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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
Q

Anti-Dysrhythmic - Medication types

A

1) Beta 1 Blockers
2) K+ Channel Blockers
3) Ca+ Channel Blockers

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26
Q

Anti-Dysrhythmic - Beta 1 Adrenergic Blockers (Class II) - Actions of Propanalol

A
  • Blocks EP/NE
  • Lowers HR
  • Decreases SA node
  • Decreases contraction
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27
Q

Anti-Dysrhythmic - K+ Channel Blockers (Class III) - Actions of Amiodarone

A

Delays re-polarization of the myocardial cells and lengthens refractory period

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28
Q

Anti-Dysrhythmic - Ca+ Channel Blockers (Class IV) - Actions of Diltiazem

A
  • Muscle contraction is regulated
  • Decreases HR
  • Decreases Ca+ influx
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29
Q

Anti-Dysrhythmic - Side/Adverse Effects

A
  • Bradycardia
  • HF
  • Hypotension
  • Bronchoconstriction
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30
Q

Anti-Dysrhythmic - Nursing considerations

A
  • Vitals (BP, HR)
  • ECG
  • Input/output
  • K+ levels
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31
Q

Diuretics - Actions and Treatments

A
  • Work as an hypersensitiveness

- Prompts a loss of sodium and promotes loss of water

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32
Q

Diuretics - Use for Treatment

A
  • Edema treatment
  • CHF
  • Lowers BP
  • Increase urine volume/production
  • Renal disease
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33
Q

Diuretics - Loop Diuretics- Action

A
  • Blocks re-absorption of Na and Cl in the loop of Henle
  • Reduced edema in HF
  • Increase urine output
  • Furosemide and Bumetanide
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34
Q

Diuretics - Side/Adverse Effects

A
  • Nausea
  • Weakness
  • Orthostatic hypotention
  • Electrolyte imbalance
  • Arrhythmia
  • Vomiting
  • Muscle spasms
35
Q

Diuretics - Nursing considerations

A
  • VS (BP)
  • Check weight for changes
  • Input/output - Assess Electrolytes
  • Edema pitting scale
  • Ensure medication is taken in the morning
36
Q

Diuretics - Potassium Sparing - Action of Aldactone

A
  • Retains K+

- Na+ and water excreted

37
Q

Diuretics - Potassium Wasting - Actions of Loop and Thiazide diuretics

A

Excretes K+ in the loop of Henle (loop) and distal tubules (thiazide)

38
Q

Medication type and function for Thiazide Diuretic?

A

Hydrochlorothiazide - prevents re-absorption of Na+ in kidneys
- Loss of Na+, K+ and Mg+

39
Q

Medication type and function for Loop diuretic?

A

Furosemide - Increases Na+ loss in the loop of Henle

- Loss of Na+, K+, Ca+ and Mg+

40
Q

Medication type and function for Potassium sparing?

A

Spironolactone - Prevents re-absorption of Na+ but promotes re-absorption of K+
- Loss of Na+ and Mg+

41
Q

Anti-Hypertensives - Medications to treat

A

1) Diuretics
2) Calcium Channel blockers
3) Agents affecting RAAS - inhibitors/blockers
4) Adrenergic agents
5) Direct-acting vasodilators

42
Q

Anti-Hypertensives - RAAS - ACE (Angiotensin converting enzyme) Inhibitors - Actions

A
  • Lower ACE
  • Inhibit formation of Angiotensin II
  • Inhibit Vasoconstriction
  • Stimulates secretion of aldoesterone
43
Q

Anti-Hypertensives - RAAS - ACE (Angiotensin converting enzyme) Inhibitors - Medication Types (-pril)

A
  • Enalapril

- Captopril

44
Q

Anti-Hypertensives - RAAS - ACE (Angiotensin converting enzyme) Inhibitors - Side/Adverse Effects

A
  • Renal symptoms
  • Laryngeal Edema
  • Cough
  • Angio edema
45
Q

Anti-Hypertensives - RAAS - ACE (Angiotensin converting enzyme) Inhibitors - Nursing considerations

