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PHARMACOLOGY > PHARM: MODULE 7: CARDIOVASCULAR & HEMATOLOGICAL AGENTS > Flashcards

PHARM: MODULE 7: CARDIOVASCULAR & HEMATOLOGICAL AGENTS Flashcards

1
Q

Cardiovascular medications are essential tools in managing many acute physiological situations as well as common
chronic diseases such as _____________ and __________________

A

Hypertension, atrial fibrillation

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2
Q

Anticoagulants are commonly prescribed to prevent
potentially life-threatening ______________ especially in populations with a history of thromboembolic events or those in a
hypercoagulable state.

A

blood clots, hypercoaguable state

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3
Q

What are some types of cardiac glycoside medications used to treat diseases of the cardiovascular system?

A

DIGOXIN

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4
Q

types of antianginal meds used to treat diseases of the cardiovascular system?

A

nitrates (SL nitroglycerine)

Beta- adrenergic blockers (-olol)

Calcium channel blockers

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5
Q

What are some types of anti- dysrhythmic medications used to treat diseases of the cardiovascular system?

A

Beta 1 adrenergic blockers
-Potassium channel blockers
- Calcium channel blockers

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6
Q

Name types of diuretic meds used to treat diseases of the cardiovascular system?

A

Loop diuretics

Thiazide and thiazide like

Potassium sparing

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7
Q

types of antihypertensive meds used to treat diseases of the cardiovascular system?

A

-Calcium channel blockers

  • ACE inhibitors (-pril)
  • Angiotensin II receptor blockers (ARB) (-Sartan)
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8
Q

types of anticoagulant meds used to treat diseases of the cardiovascular system?

A

-Heparin

  • Low Molecular weight heparin
  • Warfarin
  • DOAC’s
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9
Q

types of antiplatelet meds used to treat diseases of the cardiovascular system?

A
  • Aspirin (ASA)
  • ADP Receptor blockers
  • Glycoprotein IIb/ IIIa receptor blockers
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10
Q

NAME some antilipidemic meds that are used to treat diseases of the cardiovascular system?

A
  • HMG- CoA Reductase inhibitors (-statins)
  • Bile acid resins or bile sequestrants
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11
Q

What is Digoxin used for? (Cardiac glycosides)

A

-congestive heart failure
-AFIB
-controls irregular heartbeats (arrhythmias)

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12
Q

What are the side/ adverse effects of Digoxin? (Cardiac glycosides)

A

Fatigue, headache, weakness, blurred vision, yellow or green vision, arrhythmias, bradycardia, ECG changes, AV block/ SA block, anorexia, nausea, vomiting, diarrhea, electrolyte imbalances - toxicity

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13
Q

What are the nursing considerations for Digoxin? (Cardiac glycosides)

A

-Evaluate for ventricular dysrhythmias
-history of hypersensitivity
-renal function should be assessed
-Be cautious with those with acute MI, incomplete heart block, and renal insufficiency, pregnancy, and elders

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14
Q

What is Nitrates (SL Nitroglycerine) used for? (Antianginal)

A

To cause venous and arteriole dilation of smooth muscle. The vasodilation allows for a decrease in preload –> reducing cardiac output and workload of the heart, which helps to lower the myocardial oxygen demand

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15
Q

What would you use a Short acting Nitrates (SL Nitroglycerine) for? (Antianginal)

A

acute angina

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16
Q

What would you use a long acting Nitrates for? (Antianginal)

A

Use a transdermal patch and extended release nitroglycerin ( ISOSORBIDE)

helpful in treating hypertension

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17
Q

side/ adverse affects of Nitrates (SL Nitroglycerine)? (Antianginal)

**remember the 3 H’s

A

Always check BP before giving this drug

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18
Q

What are nursing considerations when administering Nitrates (SL Nitroglycerin)? (Antianginal)

A
  • Give in intervals of 3 doses - one spray SL, wait 5 min, second spray 5 min, third spray, if it does not subside by third spray - call 911.
  • Check BP after each spray. Patient can develop tolerance to drug.
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19
Q

What do Beta- Adrenergic Blockers (-olol) do? (Antianginal)

A

Slows heart rate (negative chronotropic effect) and reduces contractility (negative inotropic effect)

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20
Q

What are Beta- Adrenergic Blockers (-olol) used for? (Antianginal)

