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Nursing I > Pharm: Cardiac > Flashcards

Pharm: Cardiac Flashcards

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1
Q

what is the name of a cardiac glycoside?

A

digoxin (digitalis preparations)

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2
Q

digoxin has positive inotropic effects. What is that?

A

increases myocardial contractility

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3
Q

digoxin has negative chronotropic effects. What is that?

A

decreases (slows) heart rate

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4
Q

take what before digoxin admin?

A

apical pulse for 60 sec (baseline pulse)

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5
Q

do not give digoxin when pulse is what?

A

<60 or >100

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6
Q

digoxin is contraindicated when pt has what kind of HF?

A

diastolic HF

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7
Q

most worrisome side effect of digoxin?

A

bradycardia (no perfusion)

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8
Q

digoxin has a ____ therapeutic window

A

short

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9
Q

___ lvls drawn prior to digoxin admin

A

dig

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10
Q

true or false: digoxin has a long 1/2 life, increasing the risk for toxicity

A

true.

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11
Q

other than dig lvl, what other serum lvl should we look at before admin of digoxin?

A

potassium (hypokalemia can precipitate dig toxicity)
<3.5

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12
Q

chest pain that occurs with exertion and is predictable

A

stable angina

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13
Q

chest pain that occurs frequently w/ progressive severity unrelated to activity (unpredictable)

A

unstable angina

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14
Q

chest pain due to abnormal coronary artery spasm (vasospastic), occurs during rest

A

prinzmetal (variant)

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15
Q

antianginal drugs that promote vasodilation, decrease workload on heart, and decrease pressure in vessels

A

nitrates

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16
Q

routes of admin of nitrates

A

-SL, TL (top surface of tongue), topical, aerosol spray (inhalation), IV
-buccal and oral extended release

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17
Q

process of taking nitro before calling EMS?

A

1) 1 dose SL of nitro
2) wait 5 min
do steps 1 and 2 (x3), and if chest pain continues, call EMS

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18
Q

true or false: do not obtain baseline vitals before nitrate admin

A

false. Take vitals before admin, especially BP because of the risk of hypotension from the vasodilation

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19
Q

what position should the pt be in when taking a nitrate?

A

sitting or lying down (bc of hypotensive effect)

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20
Q

what serum lab has to be monitored while on nitrates?

A

potassium (normal = 3.5-5)
effects contractility and rhythm of heart

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21
Q

digoxin antidote

A

immune FAB (DSFab)

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22
Q

serum digs lvls should be what for dysrhythmias and for HF

A

dysrhythmias= 0.8-2 ng/mL
HF= 0.5-1 ng/mL

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23
Q

meds that reduce hypertension and decrease edema

A

diuretics

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24
Q

type of diuretic that act on the ascending loop of Henle (in kidneys)

A

loop diuretics

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25
Q

when water goes, what follows?

A

electrolytes (potassium, calcium, magnesium)

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26
Q

since loop diuretics can cause loss of potassium, what might a pt also be put on

A

potassium supplement (could cause hypokalemia)

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27
Q

two worrisome side effects from loop diuretics

A

electrolyte imbalances and orthostatic hypotension (monitor BP before admin)

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28
Q

monitor _____ lvls when a pt is on a loop diuretic, especially when concurrently taking digoxin

A

potassium

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29
Q

what two things to monitor DAILY when pt on loop diuretic?

A

urinary output and weight (determine body fluid gain/loss)

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30
Q

1L of fluid is = to ___ Ibs

A

2.2 Ibs

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31
Q

name a loop diuretic

A

furosemide (Lasix)

32
Q

PREVENT the formation of clots that inhibit circulation

A

anticoagulants

33
Q

prevent platelet aggregation (platelets less sticky, can’t clump)

A

antiplatelets

34
Q

dissolve clots that have already formed

A

thrombolytics

35
Q

are anticoagulants used prophylactically?

A

yes

36
Q

do anticoagulants dissolve clots that are already formed?

