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Pharm 2 > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

Albumin

A

Natural protein produced by liver

5% albumin- common
25% albumin- brings 3.5x fluid into the blood vessel in 15-30 min
(Emergent situations)

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2
Q

Dextran

A

Synthetic polysaccharide
Plasma volume doubles w/in a few min, can last 12 hours ⌛

Vitals ⬆️
Watch 🫀due to ⬆️pressure
Put on tele

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3
Q

Cryoprecipitate

A

🩸product

To manage acute bleeding

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4
Q

Fresh frozen plasma

A

🩸Product

⬆️clotting factors

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5
Q

Packed red blood cells

A

🩸Product

⬆️Oxygen carrying capacity

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6
Q

Whole blood

A

🩸Product
Same as packed red blood cells
⬆️oxygen carrying capacity
Emergent 🚨needs
>25% blood loss

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7
Q

🩸 Transfusions

A

19G needle or larger
Hang w/in 30 min ⌛
Use a pump
- Nl saline piggyback
-appropriate 🩸tubing
-infuse no more than 4 hrs

Vitals!
Before🩸, 15 min, hourly⏰, finish☑️, 1hr after

✋🏽Stay in room for 1st 15min

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8
Q

Hemolytic Reaction due to 🩸, manifestations & treatment

A

HLA typing is wrong
Manifestations:
HA, 🥶, shaking,🤒, 🤮, red urine, flank pain, shock, renal failure
☠️w/in 7-12 days

Treatment:
Diuretics 💛
Rapid administration of IVF 💦
Dialysis

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9
Q

Allergic reaction due to 🩸

A

Due to:
Foreign plasma proteins (hives)
Anti-IgA mediated response (anaphylaxis) 🫁

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10
Q

Suspected transfusion reaction 🩸

A

✋🏽turn off 🩸
Stay in 👇🏽the room

Notify doctor 👨🏻‍⚕️- ☎️ to help notify Dr
Normal saline 💦-change tubing
Oxygen 🌬️
Vitals 🌡️🩺

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11
Q

🫀 Failure Facts

A

Ejection fraction <65%
⬆️ HR doesn’t help
⬇️ renal 🫘perfusion
⬇️ urinary 💛 output

Sx:
Dyspnea, 😴, 💦retention, 🫁edema (crackles & ronchi) , ⬇️urine output

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12
Q

Intropic

A

Force of 💪🏽 contraction

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13
Q

Chronotropic

A

Rate of heartbeat

(Positive or Negative)

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14
Q

Positive ➕ inotropic drugs

A

⬆️💪🏽contraction

Treats HF

Cardiac glycoside

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15
Q

Mechanism of Action for ACE Inhibitors

A

Inhibits Angiotensin Converting Enzyme
✋🏽 Angiotensin 2 release =
Which ⬇️ blood pressure

(Angiotensin2=vasoconstriction=⬆️BP
Causes aldosterone release
Aldosterone= 💦 retention=🩸volume)

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16
Q

Prodrugs

A

-pril drug
quinapril, benzapril, remipril, fosinopril

ACE inhibitor
Not for cirrhosis
Needs 👍🏽liver function

Enalapril- only IV ACE 💊

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17
Q

Catopril

A

Not a prodrug
ACE inhibitor
Can take x3/day 🌄☀️🌜
Short half life
Can take w/⬇️ liver function

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18
Q

Lisinopril

A

Not a prodrug
ACE inhibitor
Once to x2/day dose
Can take w/⬇️ liver function

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19
Q

ACE Inhibitor & ARBs adverse/side effects

A

Hyperkalemia
(Shifting from inside cell to outside)
Headache 🤕
Bradykinin release (angioedema)

Difference❗️
ACE- dry cough😷
ARBs- kidneys not protected
🚫dry cough❗️😷
More expensive 🤑
Gingival Hyperplasia- bad for 🫀

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20
Q

ACE inhibitors and ARBs are contraindicated in…

A

Pregnancy 🤰🏻 and
👩‍🍼 Breastfeeding mothers

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21
Q

ARB mechanism of action 🏃🏽

A

🙅🏽‍♀️Blocks angiotensine 2 receptors

Which ⬇️ blood pressure

(Angiotensin2=vasoconstriction=⬆️BP
Causes aldosterone release
Aldosterone= 💦 retention=🩸volume)

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22
Q

Angiotensin 2 Receptor Blockers are…
(ARBs)

A

-Sartan drugs
Losartan - cheap 💸
Valsartan- cheap 💸
Olmesartan

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23
Q

Angiotensin Receptor Nephrolysin adverse/ side effects
(ARNIs)

