Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm > heart failure > Flashcards

heart failure Flashcards

1
Q

what is heart failure?

A

condition where heart cannot effectively pump enough blood to meet body o2 and nutritional needs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

heart failure may result from?

A

impaired myocardial contraction during systole
impaired relaxation and filling of ventricles during diastole
combination therof

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

CHF caused by ___

do all have congestive symptoms?

what is the preferred term?

A

freq accumulated of fluid in lungs

heart failure is preferred term

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is occurring at the cellular level of heart failure?

A

dysfunction of contractile myocardial and endothelial cells that line heart and vessels

endothelial dysfunction allows narrowing of vessel lumen

  • leads to clot formation and vasoconstriction, which furthers narrowing
  • major factors in CAD and HTN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are some other causes of HF?

A

hyperthyroidism

  • Excessive IV fluids or blood transfusions
  • Anti-dysrhythmic meds
  • Drugs that cause sodium and water retention
  • corticosteroids, estrogens, NSAIDs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are some clinical manifestations for heart failure?

A
  • Dyspnea
  • Fatigue
  • Lead to exercise intolerance, ** fluid retention
  • *resulting in pulmonary congestion and peripheral edema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

medication for heart failure?

A

**diuretics in combination with ACE inhibitor and ARB

digoxin may be added to above combo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

where do ARBs block?

A

between amgopetmsom II and the cellular effects (vasoconstriction, aldosterone secretion, sodium and water mention, vascular cell growth)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the best way to administer dig?

A

given orally or IV

liquid is better absorbed than tablets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are some factors that decrease absorption?

A

**presence of food in GI tract
delayed gastric emptying
malabsorption syndromes
**concurrent adminstration fo some medications (table 25-4)
-Licorice and aloe -> potassium depletion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what serum level does toxicity occur with dig?

A

may occur at any level ***

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how much of dig is excreted unchanged by the kidneys?

A

60-70%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

where is the remainder of dig that is not excreted

A

remainder metb or excreted by non-renal routes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the reference range for dig?

A

0.8-2ng/mL

half-life 36 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

MOA of dig?

A

improves cardiac contractility and pumping ability
helps to relief HF symp and dec hospitalizations but does not prolong survival
-Usually given concomitantly with diuretic and ACE inhibitor or ARB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

indications for dig?

A 
Heart failure
Atrial fibrillation
Atrial flutter
Acute or chronic conditions
Digitalization or maintenance therapy
**Improves ejection fraction and exercise tolerance
17
Q

Is the following statement True or False?

Digoxin exerts a positive chronotropic effect on the heart in HF.

A

False.

Digoxin exerts a positive inotropic effect on the heart in HF. In patients with atrial dysrhythmias, digoxin has a negative chronotropic effect.

18
Q

contraindications for dig?

A 
Severe myocarditis
Ventricular tachycardia
Ventricular fibrillation
Used cautiously in
Acute MI, heart block, WPW syndrome
Adams-Stokes syndrome
Electrolyte imbalance, renal impairment
19
Q

what is Wolf parkinson white syndrome?

A

an extra electrical pathway between your heart’s upper and lower chambers causes a rapid heartbeat. The extra pathway is present at birth and fairly rare.

20
Q

what is adam-stokes syndrome?

A

the normal heartbeat passing from the hearts upper to lower chambers is interrupted. This result in a condition called a “heart block.” When a heart block occurs the heart rate usually slows considerably. This can result in inadequate blood flow to the brain and fainting.

21
Q

which administrative route is not recommended for dig?

A

**IM bc of pain and possible muscle necrosis at injection site

22
Q

max drug effect occurs when in dig?

when does it occur?

A

when steady state tissue concentration is achieved ***

occurs in approx 1 week unless loading doses are used ***
higher doses given 6-8 hours apart over 24 hour period

23
Q

what is rapid digitalization?

A

Has higher risks of toxicity

Usually for atrial tachydysrhythmia with continuous cardiac monitoring rather than HF

24
Q

what is slow digitalization?

A

Achieved by initiating therapy with maintenance dose

25
Q

does dig have a wide or narrow therapeutic index?

A

narrow**

26
Q

what are some toxicity signs and symp?

A 
Bradycardia
Potentially life-threatening heart rhythm disturbances
Nausea/vomiting, appetite loss
Abdominal discomfort, blurred vision**
Mental changes
27
Q

what are some contributing factors that affect dig tox?

A

accumulating of larger than new maintenance doses, hypothyroiism
rapid load or digitalization, hypoxia
**-impaired renal function, **electrolyte imbalance
age extremes (young or old)
***concurrent cardiac med treatment

28
Q

T or F

reducing dig dose will eliminate toxicity?

A

F must just discontinue med all together

29
Q

presence of serious dysrhythmias indicate what? (dig tox mgmt)

A

Potassium chloride, lidocaine
Atropine, other dysrhythmics
Digoxin immune fab

30
Q

2 examples of ACE inhibitors?

A

captopril and ramipril

31
Q

are ACE inhibitors first or second line treatment?

A

first line agents for htn in people with diabetes

particularily those w type 1 diabetes and/or diabetic nephropathy

32
Q

what do ACE inhibitors do?

A

cause diuresis and dec blood vl and dec heart load

33
Q

some adverse effects of ACE inhibitors?

A

**persistent cough (may need to d/c)
acute hypotension may occur when capropril is started, especially in patients with fluid vol deficit
**hyperkalemia may develop in patients with DM or renal impairment or those taking NSAIDS, K supplements or K sparing diuretics

34
Q

what are ARBS?

A

Angiotension II Receptor Blockers (ARBs)

Example Losartan

35
Q

what do arbs do?

A

Potent vasodilating effect, often used with diuretics

36
Q

which ethnicity are ARBs not effective alone?

A

In African-Americans/Canadians, ARBs alone are ineffective, CCBs are considered first choice drug

37
Q

ARBS side effects?

A

Dizziness, muscle cramps or weakness, heartburn, diarrhea, decreased sensitivity to touch
Some reports of angioedema ->evaluate immediately

38
Q

what is angioedema??

treatment?

A

Angioedema is a form of severe swelling beneath the skin’s surface. In some cases, the swelling occurs along with the appearance of hives. This is why angioedema is sometimes referred to as “giant hives.” Hives are itchy, red welts that develop on the surface of the skin.

Both angioedema and hives are typically caused by an allergic reaction to food or medication.

Treatment is antihistamines, in severe cases -> prednisone

Pharm (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions