Exam 5: Units 8 and 9 Flashcards
1
Q
class furosemide
A
loop diuretic
2
Q
furosemide acts on the
A
Loop of Henle
3
Q
furosemide mainly prevents the reabsorption of this electrolyte
A
Na+
4
Q
this follows sodium
A
water
5
Q
MOA furosemide
A
prevents reabsorption of Na+ through the Loop of Henle
6
Q
furosemide can be used for
A
rapid fluid/sodium excretion
7
Q
furosemide increases urine ouput, even in the presence of
A
renal failure
8
Q
black box warning for furosemide
A
water and electrolyte depletion
9
Q
this rare adverse effect can come from furosemide use
A
ototoxicity
10
Q
absence of/extremely low production of urine
A
anuria
11
Q
furosemide is contraindicated in the presence of _______ imbalances
A
electrolyte imbalances
12
Q
furosemide is contraindicated in this allergy
A
sulfa allergy = diuretics are sulfa drugs
13
Q
furosemide is contraindicated in the presence of these medications
A
other ototoxic medications
14
Q
furosemide can cause dysrhythmias with
A
digoxin
15
Q
a patient taking furosemide should eat ___ -rich foods
A
potassium-rich foods
16
Q
class hydrochlorothiazide (HCTZ)
A
thiazide diuretic
17
Q
HCTZ is the first-line treatment for
A
HTN
18
Q
HCTZ acts on the
A
DCT
19
Q
HCTZ blocks reabsorption of
A
Na+ (water follows)
20
Q
HCTZ is contraindicated in these 3 things
A
anuria
hypersensitivity
hepatic coma
21
Q
HCTZ has side effects similar to
A
furosemide, but not as potent since this is a weaker diuretic
22
Q
HCTZ decreases _____ excretion, so be mindful of toxicity
A
lithium
23
Q
HCTZ can cause toxicity when taken with
A
digoxin
24
Q
use caution with furosemide and HCTZ in patients with
A
gout - both can reabsorb uric acid
25
patients taking HCTZ and furosemide should eat foods rich in _____ and avoid _____
potassium-rich foods
avoid prolonged sun exposure (photosensitivity)
26
class spironolactone
potassium-sparing diuretic
27
spironolactone acts on the
DCT and collecting duct
28
MOA spironolactone
competes with aldosterone for receptor sites on the distal tubules
increases diuresis without excreting K+
29
because of its MOA, spironolactone can also be classed as a
aldosterone antagonist
30
a patient with _____ can be given spironolactone (in addition to its other indications)
PCOS
31
black box warning for spironolactone
Use only when necessary! Associated with tumors in lab animals
32
spironolactone can cause these two side effects in men
gynecomastia
impotence
33
spironolactone can cause these two side effects in women
hirsutism
menstrual irregularity
34
use ____ when handling spironolactone
gloves
35
patient should do this 2-3 times a week while on spironolactone
weigh themselves 2-3 times a week and report any gain/loss
36
class fludrocortisone
mineralocorticoid
37
fludrocortisone mimics the same action as
aldosterone
38
action of aldosterone and fludrocortisone
reabsorb Na+ and water
39
fludrocortisone favors the excretion of
potassium
40
fludricortisone replaces adrenocortical insufficiency in
Addison's Disease
41
do not administer fludrocortisone to patients with a known
fungal infection
42
3 side effects with fludrocortisone
hypokalemia
fluid retention/edema
hyperglycemia
43
a patient taking fludrocortisone should eat these kinds of foods
high in potassium
44
fludrocortisone can impair
wound healing - report s/s of infection
45
class nitroglycerin
vasodilator
organic nitrate
46
main action of nitroglycerin
lowers BP
47
MOA nitroglycerin
converts to nitric oxide resulting in the release of calcium ions in smooth muscle
48
main indication for nitroglycerin
angina
49
nitroglycerin is contraindicated with this kind of injury
head injury with increasing intracranial pressure
50
3 H's of nitroglycerin side effects
Headache
Hypotension
Hot flushing (facial redness)
51
nitroglycerin can cause this cardiovascular finding as a result of lowering blood pressure
reflex tachycardia
52
never use this drug with nitroglycerin
sildenafil (Viagra)
= severely low BP leading to death
53
apply the transdermal nitroglycerin in this freqency
one patch a day at the same time each day
54
how many doses max of nitroglycerin per day (oral tablets)
3 doses max
55
an oral nitroglycerin tablet should
