Exam 2 Flashcards
1
Q
Indications for Heparin?
A
PE, VTE Prpx, DIC, MI
2
Q
Indication for Lovenox?
A
Post Surgery and MI unstabel angina STEMI
3
Q
Indication for warfin?
A
Long term prox of thrombisis, DVT and PE prevention, Heart valves, and AFIB
4
Q
Indication for Eliquis?
A
stroke and embolism prevention DVT prophalyxis
5
Q
Indications for Xarelto?
A
DVT PE prevention, stroke in AFIB DVT PET tx
6
Q
Indication of Pradaxa ?
A
DVT and PE tx,
7
Q
MOA of heparin?
A
inactivates thrombin and Xa
8
Q
MOA of Lovenox?
A
inactivates Xa and less thrombin because of short chain
9
Q
MOA of Warfin?
A
Vit K Antagonist prothrombin and X stopper
10
Q
Eliquis MOA?
A
Selective Xa inhibitor
11
Q
Xarelto MOA?
A
Selective inhibition of Xa
12
Q
Pradaxa MOA?
A
Thrombin inhibitor
13
Q
Reversal Agent for Heprin?
A
Protamine sulfate
14
Q
Reversal Agent for Lovenox?
A
Protomine Sulfate
15
Q
Antidote for Warfin?
A
VitK
16
Q
Eliquis Reversal Agent?
A
Andexxa
17
Q
Xeralto reversal agent?
A
Andexxa
18
Q
Labs to monitor Heprn?
A
aPTT or anti-Xa assay
19
Q
Labs to moitor Warfin?
A
PT (INR)
20
Q
Monitor labs for warfin how often when starting use?
A
daily q5 days, then 2x per week 1-2 weeks, 1x per week 1-2 months the q 2-4 weeks
21
Q
Routes for Heprin?
A
SQ, IV
22
Q
Platlets level for HIT?
A
less than 100,000
23
Q
normal aPTT value?
A
40 seconds
24
Q
aPTT value if on heprin?
A
60-80 seconds
25
Half life of heprin?
1.5 hours
26
Do not use heparin after what type of surgery?
eye, brain, or spinal cord surgery
27
It someone on Heparin gets HIT what anticoaug do you give them?
Argatroban
28
SE of Lovenox?
Bleeding neuro injury
29
What is the forst line therapy for prevention and tx of DVT?
Lovenox
30
What is a serious SE of Warfin?
optic atrophy
31
What drugs are inducers making less drug available?
Carbamazepine, phenytonin, rifampin, st john wart
32
What drug are inhibitors, increaseing effects?
ketoconazole, itraconazole, ritonavir
33
Can prego women take Warfin?
No
34
What anticoagulant can prego wone take?
Heparin
35
What class of drug is Xarelto?
Xa inhibitor
36
What class of drug is Dabigatran?
Direct Thrombin Inhibitor
37
What is reveersal agent for Pradaxa?
Praxbind aka idarucizumb
38
If somone is having dyspepsia due to Pradaxa what do you give them?
food or PPI
39
Indications for ASA?
Stroke, TIA, angina, MI, MI hx, 65 older men and women
40
Indication for Plavix?
Post event med, px blocking coronary artery stents, reent MI
41
Indications for Alteplase?
MI, ischemie stroke massive PE (saddle)
42
ASA MOA?
Irreversible inhibition of cyclooxgenase
43
MOA of Plavix?
Blocks ADP receptors stopping ADP platlet aggregation
44
MOA of Aleplase?
covnersion of plasminogen to plasmin stopping the fibrin matrix of thrombi
45
ASA SE?
Gi bleed....hemorrhagic stroke
46
Plavix SE?
not many but similar to ASA. TTP
47
Serious SE of TPA?
Bleeding and intracranial hemorrhage
48
Nursing considerations for tPA?
must get CT, watch for bleeding, dont be dumb
49
How long till someone can et tPA?
4.5 hours
50
Plavix nursing considerations?
bleeding, stop 5 days before surgery, ITP
51
ASA nursing considerations?
stop using 7-10 days before surgery
52
What are Class I antidysrhythmic?
Sodium Channel Blockers
53
What are class II antidysrhythmic?
Beta Blockers
54
What are class III antidysrhythmic?
K+ channel blockers
55
What are class IV antidysrhythmic?
Calcium channel blockers
56
What drug is a class 1A?
Quinidine
57
What drug is a class 1B?
Lidocaine
58
What drug is a class 1C?
Flecainide
59
What drug is a class II?
Propranolol
60
What drug is a class III?
Amiodarone
61
What drugs are class IV?
Diltiazem and Verapamil
62
Why would you use Quinidine?
A-Fib, A-F;utter, SVT and Sustained VT
63
Why use lidiocaine?
Severe ventricular dysrhythmias
64
Why use propranolol?
A-fib/A-flutter, tachy dysrythmias, ventricular dysrhythmias.