A

To decrease frequency of angina attacks by exertion

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21
Q

What are the side/ adverse affects for Beta- Adrenergic Blockers (-olol)? (Antianginal)

A

What are the side/ adverse affects for Beta- Adrenergic Blockers (-olol)? (Antianginal)
-Fatigue during exercise because these drugs prevent HR increase.
- Postural hypotension

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22
Q

What are some nursing considerations when administering Beta- Adrenergic Blockers (-olol)? (Antianginal)

A

-Change positions slowly
-Do not discontinue abruptly
-Do not take OTC meds or herbal supplements without discussing with a health care provider.
-Monitor pulse - >50bpm.
-Alternate periods of exercise with periods of rest

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23
Q

What are calcium channel blockers used for? (Antianginal)

A

to relax arterial smooth muscle which lowers BP. –> Decreases afterload causing a decrease in myocardial oxygen demand

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24
Q

What do calcium channel blockers do? (Antianginal)

A

-Slows conduction velocity –> decreases HR and cardiac workload
-Dilates coronary arteries, more O2 to myocardium

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25
Q

What are the side/adverse affects of calcium channel blockers? (Antianginal)

A

-Constipation
-Fluid retention

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26
Q

What are some nursing considerations when administering calcium channel blockers? (Antianginal)

A
  • Take BP on both arms while laying down
    -Keep record of frequency and severity of each angina attack
    -Change positions slowly
    -Alert health care provider if shortness of breath, weight gain, and slow heartbeat appear
  • avoid grapefruit juice

*Do not crush or break XR tabs

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27
Q

What do Beta 1 Adrenergic Blockers do? (Anti-dysrhythmics)

A
  • Block the effect of epinephrine and norepinephrine on the heart
  • Decreases the ability of the SA node to fire spontaneously, decreasing conductivity
  • Decreases cardiac contraction
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28
Q

What are the side/ adverse affects of Beta 1 Adrenergic Blockers?
(Anti-dysrhythmics)

A

bronchoconstriction

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29
Q

What do Potassium channel blockers do? (Anti-dysrhythmics)

A

-They block potassium channels !!

-cause vasodilation

-Delay the repolarization of the myocardial cells

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30
Q

What are the side/ adverse affects for potassium channel blockers?
(Anti dysrhythmics)

A

…

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31
Q

What are some nursing considerations when administering potassium channel blockers?
(Anti dysrhythmics)

A

correct hypokalemia prior to therapy

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32
Q

What do calcium channel blockers do?
(Anti dysrhythmics)

A
  • stops the calcium influx across cardiac and smooth muscle
  • Decreases excitability, conductivity, and contractility of the heart
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33
Q

What are the side/ adverse affects of calcium channel blockers?
(anti- dysrhythmics)

A

Bradycardia, heart failure, hypotension

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34
Q

What are some nursing considerations when administering calcium channel blockers?
(anti- dysrhythmics)

A
  • monitor vitals
    -ECG
  • measure/ monitor intake and output
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35
Q

What do Loop diuretics do? (Diuretics)

A

Blocks the reabsorption of sodium and chloride in the loop of henle
- Reduces edema associated with HF, hepatic cirrhosis, chronic renal failure, hypertension
- Can increase urine output even when renal blood flow is lowWhat do Loop

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36
Q

What are some side/ adverse affects with loop diuretics? (Diuretics)

A

severe potassium loss, hypovolemia, hypotension, ototoxicity, decrease in glucose

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37
Q

What are some nursing considerations when administering loop diuretics? (Diuretics)

A
  • Baseline weight, postural BP, electrolytes (potassium), ascites, abnormal girth, ototoxicity
  • Monitor lab values for glucose and uric acid
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38
Q

What do thiazide and thiazide like medications do? (Diuretics)

A

Acts of distal tubule.
- Blocks sodium reabsorption and increases potassium and water excretion

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39
Q

What are some nursing consideration when administering thiazide and thiazide like medications? (Diuretics)

A
  • Cautious in patients with hyperlipidemia. Increase potassium in diet. Monitor lab values and signs of gout
  • Baseline weight, postural BP, electrolytes (potassium), ascites - abdominal girth.
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40
Q

What are some side/adverse affects of thiazide and thiazide like medications? (Diuretics)

A

-fluid and electrolyte imbalance
-Hyperglycemia

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41
Q

What do potassium sparing diuretics do? (Diuretics)

A
  • Blocks exchange of sodium and potassium in distal tube –> causes sodium to stay in tubule and leave through urine and more potassium to be retained
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42
Q

What are some nursing considerations when administering potassium sparing diuretics? (Diuretics)

A

Not to be used in clients with renal insufficiency or hyperkalemia

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43
Q

What are some side/ adverse affects of potassium sparing diuretics? (Diuretics)

A

Report fever, rash, sore throat, accelerated hair growth - females, testicular - males.

