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Pharmacology Midterm 2 > Module 7 - Cardiac/Anticoagulant Medication > Flashcards

Module 7 - Cardiac/Anticoagulant Medication Flashcards

1
Q

What is Cardiac Output?

A
  • Volume of blood pumped by the heart in 1 minute
  • 5-6 L
  • CO= SV x HR
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2
Q

Factors that affect CO

A
  • Stroke Volume - volume of blood pumped from the heart with each beat
  • Heart Rate - beats/min
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3
Q

What is blood pressure?

A
  • Pressure of blood pushing against the walls of the arteries
  • Systolic
  • Diastolic
  • Normal range <135/85
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4
Q

What regulates blood pressure?

A

Renin - produced in the kidneys

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5
Q

Function of the Renin- Angiotensin - Aldosterone system

A
  • ACE - Angiotensin converting enzyme found in pulmonary circulation
  • Aldosterone - produced by adrenal glands
  • Sodium/Water retention - Increases BP
  • K+ excretion
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6
Q

Medications - Cardiac Glycosides - Function and Treatment

A
  • Increase force of myocardial contraction - treats HF
  • Improves CO
    Treats:
  • Atrial fibrillation
  • CHF
  • Paroxysmal atrial tachycardia
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7
Q

Cardiac Glycosides - Medication types

A

Digoxin and Digitoxin

- Similar drugs but different is Digitoxin has a more prolonged half life

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8
Q

Cardiac Glycosides - Digoxin - Action and Use

A
  • Increases force and velocity of myocardial contraction
  • Decreases HR
  • Boots CO - improves systolic emptying
  • Excreted from kidneys easily
  • Taken orally
  • Half life - 36-48 hrs
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9
Q

Cardiac Glycosides - Digoxin - Precaution

A

Carries a high risk of toxicity

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10
Q

Cardiac Glycosides - Digoxin - Side/Adverse Effects

A
  • Increased urine production
  • Lowers appetite
  • Difficulty breathing
  • Confusion
  • Weakness
  • Arrhythmia
  • Fatigue
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11
Q

Cardiac Glycosides - Digoxin - Nursing considerations

A
  • V/S (HR)
  • Hold Diogxin if HR <60 bpm
  • Monitor K+ levels
  • Assess LOC
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12
Q

Cardiac - Anti-Anginal - Functions

A
  • Beta- Blocker/Ca+ Channel Blockers
  • Increases blood flow to the myocardium
  • Slows HR
  • Dilates veins
  • Less force for heart contractions
  • Lowers BP
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13
Q

Cardiac - Anti-Anginal - Medication Types

A

1) Nitrates
2) Beta-Blockers
2) Calcium Channel Blockers

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14
Q

Cardiac - Anti-Anginal - Nitrates - Actions and Treatment

A
  • Relaxes arterial/venous smooth muscle
  • Lowers HR
  • Lowers workload
  • Lowers BP
  • Anginal treatment
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15
Q

Cardiac - Anti-Anginal - Nitrates - Types of Nitrates

A

1) Short Acting - SL/Sprays Nitroglycerins - dilates arteries
2) Long Acting - Isodorbide dinitrate - more stable/effective in long term

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16
Q

Cardiac - Anti-Anginal - Nitrates - Side/Adverse Effect

A
  • High tolerance
  • Hypotension
  • Headaches
  • Dizziness
  • Hypersensitvity
  • Nausea
  • Chest pain
  • Vomiting
  • Allergic reactions
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17
Q

Cardiac - Anti-Anginal - Nitrates - Nursing considerations

A
  • V/S (BP, HR)
  • Drug interactions
  • Spray use: 1 spray = wait 5 min and check BP, 2nd spray = wait 5 min repeat BP, 3rd spray = wait 5 min, repeat BP and call 911 if chest pain persists
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18
Q

