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Pharm 2 > Chapters 22 & 23 > Flashcards

Chapters 22 & 23 Flashcards

1
Q

Blood fluid coming back into heart. Stretch of ventricles.

A

Preload

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2
Q

Combination of cardiac output and systemic vascular resistance. Minimum pressure to push fluid throughout the body.

A

blood pressure

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3
Q

Persistent systolic bp over 150 and or diastolic over 90

A

hypertension

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4
Q

Amount of pressure against which the heart must work to eject blood during systole.

A

Afterload (SVR)

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5
Q

Cardiac output per minute

A

4-8L/min

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6
Q

Why is HTN called the silent killer

A

organs are being damaged

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7
Q

How do we decrease BP?

A

dilate the arteries

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8
Q

With higher bp how do the arteries react?

A

shears and damages inside arteries increasing risk of artherosclerosis

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9
Q

90% of the cases have this type of htn

A

Primary or idiopathic (essential HTN)

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10
Q

Non-pharm treatments usually used to begin with in patients with HTN

A

diet, exercise, salt reduction, yoga

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11
Q

Peripheral blockers work against SNS

A

Alpha 1/Beta 1

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12
Q

Central agonists work SNS

A

Alpha 2

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13
Q

What adverse effects to the adrenergics do against the SNS

A

Bradycardia, hypotension-syncope, CNS depression

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14
Q

How long could it take for full effects against the adrenergics?

A

4-6 weeks

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15
Q

Alpha 2 agaonists. Most commonly used method is patches.

A

Clonidine (Catapress)

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16
Q

Alpha 1 Blocker. Extended release tablets- caplet will be defecated. Make sure patient understands and knows that medication has been absorbed.

A

Doxazosin (Cardura)

Prazosin (Minipress)

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17
Q

Dual alpha/beta blocker that is used.

A

Carvedilol (Coreg)

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18
Q

Decrease the heart rate and myocardial contractility. Reduce cardiac output and workload

A

Beta-adrenergic antagonists

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19
Q

What do ACE inhibitors block?

A

bock conversion of angiotensin 1 to 2

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20
Q

When are ACE inhibitors given to patients

A

slow progression of heart failure
given after MI
Can delay progression of kidney failure in diabetes

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21
Q

Given PO, well tolerated. ACE Inhibitor meds. (pril meds)

A

Catopril (capoten)

Lisinopril (zestril)

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22
Q

Adverse Effects of ACE Inhibitors.

A

cough due to bradykinin excess, Hyperkalemia

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23
Q

Contraindications of ACE inhibitors

A

Renal failure pregnance in 2nd and 3rd trimester

24
Q

Prevent angiotensin 2 from activating its target receptors. Have long half lives so can be given PO once daily.

A

Angiotensin 2 Receptor Blockers (ARB)

25
Q

Report headaches/dizziness due to hypotension. ARB. Given if patient cannot tolerate ACE.

A

Losartan (Cozaar)

26
Q

Why are ACE inhibitors used more?

A

Longer on the market so more research
cheaper
Docs more comfortable with this

27
Q

Potent. Causes hypotension easily. Given PO, IM, IV. Dilates arteries= lower bp. PO encourage to take with meals- increases availability. IV reassess BP in 10 min after admin.

A

Hydralazine (Apresoline)

28
Q

Nursing responsibilities of direct acting vasodilators?

A

Don’t stop abruptly
Check for any swelling
Position changes slowly due to potential hypotension/syncope

29
Q

Adverse effects of Direct-Acting Vasodilators

A

reflex tachycardia (coadminister with Beta-blocker)

30
Q

BP lowers it causes the body to respond through the kidneys to hold on to fluid. What should be given?

A

diuretics

31
Q

Untreated or poorly controlled HTN- stopping medications “cold turkey”

A

Hypertensive Emergency (lower bp 20-25%)

32
Q

What med is given in hypertensive emergency?

A

Sodium nitroprusside (Nitropress)

33
Q

Normal creatinine and potassium lab levels?

A

Creatinine: 0.5-1.4
Potassium: 3.5-5.2

34
Q

First line agent that is used in htn in African Americans

A

HCTZ

35
Q

Insufficient blood flow/chest pain

A

angina

36
Q

Insufficient blood flow to the hart muscle from narrowing of coronary artery may cause….

A

chest pain

37
Q

When there is obstruction of blood flow to the heart tissue due to blockage

A

MI

38
Q

Very predictable. Chest pain that occurs with exertion and rest will relieve.

A

Chronic Stable Angina

39
Q

Occurs when coronary arteries spasm. Caused by vasoconstriction= not necessarily r/t atherosclerosis. Unpredictable.

A

Vasospastic- Prinzmetal angina

40
Q

Chest pain that is unpredictable, not related to exertion (so happen at rest), rest does not fix. An impending MI.

A

Unstable angina

41
Q

Dilate veins, reducing the amount of blood returning to the hear. Dilate the coronary arteries, bringing more blood to the myocardium.

A

Organic nitrates

42
Q

Short-acting nitrate. Sublingual or buccal to terminate acute angina.

A

Nitroglycerin (Nitro-stat, Nitro-bid)

43
Q

Long acting nitrate. Oral or patch to decrease frequency and severity of episodes.

A 
Isosorbide dinitrate (Isordil)
Isosorbide mononitrate (Imdur)
44
Q

Adverse effects of nitrate medications

A

flushing of skin
headache
orthostatic hypotension/syncope

45
Q

Do not take with 24 hours of _______ or other meds that cause hypotension.

A

Viagra

46
Q

When should we hold Nitrate meds?

A

If BP is less than 90/60 or HR over 100

47
Q

When is Beta Adrenergic Blockers beneficial

A

exercise and after MI

48
Q

Beta Blockers Med for prophylaxis of chronic angina

A

Atenolol (Tenormin)

Metoprolol (Lopressor)

49
Q

Adverse effects of Beta Blockers

A

Hypotension, fatigue, weakness, dizziness

50
Q

If patient is taking beta blockers and is diabetic what should we monitor?

A

glucose frequently

51
Q

Ions responsible to cause a cardiac contraction

A

Potassium (inside cell)
Sodium (outside)
Calcium (outside)

52
Q

Dilate arterial smooth muscle, reducing blood pressure and decreasing cardiac workload. Some also decrease the heart rate, reducing the workload on the heart, and dilate the coronary arteries.

A

Calcium Channel Blockers

53
Q

Reducing force of contraction is called…….

A

negative inotropic effect

54
Q

Ca Channel Blocker. Used to treat HTN and angina. Little to no effect on myocardium itself.

A

Dihydropyridines (PO)

Amlodipine (Norvasc)

55
Q

Ca Channel Blocker. Longest half-life=30-50 hours= once daily dosing.

A

Verapamil (Calan)

56
Q

Adverse effects of Ca Channel Blockers.

A

Dizziness
Flushing
Hepatotoxicity, Heart Failure (RARE)
pulmonary edema (crackles or rhonchi in lungs)

57
Q

Smooth muscle and myocardium. Used to treat HTN, angina and dysrhythmias. Have a negative inotrope effect. Lowers heart rate.

A

Nondihydropyridines

Diltiazem (Cardizem)

Pharm 2 (4 decks)

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