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test 2 nursing > CV Pharmacology > Flashcards

CV Pharmacology Flashcards

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0
Q

What are ACE inhibitors used for:

A
  • hypertension
  • heart failure
  • myocardial infarction
  • diabetic and nondiabetic nephropathy
  • clients at high risk for a CV event
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1
Q

What are the side effects of ACE inhibitors

A
  • First dose orthostatic hypotension with diuretics
  • cough related to kinase
  • Hyperkalemia
  • rash
  • Angioedema– d/c drug- administer epinephrine
  • neutropenia- rare- monitor WBC
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2
Q

Medication and food interactions for ACE inhibitors

A
  • diuretics - first dose hypotension
  • antihypertensive meds-additive effect
  • K+ supplements
  • ⬆️ levels of lithium carbonate
  • NSAIDS- ⬇️ risk of effect of ACR
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3
Q

ACE inhibitor suffix

A

“-pril”

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4
Q

ARBs suffix

A

“-sartan”

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5
Q

What are ARBs used for:

A
  • hypertension
  • HF and prevention of mortality following MI
  • stroke prevention
  • delay progression of diabetic nephropathy
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6
Q

What are the side effects of ARBs

A
  • Angioedema

* Fetal injury

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7
Q

K+ sparing diuretics

A

“-tone”

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8
Q

Loop diuretic

A

Furosemide (Lasix)

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9
Q

Thiazide Diuretics

A

Hydrochlorothiazide

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10
Q

Discontinue what medication before starting ACE inhibitors?

A

Discontinue diuretics 3 days before starting ACE inhibitors

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11
Q

Loop Diuretic Medication

A

Furosemide (Lasix)

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12
Q

Thiazide Diuretic Medication

A

hydrochlorothiazide

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13
Q

K+ sparing diuretic medication

A

“-tone” spironolactone/aldactone

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14
Q

Osmotic Diuretic Medication

A

Mannitol

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15
Q

Potassium and Digoxin concerns

A

Low K+ level will potentiate the action of Digoxin

Place patients on Digoxin at risk for toxicity

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16
Q

ACE Inhibitor Medications

A

Enalapril
Captopril
Lininopril

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17
Q

ACE inhibitors are what?

A

Vasodilators

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18
Q

Pressor

A

Something which causes the BP to go up

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19
Q

Alpha pressor

A

Pressurizes the arteries - Tighten up the arteries by stimulating the alpha receptors in the arteries

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20
Q

Beta pressor

A

Pressurizes heart or lungs - stimulate the beta1 receptors in the heart - this increases both HR and inotropy (contractility), which ↑ CO and hopefully BP

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21
Q

Beta 1

A

Heart

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22
Q

Beta 2

A

Lungs

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23
Q

Beta Blocker Medications

A

metoprolol (Lopressor)

atenolol

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24
Q

4 B’s to watch out for when giving Beta Blockers

A

Bradycardia < 60
Decreased BP
Bronchoconstriction
Blood Sugar Masking

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25
Q

A calcium channel blocker is a what?

A

Vasodilator

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26
Q

Calcium Channel Blocker medications

A

amlodipine (Norvasc)
nifedipine (Procardia)
diltiazem (Cardizem)

27
Q

Calcium Channel Blockers - MUCH

A

Meals give with
Under 100 systolic
Blocks calcium
Hypertension

28
Q

ARBs Medications

A 
losartan (Cozaar)
candesartan (Atacand)
losartan (Cozaar)
valsartan (Diovan)
telmisartan (Micardia)
olmesartan (Benicar)
29
Q

Hypertension and CHF Medications ABCD

A

Ace Inhibitors
Beta Blockers
Calcium Channel Blockers
Diuretics

30
Q

Hypertension Medications

A

Diuretics - volume depletion
Aldosterone Receptor Blockers - inhibits aldosterone binding
Beta-Blockers - block SNS, ↓ HR and BP, used after MI
Vasodilators - ↓ peripheral resistance –> ↓ BP & ↑ CO
ACE inhibitors - ↑ peripheral resistance –> ↓ BP
Calcium Channel Blockers - ↓ workload of heart through arterial vasodilation, reduce cardiac afterload

31
Q

HTN Medications 2 main actions

A

Decrease the volume of circulating blood

Reduce SVR

32
Q

Vasodilators

A 
Hydralazine (Apresoline)
Nitrates (Nitroglycerine)
Beta blockers
ACE inhibitors
CCBs
33
Q

