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Pharmacology > Chapter 6 > Flashcards

Chapter 6 Flashcards

1
Q

What do we measure on an EKG?

A

P wave
QRS complex
ST segment
T wave

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2
Q

What does the PR interval tell us?

A

atrial depolarizations

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3
Q

What is the time that the PR interval should be?

A

0.2 seconds

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4
Q

what is the QRS segment

A

ventricular depolarization

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5
Q

what is the QT segment?

A

ventricular repolarization

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6
Q

preload

A

volume in ventricles prior to contraction

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7
Q

stroke volume

A

volume of blood pumped out of the ventricles

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8
Q

cardiac output

A

volume of blood pumped by each ventricle in one minute

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9
Q

what is the equation for cardiac output

A

CO = SV x HR

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10
Q

ejection fraction

A

% of blood pumped from the heart with each contraction

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11
Q

describe the relationship between heart rate and cardiac output

A

HR increases
less filling time
Decreased cardiac output

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12
Q

PNS does what

A

decreases HR

vagus nerve

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13
Q

SNS does what

A

increases HR
norepinephrine
decrease CO

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14
Q

why might someone have edema?

A

hypertension
heart failure
severe protein deficiency
renal failure

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15
Q

What makes pulmonary arteries different from other arteries?

A

they are the only arteries that carry blood to the heart

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16
Q

Blood pressure is influenced by what

A
  • Cardiac output
  • Compliance (ability of any compartment to expand to accommodate increased content)
  • blood volume (hypovolemia/ hypervolemia)
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17
Q

When should you NOT administer cardiac meds

A

BP lower than 100

HR higher than 100

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18
Q

What factors are involved in the homeostatic regulation of the CV system?

A

Neural (ANS)
Endocrine (epinephrine, norepinephrine, ADH)
RAAS (renin angiotensin aldosterone system)

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19
Q

Kidney functions

A

filtration, reabsorption, secretion, regulate BP, produce RBC, eliminate drugs and hormones

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20
Q

What causes vasoconstricion (hormone)

A

seratonin

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21
Q

fibrinolysis

A

degradation of a clot

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22
Q

What are plasma anticoagulants

A

oppose coagulation

thrombus (clot)

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23
Q

WBC count range

A

4,000 to 10,000

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24
Q

platelet count range

A

150,000 to 400,000

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25
Q

hyperlipidemia takes what into account?

A

total cholesterol
triglycerides
LDL
HDL

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26
Q

normal ranges for cholesterol triglyceries, LDL and HDL

A 
Cholesterol = less than 200 
triglycerides = less than 150
LDL = less than 100 
HDL = greater than 50
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27
Q

What is a big side fx to hypertension meds that impacts compliance?

A

ED / incompotence

fatigue because BP is lower than what it usually is

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28
Q

embolus

A

a traveling thrombus

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29
Q

describe the damage that thrombi and emboli can do

A

they are caused by vessel damage
DVT
impede blood flow to tissues
platelets get stuck on fatty streaks of plague and this eventually forms a thrombus

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30
Q

Atherosclerosis

A

damage to vessel wall from irritation causing scar tissue

– lipids become attached to the lining of the arterial wall – causing narrow arteries

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31
Q

Coronary artery disease

A

plague buildup in coronary arteries block blood flow delivering to cardiac muscle

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32
Q

MI

A

lack of blood flow to the cardiac muscle resulting in death of tissue

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33
Q

Cerebrovascular accident

A

interruption in cerebral arteries to the brrain

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34
Q

Cerebrovascular accident: TIA

A

transient ischemic attack

  • for a period of time, an area of the brain has no CO2
  • all symtoms resolve in 24 hours
  • indicates that a worse embolic event is going to happen
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35
Q

Cerebrovascular accident: CVA

A

i think this is a stroke

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36
Q

Hemorrhagic vs embolic stroke

A

Ischemic strokes are caused by atherosclerosis or a blood clot that blocks the flow of blood to the brain

Hemorrhagic strokes are caused by a blood vessel that ruptures and bleeds into the brain.

37
Q

Arrhythmia

A

deviation from the normal pattern of impulse conduction and contraction

38
Q

Describe what is happening what there is a heart block

A

there is a delay in conduction, or disassociation in conduction between the atrium and the ventricle

39
Q

Atrial fibrillation

A

atrium are not contracting; they are quivering –> blood is not ejected out of the properly; sit in atrium and clots; some people have symptoms; treat with meds that slow the HR to restore to normal sinus rhythm

40
Q

ventricular tachycardia

A

sometimes w pulse and sometimes without a pulse (unstable); associated with people who are in CHF or recent MI; treat with meds that slow heart rate

41
Q

What is the normal PR interval value? what does it indicate if it is normal that that value?

A

PR interval normal is less than 0.2 seconds

–> if it is greater than this, its heart block

42
Q

heart failure

A

heart is not pumping enough to meet the bodies needs

43
Q

right sided heart failure

A

unable to pump to the lungs to pick up o2

44
Q

left sided heart failure

A

unable to pump o2 to rest of body

45
Q

What are things to check during the nursing process before administering cardiac medications?