65
Why use amiodarone?
recurrent V-fib, V-tach and A-Fib (not FDa approved)
66
Why use Diltz or Varapamil?
severe ventricular and atrial dysrhythmias
67
What are the pro-dysrhythmic drugs?
Quinidine, Flecainide,
68
What phase do sodium channel blockers act in the fast potentials?
Phase 0
69
What phase of fast potentials has no effect from antidysrhythmic drugs?
Phase 1
70
What pahse of the fast potentials do class 2 and 3 antidysrythmics act on?
Phase 2
71
What phase of fast potientals do class IV drugs work on?
Phase 3
72
Wher do fast potentials take place in heart?
Budle of HIS and Perkenjie fibers of ventricles
73
Where do slow potentials act on heart?
SA and AV node
74
What causes Phase 0 in slow potentials?
slow influx of C+
75
What decreases automaticity in the sA node?
BB/C+c blockers
76
AE of Quinidine?
Diarrhea, Cardiotoxicity, atrial embolism Hypotension, Cinchoism (Q-DHACC)
77
AE of Lidocaine?
Seizures, cardiac arrest, CNS toxicity, (L-SCC)
78
AE of Flecainide?
Cardia Arrest, HF (F-CAHF)
79
AE of Propranolol?
Bronchospasm, bradycardia, hypotension (P-BBH)
80
AE of Amiodarone?
HF, Pneumonia, photosensitivity, blue/gray skin
81
AE of Diltz and Verap
HF, Hypotension, Edema (DV-HHE)
82
What can amiodarone cause toxicity to?
Thyroid toxicity, Cardio, lungs, liver, CNS, GI
83
What is indication for adenosine?
P-SVT
84
Dosing of Adenocard?
6mg then try 12mg
85
MOA of Adenocard?
Slows conduction through the AV node and drops automaticity in SA node
86
What do you see on ECG with Adenocard?
prolong PR interval
87
Where do you want to inject Adenocard?
close to heart on left side
88
Push Adenocard then what?
NS
89
What to have patient on when giving adenocard?
Zoll and ECG
90
AE of Adenocard?
hypoteniosn, brad, chest pain
91
Normal for heart to stop 1-5 seconds with adenocard?
yes
92
Where does adenocard block re entry pathways?
AV node
93
Indication for Digoxin?
Supra-ventricular dysthythmias
94
Effect on an ECG of Digixon?
prolonged PR interval short QT interval ST depression
95
Before giving Digixon must do what?
Check apical pulse
96
What is theraputic range of Digoxin?
0.5-0.8 nanograms
97
S/S of digxion toxicity?
N/V/D, changes in vision, hypokalemia can contribute too.
98
How to treat Dig toxicity?
Stop infusion, Give IV fluids
99
What is antidote for digixion?
Digibind Immune Fab
100
What labs post dig toxicity?
Dig lvl and K+
101
Hold dig if levels are between what?
>1.8 call doctor if >2
102
MOA of ACE-I?
stops angiotensin II allowing blood vessels to dilate reducing blood volume.
103
AE of ACE-I?
Angioedema, Cough, hypotenison on first dose, renal failure hyerkalemia
104
Advantage of ACE-I in HTN?
no cardiac reflex interferance, no electrolyte changes, no sleepiness or sexual dysfunction, less cardio risk
105
Advantage of ACE in HF?
reduces afterload, increase cardiac output, renal blood flow, stops cardiac structure changes in heart
106
Advantage of ACE-I in MI patients?
reduces mortality, less chance of HF
107
What ACEs are approved post MI?
Captopril, Trandolapril, and lisinopril
108
MOA of ARBS?
blocks actions of angiotensin II to receptors on blood vessels.
109
What is alower risk SE when using ARBS?
lower risk of cough
110
AE of ARBS?
Angioedema, well tolorated
111
Where does Verapamil work?
Arteroiles and blocks SA node
112
Where does Nifedipine work?
Vascular smooth muscle promoting vasodilation
113
How to prevent reflux tachycardia with CCB's?
use Beta Blockers
114
What is a unique AE of Minoxidil?
Hypertrichosis (hair growth)
115
What is unique AE of Nitropress?
Thiocyanate toxicity causes CNS effects)
116
Does hydralazine decrease pre or after load?
afterload because it dialates arterioles
117
Does nitro dilate veines or arterioles?
Veins
118
Prazosin dialates what?
Veins and arterioles.
119
Drugs that dilate veins decrease what?
Preload
120
Drugs that dilate arterioles decrease what?
afterload
121
AE of Vasodilators?
Postural hypotenison, Reflex Tachy, more blood volume
122
What do you use for someone on a vasodilator that has expanded blood volume?
Diuretics
123
Whar drug to use on somone that has Tachy from Vasodilators?
Beta Blockers
124
What can vasodilators be used for?
HTN crisis.
