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Perfusion Flashcards

1
Q

Screening for cholesterol timing?

A

Low risk- q 1- 2 years starting middle age

High risk- yearly screening starting in childhood

Universal screening ages 9-11

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2
Q

Atorvostatin drug class

A

HMG- CoA reductase inhibitor (statin)

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3
Q

Atorvostatin MOA

A

Decreases total serum cholesterol, LDL, VLDL, and triglycerides

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4
Q

Atorvostatin uses

A

Hypercholesteremia

Reduce cardiovascular events in pts with multi risk factors

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5
Q

Atorvostatin use in children

A

First line for dyslipidemia

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6
Q

Oa Atorvostatin considerations

A

Lifestyle modifications first

Caution in liver disease- may accumulate

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7
Q

Atorvostatin adverse effects

A

MYOPATHY (mild muscle pain to rhabdomyolysis)

Nausea & constipation

Cramps and diarrhea/abdominal pain

Headache and skin rash

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8
Q

Atorvostatin contras

A

Pregnancy and lactation

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9
Q

Atorvostatin assessment

A

Muscle pain/weakness

GI complaints

Headache

Cholesterol improvement (1-2 weeks, 4-6 for total outcome)

Liver enzymes periodically

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10
Q

Atorvostatin teaching

A

Take in the PM

use contraceptives

Report muscle symptoms, fatigue, cola colored urine (signs of rhabdomyolysis)

Low fat diet- oat cereal daily

No smoking

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11
Q

Captopril drug class

A

Ace inhibitor

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12
Q

Captopril use

A

BP med

Decreased vasoconstriction and decreases aldosterone production

Vasodilation and reduces water and sodium retention

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13
Q

Captopril uses

A

Heart failure

Hypertension

Used alone or in combo

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14
Q

Adverse effects of Captopril

A

Angioedema

Persistent cough- switch to different med

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15
Q

Contraindications for Captopril

A

Bbw: pregnancy

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16
Q

Captopril assessment

A

Persistent cough

Angioedema

Dizziness, syncopal episodes, orthostatic hypotension

Look at potassium levels (can be elevated)

