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drugs > DRUGS FINAL > Flashcards

DRUGS FINAL Flashcards

1
Q

pathogenesis

A

disease development

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2
Q

morphology

A

tissue and cell structure

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3
Q

non modifiable risk factors

A

age, sex, ethnicity, race, genetics

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4
Q

modifiable risk factors

A

diet, weight, activity level, substance use

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5
Q

primary prevention

A

addressing risk factors prior to onset of disease (immunizations)

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6
Q

secondary prevention

A

detecting disease while asymptomatic to treat or cure a disease process (pap smear, blood pressure monitoring, lab tests)

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7
Q

tertiary prevention

A

intervening to prevent further deterioration and/or limit disease complications (medications, surgeries, support groups)

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8
Q

hypoxic cellular injury

A

deprives cells of oxygen and interrupts oxidative metabolism and ATP generation

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9
Q

causes of hypoxic cell injury

A

inadequate oxygen in air, respiratory disease, inability of cells to use oxygen, edema, ischemia

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10
Q

pharmacokinetics

A

mechanisms by which medications travel throughout the body and undergo biochemical processes to achieve outcomes

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11
Q

ADME

A

absorption, distribution, metabolism, excretion

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12
Q

half-life

A

amount of time required for the body to metabolize half of the medication

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13
Q

pharmacodynamics

A

relationship between the medication and the organ systems to produce effects

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14
Q

agonist

A

bind to or mimic receptor activity

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15
Q

antagonist

A

block the usual receptor activity

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16
Q

cardinal signs of inflammation

A

rubor (redness), tumor (swelling), calor (heat), dolor (pain), functio laesa (loss of function)

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17
Q

serous exudate

A

watery, minimal proteins; results from plasma entering the inflammatory site

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18
Q

hemorrhagic exudate

A

occurs with severe tissue injury that causes damage to blood vessels or when there is significant leakage of RBCs from capillaries

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19
Q

membranous or pseudomembranous

A

mucous membrane surfaces; composed of necrotic cells within a fibropurulent exudate

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20
Q

purulent or suppurative exudate

A

contains pus; composed of degraded leukocytes, proteins, and tissue debris

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21
Q

fibrinous exudate

A

contains large amounts of fibrinogen; forms a thick and sticky meshwork

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22
Q

healing by primary intention

A

small, clean wound; no tissue loss

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23
Q

healing by secondary intention

A

great loss of tissue with contamination

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24
Q

stages of healing

A

inflammatory, proliferative, remodeling

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25
Q

inflammatory stage of healing

A

onset at time of injury; formation of blood clot and migration of phagocytes

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26
Q

proliferative stage of healing

A

primary aim to build new tissue to fill wound space

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27
Q

remodeling stage of healing

A

onset 3 weeks after injury with the development of scarring; decreased vascularity

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28
Q

causes of impaired wound healing

A

malnutrition, impaired blood flow and oxygen delivery, impaired inflammatory and immune responses, infection, wound separation, foreign bodies, aging

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29
Q

functions of nervous system

A

controls skeletal muscle movement, help regulate cardiac and visceral smooth muscle, enable reception, integration, and perception of sensory information, facilitate adjustment to external environment

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30
Q

ANS functions

A

regulating, adjusting, and coordinating vital visceral functions (blood pressure, blood flow, body temperature, respiration, digestion, metabolism, elimination)

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31
Q

nociceptive pain

A

nociceptors are activated in response to actual or impending tissue injury

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32
Q

neuropathic

A

arises from direct injury to nerves

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33
Q

cutaneous

A

sharp, burning pain; origin in skin or subcutaneous tissues

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34
Q

deep somatic

A

more diffuse and throbbing, origin in body structures

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35
Q

visceral

A

diffuse and poorly defined; results from stretching, distention, and ischemia of tissues

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36
Q

referred

A

originates at visceral site but perceived as originating in part of the body wall that is innervated by neurons entering the same segment of the NS

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37
Q

nonpharmacologic pain management

A

cognitive-behavioral (relaxation, distraction, guided imagery, biofeedback), heat, cold, acupuncture

