Pharm cardiac Flashcards by Amanda S.

class I (sodium is #1)

Na channel blockers

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class I - salty CAB driver

1C
1A
1B
salty cab driver

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1C (1 degree C is zero)

decreases slope of phase O (depolarization) the most, then A and B.

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1C adverse effects (C, you can’t use it post MI)

can’t use post MI

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1A adverse effects (A1 gives me headaches, lupus, and tornados)

cinchonism (headache), drug induced SLE (lupus) Td Pointes (Torsades de Pointe)

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1B - best for what? (Be the best post MI)

best post-MI

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1C, 1A, 1B pneumonic for adverse effects

CQUDPB -

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class II (beta after alpha) - and what do they end in?

beta blockers (end in olole)

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class II decreases (II times II is 4)

phase 4 depolarization

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class II how to memorize - 4 letters

Beta, SA/AV, olol, AFib

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class II adverse effects (2nd class HIC)

COPD exacerabtion, impotence, hypoglcemia

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class III (3 potatoes)

potassium blockers

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class III - potassium channel blockers.

prolong refractory period. delay repolarization.

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class III adverse drug reactions (amor, check your TFT)

TdP (torsades)
PFT - pumonary
LFT - liver
TFT - thyroid

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class IV (4 milk)

ca channel blockers

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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)

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class IV adverse effects (I have edema and constipation in my 4th class)

edema and constipation

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quinadine (1A) - what is it used for? (Quin is a superhero flying through vents)

used for superventricular type atrial dysrthymias and ventricular dysrthymias

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quinadine adverse effects (I’m going deaf from listening to Quin)

can cause emboli, aFib, tennitis

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lidocaine (1B) - only for (can only numb the vents)

Note changes on EKG. Only for ventricular dysrhythmia

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How to administer Lidocaine in an emergency? (IM having an emergency with lidocaine)

Give IV only (IM in an emergency). inactive in PO form.

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lidocaine for local anesthesia, never given how?

NEVER given IV

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lidocaine adverse effects (lido makes me lie down)

Drowsiness
Parasthesias, tremors, twitching, Seizures Slurred speech

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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).

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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