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Pharm > Mod 7 - Cardiac Meds > Flashcards

Mod 7 - Cardiac Meds Flashcards

1
Q

what does vasoconstriction do to the blood pressure?

A

increase BP

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2
Q

what does vasodilation do to the blood pressure?

A

decrease BP

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3
Q

What is the most important implementation when giving meds?

A

Determine is it safe to give this medication to this patient at this time

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4
Q

What are we worried about when giving meds that get rid of fluid?

A

BP dropping

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5
Q

what meds get rid of fluid

A

diuretics (furosemide), ACE inhibitors (lisinopril), ARBs (losartan)

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6
Q

When are we worried about BP

A

if the medication is changing vessel size or fluid levels

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7
Q

When would you hold a med?

A

antihypertensives BP <100/60
HR <60
warfarin - if PT is too high or low range depends normal 0.8-1.2, on warfarin 2.0-3.0, with mechanical valve 2.5-3.5
heparin in PTT is too high or low

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8
Q

Why could someone have a low HR

A

just woke up, other meds, athlete, normal

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9
Q

what happens during vasodilation of veins

A

venous return slows so decreases the work of the heart

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10
Q

what happens during vasodilation of arteries (ateriodilation)

A

decrease in BP

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11
Q

What is the first line of defence for HTN

A

Furosemide (Diuretics)

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12
Q

Brief description of the RAAS System

A

low BP and low volume causes release of renin from kidneys. that stimulates conversion of angio 1 to angio 2 in the lungs with angioconverting enzyme. angio 2 causes vasoconstriction increases BP, and the release of aldosterone which retains Na+ and water and excretes K+ which increases blood volume (neg feedback loop).

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13
Q

Where do ACE inhibitors interrupt the RAAS system

A

blocks the converting enzyme for angio 1 to angio 2

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14
Q

where do ARBs interrupt the RAAS system?

A

ARBs block angio 2 receptors and do not allow them to do their job

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15
Q

what is the normal range for PT?

A

0.8-1.2 secs

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16
Q

what is the therapeutic range for someone on warfarin

A

2.0-3.0 secs

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17
Q

what is the therapeutic range if the pt has a mechanical valve

A

2.5-3.5 seconds

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18
Q

What classifications of medications do you check just BP for?

A

Diuretics (Furosemide), ACE Inhibitors (Lisinopril), ARBs (Losartan), Nitrates (Nitroglycerin),

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19
Q

What classifications of medications do you check just HR for?

A

Cardiac Glycosides (digoxin)

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20
Q

What classifications of medications do you check BP and HR for?

A

Calcium Channel Blockers (diltiazem), Beta Blockers (metoprolol)

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21
Q

Which will affect aPPT hep subq or hep IV

A

Hep IV

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22
Q

what can subq hep lead to?

A

Heparin‐induced thrombocytopenia (HIT). a potentially devastating immune mediated adverse drug reaction caused by the emergence of antibodies that activate platelets in the presence of heparin.

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23
Q

what is the antidote for Heparin

A

Protamine sulfate

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24
Q

What is the antidote for Warfarin

A

Vitamin K

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25
Q

What medications does grapefruit juice interact with?

A

Calcium channel blockers, warfarin, some statins

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26
Q

how does digoxin work?

A

It inhibits the Na+/K+ pump resulting in an increase of intracellular Na+ and an influx of Ca2+ into cardiac cells. causes the cardiac muscle fibres to contract more efficiently and increase CO (slower, stronger beat)

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27
Q

what is the O/E of digoxin

A

bradycardia, fatigue, digoxin toxicity (nausea, vomiting, halos)

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28
Q

what is digoxin used for?

A

HF and atrial fib

29
Q

what are some considerations for digoxin?

A

check HR stop and think if <60
therapeutic level of digoxin 0.8-2.0
monitor serum K+ levels because hypokalemia of digoxin tox. (normal 3.5-5)
Digibind treats digoxin toxicity

30
Q

how does Diltiazem work?

A

inhibits ca2+ during depolarization to decrease workload of the heart and increase O2 supply to myocardium, relax SM and decrease BP and HR

31
Q

what are the uses of diltiazem?

A

angina, HTN, tachycardia

32
Q

what is the O/E of diltiazem?

A

hypotension, bradycardia, fatigue, arrhythmia

33
Q

what are some nursing considerations for diltiazem

A

take BP and HR, change position slowly, avoid grapefruit juice

34
Q

how does furosemide work?