Dietary restrictions: avoid potassium and salts that contain potassium

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44
Q

What do calcium channel blockers do? (Antihypertensive)

A
  • Inhibits calcium from entering, limiting muscular contraction.
  • Low doses cause smooth muscle in arterioles to relax = decrease in peripheral resistance = decreased BP
45
Q

What are some nursing considerations when administering calcium channel blockers? (Antihypertensive)

A

Education, electrocardiogram, heart rate, BP should be assessed prior to therapy, vital signs should be monitored regularly.
- Grapefruit juice is a absolute no

46
Q

What are some side/ adverse affects of calcium channel blockers? (Antihypertensive)

A

-heart failure
-hypotension
-bradycardia

47
Q

What do ACE inhibitors (-prill) do? (Antihypertensive)

A
  • Angiotensin II converting enzyme causes vasoconstriction - by blocking the effects of angiotensin II converting enzyme there is no vasoconstriction, causing a decrease in BP
  • Lowered peripheral resistance and a decrease in blood volume
48
Q

What are the side/ adverse affects of ACE inhibitors (-prill)? (Antihypertensive)

A
  • DRY COUGH
  • postural hypotension (or dizziness)
  • angioedema (means swelling of the deeper layers of the skin)
  • hypersensitivity
  • non-inflammatory swelling of the skin
  • mucous membranes
49
Q

What do angiotensin II receptor blockers (ARB) (-sartan) do? (Antihypertensive

A

What do angiotensin II receptor blockers (ARB) (-sartan) do? (Antihypertensive)
- Blocks the receptors for angiotensin II in arteriolar smooth muscle and adrenal glands.
-Arteriolar dilation and increased sodium excretion.
-Normally combined.

50
Q

What are the side/ adverse affects of angiotensin II receptor blockers (ARB) (-sartan)? (Antihypertensive)

A

-hyperkalemia
-low bp
-cough
-DIZZINESS
-headache
-drowsiness
-diarrhea
-abnormal taste sensation (metallic/salty)
-rash

51
Q

What are some nursing considerations when administering angiotensin II receptor blockers (ARB) (-sartan)? (Antihypertensive)

A
  • Avoid salt substitutes containing potassium
  • potassium supplements, or other drugs that may increase potassium levels - hyperkalemia
52
Q

What does heparin- IV do? (anticoagulant - veins)

A

decrease the clotting ability of the blood and help prevent harmful clots from forming in blood vessels.

53
Q

What are the side/ adverse affects of heparin- IV ? (anticoagulant - veins)

A

Alopecia, rashes, urticaria, anemia, pain at site, osteoporosis, fever, hypersensitivity

54
Q

What do Low molecular weight heparins - SC do? (anticoagulant - veins)

A
  • Enhances the inhibitory action of antithrombin III and specifics to factor X.
  • Produces a more stable response than heparin
55
Q

What are the side/ adverse affects of Low molecular weight heparins - SC? (anticoagulant - veins)

A

-Dizziness
-headache
-insomnia
-edema
-constipation
-nausea
-vomiting
-alopecia
-ecchymosis
-pruritus
-rash
-urticaria
-bleeding
-anemia
-eosinophilia
-thrombocytopenia
-erythema at injection site
-hematoma
-irritation
-pain
-osteoporosis
-fever

56
Q

What does Warfarin -ORAL do?
(anticoagulant - veins)

A

Treat and prevent blood clots

57
Q

What are some side/ Adverse affects of Warfarin -ORAL?
(anticoagulant - veins)

A

-necrosis
-nausea
-calcium build up in blood vessels
-bleeding
-fever

58
Q

What are some changes to note when a patient is changing over from Heparin to Warfarin?

A
59
Q

What are some changes to note when a patient is changing over from Heparin to Warfarin?

