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UNRS 113 Pharmacology > Heart Failure Drugs & Antilipemics > Flashcards

Heart Failure Drugs & Antilipemics Flashcards

1
Q

digoxin toxicity

A

HR below 60/new irregular rhythm, anorexia, nausea, confusion, blurred yellow tinged appearance of halos are symptoms. Discontinued by MD ONLY, takes about 1 wk for drug to be eliminated from body.

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2
Q

What is digoxin overdose?

A

Antidote: digoxin immune Fab (Digibind)

- Therapeutic classification: antidotes
- Pharmacologic classification: antibody
- Indications: serious life-threatening overdose w/digoxin
- Action: antibody produced in sheep that binds to unbound digoxin serum
- Therapeutic effect: bind & subsequent removal of digoxin, preventing toxic effects
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3
Q

What is LDL?

A

Low-density lipoproteins bad/lousy cholesterol

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4
Q

What is HDL?

A

high-density lipoproteins good/healthy cholesterol

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5
Q

What are recommended therapeutic lifestyle changes to ↓ cholesterol?

A
  • Diet: ↓ cholesterol & saturated fat, ↑ soluble fiber & plant stanols & sterols
  • Weight control
  • Exercise: 30-60 min of activity
  • Smoking cessation
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6
Q

Statins adverse effects

A

hepatotoxicity (0.2-2%), myopathy (5-10%), Rhabdomyolysis (rare)

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7
Q

What are S/S of hepatotoxicity?

A

anorexia, nausea, vomiting, yellow skin/sclera, dark urine

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8
Q

Blood flow of heart?

A

Venus

Right
Atrium
Tricuspid > Right Ventricle > Pulmonary valve > Lungs

escaped the

Left
Atrium
Bicuspid > Left ventricle > Aortic valve > Body

and Pushed All the cheese in the VALVES on the way out!
PULMONARY AND AORTIC VALVE are points of exit from the ventricles.

Aorta= 5 letters= Right Vena Cava = 4 letters = Left

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9
Q

S/S left HF

A

cough, pulmonary edema, dyspnea,

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10
Q

S/S right HF

A

jugular vein distention, ascites, pedal edema

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11
Q

(RAAS) ACE Inhibitors

MOA

A

↓ Na, Cl, K reabsorption in ascending loop of henle results in diuresis

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12
Q

ACE Inhibitors

Drug Effects

A

↓ blood volume, ↓venous pressure (preload) & arterial pressure (afterload). ↓pulmonary & peripheral edema

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13
Q

ACE Inhibitors

Indications

A

Acute & chronic HF

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14
Q

ACE Inhibitors

Adverse Effects

A

hypokalemia (↑ risk of digoxin toxicity), severe hypotension

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15
Q

ACE Inhibitors

Nursing Implications

A

Assess pt.’s fluid volume, VS, labs

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16
Q

Theraputic window for digoxin?

A

0.5-0.8 ng/mL

17
Q

How long does it take digoxin to leave the body?

A

1 wk

18
Q

Difference between Statin & Nicotinic Acid

A

Nicotinic: ↓ triglycerides mainly 20-50%, ↓ LDL to lesser extent 5-25%, Raise HDL cholesterol 15-35%

Statin: Drug Effects: ↓ LDL cholesterol by 25-63%

19
Q

Statin contradindication

A

Avoid Crestor in Asian pt decent/prescribe smaller doses, grapefruit juice pregnancy category X

20
Q

Statin Nursing Implication

A

2 wks effect, max 4-6wks, reversal of effects upon withdrawal, monitor LFT & CK levels, assess for ℅ weakness, muscle aches

21
Q

Statin Pt Education

A

Most effective when taken @ bedtime, immediate report muscle pain/weakness or indications of liver dysfxn, avoid alcohol

22
Q

Nicotinic MOA

A

B vitamin known as niacin (B3). higher doses are needed than available in OTC vitamins.

23
Q

Nicotinic Drug Effects

A

↓ triglycerides mainly 20-50%, ↓ LDL to lesser extent 5-25%, Raise HDL cholesterol 15-35%

24
Q

Nicotinic Adverse Effects

A

intense facial flushing & pruritus, GI distress (self-limiting), hepatotoxicity

25
Q

Nicotinic Nursing Implications/Pt Education

A

instruct pt to take 325 mg of ASA 30 min prior to dose to ↓ decrease flushing

26
Q

Vasodilators MOA

A

Isorils belongs to same family w/nitroglycerin. Causes selective dilation of veins ↓ preload & ↓ congestive symptoms. Hydralize causes selective dilation of arterioles, improving CO ( ↓ afterload ) and renal blood flow (↑ urine output/ ↓ volume)

27
Q

Normal Potassium levels

A

3.5-5 mEq/L

28
Q

Cardiac glycosides MOA

A

inhibits sodium-potassium adenosine triphosphate pump, causing accumulation of calcium in cardiac myocytes. Calcium augments contractile force by facilitating interaction of myocardial actin and myosin

29
Q

Cardiac glycosides Drug Effects

A

Positive inotropic effect ↑ force of ventricular contract, thus ↑ CO, which reverse overt manifestation of HF
Sodium-potassium adenosine triphosphate pump keeps K+ IN cell and keeps Na+ and Ca++ OUT of cell.
Digoxin allows Na+ and Ca++ INTO cell and K+ OUT of cell.

30
Q

Cardiac glycosides Indications

A

seconline HF; atrial fibrillation

31
Q

Cardiac Adverse Effects

A

digoxin toxicity, cardiac dysrhythmia

UNRS 113 Pharmacology (3 decks)

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