Cardiac - Anti-Anginal - Beta Blockers (-olol) - Actions

A
  • Negatives chronotropic/negative inotropic
  • Decrease frequency/severity of angina attacks
  • Decrease BP
  • Decrease HR
    Medication: metoprolol, atenolol
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19
Q

Cardiac - Anti-Anginal - Beta Blockers - Treatments

A
  • Chronic Angina
  • HF
  • Hypertension
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20
Q

Cardiac - Anti-Anginal - Beta Blockers - Side/Adverse Effects

A
  • Bradycardia
  • Fatigue
  • Weakness
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21
Q

Cardiac - Anti-Anginal - Beta Blockers - Nursing Considerations

A
  • V/S (HR, BP)
  • Do not stop abruptly causes rebounding
  • Do not administer if HR is <60
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22
Q

Cardiac - Anti-Anginal - Ca+ Channel Blockers - Actions and Treatment (-ine)

A
  • Relaxes arteries
  • Lowers BP
  • Lowers conduction
  • Lowers HR
  • Decreases CO - dilates coronary arteries
  • Treats Hypertension and dysrhythmia
    Medication: amlodipine, nicardipine
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23
Q

Cardiac - Anti-Anginal - Ca+ Channel Blockers - Side/Adverse Effect

A
  • Hypotension
  • Bradycardia
  • Fatigue
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24
Q

