Exam 2 (HF, Arrythmia, Clotting)

Question 1

Metoprolol indications and actions
- What are the indications?
(Think BP and Nala)
- Action: What does it block?
- what does it “have”

Answer 1

• HTN
• Acute MI
• Angina Pectoris
• HF

Action
- Blocks Beta 1 receptors
- Has negative chronotropic effect

Question 2

Metoprolol pharmacokinetics
- What 2 routes?
- Is it an extended or short-release form?
- How to dose? (trick question)

Answer 2

• Orl and IV
• Extended-release
• Dose varies by severity of HF

Question 3

Adverse effects of Metoprolol
- What can it worsen?
- Can it increase or decrease HR (name for it)
- What to monitor

Answer 3

• can worsen HF - if given during acute exacerbation
• Bradycardia
• Monitor HR and BP

Question 4

What are contraindications of Metoprolol?
- 2 contraindicaionts

What are cautions when taking metoprolol (People with “blank” should not have it
- can you stop the med abruptly

Answer 4

• heart block and sinus bradycardia
• caution with asthma, COPD, CHF
• do not stop abruptly!!!

Question 5

What are the uses of Cardia Glycosides?
Digoxin (Lanoxin)
- Treats what 2 heart issues?

• can it decrease or increase life span??

Answer 5

• Treats HF and Treats arrhythmia
• Decreases life span - due to inotropic effect

Question 6

What are the actions of Digoxin
- Increases the ______ of myocardial contraction
- slows conduction of what?
-Its contraindicated with what 2 issues
- does it increase or decrease urine output?

Answer 6

-slows conduction of electrical impulses through the heart Increases strength
- contraindicated with bradycardia or heart block
- Increases urine output

Question 7

Why is it important to check the Digoxin level
- (why would you need to be cautious with this drug?

Cautions:
- what are cautions in digoxin
- in older or younger patients
- does it affect kidneys
- any cautions with heart issues or thyroid

Answer 7

• Narrow margin of safety; narrow therapeutic range (0.5-2.o ng/ml)

caution
- older patient
- renal impairment (must check renal function)
- MI
-Thyroid disorders

Question 8

Can digoxin cause cardiac dysrhythmias?
- does it cause obesity, no cause or vomiting or abd pain
- Can it cuase an electrolyte imbalance?
- can it lead to headaches, weakness, viual disturbances, and confusion

Answer 8

• yes
• no it can cause anorexia, NV and abd pain
• yes
• yes

Question 9

Which drug has an adverse effect where you have yellow vision?

Answer 9

Digoxin

Question 10

What type of pulse do you check before giving digoxin?
- what also do you monitor?
- Should you check digoxin lvels regularly

Answer 10

Apical pulse
- Monitor labs, including drug levels, electrolytes, Mg, Ca, renal labs
- Yes, check regularly

Question 11

What is the drug name for short-term therapy for advanced HF

Answer 11

Phosphodiesterase Inhibitors

Question 12

Phosphodiesterase Inhibitors works by inhibiting enzyme in cardiac muscle resulting in More Ca+ for cardiac contraction. This causes increased contractility and vasodilation. What type of effect is this?

Answer 12

Inotropic effect

Question 13

Phosphodiesterase inhibitors are given in which route only

Answer 13

IV route only

Question 14

What are the contraindications for Phosphodiesterase Inhibitors?
- What type of MI?
- Fluid volume defecit or excess?
- arrythmias in ventrical or atrium

Answer 14

• Allergy
• Severe aortic or pulmonic disease
• Acute MI
• FV deficit
• Vent. arrhythmias

Question 15

What are the adverse effects of Phodiesterase

Answer 15

• Arrythmias
• HTN
• Chest Pain

Question 16

HCN Blockers does what to the heart rate and also must be…

Answer 16

• Slows heart rate and must be sinus tachycardia

Question 17

• Blocking the ___’s slows the heart’s pacemaker, the
  sinus node, in the repolarizing phase of the action
  potential
• What blocker does this therapeutic actions

Answer 17

HCN Blockers Therapeutic actions

Question 18

For HFrEF never give what 2 drugs

Answer 18

digoxin and milridnone