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38
Q

pharmacologic interventions

A

non-opioid analgesics (NSAIDS, acetaminophen), opioid agonists (morphine), opioid antagonists (naloxone), adjuvant agents (gabapentin)

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39
Q

first generation NSAIDS

A

ibuprofen, naproxen, diclofenac, ketorolac)

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40
Q

NSAIDS therapeutic use

A

inflammation suppression, mild-moderate pain, fever reduction

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41
Q

NSAIDS complications

A

DYSPEPSIA, HEARTBURN, abdominal pain, nausea, decreased urine output, weight gain, increased BUN/creatinine

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42
Q

NSAIDS contraindications

A

hypersensitivity reactions, pregnancy, PUD, bleeding disorders

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43
Q

NSAIDS interactions

A

anticoagulants, glucocorticoids, EtOH, OTC medications

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44
Q

acetaminophen therapeutic uses

A

analgesia, antipyretic effects, preferred in children with viral infection

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45
Q

acetaminophen complications

A

ACUTE TOXICITY: liver damage with NVD, sweating, abdominal pain

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46
Q

acetaminophen contraindications

A

pregnancy, hypersensitivity reactions, liver disease, EtOH

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47
Q

acetaminophen interactions

A

EtOH, anticoagulants, acetylcysteine

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48
Q

morphine therapeutic uses

A

moderate to severe pain, sedation

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49
Q

morphine complications

A

RESPIRATORY DEPRESSION, CONSTIPATION, URINARY RETENTION, SEDATION, OPIOID TOXICITY TRIAD (coma, respiratory depression, pinpoint pupils), orthostatic hypotension, cough suppression, NV

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50
Q

morphine contraindications

A

caution in pregnancy, premature infants, respiratory conditions, GI conditions with constipation, hepatic/renal disease

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51
Q

morphine interactions

A

CNS DEPRESSANTS, anticholinergics, antihypertensives

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52
Q

naloxone therapeutic uses

A

reversal of opioid effects

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53
Q

naloxone complications

A

tachycardia, tachypnea, abstinence syndrome

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54
Q

naloxone contraindications

A

pregnancy, opioid dependence

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55
Q

naloxone interactions

A

opioid agonists

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56
Q

gabapentin therapeutic uses

A

neuropathic pain, neuralgia

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57
Q

gabapentin complications

A

bone marrow suppression, NVD, constipation, drowsiness, rash

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58
Q

gabapentin contraindications

A

pregnancy

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59
Q

gabapentin interactions

A

CNS depressants

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60
Q

migraine clinical manifestations

A

without aura: pulsatile, throbbing, unilateral headache that lasts 1-2 days and is aggravated by routine physical activity; NV, photophobia, phonophobia
with aura: similar to without aura, with reversible visual symptoms; flickering lights, spots, lines, numbness

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61
Q

pharmacologic management of migraines

A

NSAIDS, acetaminophen, serotonin receptor agonists (triptans): sumatriptan

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62
Q

sumatriptan therapeutic uses

A

abortive therapy for migraine

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63
Q

sumatriptan complications

A

CHEST PRESSURE (heavy arms, chest tightness), coronary artery vasospasm/angina, DIZZINESS

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64
Q

sumatriptan contraindications

A

pregnancy risk vs reward, liver failure, ischemic heart disease, MI history, uncontrolled HTN, cardiovascular disease

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65
Q

sumatriptan interactions

A

MAOIs, concurrent use of triptans, SSRIs

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66
Q

myasthenia gravis

A

disorder of transmission at the NMJ that affects communication between the motoneuron and the innervated myocyte

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67
Q

myasthenia gravis clinical manifestations

A

GENERALIZED WEAKNESS AND FATIGUE WITH SUSTAINED EFFORT, ptosis, diplopia, dysphagia, proximal limb weakness, speech impairments, MYASTHENIC CRISIS (airway and breathing)

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68
Q

myasthenia gravis treatment

A

reversible cholinersterase inhibitors (neostigmine), immunosuppressive therapies, IV immunoglobulin, supportive measures during acute crisis

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69
Q

neostigmine therapeutic uses

A

myasthenia gravis

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70
Q

neostigmine complications

A

EXCESSIVE MUSCARINIC STIMULATION (increased GI motility/secretions, diaphoresis, increased salivation, bradycardia, urinary urgency, CHOLINERGIC CRISIS (bronchospasm/cardiac arrest))