A

Angioedema
Hyperkalemia
Significant Hypotension ⬇️
Poor renal 🫘function

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24
Q

Valsartan/sacubitril

A

ARNI 💊

Reduces cardiovascular death or 🫀failure hospitalizations by 20%

Adverse:
Significant hypotension

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25
Q

Beta blocker facts

A

Cardioprotective
Slows conduction of SA node, ⬇️ HR
Allows ⏱️for ventricles to fill

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26
Q

Metoprolol

A

Beta Blocker 💊
-lol medication

Most common beta blocker to treat 🫀failure
⬇️ HR

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27
Q

Carvedilol

A

Beta Blocker 💊
-lol medication

Slows progression of🫀failure
⬇️ HR

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28
Q

Phosphodiesterase Inhibitor MOA

A

Vasodilation
⬇️BP
➕inotropic & chromotropic response

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29
Q

Milrinone

A

Phosphodiesterase Inhibitor 💊
Not used as often- ⬇️outcomes
IV- use pump
Short term 💊
Vasodilation

Adverse effects:
Ventricular dysrhythmia 🫀
Aggravation of angina
Hypotension ⬇️
Hypokalemia
Thrombocytopenia
⬆️LFTs

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30
Q

Hydralazine/isosorbide dinitrate

A

Misc HF drug 💊
HTN/ anti anginal

1st drug for African 🇺🇸

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31
Q

Nesiritide

A

Misc HF drug 💊
Synthetic BNP
Vasodilates
⬆️ Urine💛output

Used in ICU- treat severe HF due to ⬇️renal 🫘 function & ⬆️mortality

32
Q

Dobutamine

A

Misc. HF 💊
Similar to dopamine
Given as a continuous infusion ♾️

33
Q

Alpha andrenergic 1 & 2…

A

Vasoconstricts 🩸 vessels, ⬆️ BP

34
Q

epinephrine

A

Vasoconstrictive 💊 for ACLS= IV
IV is 1mg/ml or 0.1mg/ml
IM or SubQ for diabetics

🤏🏽dose:
⬆️ contractility (➕inotrope)
⬆️HR (➕chomotrope)

⬆️dose: (IV drip💧)
Vasoconstricts= HTN= ⬇️💛 urination

Adverse effects❗️:
Tremors, insomnia, tachycardia, HTN

35
Q

Norepinephrine

A

Treatment of hypotension & shock 😳
Continuous IV infusion ♾️

Stimulates Beta 1 receptors:
⬆️contractility (➕inotrope)
⬆️HR (➕chromotrope)
Stimulates alpha adrenergic receptor:
Vasoconstriction
⬇️renal 🩸flow
Last resort due to kidney issues❗️

Adverse side effects:
HA, significant hypertension

36
Q

Dopamine

A

💊choice for shock related sx
Given by continuous ♾️IV infusion

🤏🏽dose:
⬆️🩸flow to🫀, kidneys, 🧠(💛urine production)
⬆️dose:
⬆️contactability (➕inotrope)
Vasoconstriction=⬆️ BP
=⬇️💛urine output

37
Q

Dobutamine

A

Similar to dopamine
Treatment of HF
⬆️contractility= ➕stroke volume
(➕ inotrope)
Continuous IV ♾️ infusion

38
Q

Fenoldopam

A

Short term tx of HTN
⬇️BP
⬆️🫘renal🩸 flow

39
Q

Midodrine

A

Treats orthostatic hypotension
Peripheral Constrictriction
(⬆️BP)

Adverse effects:
Supine 🛌hypertension
Insomnia 😳

Nursing implications:
Orthostatic vitals
PO 💊 2-3x/day before standing up
(Every 4 hours)
Take with lots of 💦 in ☀️
🚫💊after 6pm= 🛌HTN
Min of 4 hrs before sleep 💤

40
Q

Mirabegron

A

Treats OAB by expanding bladder
Relaxes Detrusor muscle

Adverse effects❗️:
HTN & UTIs 💛

Sustained release 💊
🚫 chew 🤭😬🦷

41
Q

Phenylephrine

A

Short term treatment of shock 😳
Controls SVT 🫀

IV, topical, ophthalmic, nasal

42
Q

Phentolamine

A

Vasodilation
Injection into penis 🍆 for ED
🦷reversal of anesthetic 🔄

43
Q

Quinidine

A

Class1 Antidysrhythmic Drug 💊
Treats Ventricular Dysrhythmia
Class 1a Sodium Channel Blocker
PO, IV, IM