A

inhibit absorption of Na+ in loop of henle causing fluid loss, and loss of Na+ and other electrolytes

35
Q

what are the uses of furosemide

A

treat HTN and edema

36
Q

what are the O/E of furosemide

A

hypotension, dehydration, electrolyte imbalances (hyponautremia, hypokalemia - can cause arrhythmias)

37
Q

what are some considerations of furosemide?

A

may take a K+ supplement
assess BP
change position slowly
dehydration so drink fluids
take in morning to not interfere sleep with need to urinate
if BID take last dose at 4pm no later
toxicity includes renal toxicity and ototoxicity

38
Q

how does metoprolol work?

A

blocks beta-1 receptors in the heart causing decrease HR and decrease in BP by blocking epi
high doses can block beta-2 receptors in the lungs causing bronchoconstriction

39
Q

what are the uses of metoprolol

A

HTN, fast HR, chest pain due to poor bf to the heart, early intervention for MI

40
Q

what are the O/E of metoprolol

A

hypotension, bradycardia, fatigue, SOB

41
Q

what are the nursing considerations of metoprolol

A

check HR and BP everytime, slow change of position

42
Q

how does lisinopril work

A

blocks conversion of angio1-angio2, leads to vasodilation and water and salt excretion which decreases bv and bf, decreases BP. it retains K+

43
Q

what are the uses of lisinopril

A

HTN, HF

44
Q

what are the O/E of lisinopril

A

hypotension, cough, hyperkalemia

45
Q

what are the nursing considerations of lisinopril

A

monitor BP, switch to ARB if cough is persistent, hyperkalemia- dont increase diet of K+

46
Q

how does losartan work

A

blocks angio 2 receptors to produce vasodilation and not allow it to stimulate the release of aldosterone which in turn will cause more water and electrolytes to be excreted.

47
Q

what is the use of losartan

A

HTN

48
Q

what is the O/E of losartan

A

hypotension

49
Q

what are the nursing considerations of losartan

A

check BP everytime, change position slowly

50
Q

how does nitroglycerin work

A

relaxes SM to produce vasodilation, slow blood return = dec. work of heart, arteriodilation = decrease BP

51
Q

what are the uses of nitroglycerin

A

angina

52
Q

what are the O/E of nitroglycerin

A

hypotension, severe headache

53
Q

what are some nursing considerations for nitroglycerin

A

3 sprays q5min check BP each time, have pt sit bc of hypotension, teach signs of hypotension, goal 0/10 pain, OPQRSTTU, symptoms vary between gender, prophylactic use

54
Q

how does artovastatin work?

A

inhibits HMG-CoA reductase and cholesterol synthesis, which reduces LDL

55
Q

what are the uses of artovastatin

A

hyperlipidemia and prevention of CVD

56
Q

what are the O/E of artovarstatin

A

myalgia, muscle cramps/aches (usually deal breaker)

57
Q

what are the nursing considerations for artovastatin

A

routine liver assessments, take same time every day, report jaundice or muscle weakness

58
Q

how does warfarin work

A

inhibit synthesis of vit. K dependant clotting factors and anticoagulant proteins

59
Q

what are the uses of warfarin

A

DVT, Pul. emboli

60
Q

what are the O/E of warfarin

A

bleeding, hemorrhage

61
Q

what are some nursing considerations for warfarin

A

vit k is reversal agent, monitor PT = 2.0-3.5, avoid alc, grapefruit juice, sharp objects, floss gentle, teach signs of bleeding, dont increase vit. K intake (leafy greens)

62
Q

how does heparin work

A

inhibits the activated coagulation factors involved in the clotting sequence (Xa, IIa). Prevents the formation of a stable fibrin clot by inhibiting activation of the stabilizing factor. Does not breakdown existing clots.

63
Q

what are the uses of heparin

A

DVT, pulmonary emboli, acute MI

64
Q

what are the O/E of heparin

A

Hemorrhage

65
Q

what are some nursing considerations for heparin

A

protamine sulfate slow infusion = antidote

bruising, bleeding gums, no PO form

66
Q

how does aspirin work

A

inhibit platelet activation and aggregation

67
Q

what are the uses of aspirin

A

PAD, MI, stroke, history of MI

68
Q

what are the O/E of aspirin

A

bleeding

69
Q

what are some nursing considerations for aspirin

A

effects last lifetime of a platelet (7days)
avoid NSAIDS, alcohol
report tinnitus, bleeding
educate S&S of bleeding

Pharm (9 decks)

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