Exam 4 Flashcards
1
Q
What is the mechanism of action of beta blockers?
A
Blocks the effects of norepinephrine and epinephrine at adrenergic beta 1 + 2 receptors in different organs and tissues
2
Q
What are examples of cardioselective beta blockers (beta 1)?
A, M
A
Atenelol, metoprolol
3
Q
What are examples of non selective beta blocker (B 1+2)?
P, C, L
A
Propanalol, carvedilol, labetalol
4
Q
What do cardioselective beta blockers affect?
A
Heart
5
Q
What do beta 1 blockers effect?
A
- Decreased HR
- Decreased cardiac contractility
6
Q
What do beta 2 receptors effect?
A
- vasodilation
- bronchoconstriction
- Delayed hypoglycemic recovery
7
Q
What are beta blockers used to treat?
A
- prevention of migraine headaches
- post MI
8
Q
What are the Contraindications of taking beta blockers?
Block
A
- heart block or bradycardia
- FDA black box: DO NOT ABRUPTLY STOP, taper off over a period of 1-2 weeks
- abrupt withdrawal with result in MI, rebound HTN, and tachycardia
9
Q
What do all antihypertensives cause?
A
Impotence
10
Q
What are the adverse effects of taking beta blockers?
5 B’s
A
- bradycardia
- breathing problems
- blood sugar masking
- bad HF
- bad for falls
11
Q
What assessment should the nurse conduct on a pt taking beta blockers?
A
- complete history and physical exam
- BP screening
- weight
- I and O
- breath sounds
- Glucose levels
12
Q
When a pt is taking beta blockers what HR should be reported to the HCP?
A
- less than 60 BPM
- greater than 100 BPM
13
Q
What should the nurse be aware of before administering beta blockers?
TWFTIA
A
- if given through the IV, tele is recommended
- if given orally take with food to increase absorption
14
Q
What should the nurse educate the patient on when taking beta blockers?
Long term
A
- do not abruptly stop, drug must be weaned
- medications are for long term prevention of angina not for immediate relief
- spending time in a hot bath, hot tubs, saunas will cause fainting
15
Q
What is the mechanism of action of ACE inhibitors?
na
A
- excretion of Na and some water into the urine reducing preload ( Na retention)
16
Q
What do ACE inhibitors end with?
A
- Pril
17
Q
What are ACE inhibitors used to treat?
A
- heart failure
- HTN
- post MI
18
Q
What are the contraindications of taking ACE inhibitors?
BBW, BF
A
- FDA BLACK BOX WARNING: fetal toxicity
- do not give to pregnant women
- Black people do not respond well yo ACE inhibitors
19
Q
What are the interactions of taking beta blockers?
NS, OHTN, D
A
- NSAIDS
- use with other hypertensives/ diuretics cause hypotension
20
Q
What are the most common adverse effects of taking ACE inhibitors?
A
A- void during pregnancy
A- ngioedema
C- ough
E- levated K+
21
Q
What should the nurse educate the patient on when taking ACE inhibitors?
DNTN
A
- DO NOT TAKE NSAIDS
22
Q
What is the mechanism of action for ARBS?
A
Block binding of angiotensin II receptors which prevents vasoconstriction
23
Q
What are ARB’s used to treat?
A
- HTN
- heart failure
- recent MI
24
Q
what are the contraindications of taking ARB’s?
A
- FDA BLACK BOX WARNING: fetal toxicity
- renal impairment
- liver dysfunction ( decrease dose)
25
What do ARB’s interact with?
| NS, L, P(K) , R
- NSAIDS
- Lithium
- Potassium
- Rifampin
26
What are the most common adverse effects of taking ARB’s?
- chest pain
- fatigue
- hypoglycemia
- diarrhea
- UTI
- Anemia
- weakness
27
What is the mechanism of action of nitrates?
- vasodilators
28
What are nitrates used to treat?
| AA
Management of stable and unstable vasopastic angina
29
What are the C/I of taking nitrates?
CAG, H, SHI,
- closed angle glaucoma
- hypotension
-Severe head injury
- when mixed with ED drugs causes severe BP drop
30
What are the adverse effects of taking nitrates?
SH, H
- severe headache
- hypotension
31
What should the nurse understand before administering nitrates?
RIBOS, HOLD
- must be administered while pt is resting in bed or sitting in chair
- hold med if HR is below 60 BPM or greater than 100 BPM
32
What should the nurse educate the patient on when taking oral route of nitrates?
| TBM, 6
- take before meals with 6oz of water
33
What should the nurse educate the patient on when taking nitrate through the sublingual route?
- avoid exposure to light, plastic, cotton, air, heat, and moisture because it will deactivate NTG
- take at first sign of chest pain
- 1 pill should resolve chest pain
34
What is the mechanism of action of alpha II agonists?
- inhibits outflow of norepinephrine
35
What are alpha II agonists used to treat?
| CLONIDINE
- BP ( decreases it)
- management of ADHD
36
What are the adverse effects of taking AIIA?
OH, GIU, I, R
- orthostatic hypotension
- drowsiness
- GI Upset
- impotence
- rash
37
What are the contraindications of taking AIIA?
D, N, A, DIG
- diuretics
-nitrates
- antidepressants
- digoxin
38
What should the nurse educate the patient on when taking AIIA?
| DSA, NOTC
- do not stop abruptly
- do not take with OTC medication, alcohol or CNS depressants
39
What is an example of a vasodilator?
Hydralazine
40
What is the mechanism of action of a vasodilator?
