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PharmII > Exam4 > Flashcards

Exam4 Flashcards

1
Q

Maturation of ovarian follicle

A

Gonadotropin

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2
Q

Potential result of ovulation stimulation by
Menotoropin or clomiphene

A

Twins

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3
Q

Methylergonovine reduces this post partim

A

Hemorrhage

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4
Q

Treats preeclampsia.

A

Magnesium

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5
Q

Induction of labor

A

Oxytocin

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6
Q

Needed in order to give oxytocin

A

Infusion pump

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7
Q

Cheap imposter for cervical ripening

A

Misoprostol

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8
Q

Reverses magnesium toxicity

A

Calcium gluconate

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9
Q

Adrenergic agonist that stops hyperstimulation of uterus

A

Terbutaline

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10
Q

Thickens cervical mucus

A

Clomiphene

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11
Q

Severe hypertension

A

Preeclampsia

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12
Q

Gel for cervical ripening

A

Dinoprostone

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13
Q

Sex the night b4 injection & the next 2-3 days

A

Menotropin

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14
Q

Menotropin is a combo drug of____& LH

A

FSH

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15
Q

Terbutaline decreases these

A

Contractions

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16
Q

% of water in body

A

60
⬆️ in infants
⬇️ in elderly

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17
Q

Colloids

A

Plasma volume expanders like:
-albumin
- globulin
-fibrinogen
Tx: hypovolemic shock
-burns
-hemorrhage
- surgery

Side effects:
-dilution effect alters coagulation

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18
Q

If protein falls below ______ fluid shifts from blood to tissue

A

5.3 g/dL

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19
Q

Albumin

A

Natural protein made in liver
Pull fluid back into blood vessel
Human donation
5% albumin= most common
25%albumin = emergent, blood loss, 3.5x the amount in 15-30 min
⬆️ BP
⬆️ HR

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20
Q

Dextran

A

Synthetic polysaccharide
Longer acting within minutes
Double plasma volume
Put pt on tele

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21
Q

Blood products

A

Expensive
Human donor

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22
Q

Cryoprecipitate

A

Blood product
Acute bleeding

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23
Q

FFP

A

Fresh frozen plasma
Blood product
⬆️ clotting factors

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24
Q

PRBC

A

Packed red blood cells
Blood product
⬆️ oxygen carrying capacity

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25
Q

Whole blood

A

Blood product
⬆️ oxygen carrying capacity
Emergent🚨
>25% blood loss
Higher risk for reaction

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26
Q

Blood transfusion

A

> or = 19 gauge needle
Hang within 30 min
Appropriate tubing
Normal saline piggy back
Infuse over a max 4 hrs
Stay in room for first 15 minutes

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27
Q

Blood transfusion vitals

A

B4
Every 15 min after
Then hrly
At completion
1 hr after completion

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28
Q

Hemolytic reaction

A

Clue: think infection/kidney
- headache
- chills
- shaking
-fever
- vomiting
- red urine
-flank pain
- shock
- renal failure
-death in 7-12 days

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29
Q

TX for Hemolytic reaction

A
  • Diuresis/diuretics
    -rapid IV fluids
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30
Q

Allergic reaction happens because…

A

foreign plasma protein
-shown as urticaria
Anti-IgA mediated response
- shown as anaphylaxis

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31
Q

Tx for allergic reaction

A

Benadryl
Tylenol

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32
Q

Suspected transfusion reaction, what do you do?

A
  1. Stop blood
  2. Stay in room
  3. Notify Dr
  4. Normal saline
  5. Oxygen
  6. Set of vitals

What can another nurse do?

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33
Q

Define heart failure

A

Inability to eject blood due to:
Chamber dilation
⬆️ intracardiac pressure
Ejection fraction <65%

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34
Q

Symptoms of heart failure

A

Dyspnea
Fatigue
Fluid retention
Pulmonary edema
⬇️ urine out put

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35
Q

Inotropin

A

Force of muscular contractions🫀
Goal is to ⬆️

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36
Q

Chronotropic

A

Rate of heartbeat

Positive drug =⬆️ HR

Negative drug =⬇️ HR

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37
Q

Dromotropic

A

Conduction of electrical impulse

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38
Q

Digoxin

A

0.5 - 2
Cannot stop cardiac remodeling

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39
Q

Digoxin. Toxicity

A

Nastagmous
Walking problems
Infusion dysthythmias
Death

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40
Q

Goals per the American ❤️ Association and American college of cardiology

A

⬇️ effects of renin-angiotension- aldosterone system

⬇️ effects of sympathetic nervous system

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41
Q

What does “ace” in ace inhibitors stand for

A

Angiotension
Converting
Enzyme

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42
Q

Ace inhibitors

A

Stops ACE to prevent angiotensin II
⬇️ BP

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43
Q

Angiotensin II is a…

A

Vasoconstrictor that causes aldosterone to release

44
Q

Aldosterone Causes..,.

