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Nurs 2800 > Perfusion Pharm > Flashcards

Perfusion Pharm Flashcards

1
Q

Thiazide and Thiazide -like Diuretics

A

Anthihypertension and are a thiazide type drug

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2
Q

MOA of thiazide drugs

A

Chloride pump blocker
= keeps the chloride and sodium in distal tubule

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3
Q

Thiazide drugs act in which part of the renal system

A

distal TUBULE
Thiazide = tubes

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4
Q

Potassium sparing diuretics prototype

A

Spironolactone

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5
Q

Benefit of spironolactone

A

spare the potassium so they can give to those in hypokalemia

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6
Q

where and what does potassium sparing dietetics work on

A

Works on aldosterone in the distal tubule and collecting ducts

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7
Q

Spironolactone adverse effects

A

Hyperkalemia, dysrhythmias, gynecomastia, impotence, and deminished

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8
Q

Why isn’t potassium-sparing diuretics used as a primary diuretic

A

It’s a weak diuretic and usually is added as a second

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9
Q

mild fluid retention would most likely get which diuretic

A

Thiazide

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10
Q

Severe edema would most likely get what diuretic

A

LOOP

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11
Q

Potassium rich foods to avoid for a spironalactone

A

Avacado, bananas, broccoli

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12
Q

hypertension is the ____ common cardiovascular disease

A

most

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13
Q

HTN can cause

A

heart failure, MI are most common deaths related to hypertension
damage to
1. kidney
2. brain
3. your eyes (oh my!)
4. blood vessels

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14
Q

Dx of HTN

A

2 BP readings on 2 separate occasions

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15
Q

Categorizing BP (normal- stage 2 HTN

A

Normal: <120/80
Elevated: 120-129/<80
Stage 1: 130-139/80-89
Stage 2 >140/>90

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16
Q

Hypotension is considered

A

< 100/60 (unless provider specifies)

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17
Q

Is stage 1 HTN treated with drugs

A

only if there is cardiovascular risk

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18
Q

Is stage 2 HTN treated with drugs

A

oh yes.

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19
Q

First line drugs for non black people with HTN

A

Thiazides, Calcium channel blocker, Ace inhibitor, or Angiotension receptor blockers

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20
Q

Black people with HTN recommended to get treated with

A

Thiazides, Calcium CB before ACE or Angiotension receptor blockers

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21
Q

Medications for Kidney diseased people with HTN

A

ACE or ARB

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22
Q

Therapeutic lifestyle changes to people with HTN with no drugs

A

TLC
1. good weight
2. - alcohol
3. restrict sodium
4. exercise

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23
Q

4 first line medications for htn

A

thiazide
ACE inhibitors
angiotensin receptor blockers
calcium channel blockers

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24
Q

what can we do keep patients adherence to meds on HTN

A

Educations on why its important
consider generic forms (cost)
report adverse effects to dose can be adjusted or changed

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25
Q

Thiazide diuretics used in

A

mild to moderate HTN used to reduce fluid reduction

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26
Q

Adverse effects Thiazide

A

Dehydration
Increase uric acid levels

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27
Q

Renin-Angiotensin-Aldosterone System (RASS) is important because

A

Is one of the primary homeostatic mechanisms to control BP and fluid balance

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28
Q

Renin is secreated by and does what

A

kidneys and changes angio-tensin 1 that floating around in the blood to angiotensinogen

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29
Q

Types of angiotensin

A

Angiotensinogen: no change
Angiotensin 1:
See cards***

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30
Q

Steps to the RAAS system

A

BP is low so the kidney produces renin which makes agiotensin 1 from angiotensinogen
2. ace coverts 1 to 2
3. A2 causes vasoconstriction and the release of aldosterone

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31
Q

ACE inhibitors do what

A

Blocks the enzyme that creates Angiotensin 2 from being created from A1

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32
Q

ARB blockers do what

A

A2 is still being made, but A2 receptor is blocked so A2 cannot be utilized

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33
Q

can you be on both ACE and ARB meds

A

nah

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34
Q

ACE inhibitors meds all end in

A

-pril

35
Q

What are ACE inhibitors often used with?

A

Thiazide

36
Q

ACE inhibitors adverse effects

A

Hyper K
dry cough
angioedema (females and black)
orthostatic hypotension

37
Q

Contraindications to ACE inhibitors

A

Pregancy cat. D due to defects
Hyperkalemia

38
Q

MOA of ACE inhibitors

A

Block conversion of A1 to A2

39
Q

ACE inhibitors Food/Drug interactions

A

NSAIDS - decrease antihypertensive activity and worsen preexisting renal disease.