- vasodilator
- reduction in afterload
41
what are vasodilators used to treat?
HTN
42
What are the C/I of taking vasodilators like hydralazine?
| CE,HI, H
- cerebral edema and head injury
- hypotension
43
What are the adverse effects of taking a vasodilator?
TRASH
- significant hypotension
- tachycardia
- rash
- hydralazine toxicity
44
what should the nurse educate the patient on when taking vasodilators?
- rise slowly to decrease orthostatic hypotension, dizziness, and syncopation episodes
45
What should the nurse understand before administering vasodilators?
| MCL,TWF
- may cause lupus
- take with food
46
What drug class end in -ipine?
Calcium channel blocker
47
What is the mechanism of action for calcium channel blockers?
Prevent muscle contraction, relaxes the heart
48
What are the interactions when taking calcium channel blockers?
A, HTN
- angina
- HTN
49
What does CCB interact with?
| GFJ
- grapefruit juice ( increased effect)
50
What are the adverse effects of taking CCB?
HERDV
- hypotension
- rash
- edema
- variable HR
-dyspnea
51
What should the nurse assess in a pt before administering CCB?
BH, DW, MOHF
- bowel habits
- daily weights
- manifestations of HF
52
What should the nurse understand before administering CCB?
Hold
- hold if HR is less than 60BPM
53
What should the nurse educate the patient when taking CCB?
| AGF, CPS
- avoid grapefruit
-do not stop abruptly
- change positions slowly
54
What is the mechanism of action of Digoxin?
- increased contractility
- increase SV which decreases HR
55
what is digoxin used to treat?
- heart failure
56
What are the C/I of taking digoxin?
HB, VFIB
- heart block
-V-fib
57
What are the adverse effects of taking digoxin?
H, F, B, NTI
- headache, fatigue
- bradycardia
- narrow TI so they have a higher chance of toxicity
58
What kind of assessment should the nurse preform on a pt taking dig?
CA, AP, EKMG,SDL, RF
- complete assessment ( confusion, constipation, decreased HR and BP, yellow and green halos)
- apical pulse for a full minute
- electrolytes K and Mg
- serum dig levels ‘
- renal function
59
What should the nurse understand before administering Digoxin?
- Hold if HR is below 60BPM or above 100 BPM
- may require loading dose
- administer w/ meals but not those high in fiber
60
What should the nurse educate the patient taking digoxin on?
CHR
- check HR before taking
61
What are the early signs of dig toxicity?
BAD VAN
B- bradycardia
A- anorexia
D- diarrhea
V- visual disturbances
A- abdominal cramping
N- nausea and vomiting
62
What is the antidote for dig toxicity?
Digoxin immune fab AKA: Digifab
63
What is amiodraone used to treat?
| V IS THE ONE
- V- fib and V tachycardia
- supraventricular dysrhythmias
64
What are the C/I of taking amiodraone?
HB, SSB
| it takes one block to slow the heartdown
- Heart block
- severe sinus bradycardia
65
What are the adverse effects of taking amiodraone?
Eyes
- halos
- dry eyes
- photosensitive
- hepatotoxicity
66
What is adenosine used to treat?
- changes the supraventricular tachycardia to sinus rhythm when CCB isnt working for the pt
67
What are the adverse effects of taking adenosine?
I’m alive but im dead
- momentary asystole ( kills you for a second)
- chest pressure
68
What is the antidote to heparin?
Protamine sulfate
69
What is the antidote for warfarin?
- Vitamin K
70
What is the only drug that busts blood clots?
Aletplase (TPA)
71
What are the adverse effects of taking thrombolytics?
ICB
Intracranial bleeding
72
What is a normal aPTT time?
25-35 seconds
73
Why shouldn’t heparin be given to children under 3 years of age?
It contains benzyl alcohol which they cannot metabolize yet which causes gasping syndrome
74
What is atrovastatin ( Lipitor) used to treat?
Reduce LDL levels and total cholesterol levels
75
What are the adverse effects of taking atorvastatin ( Lipitor)?
| DS, M+ JP, REDDISH BROWN
- difficulty sleeping
- myalgia and joint pain
- rhabdomyolysis causing reddish brown urine
76
What are the contraindications of taking atrovastatin ( Lipitor) ?
- Px, LD
- pregnancy category X
- liver disease
77
What should the nurse educate the patient on when taking atrovastatin ( Lipitor)?
Meal
- take with evening meal or at bedtime
78
What is gemfibrozil used to treat?
| CHOL
- increased HDL levels
- decrease triglyceride levels
79
What are the C/I of taking gemfibrozil?
| lets hope not to find gem shaped stones in your renal system
- existing galbladder disease
- hepatic function
- renal impairment
80
What are the adverse effects of taking gemfibrozil?
| G,PPTT, I, DUOP, R
- gallstones
- prolonged PT time
- impotence
- decreased urine output
- rash
81
What should the nurse understand before administering gemfibrozil?
PC, MLF+PT
- pregnancy category C
- monitor liver function and PT times during therapy
82
What is the normal K levels?
( 3.5- 5.0)
83
What labs need to be monitored for warfarin?
INR and PT
84
What are the contraindications of taking hydralazine?
| DONT HIT YOU H GETTING HY
Head/ cerebral injury
85
what labs need to be monitored with a pt taking heparin?
They need to monitor aPTT
86
What are the three BBW for amiodraone?
- proarythmic, pulmonary toxicity, hepatoxcity
87
What medication is used to stop excessive bleeding in pts?
| AA
- aminocaporic acid