A

Increased risk of bleeding due to the high amounts of anticoagulants in the blood

60
Q

What does DOACs do? (anticoagulant - veins)

A

-Prevents stroke and venous thrombo-embolism
-Manages A-FIB
-Factor X inhibitors
-Factor II inhibitors

61
Q

What are some nursing considerations when administering DOACs?
(anticoagulant - veins)

A

monitor client condition, provide education - nose bleeds, bruising, excessive menstrual flow, “coffee ground” emesis, tarry stools, tea-colored urine, bright red bleeding from rectum, dizziness, fatigue, pale or pasty looking skin

62
Q

What are some side/adverse affects of DOACs?
(anticoagulant - veins)

A

nose bleeds, bruising, excessive menstrual flow, “coffee ground” emesis, tarry stools, tea-colored urine, bright red bleeding from rectum, dizziness, fatigue, pale or pasty looking skin

63
Q

What does Aspirin (ASA) do?
(antiplatelet - arteries)

A

-Binds irreversibly to enzyme cyclooxygenase in platelets.
-Inhibits platelet aggregation.
-Lasts as long as a week.

64
Q

What are some side/adverse affects for Aspirin (ASA)?
(antiplatelet - arteries)

think blood thinner

A

tinnitus, dyspepsia, epigastric distress, nausea, abdominal pain, anorexia, hepatotoxicity, vomiting, anemia, hemolysis, rash, urticaria, allergic reactions, excessive bleeding

65
Q

What are some nursing considerations when administering Aspirin (ASA)?
(antiplatelet - arteries)

A

Gastritis or GI bleeding

66
Q

What do ADP receptor blockers do?
(antiplatelet - arteries)

A

-Irreversibly alters receptors for ADP on plasma membrane of platelets.

-ADP = unable to bind = platelets cannot receive chemical signals for aggregation

67
Q

What are some nursing considerations for ADP receptor and Glycoprotein IIb/IIIa receptor blockers?
(antiplatelet - arteries)

A

Increased bleeding risk. Avoid strenuous activity, do not take OTC containing ASA, report spontaneous bleeding - nosebleeds, gums, bruising.

68
Q

What do Glycoprotein IIb/IIIa receptor blockers do?
(antiplatelet - arteries)

A

-Inhibits enzyme for platelet aggregation.
-Prevents Thrombus formation

69
Q

What do HMG-CoA Reductase Inhibitors (-statins) do?
(antilipidemic)

A

-Inhibit the enzyme HMG-CoA reductase

-lowering LDL + increasing HDL

70
Q

What are some side/adverse affects of HMG-CoA Reductase Inhibitors (-statins)?
(antilipidemic)

A

-GI complaints - cramping, diarrhea, constipation.

-Liver damage if grapefruit interacts with drugs -

inhibits metabolism, allowing them to reach toxic levels.

71
Q

What are some nursing considerations when administering HMG-CoA Reductase Inhibitors (-statins)?
(antilipidemic)

A

Pregnancy X, monitor liver function, may cause weakness and myalgias

*Should be given at night because biosynthesis occurs at night

72
Q

What do Bile acid resins or Bile sequestrants do?
(antilipidemic)

A

-Bind bile acids. Bile inhibitor - stops the breakdown/absorption of fats and cholesterol is excreted in digestive tract in stool.

-The reduction in cholesterol causes the liver to create more LDL receptors, which removes more cholesterol from blood.

73
Q

What are the side/adverse affects of Bile acid resins or Bile sequestrants?
(antilipidemic)

A

Abdominal pain, bloating, diarrhea, steatorrhea, constipation, high potential for drug-drug interaction, interferes with absorption of vitamins and minerals

74
Q

What are some nursing considerations when administering Bile acid resins or Bile sequestrants?
(antilipidemic)

A

Take meds before meals, space out all medication to avoid all interference, ensure to drink all of the liquid and drink immediately post mixing.

75
Q

What are some healthy behaviours that patients can participate in to minimize symptoms of cardiovascular disease?

A

-Low fat, low sodium diet.
-Exercise - 30 min/5 days. Moderate.
-Decrease stress - coping strategies.
-Increase sleep.
-Maintain healthy weight.

76
Q

Cardiovascular Medication are used to treat what disorders?

A

-Hypertension
-Angina
-Atrial Fibrillation
-Coronary Artery Disease

77
Q

What is the role of the Cardiovascular System?

A

it transports nutrients and waste, pumps blood and circulates oxygen

78
Q

How does the circulatory system maintain and regulate blood pressure?

