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PHARM 2, Exam 3 > Heart, Angina, MI, and Shock > Flashcards

Heart, Angina, MI, and Shock Flashcards

1
Q

DIGOXIN

MOA

A

Keeps sodium in the cell, causing calcium to come out; when calcium is released it produces a more forceful contraction

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2
Q

DIGOXIN

theraputic ranged

A

0.5-2
over 2 you have digoxin toxicity
(check levels every 6-12hrs after administration)

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3
Q

DIGOXIN TOXICITY

>2

A

vomitting, dizziness, confusion, vision changes(yellow/green/white halos)*,

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4
Q

DIGOXIN

Administration

A

IV or PO
IV–> faster; digitalization
(when you increase dose enough until tissues become saturated it to DECREASE HF)

Take at same time each day(NO SKIP OR DOUBLE)

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5
Q

DIGOXIN

Adverse Effects/INTERVENTIONS

A

Gi symptoms

  • monitor/report GI symptoms
  • vomitting may cause Hypokalemia
  • monitor K levels, low K >’s risk of toxicity; if levels are low give patient K
CNS symptoms (halos, HAs)
- monitor/report;
Cardiac Dyrthmias (especially with toxicity)
- take apical pulse full minute before giving medication; withhold if it's
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6
Q

DIGOXIN TOXICITY ANITDOTE

A

digibind

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7
Q

DIGOXIN

Contraindications

A

V-fib, tachycardia
-unless if caused by HF it is okay
digoxin toxicity

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8
Q

DIGOXIN INTERACTIONS

A

anti-dysrhythmics increase digoxin levels

Diuretics

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9
Q

Nesiritide (Natrecor)

MOA

A

reduce pre-load and after-load

VASODILATION

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10
Q

Nesiritide (Natrecor)

Adverse Effect

A

Severe Hypotension

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11
Q

Procainamide (pronestly)
[Sodium channel blocker]
MOA

A

increases duration of the action potential; BLOCKS SODIUM

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12
Q

Procainamide (pronestly)

AE/INTERVENTIONS

A

systemic lupus syndrome: butterfly rash, fever, swelling/enlargement
-If they have this syndrom stop the drugs, give them analgesics to help with pain and fever

Neutropenia and thrombocytopenia

  • look for s/s and infections;
  • teach them about bleeding and bruising
  • monitor CBC weekly for 1st 12 weeks while on drug ; If patient gets this A.E stop drop

Cardiotoxicity

  • IF this occurs stop drug;
  • monitor ECG and vitals signs
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13
Q

Lidocaine (Xylocaine)

A.E

A

SAMS

Seizures
Altered CNS
Muscle twitching
Slurred/difficult speech

-Seizures (give Phenytoin)

Respiratory Arrest
-monitor EKG

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14
Q

Propafenone (Rythmol)

A.E/Interventions

A

bradycardia, HF, dizziness, and weakness

Monitor for HR, chest pain, and edema

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15
Q

Amiodarone (Cordarone, Pacerone)

A.E

A

Pulmonary toxicity
-dyspnea, decrease breath sounds
Hypotension
Bradycardia

BE CONCERNED ABOUT
visual disturbances, liver and thyroid function, CNS effects, phlebitis (inflammation of vein you put it in)

AV heart block!

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16
Q

Adenosine

MOA

A

terminates tachycardia

17
Q

Adenosine

Administration

A

IV push as a bolus, flush afterwards!
(Can literally stop the heart)
warn patient they may as if they’re dying

18
Q

Adenosine

A.E

A

dyspnea, vasoconstriction, vasodilation, and flushing in the face

19
Q 
Salicylic Acid (Aspirin)
MOA
A

prevents clots; works as a blood thinner

20
Q 
Salicylic Acid (Aspirin)
Administrations
A

orally (WITH food)*
(low does of aspirin (81mg) to prevent strokes,/MI)

Aspirin 325 mg should be taken during initial acute episode of MI
-CHEW IT AND SWALLOW iT! WANT This TO WORK FAST

21
Q 
Salicylic Acid (Aspirin)
A.E/ Intervention
A

GI effects
-proton pump inhibitor; monitor/report

hemmorrhagic stroke
-monitor for s/s of weakness, dizziness, and HA

prolonged bleeding time/Gastric
-monitor bleeding and observe GI bleed (coffee emesis, and tarry stools)

bleed/thrombocytopenia
- monitor for bleeding gums, etc .

tinnitus, hearing loss*

22
Q 
Salicylic Acid (Aspirin)
Interactions
A

NSAIDs, warfarin or any other med that enhance bleeding

Aspirin mixed with beta-blockers, reduces the beta-blocker effect

Corticosteriods decrease effects of asthma and increase risk for GI bleed

Caffeine increases absorption

23
Q

Morphine

MOA

A

DRUG CHOICE WHEN PT HAS MI

24
Q

Morphine

A.E

A

RESPIRATORY DEPRESSION*

  • if less than 12bpm STOP
  • NARCAN
  • cough

contstipation(when longer periods of time)

  • laxatives, stool softeners
  • increase fiber and fluid

orthostatic hypotension
-assit with ambulation

urinary retention

  • assess bladder for distention every 4-6 hours
  • void every 4 hrs
25
Q

Morphine

Contraindications

A 
Asthma
Obese pts.
Slow GI motility
enlarged prostate
liver/renal disease
26
Q

Morphine Interactions

A

Sedation drugs

Anticholinergic drugs

27
Q

Alteplase

Administration:

A

Reconstitute with sterile before injection
swirl gently to dissolve powder
store at room temperature

28
Q

Alteplase

A.E

A

BLEEDING RISK (since it breaks clots)

cerebral effects

cardiovascular

  • monitor BP (HYPOtension)
  • continuous EKG

gingival bleeding/nose bleed. GI bleeding, bleeding at puncture sites
-monitor for bleeding

pulmonary edema

I

29
Q

Alteplase

Contrindications

A

ACTIVE INTERNAL bleeding
Aneurysms
Severe Hypertension
MI

30
Q

Aneurysms

Interactions

A

drugs that alter platelet function

31
Q

Dopamine

MOA

A

moderate dose
-vasodilation and increases the heart rate

high doses
-all above plus vasoconstriction which treats shock

32
Q

Dopamine

Administration

A

IV (continuos)

-stop at first evidence of infiltration

33
Q

Dopamine

Adverse Effects

A

Vasoconstriction that can lead to hypertensive crisis

Increase HR and cause dysrthmias

  • provide continuos cardiac monitoring
  • Report dysrthmias, increased HR, and chest pain

Extravastation
- monitor IV site carefully (infuse through central line if possible) discontinue at first sign of irritation

34
Q

Dopamine

Contraindications

A

with tachydysrhythmias and ventricular fibrillation

Caution with hyperthyroidism, angina, history of MI, hypertension, and diabetes

PHARM 2, Exam 3 (2 decks)

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