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Pharmacology > Lipid Meds, Antianginals, Anticoagulents > Flashcards

Lipid Meds, Antianginals, Anticoagulents Flashcards

1
Q

What organ produces lipoproteins?

A

The liver

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2
Q

How do LDL go through circulation (molecule type)?

A

Triglycerides, cholesterol, lipids

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3
Q

What is LDL used for?

A

Used as energy or stored for future energy use

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4
Q

How do HDL travel through circulation? (Molecule type)

A

enter circulation as loosely packed lipids

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5
Q

What is HDL used for?

A

Used for energy

Pick up fat/cholesterol remenants from LDL breakdown

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6
Q

What things may cause hyperlipidemia?

A

Excessive intake of fats

Genetics: altered fat metabolism (causes high fat content in blood)

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7
Q

What do lipid lowering agents do? (Action)

A

Lower serum levels of cholesterol and lipids

Prevent CAD

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8
Q

What are some modifiable risk factors of CAD

A 
Gout
Smoking 
Sedentary lifestyle 
High stress 
HTN
Obesity 
Diabetes 
Untreated bacterial infections
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9
Q

What are non-modifiable risk factors for CAD

A

Genetics
Age
Gender

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10
Q

How do HMG-CoA inhibitors work (action)?

A

Enzyme HMG-CoA is involved in synthesis of cholesterol. Drug blocks enzyme action = decreased cholesterol, LDL, triglycerides and increased HDL levels

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11
Q

What are indications of HMG-CoA inhibitors?

A

Hyperlipidemia

Prevent CAD

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12
Q

Nursing considerations for HMG-CoA inhibitors

A

Do not give to: liver disease, pregnant/breastfeeding, under 10 y.o.
CAUTION with geriatrics

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13
Q

What are some adverse effects of HMG-CoA inhibitors

A

Flatulence, abdominal pain/cramps, N/V, constipation
Blurred vision, insomnia, fatigue
Liver failure, rhabdomyolysis (muscle break down releases molecule damaging to kidneys)
Yellowed skin/eyes

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14
Q

Patient teaching for HMG-CoA inhibitors

A

No grapefruit!!!

Report muscle weakness or tenderness

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15
Q

Nursing assessments for HMG-CoA inhibitors

A

Liver disease or alcoholic liver disease
Pregnancy/lactation
BS, neuro status, VS, elimination patterns, labs (liver enzymes)

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16
Q

What is action of cholesterol absorption inhibitors?

A

Inhibit absorption of cholesterol in small intestine

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17
Q

What are indications for cholesterol absorption inhibitors?

A

Lower serum cholesterol

Familial hypercholesterolemia

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18
Q

What are contraindications for cholesterol absorption inhibitors

A

Pregnancy or lactation if combined with statins

Allergy

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19
Q

What patients do we need to take precautions with for cholesterol absorption inhibitors

A

Elderly and liver disease

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20
Q

Adverse effects of cholesterol absorption inhibitors

A

Abdominal pain, diarrhea
Dizzy, fatigue, upper respiratory infection,
Muscle aches, back pain, yellowing skin/eyes

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21
Q

Nursing considerations for cholesterol absorption inhibitors

A

Assess for pregnancy

/lactation, allergies, liver function, blood sugar, elimination patterns, lab values (liver enzymes) RR

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22
Q

Action of nitroglycerin

A

Acts on smooth muscle to relax capillaries, veins, arteries = lowered systemic BP

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23
Q

Indications of nitroglycerin

A

Chest pain

HTN

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24
Q

Where are nitrates excreted and metabolized

A

Metabolism liver and excretion kidneys

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25
Q

Contraindications of nitroglycerin

A

anemia, head trauma, cerebral hemorrhage,

Pregnancy/lactation

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26
Q

Who are we cautious with for nitroglycerin

A

Hepatic/renal disease

Hypotension, hypovolemia

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27
Q

Adverse effects of nitroglycerin

A

Headache,
GI upset
Hypotension, tachycardia, syncope, angina

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28
Q

What are some drug/food interactions with nitroglycerin

A

Ergot derivatives
Heparin
Sildenafil (and other “fils”)

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29
Q

Nursing considerations for nitroglycerin

A 
CV and respiratory assessment 
VS and ECG 
Monitor during therapy: 
Hepatic and renal function 
CBC 
Electrolytes 
Assess for chest pain
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30
Q

How to take SL nitroglycerin and what to do if chest pain is not relieved

A

Tablet under tongue (every 5 min) 3 tabs total until chest pain relief
Call 911 if chest pain not relieved

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31
Q

Inpatient consideration for nitroglycerin SL route

A

Patent IV available

32
Q

Onset of IV nitroglycerin

A

Rapid onset

33
Q

Duration of nitroglycerin patch

A

Longer duration than SL tabs

34
Q

Teach patients to do what when taking nitroglycerin

A

Sit on the floor

35
Q

Stable angina

A

when you get angina symptoms during moderate physical activity or when pushing yourself physically
Go away with rest or meds
Can become unstable

36
Q

Unstable angina

A

you get angina symptoms while doing very little or resting

More dangerous form of angina

37
Q

Which is more dangerous: stable angina or u stable angina?