A
  • Assess Edema
  • V/S (BP)
  • Assess cough description and types
46
Q

Anti-Hypertensives - RAAS - Angiotensin II receptor blockers (ARB)- Actions and Uses

A
  • Block vasoconstriction effects
  • Lowers BP
  • Lowers Aldosterone
  • Decrease vasoconstriction
  • Safer for kidneys - can be given to prevent renal failure for diabetes clients
47
Q

Anti-Hypertensives - RAAS - Angiotensin II receptor blockers (ARB) (-sartan) - Medication Types

A
  • Losartan

- Valsartan

48
Q

Anti-Hypertensives - RAAS - Angiotensin II receptor blockers (ARB) - Side/Adverse Effects

A
  • Hyperkalemia
  • Arrhythmia
  • Muscle spasms
49
Q

Anti-Hypertensives - RAAS - Angiotensin II receptor blockers (ARB) - Nursing considerations

A
  • V/S (BP, HR)

- Assess K+ levels

50
Q

Anti-Hypertensives - Adrenergic Agents - Types

A

1) Beta Adrenergic Blockers (Beta Blockers)
2) Alpha Blockers
3) Alpha Agonist
4) Combination - Alpha + Beta Blockers

51
Q

Anti-Hypertensives - Beta Blockers - Actions

A 
Blocks effect of EP/NE on vascular system
- Promotes vasodilation 
- Lowers BP
- Lowers HR
Medication: Metoprolol
52
Q

Anti-Hypertensives - Beta Blockers - Side Effects

A
  • Bradycardia
  • Bronchoconstriction
  • Hypotension
  • Weakness
  • Fatigue
53
Q

Anti-Hypertensives - Alpha Blockers - Actions

A
  • Lowers sympathetic response
  • Blocks EP/NE
  • Promotes Vasodilation
  • Lowers BP
    Medication: Doxazosin
54
Q

Anti-Hypertensives - Alpha Blockers - Side Effects

A
  • Orthostatic hypotension
  • Dizziness
  • Bradycardia
  • Constipation
55
Q

Anti-Hypertensives - Alpha 2 Agonist - Actions and Uses

A
  • Reduces sympathetic response
  • Lowers BP
  • Can increase Na+ and water retention
    Medication: Clonidine
56
Q

Anti-Hypertensives - Alpha 2 Agonist - Side Effects

A
  • Hypotension
  • Dry mouth
  • Edema
  • Bradycardia
  • Dry mouth
  • Constipation
57
Q

Anti-Hypertensives - Combination- Alpha 1 and Beta blockers - Action and Uses

A
  • Centrally acting
  • Blocks EP/NE
  • Lowers HR
  • Lowers BP
    Medication: labetalol
58
Q

Anti-Hypertensives - Combination- Alpha 1 and Beta blockers - Side Effects

A
  • Orthostatic hypotension
  • Bradycardia
  • Bronchoconstriction
  • Constipation
  • Dizzines
  • Lethargy
59
Q

Anti-Hypertensives - Nursing Considerations for all

A
  • V/S (BP, HR)
  • Assist in changing position
  • Promote hydration
  • Assess intake/output
  • Assess LOC
  • Assess Edema
60
Q

Anti-coagulants - Actions

A
  • Prevents MI

- Decreases and prevention of blood clots

61
Q

Anti-coagulants - Medication Types (-parin)

A

Low weight heparin: enoxaparin

62
Q

Anti-coagulants - LWH - enoxaparin - Actions and Uses

A
  • Inhibits thrombin formation
  • Decrease fibrin
  • Prevention of clots
  • Prevent DVT
63
Q

Anti-coagulants - LWH - enoxaparin - Side/Adverse Effects

A
  • Bruising
  • Bleeding - gums, nose bleeds
  • Hematoma
64
Q

Anti-coagulants - LWH - enoxaparin - Nursing considerations

A
  • Do not give via IM
  • Assess for black stools (blood in stool)
  • Assess lab values INR (loss of blood)
65
Q