Adverse effect:
Cinchonism (tinnitus, blurry 👀, HA, nausea)
Can happen weeks later

44
Q

Procainamide

A

Class1 Antidysrhythmic Drugs 💊
Treats ventricular dysrhythmia
Class 1a Sodium Channel Blocker
PO, IV, IM

Adverse effects:
Lupus erythematosus-like syndrome, blood dyscrasias

45
Q

Lidocaine

A

Class1 Antidysrhythmic drug 💊
Treats ventricular dysrhythmias
Class 1b Sodium channel blocker
IV

Adverse Effect:
CNS symptoms, confusion, drowsiness

46
Q

Mexiletine

A

Class1 Antidysrhythmic drug 💊
Treats ventricular dysrhythmias
Class 1b Sodium channel blocker

Form: PO
👅oral analog of lidocaine

47
Q

Propafenone

A

Class1 Antidysrhythmic drug 💊
Treats- Life threatening ventricular dysrhythmias❗️& further dysthymias

Class 1c Sodium channel blocker
Form: PO

48
Q

Flecainide

A

Class1 Antidysrhythmic drug 💊
Treats:
Life threatening ventricular dysrhythmias
CAST- 🫀Arrhythmia Suppression Trial

Class 1c Sodium channel blocker
Form: PO
Long 1/2 life ♾️
Can’t adjust dose for 3-5 days
⬇️ dose possible

49
Q

Amiodarone

A

Class3 Antidysrhythmic drug 💊

Treats:
Life threatening dysthymias only
SVTs
IV- 🫁care 75% get adverse effects
Long 1/2 life- effects take 2-3months to resolve

▪️warning❗️- 🫁toxicity
Adverse effects❗️-
Cardiotoxicity, induction of dysrhythmias🫀, corneal 👁️microdeposits, skin photosensitivity 🫳🏼

Don’t take w/ Digoxin❗️
Levels double
If needs digoxin, ✂️dose in 1/2

50
Q

Verapamil

A

Class4 Antidysrhythmic drug💊
Treats:
AFib & SVTs 🫀

Also taken with/Renauds

51
Q

Diltiazem

A

Class4 Antidysrhythmic drug💊
Treats:
AFib & SVTs 🫀

52
Q

Adenosine

A

Other Antidysrhythmic drug💊
IV push
1/2 life of 10 sec ⌛️
Asystole for seconds… flatline

Treats:
SVTs 🫀not responding to Verapamil

53
Q

Adenosine

A

Other Antidysrhythmic drug💊
IV push
1/2 life of 10 sec ⌛️
Asystole for seconds… flatline

Treats:
SVTs 🫀not responding to Verapamil

54
Q

Clomiphene

A

Thickens cervical mucus

55
Q

Clomiphene

A

Thickens cervical mucus

56
Q

Dinoprostone

A

Gel for cervical ripening

57
Q

Preeclampsia

A

Severe hypertension

58
Q

Oxytocin

A

Induction of labor

59
Q

Misoprostal

A

Cheap imposter for cervical ripening

60
Q

Magnesium

A

Treats preeclampsia

61
Q

Magnesium

A

Treats preeclampsia

62
Q

Infusion pump

A

Needed to administer oxytocin

63
Q

Menotropin

A

Sexual intercourse the night before the injection 💉and the next 2-3 day

64
Q

Menotropin is a combo drug of

A

FSH and LH

65
Q

Gonadotropin

A

Maturation of the ovarian follicle

66
Q

Calcium gluconate

A

🔄Reverses magnesium toxicity

67
Q

Methylergonovine reduces postpartum

A

Hemorrhage 🩸

68
Q

Magnesium decreases these reflexes

A

Deep tendon reflexes 💪🏽

69
Q

Terbutaline

A

Adrenergic agonist stops hyperstimulation of uterus

Decreases contractions 🤰🏻

70
Q

Potential result of ovulation stimulated by Menotropin or Clomiphene

A

Twins 👯

71
Q

Dromotrope

A

Conduction of electrical impulse

72
Q

Digoxin level

A

0.5-2

73
Q

Potassium level

A

3.5-5

74
Q

-Prils do what to potassium?

A

Elevate… (5.0+)
Avoid potassium rich foods.
Leafy green 🥗 🍊

⬆️💪🏽contraction
Peaked T waves
ST elevations

75
Q

What lowers BP but not HR?

A

ACE and ARBS

76
Q

What lowers HR but not BP?

A

Digoxin

Pharm 2 (6 decks)

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