A

Assessment (BP, HR, electrolytes, kidney function, coagulation)

implementation (is the med. appropriate at this time?)

Evaluation (produce desired response?)

46
Q

extrinsic vs intrinsic pathway

A

The quick response; begins when damage occurs to the surrounding tissues; events of this pathway are completed in a matter of seconds.

intrinsic –> longer and more complex. In this case, the factors involved are intrinsic to (present within) the bloodstream. The pathway can be prompted by damage to the tissues or resulting from internal factors such as arterial disease. The events in the intrinsic pathway are completed in a few minutes.

47
Q

What do the intrinsic and extrinsic pathways lead to?

A

common pathway – where fibrin is produced to seal off the vessel. Once Factor X has been activated by either the intrinsic or extrinsic pathway, Factor II, the inactive enzyme prothrombin, is converted into the active enzyme thrombin. Then thrombin converts Factor I, the soluble fibrinogen, into the insoluble fibrin protein strands. Factor XIII then stabilizes the fibrin clot.

48
Q

What are types of BP medications?

A

Diuretics
ACE inhibitors
Calcium channel blockers
Angiotensin II receptor blocker

49
Q

what do ACE inhibitors do?

A

Block conversation of angiotensin I to angiotensin II

50
Q

ACE inhibitor drugs all end in what?

A

-PRIL

51
Q

ACE inhibitors: who is contrindicated?

A

pregnancy and impaired renal functions

52
Q

ACE inhibitor side effects

A

cough
angioedema
pancytopenia
hyperkalemia

53
Q

Angiotensin II Receptor Blockers do what?

A

block the release of aldosterone by binding with the angiotensin II receptors

54
Q

Angiotensin Receptor Blockers (ARB) medications all end in what

A

-SARTAIN

55
Q

Angiotensin Receptor Blockers (ARB): who is contraindicated?

A

pregnancy and renal dysfuntions

56
Q

Angiotensin Receptor Blockers (ARB) side effects

A

cough and pancytopenia (but much less than ACE inhibitors)

57
Q

What is an examples of a Calcium Channel Blocker?

A

diltiazem

PINES (?)

58
Q

what do calcium channel blockers do?

A

relax and dilate arteries and slow cardiac impulse

- can be used for arrythmias

59
Q

calcium channal blocker: administratoin considerations

A

no grapefriut

immunosupression (sore throat is common)

60
Q

what are examples of vasodilators

A

hydralazine and nitroprusside

61
Q

when are vasodilators used?

A

hypertension emergencies

62
Q

how do vasodilators work

A

cause vascular smooth muscle contraction

63
Q

what is a byproduct of nitroprusside

A

cyanide

64
Q

how might nitroprusside cause hypothyroidism?

A

blocks idodine uptake and cause hypothyroidism

65
Q

what is an example of a nitrate

A

nitroglycerine

66
Q

what is something to know about nitrates

A

do not combine with other nitrates

67
Q

how should you take nitrates

A

sitting or lying down

68
Q

why should you keep your bottle of nitroglycerine out of sunlight?

A

the sun can break down the compounds

69
Q

what diuretic is first line of defsense for hypertesnion?

A

Thiazide - produced little increase in urine volume

70
Q

what is something to keep in mind about Thiazide?

A

sulfa allergy

71
Q

compare Ka sparing / wasting diurertics

A

Ka sparing - causes hyperkalemia

Ka wasting - causes hypokalemia

72
Q

what do diuretics affect

A

sodium and blood volume

73
Q

what are anti-hypotensive angents?

A

Vasopressors

  • dopamine
  • dobutamine
  • ephedrine
  • epinepherine
  • norepinephrine
74
Q

What type of meds are used for heart failure?

A

cardiac glycosides

75
Q

what is an example of a cardiac gylcoside

A

digoxin

76
Q

what does digoxin do

A

increase cardiac contractilibity, slow HR

  • therapeutic level and antidote
  • Ka
77
Q

what are 2 examples of anti arrhythmic meds

A

lidocaine

amiodarone

78
Q

What do you want to do before giving anti arrhythmic meds

A

check heart rate

- do give to someone who is bradycardic (HR<60)

79
Q

what are examples of anticoagulants

A

Heparin
Warfarin
Enoxaparin

80
Q

What do anticoagulants do

A

prevent new clots

81
Q

what do you want to check before giving anticoagulants

A

labs

82
Q

what do anticoagulants increase the risk of?

A

bleeding

83
Q

What are 2 examples of antiplatelet drugs, and what is a major side effect

A

aspirin
Clopidogrel

bleeding

84
Q

What are 3 exmaples of thrombolytics

A

urokinase
streptokinase
tPA

85
Q

What do thrombolytics do and what is a major side effect?

A

bust up clot

bleeding

86
Q

what are examples of antihyperlipidemic meds

A

statins

87
Q

what are side effects of antihyperlipidemic meds

A 
hepatotoxic 
Rhabdo (muscle pain)
niacin flushing (take aspirin)
88
Q

cholestyramine is what and causes what

A

antihyperlipidemic med and causes constipation

Pharmacology (10 decks)

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