Chapter 25 Exam Study Guide Flashcards
What does the apical pulse rate need to be to withhold digoxin?
■ If rate is less than 60 bpm, digoxin is withheld
what is another name for adenosine-
- adenocard
adenosine is what?
- Injectable antiarrhythmic agent
- Multiple electrophysiologic activities
how does adenosine work?
- Restores normal sinus rhythm in paroxysmal supraventricular tachycardia by slowing conduction time through the atrioventricular (AV) node
what 3 properties does adenosine have?
-Vasodilatory, antiadrenergic, and negative chronotropic (decrease in rate) properties that act to decrease cardiac oxygen demand
amiodarone is also known as…
- Cordarone
what is amiodarone used for?
- Oral and injectable antiarrhythmic agent approved for treatment of refractory life-threatening ventricular arrhythmias
- preventing the recurrence of atrial fibrillation
how does amiodarone work in the muscle?
-Also relaxes both smooth and cardiac muscle, causing decreases in coronary and peripheral vascular resistance and systolic blood pressure
what is an example of Beta-Adrenergic Blockers?
propranolol
propranolol is aka….
Inderal
what are beta-blockers?
Antiarrhythmics that combat arrhythmias by inhibiting adrenergic (sympathetic) nerve receptors
beta blocker action…
–Complex action and the results can include a membrane-stabilizing effect on the heart
Examples of calcium channel blockers
verapamil & diltiazem
trade name for verapamil
Calan
trade name for diltiazem
Cardizem
verapamil and diltiazem are the only calcium channel blockers that…..
possess significant antiarrhythmic activity
Calcium channel blockers treatment…
- Indicated for treatment of atrial fibrillation/flutter and PSVT
- treatment of angina and hypertension
Calcium channel blockers conduction…
–Counteract arrhythmias by slowing AV nodal conduction
What does high blood pressure increase?-
– The risk of angina – Myocardial infarction – Heart failure – Stroke – Retinopathy – Peripheral arterial disease – Kidney disease
Thiazide diuretics-
– Most patients meeting the criteria for drug therapy should be started on thiazide-type diuretics
■ Either alone or in combination with a drug from one of the other drug classes
– Appear to be as effective as other antihypertensive agents and are inexpensive
Angiotensin-Converting Enzyme (ACE) Inhibitors (ACEIs)-
– First- or second-line agents in the treatment of hypertension; decrease vasoconstriction
– Excellent alone or in combination with other antihypertensives (e.g., diuretics)
Angiotensin Receptor Blockers (ARBs) (losartan)-
– Similar to ACE inhibitors (ACEIs) (e.g., losartan)
– Block angiotensin receptor that causes vasoconstriction when stimulated by angiotensin II
Peripheral Vasodilator example
hydralazine
what is hydralazine sometimes used in the treatment of ?
moderate to severe hypertension
coronary vasodilators Include what agents?
-nitroglycerin and isosorbide
What coronary vasodilators agent is most commonly used?-
nitroglycerin
Nitroglycerin form examples-
■ SL tablets and SL spray ■ Timed-release capsules ■ Patch ■ Ointment ■ IV
Bile Acid Sequestrants examples
– cholestyramine (Questran) and colesevelam (WelChol)
Bile Acid sequestrants function…
– Bind bile acids in the intestine, interrupting the process by which bile acids are returned to the liver for reuse
Nicotinic Acid (Niacin) example…
Niaspan
Nicotinic acid function…
– Reduces hepatic synthesis of triglycerides; inhibits the mobilization of free fatty acids from the peripheral tissues
nicotinic acid raises what?
-Raises HDL cholesterol levels
nicotinic acid lowers what?
–Lowers serum total, LDL cholesterol, and triglyceride levels
Fibric Acid Derivatives (Fibrates) function…
effective in patients who have extremely high triglyceride levels, elevated cholesterol levels, and combined forms of hyperlipidemia
why is fibric acid derivatives a good choice for diabetics?
because they improve glucose tolerance
fibrates fenofibrate example
TriCor
gemfibrozil example
Lopid
Cholesterol Absorption Inhibitor-
moderately reduces LDL by inhibiting intestinal absorption of both dietary and biliary cholesterol, blocking its transport in the small intestine
cholesterol absorption inhibitor example
Zetia
– (EPA) and (DHA) are found in….
fatty cold-water fish
– (ALA) found in
flaxseed, tofu, soybean oil, canola oil, and nuts
what do fatty acids do?
– Prevent primary and secondary heart disease and reduce triglycerides
best source of fatty acids…
– Best source fatty fish, like salmon, and fish oil capsules (OTC)
omega 3 fatty acids prescription…
– Lovaza – prescription only
Warfarin function
– Alters synthesis of blood coagulation factors in the liver by interfering with the action of vitamin K
Platelet inhibitors-
■ utilize a variety of mechanisms to interfere with activation pathways to prevent platelet clumping
platelet inhibitors are given as prophylactic therapy or as secondary prevention in patients with a history of……
stroke, recent MI, or PVD
Aspirin therapy-
– Ability to inhibit platelet aggregation clumping
– Used after myocardial infarction or recurrent transient ischemic attacks to reduce risk of recurrence
– Used to reduce risk of myocardial infarction in patients with unstable angina
– Tissue plasminogen activator (t-PA) is…
a natural peptide that initiates fibrinolysis
thrombolytic agents function…
dissolve and liquefy the fibrin of an existing clot
thrombolytic drugs do what?
potentiate t-PA, resulting in clot dissolution, reperfusion of organs, and restoration of blood flow to tissues
Erythropoiesis-Stimulating Agents-
– Responsible for regulation of the production and development of blood cells, normally in the bone marrow
examples of erythropoiesis-stimulating agents
Epogen or Procrit
erythropoiesis stimulating agents are approved for what…?
–Approved for treatment of anemia, chronic renal failure
CSF definition
–Lessens severity of myelosuppression in cancer patients; has allowed chemotherapy dose intensification or maintenance of dose intensity
filgrastim (Neupogen)
is involved in the regulation and production of neutrophils in response to host defense needs
