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Med Surg > Exam 2 Meds > Flashcards

Exam 2 Meds Flashcards

1
Q

What med would you hold before a stress test? Why?

A
  • Beta blocker

- Because it would inhibit raising the HR

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2
Q

What med would you administer to a patient with sinus bradycardia?

A

Atropine

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3
Q

Medicines that cause sinus tachycardia

A
  • Beta agonists
  • Adrenergics
  • Anticholinergics
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4
Q

What medicines would you administer for a patient with sinus tachycardia? (2)

A
  • Beta blockers

- Calcium channel blockers

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5
Q

What medicines would you administer to a patient with atrial flutter (3)?

A
  • Beta blockers
  • Digoxin
  • Calcium channel blockers
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6
Q

What medicines would you administer to a patient of rapid ventricular response (Afib over 100) (3)

A
  • Beta blockers
  • Digoxin
  • Calcium channel blockers
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7
Q

What medication would you administer to a patient with ventricular standstill

A

Atropine

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8
Q

What medication would you administer for treating weinkebach

A

Atropine

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9
Q

Versed: Indication

A

Pre-op sedation

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10
Q

Nitroglycerine: Indcation

A

Angina pain

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11
Q

Methods of nitroglycerine administration (4)

A
  • Sublingual
  • Topical
  • IV Tridil
  • PO
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12
Q

Two characteristics of sublingual nitroglycerine

A
  • Works within three minutes

- Burning sensation under tongue is normal

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13
Q

Three characteristics of IV Tridil (Nitroglycerine)

A
  • BP must be within parameters
  • Watch for headache, drop in BP
  • Works very quickly
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14
Q

Four characteristics of PO Nitroglycerine (Isosorbide)

A
  • Long acting
  • Helps patient carry on with ADLs
  • Brown bottle: Deactivated by light
  • Should be taken if pain lasts more than ten minutes
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15
Q

Two characteristics of Topical Nitroglycerine

A
  • Taken off at night so body doesn’t acclimate

- Keep out of reach of children

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16
Q

Mechanism of nitroglycerine (3)

A
  • Nitro dilates vessels (decreased preload)
  • Dilates myocardial arteries (increases blood supply to heart.)
  • Dilates other arteries (decreases BP and afterload)
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17
Q

Other meds (besides nitroglycerine) used for angina: 6

A
  • Beta blockers
  • Calcium channel blockers
  • Ace inhibitors
  • ARBs
  • Anticoagulants
  • Cholesterol lowering drugs
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18
Q

Mechanism of beta blockers

A

Reduce the myocardial oxygen demand by lowering the heart rate, BP

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19
Q

What do beta blockers block?

A

The SNS. (Negative Inotropic)

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20
Q

When should beta blockers NOT be used? (3)

A
  • During acute exacerbation (use only when patient is stabilized)
  • If systolic BP is <60
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21
Q

Patient teaching for beta blockers (1)

A

Do not stop suddenly

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22
Q

Beta blocker drugs (2)

A
  • Propanalol (Inderal)

- Ateolol (Tenormin)

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23
Q

Mechanism of calcium channel blockers (3)

A
  • Slow the SA-AV node conduction
  • Slow depolarization and HR
  • Decrease BP
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24
Q

Three Calcium channel blocker drugs

A
  • Verapamil (Calan)
  • Nifedipine (Procardia)
  • Dilitazim (Cardizem)
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25
Q

ACE Inhibitors mechanism (2)

A
  • Inhibits angiotensin I from becoming angiotensin II

- Decreases afterload by reducing PRESSURE.

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26
Q

ACE inhibitors - 3 ADEs

A
  • Little cough
  • Hypotension
  • Fluid retension (usually on thiazide or loop diuretic also)
27
Q

ACE Inhibitor Drugs (2)

A

Captopril (Capoten)

Vasotec

28
Q

ARB Mechanism

A

Block angiotensin II receptors

29
Q

ARB drug (1)

A

Losartan (Cozaar)

30
Q

Mechanism of anticoagulants

A

Reduces platelet action

31
Q

Three anticoagulant drugs and one note on each

A
  • Asprin (81 mg or 325 mg)
  • Ticlopidine (if ASA not tolerated)
  • Heparin (check PTT)
32
Q