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71
Q

neostigmine contraindications

A

obstruction of renal and GI systems, seizure disorders, hyperthyroidism, PUD, asthma, bradycardia, hypotension

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72
Q

neostigmine interactions

A

atropine, NM blockers (succinylcholine)

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73
Q

Guillain-Barre syndrome

A

acute, immune-mediated polyneuropathy; results in demyelination of neurons

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74
Q

Guillain-Barre clinical manifestations

A

progressive, ascending muscle weakness of limbs, paraesthesia, numbness, cranial nerve impairments, ANS responses, pain

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75
Q

Guillain-Barre treatment

A

supportive measures based on level of paralysis, IVIG

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76
Q

Parkinson’s Disease

A

degenerative disorder of BG that results in tremors, rigidity, and bradykinesia

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77
Q

Parkinson’s clinical manifestations

A

rhythmic tremors, rigidity, bradykinesia, shuffled gait, cognitive decline

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78
Q

Parkinson’s treatment

A

nonpharmacologic: group support, daily exercise, adequate nutrition/hydration
pharmacologic: dopaminergic agents (levodopa/carbidopa), anticholinergic agents (benztropine)

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79
Q

levodopa/carbidopa therapeutic uses

A

PD

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80
Q

levodopa/carbidopa complications

A

NV, drowsiness, DYSKINESIAS (tics, tremors, head bobbing), ORTHOSTATIC HYPOTENSION, tachycardia, palpitations, psychosis

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81
Q

levodopa/carbidopa contraindications

A

cardiovascular disorders

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82
Q

levodopa/carbidopa interactions

A

pyridoxine, antipsychotics, MAOIs, TCAs

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83
Q

benztropine therapeutic uses

A

diminish cholinergic effects

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84
Q

benztropine complications

A

NV, ATROPINE-LIKE EFFECTS (dry mouth, blurred vision, urinary retention, constipation), ANTIHISTAMINE EFFECTS (sedation, drowsiness)

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85
Q

benztropine contraindications

A

glaucoma, visual disturbances, constipation, urinary retention

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86
Q

benztropine interactions

A

CNS depressants, anticholinergics, antipsychotics, TCAs

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87
Q

multiple sclerosis

A

inflammation and demyelination of cells in CNS; many exacerbations and remissions; increasing neurologic deficits with disease progression

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88
Q

MS treatment

A

nonpharmacologic: supportive care
pharmacologic: CORTICOSTEROIDS (PREDNISONE), ANTISPASMODICS (DIAZEPAM, CYCLOBENZAPRINE), Ivig, disease-modifying agents (interferon beta, mitoxantrone)

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88
Q

MS clinical manifestations

A

paresthesias, gait disturbances, pain due to spasticity, fatigue, speech disturbances

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89
Q

prednisone therapeutic uses

A

acute inflammation during MS exacerbation

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90
Q

prednisone complications

A

hyperglycemia, fluid/electrolyte imbalances, osteoporosis, ADRENAL SUPPRESSION, PEPTIC ULCERS, GI discomforts, infection

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91
Q

prednisone contraindications

A

DM, osteoporosis, endocrine disorders, GI disorders, immunocompromised/infections

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92
Q

prednisone interactions

A

ORAL ANTIDIABETIC AGENTS, NSAIDS, acetaminophen, EtOH, diuretics, immunizations, oral contraceptives, estrogens

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93
Q

diazepam therapeutic uses

A

MUSCLE SPASMS, anxiety/panic, insomnia, status epilepticus, EtOH withdrawal, anesthesia

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94
Q

diazepam complications

A

CNS DEPRESSION (sleepiness, fatigue, apathy, confusion, weakness), bradycardia, RESPIRATORY DEPRESSION, CARDIAC ARREST, incontinence, retention, dependence

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95
Q

diazepam contraindications

A

pregnancy (fetal malformations), caution with renal/hepatic impairments, comorbid cardiopulmonary conditions