A

Na and H2O retention = ⬆️ blood volume

⬆️ blood volume = ⬆️ BP

45
Q

Only Ace to be given IV

A

Enalapril

46
Q

What do “pro drugs” need

A

Good liver function

47
Q

The 5 prodrugs

A

Enalapril
Quinapril
Benazepril
Remipril
Fusinopril

48
Q

Not prodrug that has a short half life , may need frequent doses

A

Captopril

49
Q

Not prodrugs

A

Captopril
Lisinopril

50
Q

Ace inhibitors adverse effects

A

Hyperkalemia
Headache
Dry, non productive cough
Bradykinin release

51
Q

What is Bradykinin release

A

Relaxation of smooth muscle &
Angioedema I swelling of neck throat, mouth)
Causes wet cough or stridor

52
Q

Ace contraindications

A

Pregnancy
Breast feeding

53
Q

What are ARBs?

A

Angiotensin II receptor blockers

Blocks vasoconstriction & release of aldosterone

Goal: ⬇️ BP

54
Q

ARB’S end in…

A

-sartan

55
Q

ARB’S adverse effects

A

Hyperkalemia
Headache
Bradykinin release
Gingival hyperplasia
no dry cough

56
Q

ARB’S contraindications

A

Pregnancy

Breast feeding

57
Q

What does ARNi’S stand for?

A

Angiotensin receptor- neprilysin inhibitors

58
Q

ARNi’S adverse effects

A

Hyperkalemia
Angioedema

Hypotension
Poor renal function
⬆️ serum creatinine

59
Q

Valsartan/sacubitril

A

Popular

⬇️ cardiovascular death/ heart failure by 20%

Class I recommended management for pt with heart failure and ⬇️ejection fraction

Contraindication
Pregnancy
Breast feeding

60
Q

Beta blockers

A

Cardio protective quality

Blocks epinephrine & norepinephrine in heart=does not ⬆️ HR

Slows conduction of SA node =⬇️ HR

Allows for ventricles to fill

61
Q

Beta blocker end in…

A

-LOL

62
Q

Most common beta blocker & treats 🫀 failure

A

Metoprolol

63
Q

Slows progression of HF & ⬇️ rate of readmission in HF

A

Carvedilol

64
Q

. Phosphodiesterase inhibitors

A

Stops enzyme phosphodiesterase
Vasodilation
➕inotropic response
➕chromotropic response

65
Q

Milrinone

A

Phosphodiesterase inhibitor
Can’t use long term
Demonstrates poor outcome
IV, use pump

66
Q

Milrinone adverse effects

A

Hypotension
Hypokalemia

Ventricular dysrhythmia
Aggravation of existing angina
Thrombocytopenia
Elevated LFT’S

67
Q

First approved drug for a specific ethnic group

A

Hydralazine/isosorbide dinitrate

Hydralazine=Hypertensive drug
isosorbide dinitrate= antianginal drug

68
Q

Nesiritide

A

Synthetic BNP
Vasodilating effects
⬆️ urine output
Without⬆️ HR
Used in ICU
Treat severe HF
Worsens renal function
⬆️ mortality

69
Q

Adrenergic agonists

A

Stimulate SNS
Fight or flight
Mimics effects of:
Norepinephrine
Epinephrine
Dopamine

70
Q

Receptor that are vasoconstrictors of blood vessels

A

Alpha 1&2

71
Q

Receptor for cardiac stimulation

A

Beta 1

72
Q

Receptor for broncodilation

A

Beta 2

73
Q

Epinephrine

A

Non selective catecholamine
Primary drug for ACLS
IV
1 or 0.1 my/ mL
Adverse effects :
Tremors
Insomnia
Tachycardia
Hypertension

74
Q

Epinephrine Low dose

A

Beta 1
⬆️ contractility
➕ inotrope
⬆️ HR
➕ chromotrope

75
Q

Epinephrine high dose

A

Alpha, Beta 1 & Beta 2
Vasoconstriction lead to hypertension
IV drip
⬇️ kidney perfusion

76
Q

Norepinephrine

A

Non selective catecholamine
Tx: hypotension and shock
Continuous IV infusion
Converts to dopamine
Adverse effect:
Headache
Hypertension

77
Q

Norepinephrine beta 1

A

⬆️ contractility
➕inotrope
⬆️ HR
➕chromotrope
* less calcium in🫀 cells=⬇️ risk for MI*

78
Q

Norepinephrine alpha receptors

A

Vasoconstriction
⬇️ renal blood flow
Last resort bc of kidney issues

79
Q

Dopamine

A

Selective catecholamine
Drug of choice for shock
Not hard on kidneys
Given continuous infusion

80
Q

Dopamine low dosage

A

Stimulates dopaminergic receptors
⬆️ blood flow to heart, kidneys, brain.