For Heparin, you check _____

For Warfarin, you check ______

A

HEPARIN: PTT
WARFARIN: PT/INR

33
Q

Two cholesterol lowering drugs

A
  • Atorvastatin (Lipitor)

- Lovastatin (Mevacor)

34
Q

What meds wouldl you give for MI

A

1) Asprin - antiplatelet
2) Nitro - pain relief
3) Morphine - pain relief
4) Antiarrhythmics
5) Thrombolytics

35
Q

Benefits of Morpine for an MI or PE patient

A
  • Relieves pain
  • Decreases anxiety
  • slight vasodilatation effect (decrease preload)
36
Q

IV push of morphine dose

A

2-4 mg q 5-15 minutes

37
Q

Door to needle time for thrombolytics (MI)

A

30 minutes. After that, risks begin to outweigh benefits.

38
Q

Contraindicatiosn of thrombolytics (3)

A
  • Major trauma / surgery within past six weeks
  • Active bleeding
  • Pregnancy or one month post partum
39
Q

What drugs are given post PTCA? (3)

A
  • Nitroglycerine

- Anticoagulatns (Heparin, Aggrastat)

40
Q

_____ is given during CABG surgery, _____ reverses this.

A

Heparin

Protamine

41
Q

Meds administered for pulmonary edema (4)

A

1) Positive inotropics
2) Morphine
3) Diuretics
4) Other meds, depending on condition

42
Q

Three positive inotropics

A

1) Digoxin
2) Dopamine / Dobutamine
3) Primacor, Inocor

43
Q

Which of morphine’s adverse drug effects should you be especially careful of when using it for pulmonary edema?

A

May slow respiratory rate

44
Q

Drug categories used for CHF (5)

+ 3 others

A
  • ACE inhibitors
  • ARBs
  • Diuretics
  • Beta blockers
  • Digitalis

Also:

  • Positive Inotropics
  • Antihypertensive
  • Antianginal
45
Q

When would you give a CHF patient ACE inhibitors?

A

With mild sxs of failure

46
Q

ACE inhibitor indications (2)

A

MI

CHF

47
Q

ACE inhibitor administration (2)

A
  • Can be given IV at a hospital or PO at home
48
Q

If a patient is on an ACE inhibitor, you may also expect to see them on a _________ because of the _______.

A

Diuretic (loop or thiazide

Fluid retension

49
Q

What CHF patients get ARBs?

A

Patients who can’t tolerate ACE inhibitors – very similar results as ACE but without the captopril cough

50
Q

What CHF patients get beta blockers?

A

STABILIZED patients

51
Q

Why do you need to be careful with beta blockers in CHF patients?

A

They are negative inotropics. We don’t want to decrease the pumping ability during an acute exacerbation

52
Q

Why DO we give beta blockers to cHF patients

A

Blocks CNS; prevents cyclical compensatory mechanisms.

53
Q

Symptoms of dig toxicity

A
  • Vision problems
  • Halos
  • Arrhythmias
54
Q

ADE of dig

A

Bradycardia

55
Q

Why do we give digitalis to CHF patients

A

Doesn’t lower mortality rates, but does reduce symptoms and allow for ADLs

56
Q

Indication for milrinone (primacor)

A

Positive inotropi, given IV over several hours at a clinic 2 days per week for CHF patients.

57
Q

Benefits of milrinone (primacor) (2)

A
  • Improves quality of life

- Decreases readmission rates

58
Q

What meds would you administer to a patient at risk for DVTs / PE? (4)

PROPHYLACTIC

A
  • Asprin
  • Plavix
  • Heparin
  • Lovanox
59
Q

Three drugs used to treat PE

A
  • Anticoagulant (Heparin)

- Thrombolitic

60
Q

Medications indicated for CHF (5)

A
  • Epinephrine
  • Atropine
  • Lidocaine
  • Amidorone
  • Dopamine
61
Q

What drugs would you initially put a HTN patient on? (2)

A
  • Diuretics

- Beta blockers

62
Q

What drugs would you add LATER after a HTN patient has already been on meds

A
  • ACE inhibitors
  • ARBs
  • Calcium channel blockers
63
Q

What are the medications of choice in hypertensive crisis?

A
  • Sodium nitropursside

- Nitroglycerine

Med Surg (13 decks)

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