Anti-coagulants - Warfarin - Actions and Uses

A
  • Venous thrombosis
  • Prophylaxis
  • Prevent clots
    Medication: coumadin
66
Q

Anti-coagulants - Warfarin - coumadin- Side/Adverse Effects

A
  • Minor bleeding
  • Bruising
  • Hematoma
67
Q

Anti-coagulants - Warfarin - coumadin - Nursing considerations

A
  • Inhibits vitamin K dependent - monitor vitamin K
  • Ensure client avoids alcohol
  • Antidote: Vitamin K
  • Avoid herbal medicaton containing ASA/NSAID’s
68
Q

Anti-platelets - Actions and Uses

A
  • Inhibits platelets to reduce clot formation
  • Breaks down clots
  • MI and Stroke prevention
    Medication: Aspirin, Thrombolytics
69
Q

Anti-platelets - Aspirin - Actions and Uses

A
  • Decreases inflammation and risk of death from MI
  • “Blood thinner”
  • Pain
  • Fever
  • Ischemic stroke
  • MI prophylaxis
70
Q

Anti-platelets - Aspirin - Side/Adverse Effects

A
  • GI bleed
  • Stomach pain
  • Heartburn
71
Q

Anti-platelets - Aspirin - Nursing considerations

A
  • Assess for hemorrhages
  • V/S (BP)
  • Monitor Troponin
  • Ensure client does not take with alcohol
  • Antidote: Fresh frozen plasma (FFP)
72
Q

Anti-coagulation - Thrombolytics - Actions and Uses

A
  • Clot busters (existing clots)
  • Destroys fibrin/thrombin
  • MI and Stroke treatment
  • DVT treatment
    Medication: Alteplase
73
Q

Anti-coagulation - Thrombolytics - Alteplase - Uses

A
  • Acute MI

- Acute ischemic stroke

74
Q

Anti-coagulation - Thrombolytics - Alteplase - Side/Adverse Effects

A
  • Bleeding
  • Bruising
  • Hematoma
75
Q

Anti-coagulation - Thrombolytics - Alteplase - Nursing consideration

A
  • V/S (BP)
  • Assess for hemorrhages
  • Administer within 3-4.5 hr of onset of ischemic stroke
  • Avoid IM injections
76
Q

Antilipidemic - Cholesterol - HDL vs LDL

A
  • Cholesterol is a steroid
  • Promotes atherosclerosis
  • HDL = Good
  • LDL = Bad
77
Q

Why is LDL Cholesterol bad?

A

Can be embedded in the lungs, veins and heart

78
Q

Antilipidemic - Medication Types

A

1) HMG-CoA reductase inhibitors (-statins)

2) Bile acid resins

79
Q

Antilipidemic - HMG CoA reductase inhibitors - Actions and Uses

A
  • Treats lipid disorders

- Promotes less cholesterol biosynthesis in the liver

80
Q

Antilipidemic - HMG CoA reductase inhibitors - Side/Adverse effects

A
  • Muscle weakness

- Myalgia

81
Q

Antilipidemic - HMG CoA reductase inhibitors - Nursing considerations

A
  • Administer at night due to cholesterol levels being higher in the evening
  • Monitor LFT
  • Pregnancy category X
82
Q

Antilipidemic - Bile acid resins - Actions and Uses

A
  • Binds with bile - high amounts of cholesterol
  • Increases molecule size - Decreases absorption of cholesterol
  • Eliminated in feces
83
Q

Antilipidemic - Bile acid resins - Side/Adverse Effects

A
  • No Systemic effects
  • Abdominal pain
  • Constipation
  • Diarrhea
84
Q

Antilipidemic - Bile acid resins - Nursing considerations

A
  • Increase fluid
  • Should be taken with food
  • May decrease vitamin/mineral absorption
  • Assess intake/output

Pharmacology Midterm 2 (4 decks)

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