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96
Q

diazepam interactions

A

CNS DEPRESSANTS

97
Q

cyclobenzaprine therapeutic uses

A

relief of muscle spasm related to muscle injury

98
Q

cyclobenzaprine complications

A

CNS DEPRESSION, ANTICHOLINERGIC EFFECTS, MI, SEIZURES, cardiac dysrhythmias

99
Q

cyclobenzaprine contraindications

A

cardiac history, seizure history

100
Q

cyclobenzaprine interactions

A

CNS DEPRESSANTS, ANTIHISTAMINES, MAOIs

101
Q

seizure

A

abnormal behavior caused by electrical discharge from neurons in cerebral cortex; classified into focal (partial) or generalized

102
Q

focal seizures

A

begin in specific area of one cerebral hemisphere; can happen with or without impairment of consciousness/awareness

103
Q

generalized seizures

A

begin simultaneously in both cerebral hemispheres; motor (tonic-clonic) or nonmotor

104
Q

status epilecticus

A

seizures that do not stop spontaneously or occur without recovery; may lead to respiratory failure/death if left untreated

105
Q

seizure treatment

A

pharmacologic: traditional AEDs (phenytoin, valproic acid), newer AEDs (levetiracetam), benzodiazepines (diazepam, lorazepam)

106
Q

phenytoin therapeutic uses

A

focal and tonic-clonic seizures

107
Q

phenytoin complications

A

CNS (nystagmus, sedation, ataxia, cognitive impairments), gingival hyperplasia, skin rashes, DYSRHYTHMIAS, CARDIAC ARREST, hypotension, ENDOCRINE (coarse facial features, hirsutism, vitamin D metabolism disturbances)

108
Q

phenytoin contraindications

A

pregnancy (teratogenic), BBW: SLOW IV PUSH

109
Q

phenytoin interactions

A

highly toxic profile with narrow therapeutic index

110
Q

valproic acid therapeutic uses

A

focal and generalized seizures (tonic-clonic, myoclonic, absence)

111
Q

valproic acid complications

A

GI (NV, indigestion, abdominal pain, anorexia, pancreatitis), HEPATOTOXICITY (jaundice), thrombocytopenia, bone marrow suppression, hyperammonemia

111
Q

valproic acid contraindications

A

pregnancy (teratogenic), BBW (risk for suicidality, liver failure, pancreatitis)

112
Q

valproic acid interactions

A

CNS DEPRESSANTS, AEDS, antibiotics, antifungals, antipsychotics

112
Q

levetiracetam therapeutic uses

A

focal and generalized seizures (tonic-clonic, myoclonic)

112
Q

levetiracetam complications

A

CNS (dizziness, agitation, anxiety, depression, SI, vision disturbances), GI (dyspepsia)

113
Q

levetiracetam contraindications

A

avoid in pregnancy, SI, psychiatric conditions

114
Q

levetiracetam interactions

A

minor interactions (oral anticoagulants)

115
Q

diazepam & lorazepam therapeutic uses

A

muscle spasms, anxiety/panic, insomnia, STATUS EPILEPTICUS, EtOH withdrawal, anesthesia

116
Q

diazepam & lorazepam complications

A

CNS DEPRESSION (sleepiness, fatigue, apathy, confusion, weakness), bradycardia, RESPIRATORY DEPRESSION, CARDIAC ARREST, incontinence, retention, dependence

117
Q

diazepam & lorazepam contraindications

A

pregnancy (risk for fetal malformations), renal/hepatic impairments, comorbid cardiopulmonary conditions

118
Q

diazepam & lorazepam interactions

A

CNS DEPRESSANTS

119
Q

GAD clinical manifestations

A

apprehension, anxiety, tension, autonomic hyperactivity, fatigue, inability to concentrate, sleep disturbances

120
Q

GAD treatment

A

nonpharmacologic: CBT, meditation/mindfulness, relaxation, supportive care
pharmacologic: benzodiazepines (alprazolam), atypical anxiolytics (buspirone), SSRIs

121
Q

alprazolam therapeutic uses

A

GAD, PANIC DISORDER, seizures, insomnia, muscle spasms, EtOH withdrawal, induction of anesthesia