NOT be swallowed! This is a sublingual med
56
store nitroglycerin in
its original container - keep out of excessive light and heat
57
cardiac output is too low to meet the body's needs
pump failure
58
#1 cause of heart failure
Myocardial infarction (MI)
59
feeling short of breath/not being able to breathe correctly
dyspnea
60
2 findings with right-sided heart failure
Jugular vein distention
Peripheral edem
61
3 findings with left-sided heart failure
pulmonary edema
orthopnea
cough
62
shortness of breath while lying down
orthopnea
63
ACE inhibitors decrease .. (x2)
decrease blood pressure and blood volume
64
ACE inhibitors do NOT affect
heart rate
65
between ACE inhibitors and ARB's, which is the first choice of tx for HF
ACE inhibitor (lisinopril)
66
ACE inhibitors and ARB's block this electrolyte reabsorption
Na+
67
Due to their MOA, ACE inhibitors and ARB's can cause this electrolyte imbalance
hyperkalemia
68
which low vital sign should ACE inhibitors and ARB's be held for
low BP - NOT low HR (meds don't affect HR)
69
ACE inhibitors and ARB's are
teratogenic
70
hyperkalemia can lead to
cardiac arrhythmias
71
example of an ACE inhibitor and ARB from the ppt
lisinopril (ACE inhibitor)
losartan (ARB)
72
diuretics decrease ... (x2)
blood pressure
blood volume
73
3 D's of diuretic effects
Decrease BP
Drain fluids
Dehydrate
74
this kind of diuretic is first line of tx for acute/worsening HF
Loop diuretics - they promote rapid excretion
75
this candy lowers potassium levels in the body
black licorice/licorice root
76
take diuretics at this time
in the morning
77
avoid these meds when taking a diuretic
OTC meds - they typically have high sodium levels which can add excess sodium to the body and hinder the effect of the drug
78
beta blockers decrease ... (x2)
blood pressure and heart rate
79
hold beta blockers with these cardiac findings
HR <60
Systolic BP <100
80
beta blockers pose a risk for
hypoglycemia - beta blockers can mask s/s of low blood sugar
81
main effect of vasodilators
lower blood pressure
82
cardiac glycosides are not a first line med, but instead limited to
late stage HF
83
cardiac glycosides increase
strength of cardiac contraction
84
class digoxin
cardiac glycoside
85
MOA digoxin
inhibits the Na+/K+ pump in myocardium, causing an increase in intracellular [Ca2+], leading to an increased efficiency of cardiac myofiber contractions
86
type of drugs that affect the force or energy of muscle contractions
inotropic
87
type of drug that affects the heart rate
chronotropic
88
the effect of the speed of the electrical impulse conduction throughout the heart
dromotropic
89
digoxin is negative _____ and positive _____
Negative chronotropic (decreases HR)
Positive inotropic (increases FOC)
90
digoxin is contraindicated in these two kinds of heart block
2nd degree and 3rd degree heart block
91
92
digOXIN is a
Toxin
93
digoxin can cause toxicity with
low potassium levels
94
3 life-threatening adverse effects of digoxin
dysrhythmias
AV block
severe bradycardia
95
main sign of digoxin toxicity
changes in vision
96
antidote to digoxin
digoxin immune FAB (Digibind)
97
digoxin toxicity occurs at this level
< 2.0
98
monitor this electrolyte while taking digoxin
potassium - specifically monitor for LOW potassium
99
class milrinone
PDE-3 inhibitor
(phosphodiesterase-3 inhibitor)
DIFFERENT than sildenfil, which is a PDE-5 inhibitor
100
MOA milrinone
Blocks PDE-3, the enzyme responsible for breaking down cAMP, eventually allowing an influx of Ca2+ to the myocardium for greater cardiac contractility
101
milrinone is positive _____
positive inotropic (medicine that changes the force of cardiac contraction)
102
milrinone is indicated for
short-term tx of heart failure
103
milrinone is contraindicated in
severe heart valve disease
104
milrinone poses an increased risk for
ventricular tachycardia + dysrhythmias
105
since milrinone is toxic, the dose is generally limited to
48 hours
106
administer milrinone by ____ only
by IV only
107
a patient taking milrinone should report this immediately
report angina immediately
108
if a patient taking milrinone experiences a headache, they may take
acetaminophen