40
Q

ARB Pharmacologic class Angiotensin 2 receptor blocker

A

Angiotensin 2 receptor blocker
-> antihypertension

41
Q

therapeutic effect/uses of ARB

A

HTN, stroke prophylaxis in LVH, prevention of DMII nephropathy and off label for HF

42
Q

MOA of ARB

A
43
Q

Routes of

A
44
Q

Adverse Effect of ARBs

A

HZ, Dizzy, nasal congestion (vasodilation), fatigue insomnia
Angioedema

45
Q

Contraindications of ARB

A

Allergic and pregnancy

46
Q

Food/Drug interactions to ARB

A

NSAID same as ACE

47
Q

Calcium channel Blocker class

A

calcium channel blocker, dihydropyridines type

48
Q

Therapeutic use of calcium channel blocker

A

HTN, CAD, Angina, and dysrhythmia

49
Q

MOA for Calcium channel blockers

A

Selectively blocks calcium channels in vascular smooth muscle

50
Q

Routes for Calcium channel blockers

A

PO

51
Q

Adverse effects of Calcium channel blockers

A

CNS effects
GI: liver damage and nausea
CV: hypotension, flushing of the skin (big vessels)
peripheral edema
Heart block and heart failure
Non dihydro - brady, constipation
Dihydro - reflecx tachy , gingival hyperlasia

52
Q

Medications that are Calcium channel blockers

A

end in -pine (mostly for BP due to long acting)
Verapamil and diltiazem (short acting for vascular and cardiac muscle shitt)

53
Q

Contraindications for Calcium channel blockers

A

allergic
renal or hepatic dysfunction
brady and heartblock

54
Q

Drug/food interacitons

A

Booze (vasodillation)
Other hypertensives
Digoxin
grape fruit juice (enhances absoption

55
Q

adrenergic receptors

A

Alpha and beta

56
Q

Alpha 1

A

mydriasis (pupil dilation)
Vasoconstriction
Ejaculation
Relax the bladder neck and prostate

57
Q

Alpha 2 (don’t worry for test)

A

Location in presynaptic junction
Inhibits Norepi release

58
Q

Beta 1

A

Heart rate increases, increases inotropic contractility, renin release from kidney

59
Q

Beta 2

A

Bronchial dilation
relaxation of uterine muscle
vasodilation
glycogenolysis (breakdown glycogen into glucagen)
Skeletal muscle contraction

60
Q

Alpha1 Adrenergic Antagonists uses

A

HTN and enlarged prostate

61
Q

Alpha 1 antagonists end in

A

-sin (ahhaha sex joke)

62
Q

Alpha 1 onset

A

4-6 weeks for optimal therapeutic effects

63
Q

Alpha 1therapeutic effect/use

A

BPH, Raynauds disease

64
Q

Adverse effects with Alpha 1

A

what ever is increased with parasympathetic activity
- hypotension
-orthostatic hypotension (first dose phenomenon hypotension is especially bad at the beginning or at an increase of dose
- reflex tachy (use a beta blocker to prevent)
- ED, decreased libido, inability to ejaculate
- CNS depression (crosses blood brain barrier)

65
Q

Beta Blockers (antagonist) are both selective and non selective and are used in

A

HTN, Angina, glaucoma, HF, MI, Migraine prophylaxis,
Off label: PTSD and situational anxiety

66
Q

pregnancy category for beta antagonist

A

C

67
Q

selective and non selective prototypes

A

Selective (B1): metoprolol
Non selective (B1&2) propanolol

68
Q

Adverse effects beta blocker agonist

A

prevents the signs of hypoglycemia, impotence (no feelings about it at all) and libido, abrupt withdrawal can cause rebound cardiac excitation (MI)

69
Q

beta blockers are Contraindicated in

A

COPD and asthma (non selective like propranolol)
bradycardia and severe heart failure

70
Q

During an Overdose of Beta blockers (antaganist) give

A

Atropine (agonist)

71
Q

Nonselective A1 and Beta blocker antagonists

A

Carvedilol and labetalol

72
Q

Direct acting vasodilators are

A

directly cause vasodilation by relaxing smooth muscle

73
Q

Direct acting vasodilator medications

A

Nitroprusside (IV)
Hydralazine (PO, IV, IM)
Minoxidil aka rogaine lol (PO)

74
Q

Adverse effects of DA vasodilators

A

sodium and water retention, reflex tachycardia, lupis symptoms, chest pain HF

75
Q

Hypertensive emergency vs urgency

A

diastolic of pressure of >120 with organ system damage is an emergency and without organ system damage is urgent

76
Q

Meds during a hypertensive emergency

A
77
Q

Most common symptoms of medications

A

Chest pain, Dyspnea, headache

78
Q

Treatment of HTN urgency

A

conservative, current med is increased or 2nd drug is added
they need to follow up in 1-3 days on the new regimen

79
Q

Treatment of HTN E

A

BP lowered by 20-25% over 30-60 minutes. Additional reduction over 12-48 hours period until bp is within normal range
parenteral over oral because fucking duh

80
Q

Nitroprusside is a

A

direct vasodillator

81
Q

Therapeutic effect/uses of nitroprusside

A

1st line for aggressive, life threatening, HTN
- continuous monitoring to prevent hypotension
- limited to 72 hours because the drug is metabolized to thiocyanate and cyanide
- Switched to antihypertensive as soon as BP stabilizes

82
Q

Nitroprusside contraindications

A

HARD FUCKING NO
- inadequate cerebral circulation
kidney impairment increased risk of thiocyanate toxicity

83
Q

second line drug for hypertention

A

prozosin - beta adrenergic

Nurs 2800 (16 decks)

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