Exam 2 Meds Flashcards
What med would you hold before a stress test? Why?
- Beta blocker
- Because it would inhibit raising the HR
What med would you administer to a patient with sinus bradycardia?
Atropine
Medicines that cause sinus tachycardia
- Beta agonists
- Adrenergics
- Anticholinergics
What medicines would you administer for a patient with sinus tachycardia? (2)
- Beta blockers
- Calcium channel blockers
What medicines would you administer to a patient with atrial flutter (3)?
- Beta blockers
- Digoxin
- Calcium channel blockers
What medicines would you administer to a patient of rapid ventricular response (Afib over 100) (3)
- Beta blockers
- Digoxin
- Calcium channel blockers
What medication would you administer to a patient with ventricular standstill
Atropine
What medication would you administer for treating weinkebach
Atropine
Versed: Indication
Pre-op sedation
Nitroglycerine: Indcation
Angina pain
Methods of nitroglycerine administration (4)
- Sublingual
- Topical
- IV Tridil
- PO
Two characteristics of sublingual nitroglycerine
- Works within three minutes
- Burning sensation under tongue is normal
Three characteristics of IV Tridil (Nitroglycerine)
- BP must be within parameters
- Watch for headache, drop in BP
- Works very quickly
Four characteristics of PO Nitroglycerine (Isosorbide)
- Long acting
- Helps patient carry on with ADLs
- Brown bottle: Deactivated by light
- Should be taken if pain lasts more than ten minutes
Two characteristics of Topical Nitroglycerine
- Taken off at night so body doesn’t acclimate
- Keep out of reach of children
Mechanism of nitroglycerine (3)
- Nitro dilates vessels (decreased preload)
- Dilates myocardial arteries (increases blood supply to heart.)
- Dilates other arteries (decreases BP and afterload)
Other meds (besides nitroglycerine) used for angina: 6
- Beta blockers
- Calcium channel blockers
- Ace inhibitors
- ARBs
- Anticoagulants
- Cholesterol lowering drugs
Mechanism of beta blockers
Reduce the myocardial oxygen demand by lowering the heart rate, BP
What do beta blockers block?
The SNS. (Negative Inotropic)
When should beta blockers NOT be used? (3)
- During acute exacerbation (use only when patient is stabilized)
- If systolic BP is <60
Patient teaching for beta blockers (1)
Do not stop suddenly
Beta blocker drugs (2)
- Propanalol (Inderal)
- Ateolol (Tenormin)
Mechanism of calcium channel blockers (3)
- Slow the SA-AV node conduction
- Slow depolarization and HR
- Decrease BP
Three Calcium channel blocker drugs
- Verapamil (Calan)
- Nifedipine (Procardia)
- Dilitazim (Cardizem)
ACE Inhibitors mechanism (2)
- Inhibits angiotensin I from becoming angiotensin II
- Decreases afterload by reducing PRESSURE.
ACE inhibitors - 3 ADEs
- Little cough
- Hypotension
- Fluid retension (usually on thiazide or loop diuretic also)
ACE Inhibitor Drugs (2)
Captopril (Capoten)
Vasotec
ARB Mechanism
Block angiotensin II receptors
ARB drug (1)
Losartan (Cozaar)
Mechanism of anticoagulants
Reduces platelet action
Three anticoagulant drugs and one note on each
- Asprin (81 mg or 325 mg)
- Ticlopidine (if ASA not tolerated)
- Heparin (check PTT)
For Heparin, you check _____
For Warfarin, you check ______
HEPARIN: PTT
WARFARIN: PT/INR
Two cholesterol lowering drugs
- Atorvastatin (Lipitor)
- Lovastatin (Mevacor)
What meds wouldl you give for MI
1) Asprin - antiplatelet
2) Nitro - pain relief
3) Morphine - pain relief
4) Antiarrhythmics
5) Thrombolytics
Benefits of Morpine for an MI or PE patient
- Relieves pain
- Decreases anxiety
- slight vasodilatation effect (decrease preload)
IV push of morphine dose
2-4 mg q 5-15 minutes
Door to needle time for thrombolytics (MI)
30 minutes. After that, risks begin to outweigh benefits.
Contraindicatiosn of thrombolytics (3)
- Major trauma / surgery within past six weeks
- Active bleeding
- Pregnancy or one month post partum
What drugs are given post PTCA? (3)
- Nitroglycerine
- Anticoagulatns (Heparin, Aggrastat)
_____ is given during CABG surgery, _____ reverses this.
Heparin
Protamine
Meds administered for pulmonary edema (4)
1) Positive inotropics
2) Morphine
3) Diuretics
4) Other meds, depending on condition
Three positive inotropics
1) Digoxin
2) Dopamine / Dobutamine
3) Primacor, Inocor
Which of morphine’s adverse drug effects should you be especially careful of when using it for pulmonary edema?
May slow respiratory rate
Drug categories used for CHF (5)
+ 3 others
- ACE inhibitors
- ARBs
- Diuretics
- Beta blockers
- Digitalis
Also:
- Positive Inotropics
- Antihypertensive
- Antianginal
When would you give a CHF patient ACE inhibitors?
With mild sxs of failure
ACE inhibitor indications (2)
MI
CHF
ACE inhibitor administration (2)
- Can be given IV at a hospital or PO at home
If a patient is on an ACE inhibitor, you may also expect to see them on a _________ because of the _______.
Diuretic (loop or thiazide
Fluid retension
What CHF patients get ARBs?
Patients who can’t tolerate ACE inhibitors – very similar results as ACE but without the captopril cough
What CHF patients get beta blockers?
STABILIZED patients
Why do you need to be careful with beta blockers in CHF patients?
They are negative inotropics. We don’t want to decrease the pumping ability during an acute exacerbation
Why DO we give beta blockers to cHF patients
Blocks CNS; prevents cyclical compensatory mechanisms.
Symptoms of dig toxicity
- Vision problems
- Halos
- Arrhythmias
ADE of dig
Bradycardia
Why do we give digitalis to CHF patients
Doesn’t lower mortality rates, but does reduce symptoms and allow for ADLs
Indication for milrinone (primacor)
Positive inotropi, given IV over several hours at a clinic 2 days per week for CHF patients.
Benefits of milrinone (primacor) (2)
- Improves quality of life
- Decreases readmission rates
What meds would you administer to a patient at risk for DVTs / PE? (4)
PROPHYLACTIC
- Asprin
- Plavix
- Heparin
- Lovanox
Three drugs used to treat PE
- Anticoagulant (Heparin)
- Thrombolitic
Medications indicated for CHF (5)
- Epinephrine
- Atropine
- Lidocaine
- Amidorone
- Dopamine
What drugs would you initially put a HTN patient on? (2)
- Diuretics
- Beta blockers
What drugs would you add LATER after a HTN patient has already been on meds
- ACE inhibitors
- ARBs
- Calcium channel blockers
What are the medications of choice in hypertensive crisis?
- Sodium nitropursside
- Nitroglycerine