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17
Q

Captopril teaching

A

Caution with digoxin and lithium- can cause toxicity

Take on an Empty stomach

Signs of hypotension

Use contraceptives

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18
Q

Losartan drug class

A

ARB

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19
Q

Losartan use

A

Hypertension

Diabetic neuropathy

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20
Q

Losartan caution

A

Metabolized in the liver

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21
Q

Losartan adverse effects

A

Dizziness, muscle cramps and weakness, heartburn, diarrhea

ANGIOEDEMA

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22
Q

Losartan contraindications

A

Pregnancy

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23
Q

Losartan assessment

A

Blood pressure

Liver and kidney function and electrolytes

Hypersensitivity Rx

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24
Q

Losartan teaching

A

Contraceptive use

Risk of hyperkalemia- avoid potassium supplements and salt substitutes

Avoid grapefruit Juice

Hypotension symptoms

Monitor BP at home

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25
Amlodipine drug class
Calcium channel blocker
26
Amlodipine MOA
Relaxation and vasodilation to lower BP
27
Amlodipine use
Hypertension and CAD
28
Amlodipine age considerations
6-17 can use it Oa: start low dose- decreased drug clearance Hepatic impairment- dose reduction
29
Amlodipine adverse effects
Pulmonary edema Peripheral edema- hands/feet Nausea Abdominal pain
30
Amlodipine assessment
Gi Side effects Pulmonary and peripheral edema BP monitoring
31
Amlodipine teaching
Avoid grapefruit juice May increase simvastatin concentrations when taken together
32
Amiodarone drug class
Class III potassium channel blocker
33
Amiodarone environment?
Usually in the hospital
34
Amiodarone use
Tachyarrythmias Atrial/ventricular dysrhythmias
35
Amiodarone caution
Hepatotoxic- caution in older adults
36
Bbw for Amiodarone
Use only in life threatening situations
37
Amiodarone adverse effects
Micro deposits in eyes- blurry vision Photosensitivity
38
Amiodarone Assessment
continuous ECG and heart rate (ectopy) Eye exams Difficulty breathing, vision changes Chest x rays and LFT’s for cardiac/pulmonary/GI/CNS
39
Amiodarone teaching
At home taking- take with food, no albuterol or caffeine Follow up with cardiologist and lab tests Report abnormal heartbeat, dizziness/fainting, vision changes, difficulty breathing
40
Diltiazem drug class
Class IV calcium channel blocker
41
Diltiazem mechanism of action
Close conduction through SA and AV nodes
42
Diltiazem uses
SVT, AF, Aflutter, exercised induced tachycardia’s
43
Amiodarone contraindications
Shock, heart block, sensitivity to iodine (thyroid dysfunction)
44
Diltiazem contraindications
hepatic and renal impairment  Shock and heart block
45
Diltiazem adverse effects
Nausea, constipation dizziness headache FLUSHING hypotension edema and bradycardia
46
Diltiazem assessment
Normal sinus rhythm or baseline, heart rate, BP, arrhythmias, not having nausea and vomiting
47
Diltiazem teaching
Avoid caffeine and stimulant medications, report irregular heartbeat, dizziness/fainting
48
Nitroglycerin drug class
Organic nitrates
49
Nitroglycerin age considerations
Children: only IV nitroglycerin Older adults: more hypotension, fall risk
50
Nitroglycerin adverse effects
Severe headache (treated with acetaminophen) Mild headache normal side effect Dizziness, bradycardia, syncope, hypotension 
51
Nitroglycerin mechanism of action
Decreases blood volume/pressure within the heart Coronary artery dilation Reduces peripheral vascular resistance 
52
Nitroglycerin contraindications
Severe anemia Hypotension/hypovolemia Caution in traumatic brain injury: may increase ICP, and renal impairment
53
Nitroglycerin nursing considerations
Hold for hypotension Sublingual nitroglycerin as soon as chest pain develops, EKG 3 doses 5 minutes apart Avoid nitro exposure to light IV preparations in glass bottles with special tubing 
54
Nitroglycerin assessment
assess: EKG, blood pressure, heart rate, chest pain improved? Long acting nitro: having less episodes of chest pain
55
Nitroglycerin teaching
angina is because heart is not getting enough blood and oxygen Keep the tablets in the original dark bottle and replace every six months, do not keep on body You can take nitroglycerin for up to 3 doses 5 minutes apart Take nitroglycerin sitting down You may get a headache after- treat with acetaminophen Avoid over-the-counter decongestant/cold meds- can cause angina 
56
Atenolol drug class
Beta adrenergic blockers
57
Atenolol mechanism of action
Decrease his cardiac workload by slowing heart rate blood pressure and reducing contractility
58
Atenolol uses
Treatment of angina and hypertension Prophylaxis and treatment of MI within 24 hours of MI
59
Warning for atenolol
Black box warning: those with CAD cannot abruptly stop the medication. They must taper to prevent angina, ventricular dysrhythmias, MI or death
60
Older adult consideration for atenolol
Used frequently, monitor heart rate to avoid syncope/falls
61
Atenolol adverse effects
Heart failure, severe bradycardia/Brady arrhythmias, bronchospasm especially in COPD
62
Contra indications for atenolol
Heart block or severe bradycardia Shop/hypotension
63
Atenolol nursing considerations/assessment
Hold medication if heart rate is less than 60 or SBP is less than 90 Continuous telemetry Dizziness, blurred vision: hypotension 
64
Atenolol monitoring
Monitor: Bronchospasm, hypoglycemia in diabetics, heart rate and blood pressure after first dose for a couple of hours, syncope (Brady arrhythmia)
65
Atenolol teaching
Orthostatic hypotension risk Do not abruptly stop taking this med How to take pulse and BP: contact doctor if heart rate is under 55 Do not take with orange juice because there is a vitamin C interaction Diabetics need to monitor their blood sugars more frequently
66
Digoxin drug class
Cardiac glycosides
67
digoxin use
Mild to moderate heart failure and control of rate in chronic a-fib
68
Age related considerations for Digoxin
Children: narrow therapeutic window Oa: Not the first line, renal impairment: caution due to accumulation/toxicity
69
Digoxin adverse effects
Narrow therapeutic window: risk of toxicity Signs of toxicity: life-threatening arrhythmia, PVCs 
70
Contraindications for Digoxin
Myocarditis, heart block, VT/VF Caution: Acute MI, hypokalemia, hypomagnesemia, hypercalcemia (risk of dysrhythmia)
71
Digoxin assessment
Hold med for heart rate under 60 (adults) Hold med for hr under 70 in older children Hold men for hr under 100 in younger children EKG
72
Signs of digoxin toxicity
Green/yellow halos/blurry vision, difficulty with color
73
Digoxin monitoring
avoid potassium being too low (digoxin toxicity) Look at electrolytes Renal function- digoxin toxicity Digoxin levels BUN and creatinine EKG
74
Dogoxin teaching
Take exactly as prescribed at the same time every day Signs of digoxin toxicity- green/yellow halos/blurry vision, difficulty with color Labs and EKGs as ordered Take pulse before taking- notify doctor if HR is under 60 Consult doctor before taking OTC meds

Pharm (9 decks)

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