Cardiac - Anti-Anginal - Ca+ Channel Blockers -Nursing Considerations

A
  • V/S (BP, HR)
  • Avoid grapefruit juice
  • ECG
  • Do not crush extended release tablets
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25
Anti-Dysrhythmic - Medication types
1) Beta 1 Blockers 2) K+ Channel Blockers 3) Ca+ Channel Blockers
26
Anti-Dysrhythmic - Beta 1 Adrenergic Blockers (Class II) - Actions of Propanalol
- Blocks EP/NE - Lowers HR - Decreases SA node - Decreases contraction
27
Anti-Dysrhythmic - K+ Channel Blockers (Class III) - Actions of Amiodarone
Delays re-polarization of the myocardial cells and lengthens refractory period
28
Anti-Dysrhythmic - Ca+ Channel Blockers (Class IV) - Actions of Diltiazem
- Muscle contraction is regulated - Decreases HR - Decreases Ca+ influx
29
Anti-Dysrhythmic - Side/Adverse Effects
- Bradycardia - HF - Hypotension - Bronchoconstriction
30
Anti-Dysrhythmic - Nursing considerations
- Vitals (BP, HR) - ECG - Input/output - K+ levels
31
Diuretics - Actions and Treatments
- Work as an hypersensitiveness | - Prompts a loss of sodium and promotes loss of water
32
Diuretics - Use for Treatment
- Edema treatment - CHF - Lowers BP - Increase urine volume/production - Renal disease
33
Diuretics - Loop Diuretics- Action
- Blocks re-absorption of Na and Cl in the loop of Henle - Reduced edema in HF - Increase urine output - Furosemide and Bumetanide
34
Diuretics - Side/Adverse Effects
- Nausea - Weakness - Orthostatic hypotention - Electrolyte imbalance - Arrhythmia - Vomiting - Muscle spasms
35
Diuretics - Nursing considerations
- VS (BP) - Check weight for changes - Input/output - Assess Electrolytes - Edema pitting scale - Ensure medication is taken in the morning
36
Diuretics - Potassium Sparing - Action of Aldactone
- Retains K+ | - Na+ and water excreted
37
Diuretics - Potassium Wasting - Actions of Loop and Thiazide diuretics
Excretes K+ in the loop of Henle (loop) and distal tubules (thiazide)
38
Medication type and function for Thiazide Diuretic?
Hydrochlorothiazide - prevents re-absorption of Na+ in kidneys - Loss of Na+, K+ and Mg+
39
Medication type and function for Loop diuretic?
Furosemide - Increases Na+ loss in the loop of Henle | - Loss of Na+, K+, Ca+ and Mg+
40
Medication type and function for Potassium sparing?
Spironolactone - Prevents re-absorption of Na+ but promotes re-absorption of K+ - Loss of Na+ and Mg+
41
Anti-Hypertensives - Medications to treat
1) Diuretics 2) Calcium Channel blockers 3) Agents affecting RAAS - inhibitors/blockers 4) Adrenergic agents 5) Direct-acting vasodilators
42
Anti-Hypertensives - RAAS - ACE (Angiotensin converting enzyme) Inhibitors - Actions
- Lower ACE - Inhibit formation of Angiotensin II - Inhibit Vasoconstriction - Stimulates secretion of aldoesterone
43
Anti-Hypertensives - RAAS - ACE (Angiotensin converting enzyme) Inhibitors - Medication Types (-pril)
- Enalapril | - Captopril
44
Anti-Hypertensives - RAAS - ACE (Angiotensin converting enzyme) Inhibitors - Side/Adverse Effects
- Renal symptoms - Laryngeal Edema - Cough - Angio edema
45
Anti-Hypertensives - RAAS - ACE (Angiotensin converting enzyme) Inhibitors - Nursing considerations
- Assess Edema - V/S (BP) - Assess cough description and types
46
Anti-Hypertensives - RAAS - Angiotensin II receptor blockers (ARB)- Actions and Uses
- Block vasoconstriction effects - Lowers BP - Lowers Aldosterone - Decrease vasoconstriction - Safer for kidneys - can be given to prevent renal failure for diabetes clients
47
Anti-Hypertensives - RAAS - Angiotensin II receptor blockers (ARB) (-sartan) - Medication Types
- Losartan | - Valsartan
48
Anti-Hypertensives - RAAS - Angiotensin II receptor blockers (ARB) - Side/Adverse Effects
- Hyperkalemia - Arrhythmia - Muscle spasms
49
Anti-Hypertensives - RAAS - Angiotensin II receptor blockers (ARB) - Nursing considerations
- V/S (BP, HR) | - Assess K+ levels
50
Anti-Hypertensives - Adrenergic Agents - Types
1) Beta Adrenergic Blockers (Beta Blockers) 2) Alpha Blockers 3) Alpha Agonist 4) Combination - Alpha + Beta Blockers
51
Anti-Hypertensives - Beta Blockers - Actions
``` Blocks effect of EP/NE on vascular system - Promotes vasodilation - Lowers BP - Lowers HR Medication: Metoprolol ```
52
Anti-Hypertensives - Beta Blockers - Side Effects
- Bradycardia - Bronchoconstriction - Hypotension - Weakness - Fatigue
53
Anti-Hypertensives - Alpha Blockers - Actions
- Lowers sympathetic response - Blocks EP/NE - Promotes Vasodilation - Lowers BP Medication: Doxazosin