122
Q

aprazolam complications

A

CNS DEPRESSANTS, anterograde amnesia, TOXICITY, paradoxical response, withdrawal effects

123
Q

alprazolam contraindications

A

not safe in pregnancy/lactation, sleep apnea, respiratory depression, short-term use

124
Q

alprazolam interactions

A

CNS DEPRESSANTS, grapefruit juice, oral contraceptives

125
Q

buspirone therapeutic uses

A

GAD, panic disorder, social anxiety, bruxism

126
Q

buspirone complications

A

DIZZINESS, nausea, HA, agitation, lightheadedness, constipation, SI

127
Q

buspirone contraindications

A

do not give within 14 days of MAOIs

128
Q

buspirone interactions

A

erythromycin, ketoconazole, St. Johns wort, grapefruit juice, CNS depressants

129
Q

MDD clinical manifestations

A

lack of interest in activities/hobbies, lack of appetite, inability to concentrate/make decisions, feelings of worthlessness, lack of energy, decreased motor skills, substance use, sleep disturbances, recurring thoughts of suicide

130
Q

MDD treatment

A

nonpharmacologic: CBT, problem-solving therapy, phototherapy, electroconvulsive therapy, supportive care
pharmacologic: SSRIs (fluoxetine), serotonin/norepinephrine reuptake inhibitors (venlafaxine), tricyclic antidepressants (amitriptyline), MAOIs (phenelzine)

131
Q

fluoxetine therapeutic uses

A

MDD, OTHER DEPRESSIVE DISORDERS, panic/GAD, bipolar disorder, social anxiety disorder

132
Q

fluoxetine complications

A

sexual dysfunction, CNS stimulation, weight loss/gain, SI, SEROTONIN SYNDROME WITHDRAWAL SYNDROME, bruxism

133
Q

fluoxetine contraindications

A

potential fetal harm, concurrent use of TCAs and MAOIs, BBW (SI)

134
Q

venlafaxine therapeutic uses

A

MDD, social anxiety disorder, GAD, panic disorder, pain

134
Q

fluoxetine interactions

A

TCAs, MAOIs, ST. JOHNS WORT, warfarin, NSAIDS, anticoagulants

135
Q

venlafaxine complications

A

nausea, anorexia, weight loss, HA, insomnia, anxiety, HTN, tachycardia, SI, dizziness, blurred vision, WITHDRAWAL SYNDROME, SEROTONIN SYNDROME, sexual dysfunction

136
Q

venlafaxine contraindications

A

avoid in pregnancy/lactation, taper slowly when discontinuing, BBW (SI)

137
Q

venlafaxine interactions

A

MAOIs, CNS DEPRESSANTS, ST JOHNS WORT, anticoagulants, NSAIDS

138
Q

amitriptyline therapeutic uses

A

DEPRESSION, depressive episodes of bipolar disorder, neuropathic pain, anxiety disorders

139
Q

amitriptyline complications

A

orthostatic hypotension, ANTICHOLINERGIC EFFECTS, SEDATION, TOXICITY (dysrhythmias, confusion, agitation, seizures, coma, death), DECREASED SEIZURE THRESHOLD, diaphoresis

140
Q

amitriptyline contraindications

A

caution in pregnancy/lactation, seizure disorders, MI history, BBW (SI)

141
Q

phenelzine complications

A

CNS stimulation, orthostatic hypotension, HYPERTENSIVE CRISIS, liver damage/disease

141
Q

amitriptyline interactions

A

MAOIs, ST JOHNS WORT, ANTIHISTAMINES, ANTICHOLINERGICS, CNS depressants, cardiac agents

142
Q

phenelzine therapeutic uses

A

DEPRESSION, panic disorder, GAD

143
Q

phenelzine contraindications

A

caution in pregnancy/lactation, SSRIs, HF, cardiovascular disease, BBW (SI)

144
Q

phenelzine interactions

A

TCAs, SSRIs, ANTIHYPERTENSIVES, TYRAMINE-RICH FOODS (aged cheese, pepperoni, salami, avocados, figs, bananas, beers, wines)

145
Q

bipolar disorder treatment

A

mood stabilizer (lithium)

