Pharm cardiac Flashcards
class I (sodium is #1)
Na channel blockers
class I - salty CAB driver
1C
1A
1B
salty cab driver
1C (1 degree C is zero)
decreases slope of phase O (depolarization) the most, then A and B.
1C adverse effects (C, you can’t use it post MI)
can’t use post MI
1A adverse effects (A1 gives me headaches, lupus, and tornados)
cinchonism (headache), drug induced SLE (lupus) Td Pointes (Torsades de Pointe)
1B - best for what? (Be the best post MI)
best post-MI
1C, 1A, 1B pneumonic for adverse effects
CQUDPB -
class II (beta after alpha) - and what do they end in?
beta blockers (end in olole)
class II decreases (II times II is 4)
phase 4 depolarization
class II how to memorize - 4 letters
Beta, SA/AV, olol, AFib
class II adverse effects (2nd class HIC)
COPD exacerabtion, impotence, hypoglcemia
class III (3 potatoes)
potassium blockers
class III - potassium channel blockers.
prolong refractory period. delay repolarization.
class III adverse drug reactions (amor, check your TFT)
TdP (torsades)
PFT - pumonary
LFT - liver
TFT - thyroid
class IV (4 milk)
ca channel blockers
class IV - (calcium has 7 letters, 0+3+4 =7)
0, 3, 4 phase cardiac action potential (calcium has 7 letters, 0+3+4 =7)
class IV adverse effects (I have edema and constipation in my 4th class)
edema and constipation
quinadine (1A) - what is it used for? (Quin is a superhero flying through vents)
used for superventricular type atrial dysrthymias and ventricular dysrthymias
quinadine adverse effects (I’m going deaf from listening to Quin)
can cause emboli, aFib, tennitis
lidocaine (1B) - only for (can only numb the vents)
Note changes on EKG. Only for ventricular dysrhythmia
How to administer Lidocaine in an emergency? (IM having an emergency with lidocaine)
Give IV only (IM in an emergency). inactive in PO form.
lidocaine for local anesthesia, never given how?
NEVER given IV
lidocaine adverse effects (lido makes me lie down)
Drowsiness
Parasthesias, tremors, twitching, Seizures Slurred speech
Flecainide (1C) (Flec can be a superhero or a wolf)
used to treat supraventricular tachycardias, including AV nodal re-entrant tachycardia (AVNRT) and Wolff-Parkinson-White syndrome (WPW).
beta blockers do what? (Beta blood vessels)
relax Blood vessels
metroprolol adverse effects - and don’t use with what diagnosis? (COPD at the Met is bad)
COPD (asthma patients!), dizziness, fatigue, exercise intolerance
Amiodarone (Cordarone®) (class III) (Amor likes to fibs)
uses - Recurrent V-Fib (or tach) - emergency
A-Fib (oral)
Amiodarone (Cordarone®) half life (Amor has lived forever)
25 - 110 days
Amiodarone (Cordarone®) adverse effects (Amor, you’re blind)
Pulmonary Toxicity
Hepatitis
Corneal Microdeposits & Blindness
Thyroid dysfunction
Adenosine (Adenocard®) - NOT for (Aiden doesn’t mix with Gab either!)
aFib
Adenosine (Adenocard®) - precautions about half-life - and how long?
Precaution: Short 1⁄2 Life (1.5 – 10 seconds)
digoxin
inhibits Na and K pump. Increase output by increasing force of contraction (Inotropic)
digoxin precautions (Little Kalema, can you dig?)
hypokalemia
digoxin adverse effects - early and late (I can’t dig anorexia or blindness)
Anorexia (early)
Vision Changes (late) Narrow Therapeutic Index
digoxin drug interactions - diuretics (diuretics digging a hole with K+)
Diuretics: Combine to lower K+
digoxin antidote (the antidote is FAB, can you dig?)
Digoxin Immune FAB (Digibind®, DigiFab®)
digoxin nursing implications - what blood levels to check?
Check serum potassium & dig levels
- K+ should be normal
CAD symptoms (Caddy has PADS f)
Angina, Palpitations, Dyspnea, Syncope, Fatigue
consequences of CAD (Caddy has collateral, ischemia, and thrombus)
Development of collateral circulation
Myocardial ischemia and infarction
Thrombus, aneurysms, rupture
3 types of angina
stable, variant, unstable
stable angina - 4 Es
Transient (3-5 mins)
Relieved by rest
4 E’s (emotion, exercise, eating, extreme temp)
Prinzmetal (variant) angina - related to what? (Prinz is a spaz)
Prinzmetal (variant) Unpredictable or at rest Related to vasospasm
Unstable Unpredicable angina
Unstable Unpredicatble
Not relieved my meds / rest
most dangerous, you need to call 911 with this one
A patient is mowing his lawn on a hot Saturday afternoon. He begins to notice chest pain. What should his first action be?
stop mowing and lie down
Goals of Drug Therapy for Angina (just increase O2)
increase 02**
Reduce myocardial oxygen demand
Minimize or remove the occlusion
What drugs increase myocardial oxygen supply? (MY oxygen, MY calcium and nitrate)
▪ Calcium channel blockers
▪ Nitrates (including nitroglycerin)
Nitrates are effective in treating stable angina because of their
their dilating effect on veins and arteries
sublingual or buccal nitrate is
the fastest
nitro will stop working if
you take it too much. need to wait 12 hours in between, don’t take at night.
nitro adverse effects (you know these)
Severe headaches
Orthostatic Hypotension
Dry mouth, blurry vision
nitro drug interactions (No nitro on viagra)
Antihypertensives ↑ hypotension
PDE5 inhibitors
*****(sildenafil = Viagra) ↑ hypotension
nitro teaching
Give sublingual preparation under tongue or in buccal pouch. DON’T SWALLOW
nitro instructions
◼ Keep at room temp
◼ Check expiration date
◼ Don’t crush or chew
have a fresh bottle that hasn’t been opened
should feel a tingling sensation on tongue
with nitro. if not, it may be expired.
Wean pt from NTG - to avoid what? (Nitro is a spaz)
slowly to avoid vasospasm
adenosine - how to administer? (Aiden needs IV near the heart)
Must be given IV
As close to the heart as possible
digoxin drug interactions with ACEI (ace inhibitors) (Ace can’t dig)
increase K+ (makes dig ineffective)
digoxin drug interactions - BB,CCB
Combine to lower HR
how to adminster digoxin
- Give dig IV Push slowly over 5 minutes
digoxin implications - bradycardia
- Treat symptomatic bradycardia with atropine or pacing
1A, 1B, 1C examples (Quinn, be the light, see the flecs)
quinadine, lidocaine, flecadine
1B example (B the light-o-cane)
lidocaine
1C example (C the flecs)
Flecainide
Flecainide can cause (flecs in my lungs cause damage)
lung damage
Class IV (CCB) examples (veep in 4th class)
verapamil and diltizam
diltizam - used for? (diazapam makes me flutter)
for temporary control of Afib and A flutter
aden treats (Aiden is a superhero)
Paroxysmal supraventricular tachycardia (PSVT)
Which class of drugs is used to treat both hypertension and dysrhythmias? (a glass of milk cures everything)
CCB
ACE causes
fatigue, headache, dry cough
