood-cell formation

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9
Q

Where does hematopoiesis begin

A

Begins with stem cells in bone marrow

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10
Q

Where is hematopoiesis begin

A

Homeostatic control maintained by hormones and growth factors

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11
Q

Demands of body on WBC

A

White blood cells (WBCs) can increase concentration up to ten times normal

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12
Q

Demands of body on RBC

A

Red blood cells (RBCs) can increase up concentration up to five times normal

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13
Q

Epoetin alfa (Epogen, Procrit) category

A

Erythropoiesis-stimulating Agents

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14
Q

Epoetin alfa (Epogen, Procrit) action

A

Hormone that stimulates RBC production
Secreted inreduction in oxygen
Body experiences hypoxia or hemorrhage

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15
Q

Epoetin alfa (Epogen, Procrit) use

A

anemia due to CRF, HIV infection treated with AZT, some cancers

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16
Q

Epoetin alfa (Epogen, Procrit) adverse effects

A

Hemoglobin > 12 g/dL increased risk death, arterial & venous thromboembolic events, tumor progression
HTN, H/A, seizures, flu-like symptoms, N/V/D, rash
Black box warning

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17
Q

Darbepoetin alfa (Aranesp) category

A

Erythropoiesis-stimulating Agents

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18
Q

Darbepoetin alfa (Aranesp) duration

A

Longer duration of action than Epoetin alfa: administered 1x/week

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19
Q

Darbepoetin alfa (Aranesp) uses

A

anemia due to CRF & chemotherapy

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20
Q

erythropoiesis-stimulating agents (ESAs) FDA warning

A

not for use in PT’s w/ cancer or getting myelosuppressive therapy when the anticipated outcome is cure

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21
Q

Erythropoietin client teaching

A

Monitoring BP
correct injection technique
reporting side effects

22
Q

Clients Receiving Epoetin Alfa what to monitor

A 
BP
seizure activity
H+H
signs of thrombosis
dietary intake for essential nutrients
23
Q

Granulocyte CSF (G-CSF) function

A

colony stimulating factor

increases production of neutrophils

24
Q

Granulocyte/macrophage CSF (GM-CSF) function

A

colony stimulating factor

stimulates production of both neutrophils and macrophages

25
Q

Colony-Stimulating Factors considerations

A

monitor for hypertension, bone pain, respiratory distress and ST-segment depression

26
Q

Avoid Colony-Stimulating Factors with

A

clients with kidney and liver impairment

27
Q

Colony-Stimulating Factors teaching

A

how to avoid infections and to report adverse symptoms

28
Q

What to monitor in clients on Filgrastim (Neupogen)

A 
VS
S/Sx of infection
CBC
hepatic status
bone pain
29
Q

Platelet Enhancers cautions

A

use in caution in PT’s with cardiac disease
withhold 12 hours before and after radiation
avoid injury

30
Q

What to monitor with Platelet Enhancers

A

Monitor clients with hx of edema

Report Edema; change in urinary output or body weight or Bleeding; difficulty breathing

31
Q

Anemia

A

Blood has reduced capacity to carry oxygen

32
Q

Anemia can cause

A

Hemorrhage
Excessive erythrocyte destruction
Insufficient erythrocyte synthesis

33
Q

Anemia symptoms

A 
Pallor
Decreased exercise tolerance
Fatigue, dizziness and fainting
Increased RR and HR
Heart failure
34
Q

Antianemic Agents

A

Vitamins and minerals

Enhance oxygen-carrying capacity of blood

35
Q

Antianemic Agents examples

A

Most common are cyanocobalamin (B12), folic acid, and ferrous sulfate

36
Q

Intrinsic Factor

A

Protein secreted by stomach cells

Required for vitamin B12 metabolism

37
Q

Pernicious Anemia

A

Vitamin B12 deficiency

Sx can be reversed but nervous system damage may be permanent

38
Q

Pernicious Anemia treatment

A

cyanocobalamin

39
Q

Pernicious Anemia causes

A

Chronic alcoholism, fad diets, absorption diseases

40
Q

Folic acid deficiency in pregnancy

A

linked to neural-tube defects

41
Q

Cause of Folic acid deficiency

A

lack of sufficient dietary intake

42
Q

Folic acid anemia absorption

A

does not need intrinsic factor to be absorbed

linked to pernicious anemia (decreased B12 causes decreased folic acid)

43
Q

Antianemic Agents—Vitamin B12 and Folic Acid considerations

A

assess cause of anemia
monitor RR and cardiac
monitor K+
report SOB and edema

44
Q

Iron uses

A

Essential for metabolism and energy

45
Q

Ferritin and hemosiderin

A

maintain iron inside cells

46
Q

Transferrin

A

transports iron to other body sites

47
Q

Free iron

A

toxic

binds to protein complexes

48
Q

Iron Deficiency tx

A

iron supplements

49
Q

Iron Deficiency cause

A

Acute or chronic blood loss, peptic ulcer

Heavy menstruation, pregnancy, intensive athletic training

50
Q

Iron supplements teaching

A

Take iron with food
**Use straw to prevent staining teeth
Report signs of bleeding

Pharm 201 (24 decks)

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