146
Q

lithium therapeutic uses

A

BPD

147
Q

lithium complications

A

GI (NVD, abdominal pain), fine hand tremors, polyuria, thirst, weight gain, RENAL TOXICITY, goiter, hypothyroidism, DYSRHYTHMIAS, ELECTROLYTE IMBALANCES, hypotension, LITHIUM TOXICITY

148
Q

lithium contraindications

A

avoid use in pregnancy/lactation, BBW: lithium toxicity

149
Q

lithium interactions

A

diuretics, antihypertensives, NSAIDS, anticholinergics, SSRIs, antipsychotics

150
Q

schizophrenia treatment

A

first generation antipsychotics (chlorpromazine), second generation antipsychotics (risperidone)

151
Q

chlorpromazine contraindications

A

caution in pregnancy/lactation, BBW (death in elderly patients with dementia-related disorders)

151
Q

chlorpromazine therapeutic uses

A

acute and chronic psychotic disorders, schizophrenia

152
Q

chlorpromazine complications

A

extrapyramidal symptoms (EPS: acute dystonia, parkinsonism, tar dive dyskinesia) neuroleptic malignant symptoms (NMS: sudden high-grade fever, BP changes, dysrhythmias, muscle rigidity, change in consciousness), SEZIURES, sexual dysfunction, AGRANULOCYTOSIS (low WBCs)

153
Q

chlorpromazine interactions

A

anticholinergics, CNS depressants, levodopa

154
Q

risperidone therapeutic uses

A

SCHIZOPHRENIA DISORDERS, psychotic episodes, bipolar/impulsive disorders

155
Q

risperidone complications

A

DM, weight gain, hypercholesterolemia, orthostatic hypotension, sexual dysfunction, ANTICHOLINERGIC EFFECTS, AGITATION, DIZZINESS, SEDATION, MILD EPS

156
Q

risperidone contraindications

A

caution in pregnancy/lactation, BBW (death in elderly patients with dementia-related disorders)

157
Q

risperidone interactions

A

CNS depressants, antipsychotics, levodopa, anticholinergics

158
Q

pharmacologic treatment of HTN

A

loop diuretics (furosemide), thiazide diuretics (hydrochlorothiazide HCTZ), potassium-sparing diuretics (spironolactone), ACEi (captopril), ARB (losartan), beta adrenergic blockers (cardio selective B1: metoprolol, nonselective B1 and B2: propanolol), CCB (nifedipine, verapamil, diltiazem)

159
Q

furosemide therapeutic uses

A

HTN, pulmonary edema, HF

160
Q

furosemide complications

A

dehydration, HYPOVOLEMIA, HYPONATREMIA, HYPOKALEMIA, OTOTOXICITY, hypotension

161
Q

furosemide contraindications

A

anuria, liver disease, DM, electrolyte depletion

162
Q

furosemide interactions

A

digoxin, antihypertensives, lithium, ototoxic agents

163
Q

HCTZ therapeutic uses

A

HTN, fluid volume overload, DI, prevention of postmenopausal osteoporosis

164
Q

HCTZ complications

A

dehydration, HYPONATREMIA, HYPOKALEMIA, hypochloremia, hyperglycemia

165
Q

HCTZ contraindications

A

some risk to newborns in pregnancy, renal impairment, CVD, DM, electrolyte abnormalities

166
Q

HCTZ interactions

A

digoxin, antihypertensives

167
Q

spironolactone therapeutic uses

A

HTN, edema, HF, hyperaldosteronism

168
Q

spironolactone complications

A

HYPERKALEMIA, voice changes, impotence, dysmenorrhea, GYNECOMASTIA, hirsutism, metabolic acidosis

169
Q

spironolactone contraindications

A

wear gloves (fetal harm), hyperkalemia, taking K supplements, anuria, kidney/liver disease, metabolic acidosis

170
Q

spironolactone interactions

A

ACEi, ARB, potassium

171
Q

captopril therapeutic uses

A

HTN, HF, MI

172
Q

captopril complications

A

orthostatic hypotension, COUGH, HYPERKALEMIA, ANGIOEDEMA, rash, neutropenia

173
Q

captopril contraindications

A

not safe for pregnancy/breastfeeding, angioedema, single kidney, kidney impairment, immunocompromised

