HTN and HF

Question 1

what should be check before administering a diuretic?

Answer 1

potassium

Question 2

what should you check before administering a beta blocker?

Answer 2

pulse and heart rate

Question 3

angiotensin receptor blockers all end in _____?

Answer 3

-tan (losartan)

Question 4

nitroglycerin does what?

Answer 4

decreases preload and afterload (decrease workload of the heart)

Question 5

ACE inhibitors do what?

Answer 5

prolong life in those with HF

Question 6

what do beta blockers end in?

Answer 6

-olol

Question 7

beta blockers are good for treating _____?

Answer 7

early HF
HTN
Used in combo with CCB for reflex tachycardia

Question 8

what are the side effects of beta blockers?

Answer 8

Anadonia (loss of pleasure in doing things they like)
Insomnia, bizarre dreams
Bradycardia
Exercise intolerance

Question 9

when not to give beta blockers?

Answer 9

o HR less than 60
o BP less than 90
o Heart block
o Bronchoconstriction, not so great in asthma
o Can mask symptoms of hypoglycemia

Question 10

Ca channel blockers end in?

Answer 10

-pine

Question 11

nimodipine is only used for ____?

Answer 11

subanoractoid hemorrhage

Question 11

when do you not give a ca channel blocker?

Answer 11

do not give in HF (neg inotropic effect)

Question 12

how do thiazide diuretics effect K?

Answer 12

they are K wasting
-too low do not give

Question 13

when o you not give a thiazide diuretic?

Answer 13

Check potassium levels (too low does not give)
Dehydration = do not give
If BP is too low, do not give

Question 14

thiazide diuretics should be used cautiously in those with _____?

Answer 14

o Gout
o Diabetes

Question 15

all ace inhibitors end in?

Answer 15

-pril

Question 16

contraindications with ace inhibitors?

Answer 16

o Renal artery stenosis
o Pregnancy
o Dehydration

Question 17

when should you give dig?

Answer 17

give for HF and atrial dysrhythmia

Question 18

why do we give dig for HF?

Answer 18

its pos. inotropic

Question 19

why do we give dig for atrial dysrhythmia?

Answer 19

its neg. chronotropic
-increase HR

Question 20

when should be not give dig?

Answer 20

o HR less than 60
o Dig level over 2 (narrow therapeutic index)
o Heart block
o Have a low potassium (inverse relationship with k and dig)

Question 21

what are the s/sx of dig toxicity?

Answer 21

o Greenish-yellow halo vision from lights
o Nausea/vomiting
o Bradycardia

Question 22

what meds decrease preload?

Answer 22

• Diuretics
• Aldosterone inhibitors
• Nitroglycerin
• ACE inhibitors
• ARB’s
• Nesiritide

Question 23

what meds decrease afterload?

Answer 23

• ACE inhibitors
• ARB’s
• Nitroglycerin
• Alpha-1-blocker

Question 25

what meds decrease contracility?

Answer 25

• Digoxin
• Phosphodiesterase inhibitors

Question 26

why are beta blockers only appropriate in the beginning of HF?

Answer 26

*This allows the left ventricle to fill more completely
*Decrease in catecholamines
*Overall, decreases left ventricular work-load

Question 27

what are some late-stage HF meds that are combined?

Answer 27

• Loop diuretics
• ACE inhibitors
• Digoxin

Question 28

how does dobutamine work?

Answer 28

Works on beta 1 (increase HR, and contractility) pos. inotropic, pos. Chronotropic

Question 29

how is dobutamine administered?

Answer 29

IV

Question 30

what is dobutamine given for?

Answer 30

someone who is in cardiogenic shock

Question 31

norepi does what?

Answer 31

• Will increase the blood pressure
• Vasoconstrictor

Question 32

how do we treat high LDL’s?

Answer 32

-HMG-CoA reductase inhibitor
-niacin
-fibrates

Question 33

HMG-CoA reductase inhibitors end in what?

Answer 33

-statin

Question 34

what are side effects of HMG-CoA reductase inhibitors

Answer 34

o Hepatotoxic
o Can cause muscle aches

Question 35

what is a side effect of niacin?

Answer 35

can cause flushign

Question 36

what should not be taken with a -statin? why?

Answer 36

-fibrates
-pt. can get muscle break down, kidneys have to filter many proteins. Pt could end up dialysis. (Rhabdomyolysis)