A

Unstable angina

38
Q

How does nitroglycerin relieve angina

A

Improves blood flow to heart by dilation coronary arteries = heart does not have to work as hard

39
Q

What drug class is sildenafil

A

Erectile agents

40
Q

What is the trade name of sildenafil

A

Viagra

41
Q

Indications of sildenafil

A

Pulmonary HTN

ED

42
Q

Nursing considerations for sildenafil

A

Renal and hepatic patients need dose adjusted

CAUTION with geris

43
Q

Patient education for sildenafil

A

Do not take with nitrates within 24 hours after taking
Seek medical attention with chest pain
Report priapism
Report dizzy or poor hearing

44
Q

Adverse effects of sildenafil

A

Hypotension, headache, hearing loss

Priapism > 4 hours (medical attention!!!)

45
Q

Action of anticoagulants

A

Prevent clot formation by blocking specific clot factors

46
Q

Antiplatelet action

A

Prevent platelets from clumping and prevent clot formation

47
Q

Heparin routes

A

SQ and IV

48
Q

What lab is used to titrate heparin doses

A

ApTT

49
Q

Heparin indications

A

DVT, stroke, PE, MI, maintain IV patency (smaller dose)

50
Q

Nursing considerations for heparin

A

Bleeding risk!! Especially over 60

Contraindicated in HIT

51
Q

Adverse effects of heparin

A

Bleeding

HIT or HITT

52
Q

Patient teaching for heparin

A

Teach SXS bleeding and report
Let dental and medical staff know on heparin
Avoid NSAIDS

53
Q

What is the anecdote for heparin

A

Protamine sulfate

54
Q

What drug class is enoxaparin (lovenox)

A

Low molecular weight heparin (LMWH)

55
Q

Indications for enoxaparin

A

DVT, PE, MI

56
Q

Where to inject enoxaparin and what route

A

SQ route in abdomen

57
Q

What patients should we be precautious with for heparin

A

Elderly (increased bleeding risk)

Renal impairment patients

58
Q

Adverse effects of enoxaparin

A

Spinal hematomas with spinal puncture or nueraxial anesthesia
Bleeding
HIT or HITT

59
Q

Patient teaching for enoxaparin

A

Teach SXS bleeding and report
Notify dentist or medical staff if taking
Avoid NSAIDS

60
Q

What drug class is warfarin

A

Oral anticoagulant

61
Q

Indications of warfarin

A

prophylaxis or treat DVT/PE, thromboembolic events with Afib, Mi, stroke

62
Q

Nursing considerations for warfarin

A

Not for pregnancy
Vitamin K is anecdote
Monitor PT/INR
Many drug interactions

63
Q

What patients cannot have warfarin

A

History of hemorrhages
CNS/eye surgery
Large open wound surgery

64
Q

Warfarin adverse effects

A

Acute kidney injury

Bleeding risk with liver disease

65
Q

Warfarin patient education

A 
No grapefruit, alcohol, cranberry
INR labs 
Avoid high impact activities 
Notify HCP of falls 
Carry identification that on warfarin 
Teach SXS bleeding and report
66
Q

INR therapeutic range

A

2.0-3.0

67
Q

Normal range of PT and therapeutic range

A

10-13 secs (therapeutic is 1.5-2x more or 15-26 secs)

68
Q

What should patients avoid in their diet when taking warfarin

A

Vitamin K (leafy greens)

69
Q

What is the anecdote for warfarin

A

VitaminK (phytonadione)

70
Q

What are some examples of anti platelets

A 
Acetysalicic acid (aspirin) 
Clopidogrel (placix)
71
Q

How do anti-platelets work

A

Inhibit platelet aggregation

72
Q

Indications of antiplatelets

A

Peripheral arterial disease

Decrease stroke risk and MI

73
Q

Nursing considerations for aspirin

A

Hold med before surgeries
Taking plavix and ASA together increases bleeding risk
Not for 12 and under

74
Q

Adverse effects of aspirin

A

Bleeding
Tinnitus
Bruising

75
Q

Patient education for aspirin

A

Teach and report SxS bleeding
Report tinnitus
Avoid alcohol and NSAIDS

76
Q

How long do anti platelets last

A

7-10 days

Pharmacology (1 decks)

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