174
Q

captopril interactions

A

diuretics, antihypertensives, potassium, lithium

175
Q

losartan therapeutic uses

A

HTN, CVA prevention, delay diabetic neuropathy

176
Q

losartan complications

A

ANGIOEDEMA, hypotension, dizziness, lightheadedness

177
Q

losartan contraindications

A

not safe in pregnancy/breastfeeding, single kidney, ANGIOEDEMA D/T CAPTOPRIL

178
Q

metoprolol therapeutic uses

A

HTN, angina, tachydysrhythmias, HF, MI, migraine, hyperthyroidism

179
Q

metoprolol complications

A

BRADYCARDIA, DECREASED CO, AV block, orthostatic hypotension

180
Q

metoprolol contraindications

A

caution in pregnancy/breastfeeding, bradycardia, asthma, DM, hypotension

181
Q

metoprolol interactions

A

CCB, antihypertensives

182
Q

propranolol therapeutic uses

A

HTN, angina, tachydysrhythmias, HF, MI, migraine, hyperthyroidism, anxiety
AF, A-flutter, SVT, recurent VT, exercise induced tachydysrhythmis

183
Q

propanolol complications

A

beta 1 blockade, BRONCHOCONSTRICTION, HYPOGLYCEMIA, HYPOTENSION, BRADYCARDIA, SINUS ARREST, BRONCHOSPASM

184
Q

propanolol contraindications

A

caution in pregnancy/breastfeeding, bradycardia, asthma, DM, bronchospasm, HF

185
Q

propanolol interactions

A

CCB, antihypertensives

186
Q

nifedipine therapeutic uses

A

HTN, angina

187
Q

nifedipine complications

A

tachycardia, hypotension, TOXICITY

188
Q

nifedipine contraindications

A

MI, unstable angina, heart block

189
Q

nifedipine interactions

A

beta blockers, P450 agents

190
Q

verapamil & diltiazem therapeutic uses

A

HTN, angina, cardiac dysrhythmias, vent rate control in AF and A-flutter

191
Q

verapamil & diltiazem complications

A

hypotension, bradycardia, DYSRHYTHMIAS, TOXICITY

192
Q

verapamil & diltiazem contraindications

A

AV block, severe HF

193
Q

verapamil & diltiazem interactions

A

beta blockers, digoxin, P450 agents

194
Q

hypertensive crisis

A

systolic BP > 180 and/or diastolic > 120

195
Q

hypertensive crisis medications

A

centrally acting vasodilator (nitroprusside), vasodilator (nitroglycerin), CCB (nicardipine), beta blockers (labetalol)

196
Q

nitroprusside complications

A

excessive hypotension, brady/tachycardia, ECG changes, toxicity (HA, drowsiness, cardiac arrest)

197
Q

nitroprusside contraindications

A

liver/kidney disease, hypovolemia, electrolyte imbalances

198
Q

heart failure

A

reduced pumping ability of the heart

199
Q

ejection fraction

A

blood pumped out of ventricles with each contraction

200
Q

HF clinical manifestations

A

respiratory: SOB, dyspnea, DOE, crackles; fatigue, weakness, confusion, fluid retention, edema, cachexia, malnutrition, cyanosis, arrhythmias, sudden cardiac death

201
Q

HF treatment

A

nonpharmacologic: modifiable risk factors, oxygen therapy, heart transplant
pharmacologic: ACEi or ARB (captopril, valsartan), beta blockers (metoprolol), diuretics (furosemide, HCTZ), cardiac glycosides (digoxin)

202
Q

valsartan therapeutic uses

A

HTN, HF, MI, mortality reduction

203
Q

valsartan complications

A

ANGIOEDEMA, hypotension, dizziness, lightheadedness

204
Q

valsartan contraindications

A

not safe for pregnancy/breastfeeding, single kidney, ANGIOEDEMA D/T ACEi

205
Q

valsartan interactions

A

antihypertensives, lithium

205
Q

digoxin therapeutic uses

A

2nd line agent for HF, dysrhythmias

206
Q

digoxin complications

A

DYSRHYTHMIAS, CARDIOTOXICITY, HYPOKALEMIA, bradycardia, anorexia, NV, abdominal pain, fatigue, weakness, vision changes