MI/Unstable Angina – MONA

A

Oxygen at 4L/min
Aspirin - antiplatelet action
Nitroglycerin SL or spray - if BP > 90
Morphine IV - if pain not relieved with NTG

34
Q

Medications used to treat HF

A 
ACE Inhibitors - lower PVR, ↓ BP
ARBs - same as above
Diuretics - remove fluid from the body
Cardiac Glycosides - digoxin
Beta-Blockers - block SNS, ↓ workload of the heart
35
Q

Nitrates are used to treat

A

Ischemia
Angina
MI

36
Q

Nitrates do what

A

Dilate veins, reducing preload, dilate coronary arteries

Increase blood flow

37
Q

Short Acting Nitrate Medication

A

Nitroglycerin

38
Q

Long Acting Nitrate Medication

A

Isordil
Nitroglycerin ointment
nitro transdermal patch

39
Q

Nitroglycerin used to treat

A

Acute anginal attacks
Instruct to lie down
Repeat at 5 minute intervals
If pain persists after 3 doses –> Dr. or ER

40
Q

Dysrhythmia Medication Classifications

A 
Class 1 - Sodium Channel Blockers
Class 2 - Beta blockers
Class 3 - Potassium channel blockers
Class 4 - Calcium channel blockers
Misc. - Adenosine and Digoxin
41
Q

Sodium Channel Blocker Medication

A

Quinidine

Lidocaine

42
Q

Potassium Channel Blocker Medications

A

Amiodarone

43
Q

Misc. Dysrhythmia Medications

A

Adenosine

Digoxin

44
Q

Digoxin Toxicity

A 
anorexia
N&V
visual disturbances (halos, blurry vision)
lethargy
bradycardia
heart block
tachydysrhythmias
45
Q

Coagulation Modifier Drugs

A

Anticoagulants
Antiplatelet
Thrombolytic
Hemostatic or Antifibrinolytic

46
Q

Anticoagulant Medication

A

Heparin

warfarin (Coumadin)

47
Q

Adverse effects of anticoagulants

A 
BLEEDING
nausea
vomiting
abdominal cramps
thrombocytopenia
48
Q

Heparin is monitored by what

A

aPTTs

activated partial thromboplastin times

49
Q

Heparin half life

A

short

1-2 hours

50
Q

Heparin effects are reversed by what

A

protamine sulfate

51
Q

Low-molecular-weight heparins Medications

A

enoxaparin (lovenox)

dalteparin (Fragmin)

52
Q

Warfarin sodium (Coumadin) is monitered by what

A

PT-INR

Therapeutic is 2-4

53
Q

What is given if warfarin toxicity occurs?

A

phytonadione (vitamin K)

54
Q

When a patient is on warfarin, assess:

A 
patient hx, med hx, allergies
CIs
baseline VS, lab values
potential drug interactions - there are MANY
Hx of abnormal bleeding conditions
55
Q

When is warfarin started?

A

2-3 days after d/c heparin

Full therapeutic effect takes several days

56
Q

Antiplatelet Medications

A

Aspirin
dipyridamole (Perssantine)
clopidogrel (Plavix) and ticlopidine (Ticlid)

57
Q

Antifibrinolytic drugs do what?

A

Promote clot formation

58
Q

When are antifibrinolytic drugs used?

A

prevent bleeding after surgery or tubes

59
Q

Antifibrinolytic Medications

A 
aminocaproic acid (Amicar)
desmopressin (DDAVP)
60
Q

Adverse effects of antifibrinolytic drugs

A

Uncommon and mild

61
Q

Thrombolytic Medications

A 
Older: streptokinase and urokinase
Newer: 
Tissue plasminogen activator (TPA)
streptokinase (Streptase)
alteplase (Activase)
62
Q

Mechanism of action for thrombolytic drugs

A

b/d the clot in the BV quickly

63
Q

Adverse effects of thrombolytic drugs

A

BLEEDING

64
Q

Anticoagulant education

A 
Regular lab testing
signs of abnormal bleeding
measures to prevent bruising, bleeding, tissue injury
Wear medical alert bracelet
Avoid foods high in vitamin K
Consult physician before OTC meds

test 2 nursing (5 decks)

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