81
Q

Dopamine high dose

A

Stimulates beta 1 -⬆️ contractility
Stimulates alpha adrenergic.- ⬆️ BP by vast o construction of peripheral blood vessels
Affects kidneys negatively

82
Q

Dobutamine

A

Selective catecholamine
Tx: heart failure
Stimulates beta 1
⬆️ contractility=⬆️ stroke volume
Continuous IV

83
Q

Fenoldopam

A

Peripheral dopamine agonist
Beta 1
TX: short term for hypertension
⬇️ BP by arteriolar vasodilation
⬆️ renal blood flow

84
Q

Midodrine

A

Prodrug converted into desglymidodrine
Tx: symptomatic orthostatic hypotension
Stimulates alpha 1
Causes peripheral vasoconstriction by constricting arterioles & veins
Adverse effects
Supine hypertension
Insomnia

85
Q

Midodrine nursing implications

A

Asses orthostatic BP
Take 2-3 X daily
AM dose in bed W lots of water
Final dose: min. 4 hrs b4 sleep not after 6pm bc supine hypertension

86
Q

Mirabegron

A

Tx: overactive bladder by⬆️ bladder capacity
Stimulates beta 3
Relaxes detrusor muscle and urothelium
Adverse effects:
Hypertension
UTI
Nurse implications
sustain released so Do not chew!
stretch out peeing 4-5 hrs to empty completely

87
Q

Phenylephrine

A

Tx: short term⬆️ BP for shock
Controls SVT
Stimulates alpha
IV, topical, ophthalmic nasal

88
Q

Phantolamine

A

Adrenergic infiltration
Leads to vasodilation
TX: dental anesthetic reversal and erectile dysfunction tx /diagnosis
Inject into penis intracavernosal

89
Q

Define dysrhythmia

A

Any deviation from normal heart rhythm

90
Q

Antidysrhythmic drug

A

TX and prevent disturbances in cardiac rhythm

91
Q

P wave

A

Depolarization of atria
Multiple P waves consecutively = conduction block

92
Q

QRS complex

A

Depolarization of ventricles
Wide QRS = lethal v-tach
Skinny QRS =SVT

93
Q

T wave

A

Depolarization of the ventricles

94
Q

ST segment

A

MI dysfunction

95
Q

Long Q T

A

Can’t repolarize= 🫀 stops

96
Q

Quinidine

A

Class 1A: sodium channel blockers
Po, IV, IM
TX: atrial and ventricular duysrhythmias
Adverse effects
Cinchonism
Tinnitus
Blurry vision
Headache
Nausea

97
Q

Procaïnamide

A

Class 1A sodium channel blockers
Po, IV, IM
TX: atrial and ventricular dysthythmias
Adverse effects
Blood dyscrasias
Lupus erythematosus-like syndrome
Butterfly rash
Autoimmune

98
Q

Lidocaine

A

Class 1B sodium channel blocker
IV
TX: ventricular dysrhythmias
Adverse effects:
CNS symptoms
Confusion
Drowsiness

99
Q

Mexiletine

A

Class 1B sodium channel blocker
PO (oral of lido)
TX: ventricular dysthythmia
No adverse effect

100
Q

Propafenone

A

Class 1C sodium channel blocker
PO
TX & prevention: Life threatening ventricular dysrhythmias

101
Q

Flecaïnide

A

Class 1C sodium channel blocker
Po
Tx: life-threatening ventricular dysrhythmias
* lowest dose possible*
Adverse effect:
Proarrhythmic effects= ⬆️incidence of cardiac arrest

102
Q

Class 2 beta blockers & TX SVT

A

Propranolol
Acebutolol
Sotalol
Esmolol

103
Q

Amiodarone

A

Tx: life threatening dysrhythmias only
sustained ventricular tachycardic
Class 3 potassium channel blocker
IV
Compassion care
Long half life= 2-3 Months
Adverse effects
Pulmonary toxicity
Cardio toxicity
Corneal microdeposits(adults longer than
6m)
Skin photo sensitivity (cover up)

104
Q

Do not take amiodarone with____

A

Digoxin
⬆️ levels by 50%

105
Q

Class 4 calcium channel blockers that treat a-fib and SVT

A

Verapamil
Diltiazem

106
Q

Last resort antidyschythmic drug

A

Adenosine
Tx: SVT if verapamil isn’t working
10second half life
Push IV FAST
Adverse effect:
Asystole for seconds

PharmII (2 decks)

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