207
Q

digoxin contraindications

A

caution in pregnancy/breastfeeding, ventricular dysrhythmias, heart block, hypokalemia, advanced HF, impaired renal fx

208
Q

digoxin interactions

A

DIURETICS (hypokalemia), ACEi and ARB (hyperkalemia), sympathomimetics (dopamine), verapamil

209
Q

circulatory shock

A

acute failure of circulatory system to supply enough blood, resulting in hypoxia

210
Q

atrial fibrillation

A

rapid, disorganized atrial firing; ECG has discernible P waves and irregular QRS complexes

211
Q

ventricular tachycardia

A

impulse originates after bifurcation of bundle of His or somewhere in ventricular conduction system; wide/tall QRS

212
Q

ventricular fibrillation

A

ventricular quivering without actual contractions; ECG has disorganized fibrillations without identifiable waveforms or intervals

213
Q

antidysrhythmic agents

A

class I sodium channel blockers (lidocaine), class II beta blockers (propranolol), class III potassium channel blockers (amiodarone), class IV CCB (verapamil)

214
Q

lidocaine therapeutic. uses

A

short term use for ventricular dysrhythmias

215
Q

lidocaine complications

A

CNS (drowsiness, AMS, paresthesias, SEIZURES), RESPIRATORY ARREST

216
Q

lidocaine contraindications

A

pregnancy/breastfeeding risk vs reward, liver/kidney injuries, AV block, SB, HF

217
Q

lidocaine interactions

A

cimetidine, beta blockers, phenytoin

218
Q

amiodarone therapeutic uses

A

VT, VF, AF

219
Q

amiodarone complications

A

PULMONARY TOXICITY, SB, PHLEBITIS, AV block, liver/thyroid dysfunction, GI disturbances, photosensitivity

220
Q

amiodarone contraindications

A

not safe in pregnancy/breastfeeding, AV block, SB, liver/thyroid/respiratory dx, HF, fluid/electrolyte imbalances

221
Q

amiodarone interactions

A

quinidine, procainamide, digoxin, diltiazem, warfarin, st johns wort, rifampin, cholestyramine, diuretics, antidysrhythmics, beta blockers, grapefruit juice

222
Q

UA/NSTEMI

A

no changes to ST segment on ECG; UA has no evidence of serum markers for myocardial damage, NSTEMI has serum marker of myocardial injury present

223
Q

STEMI clinical manifestations

A

severe, crushing, constricting, suffocating pain (substernal, left arm/neck/jaw), SOB, back pain, epigastric pain, NV, fatigue, weakness, irritability, anxiety, pale/cool/moist skin, impending sense of doom, tachycardia, dysrhythmias

223
Q

STEMI

A

ST elevations on ECG; ischemic death of myocardial tissue associated with coronary atherosclerotic disease

224
Q

ACS treatment

A

morphine, oxygen, organic nitrates (nitroglycerin), aspirin, metoprolol

225
Q

nitroglycerin therapeutic uses

A

acute angina, px chronic stable angina

226
Q

nitroglycerin complications

A

HA, ORTHOSTATIC HYPOTENSION, reflex tachycardia, tolerance

227
Q

nitroglycerin contraindications

A

caution in pregnancy/breastfeeding, hypersensitivity, anemia, glaucoma, TBI, antihypertensives, hyperthyroidism, kidney/liver dx

228
Q

nitroglycerin interactions

A

EtOH, antihypertensives, PHOSPHODIESTERASE TYPE 5 INHIBITORS (PDES5)

229
Q

cardiac rehabilitation medication

A

HMG-CoA reductase inhibitors (atorvastatin)

230
Q

atorvastatin therapeutic uses

A

primary cholesterolemia, PX CORONARY EVENTS, PX MI AND STROKE

231
Q

atorvastatin complications

A

HEPATOTOXICITY, MYOPATHY

232
Q

atorvastatin contraindications

A

avoid in pregnancy/breastfeeding, liver dx, kidney impairment

233
Q

atorvastatin interactions

A

fibrates, P450 inhibitors,

drugs (2 decks)

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