A

no

37
Q

how can anticoags be administered

A

PO, subQ, IV

38
Q

name 2 anticoags

A

heparin and low molecular weight heparin

39
Q

how to administer heparin

A

subQ, IV (continuous drip, requires frequent labs)

40
Q

can heparin be given PO?

A

no, it is poorly absorbed in GI tract

41
Q

what is the lab value used to eval heparin therapy

A

PTT (1.5-2x control value) control = 60-70sec

42
Q

will everyone with elevated lvls need heparin antidote?

A

no, heparin has a short 1/2 life (4hrs)

43
Q

side effect of heparin

A

bleeding

44
Q

heparin antidote

A

protamine sulfate

45
Q

how are LMWH (low molecular weight heparin) administered?

A

subQ injection

46
Q

when are LMWH given?

A

prevent DVT/PE after ortho or abdominal surgery

47
Q

name two LMWH

A

enoxaparin (Lovenox)
dalteparin (Fragmin)

48
Q

can self admin be taught for at home use of LMWH?

A

yes

49
Q

true or false: frequent lab monitoring IS required for LMWH

A

false. it is NOT

50
Q

should aspirin be taken with LMWH

A

no

51
Q

what is the most commonly prescribed PO anticoag

A

warfarin

52
Q

warfarin inhibits the synthesis of vitamin __

A

K

53
Q

which clotting factors does warfarin effect

A

II, VII, IX, and X
2, 7, 9, and 10

54
Q

monitor which lab values on warfarin

A

PT and INR

55
Q

major side effect of warfarin?

A

bleeding

56
Q

how long does it take for warfarin to be effective?

A

24-48hrs

57
Q

how can vitamin K (antidote for warfarin) be administered

A

PO, IM, subQ, (maybe IV in ICU)

58
Q

name 2 factor Xa inhibitors (a kind of oral anticoagulant)

A

apixaban (Eliquis)
rivaroxaban (Xarelto)

59
Q

advantage of taking factor Xa inhibitors over warfarin

A

do not require routine coag monitoring (they are more expensive than warfarin)

60
Q

can a patient of warfarin eat green leafy veggies?

A

yes, they can have foods with vit K just keep a consistent intake
(fish, liver, coffee, tea) <— other foods with vit K

61
Q

suppress platelet aggregation

A

antiplatelets

62
Q

antiplatelets are used to prevent __ and ____ for pts w/ familial history

A

MI and stroke

63
Q

name of 2 antiplatelet meds

A

aspirin and clopidogrel (Plavix)

64
Q

antihyperlipidemic that reduce LDL lvls by binding with bile acids in the intestine

A

bile-acid sequestrants (cholestyramine Questran)

65
Q

__ side effects occur with bile-acid sequestrants

A

GI

66
Q

antihyperlipidemic that reduces triglycerides from plasma and VLDL

A

fibrates

67
Q

fibrates are contraindicated with _____

A

anitcoags
they compete for protein sites and has an increase for bleeding

68
Q

an OTC antihyperlipidemic that reduces VLDL and LDL

A

niacin (nicotinic acid)

69
Q

what side effect makes many people stop taking niacin

A

flushing/hot flashes

70
Q

antihyperlipidemic that acts in the cells in the small intestine to inhibit dietary cholesterol absorption

A

cholesterol absorption inhibitor

71
Q

a cholesterol absorption inhibitor must be combined with a ____ for optimum effect

A

statin

72
Q

antihyperlipidemic that inhibits the enzyme HMG CoA reductase in cholesterol biosynthesis (blocks metabolism of cholesterol)

A

Statins

73
Q

major side effect of statins

A

rhabdomyolysis

74
Q

true or false: a statin is a lifetime commitment

A

true. Abrupt discontinuation may cause rebound effect

75
Q

a name of a statin

A

atorvaSTATIN (will end in statin)

76
Q

what lab value to monitor on statins

A

LFTs because med is metabolized in the liver

Nursing I (10 decks)

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