54
Anti-Hypertensives - Alpha Blockers - Side Effects
- Orthostatic hypotension - Dizziness - Bradycardia - Constipation
55
Anti-Hypertensives - Alpha 2 Agonist - Actions and Uses
- Reduces sympathetic response - Lowers BP - Can increase Na+ and water retention Medication: Clonidine
56
Anti-Hypertensives - Alpha 2 Agonist - Side Effects
- Hypotension - Dry mouth - Edema - Bradycardia - Dry mouth - Constipation
57
Anti-Hypertensives - Combination- Alpha 1 and Beta blockers - Action and Uses
- Centrally acting - Blocks EP/NE - Lowers HR - Lowers BP Medication: labetalol
58
Anti-Hypertensives - Combination- Alpha 1 and Beta blockers - Side Effects
- Orthostatic hypotension - Bradycardia - Bronchoconstriction - Constipation - Dizzines - Lethargy
59
Anti-Hypertensives - Nursing Considerations for all
- V/S (BP, HR) - Assist in changing position - Promote hydration - Assess intake/output - Assess LOC - Assess Edema
60
Anti-coagulants - Actions
- Prevents MI | - Decreases and prevention of blood clots
61
Anti-coagulants - Medication Types (-parin)
Low weight heparin: enoxaparin
62
Anti-coagulants - LWH - enoxaparin - Actions and Uses
- Inhibits thrombin formation - Decrease fibrin - Prevention of clots - Prevent DVT
63
Anti-coagulants - LWH - enoxaparin - Side/Adverse Effects
- Bruising - Bleeding - gums, nose bleeds - Hematoma
64
Anti-coagulants - LWH - enoxaparin - Nursing considerations
- Do not give via IM - Assess for black stools (blood in stool) - Assess lab values INR (loss of blood)
65
Anti-coagulants - Warfarin - Actions and Uses
- Venous thrombosis - Prophylaxis - Prevent clots Medication: coumadin
66
Anti-coagulants - Warfarin - coumadin- Side/Adverse Effects
- Minor bleeding - Bruising - Hematoma
67
Anti-coagulants - Warfarin - coumadin - Nursing considerations
- Inhibits vitamin K dependent - monitor vitamin K - Ensure client avoids alcohol - Antidote: Vitamin K - Avoid herbal medicaton containing ASA/NSAID's
68
Anti-platelets - Actions and Uses
- Inhibits platelets to reduce clot formation - Breaks down clots - MI and Stroke prevention Medication: Aspirin, Thrombolytics
69
Anti-platelets - Aspirin - Actions and Uses
- Decreases inflammation and risk of death from MI - “Blood thinner” - Pain - Fever - Ischemic stroke - MI prophylaxis
70
Anti-platelets - Aspirin - Side/Adverse Effects
- GI bleed - Stomach pain - Heartburn
71
Anti-platelets - Aspirin - Nursing considerations
- Assess for hemorrhages - V/S (BP) - Monitor Troponin - Ensure client does not take with alcohol - Antidote: Fresh frozen plasma (FFP)
72
Anti-coagulation - Thrombolytics - Actions and Uses
- Clot busters (existing clots) - Destroys fibrin/thrombin - MI and Stroke treatment - DVT treatment Medication: Alteplase
73
Anti-coagulation - Thrombolytics - Alteplase - Uses
- Acute MI | - Acute ischemic stroke
74
Anti-coagulation - Thrombolytics - Alteplase - Side/Adverse Effects
- Bleeding - Bruising - Hematoma
75
Anti-coagulation - Thrombolytics - Alteplase - Nursing consideration
- V/S (BP) - Assess for hemorrhages - Administer within 3-4.5 hr of onset of ischemic stroke - Avoid IM injections
76
Antilipidemic - Cholesterol - HDL vs LDL
- Cholesterol is a steroid - Promotes atherosclerosis - HDL = Good - LDL = Bad
77
Why is LDL Cholesterol bad?
Can be embedded in the lungs, veins and heart
78
Antilipidemic - Medication Types
1) HMG-CoA reductase inhibitors (-statins) | 2) Bile acid resins
79
Antilipidemic - HMG CoA reductase inhibitors - Actions and Uses
- Treats lipid disorders | - Promotes less cholesterol biosynthesis in the liver
80
Antilipidemic - HMG CoA reductase inhibitors - Side/Adverse effects
- Muscle weakness | - Myalgia
81
Antilipidemic - HMG CoA reductase inhibitors - Nursing considerations
- Administer at night due to cholesterol levels being higher in the evening - Monitor LFT - Pregnancy category X
82
Antilipidemic - Bile acid resins - Actions and Uses
- Binds with bile - high amounts of cholesterol - Increases molecule size - Decreases absorption of cholesterol - Eliminated in feces
83
Antilipidemic - Bile acid resins - Side/Adverse Effects
- No Systemic effects - Abdominal pain - Constipation - Diarrhea
84
Antilipidemic - Bile acid resins - Nursing considerations
- Increase fluid - Should be taken with food - May decrease vitamin/mineral absorption - Assess intake/output

Pharmacology Midterm 2 (4 decks)

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