A

By the Baroreceptors that are found in the aortic arch and the carotid sinus. When pressure builds in these areas the Baroreceptors send a signal to the ANS to LOWER blood pressure.

79
Q

What is a way we have learned how with the baroreceptors it can lower blood pressure?

A

By the Cholinergic ACH

80
Q

What is the role of the cardiovascular system in regulating body temperature? ( what does it do to the blood vessels)

A

1a) By DILATING blood vessels: heat from the heart can then be easily removed.
2a) By CONSTRICTING blood vessels: heat can be kept in

81
Q

What is the role of the cardiovascular system in regulating the ACID/BASE BALANCE?

A

reath in oxygen and we then breath out carbon dioxide. When CO2 builds up in the blood it triggers the center in the brain to increase and blow off CO2

82
Q

t

A
83
Q

What is Blood pressure?

A
84
Q

What are ways that control and change Blood Pressure?

A

-Dehydration
-Obesity
-Diabetes
-Arteriosclerosis
-Diet and exercise
-Alcohol and drug abuse

85
Q

What are 3 things that affect Blood Pressure? / AND describe them ALL:

A

1a) Blood volume: is the amount of blood being pumped by the heart each beat
b) Peripheral resistance: is the resistance to arteries and blood flow
c) Cardiac output: is the amount of blood being pumped by the heart in a minute

86
Q

What is the BPN test:

A
87
Q

How does your body compensate to changes in LOW Blood Pressure?

A

-It activates the sympathetic response
-increase heart rate (epinephrine and norepinephrine)
-Vasoconstriction
-increase heart contractility

88
Q

How does the body compensate to changes in HIGH blood pressure?

A

-It will activate the parasympathetic response
-ACH: the heart rate will decrease
-Blood vessels will dilate
-Contractility will increase or decrease?

89
Q

What are causes to the blood volume being decreased?

A

Blood loss
-Sweating
-Excess vomiting or diarrhea
-Burns: excessive inflammation from burns causes vessels to leak

90
Q

What is stroke volume?

A

the amount of blood that is being pumped out of the LEFT ventricle per beat

91
Q

What detects changes in blood pressure? And what do they detect?

A

1a) Barrow receptors: they inform the autonomic nervous system on changes to blood pressure
2a) Chemoreceptors: they detect chemistry composition of the blood

92
Q

What system regulates Blood pressure?

A

The RAAS (renin angiotensin aldosterone system)

93
Q

When should a diuretic be given to a patient? Day OR night?

A

DAY!! Or else they will pee all night and hate us

94
Q

What are the 3 classified groups of Diuretics and explain where they work and what they do?

A

1a) LOOP DIURETICS: example =(Lasix/ furosemide)
-Fast acting
-Large urine output
-They work at the Loop of Henle in the kidneys and they promote secretion of sodium= INCREASE SODIUM LOSS
-Potassium excretion (ADVERSE EFFECTS!!! Where salt goes water follows- they are non-selective so other electrolytes can be pulled out especially potassium

2b) THIAZIDES: example= (DIURIL/ CHLOROTHIAZIDE)
-MOST common
-Less diuresis than Loop Diuretics
-They work by blocking sodium and chloride in the Distal Convoluted Tubules of the nephron
-If you block sodium from being reabsorbed it will then be excreted
-** REMEMBER WHERE SODIUM GOES WATER FOLLOWS!! **

3c) POTASSIUM- SPARING DIURETICS: example= (ALDACTONE/ SPIRONOLACTONE)
-Aldosterone antagonists
-Mild Diuresis
-They work by preventing sodium to be reabsorbed by being pulled out or inhibiting aldosterone receptors

95
Q

What are some Nursing implications of what we would want to check before giving a Diuretic to a patient?

A

-Blood pressure
-weight
-serum electrolytes
-dizziness (orthostatic hypotension)
-low sodium diet
-take in the morning to prevent nocturia

96
Q

A decrease in blood volume is at risk for what and what should you assess?

A

Dehydration and hypovolemia: assess the ankles and lower legs for pitting edema

97
Q

v

A
98
Q

What does pitting edema signify?

A
99
Q

Because Calcium Channel Blockers have a potent vasodilating effect: it can cause what??

A

REFLEX TACHYCARDIA

100
Q

Why can’t you drink grapefruit when taking a Calcium Channel Blocker?

A

because it inhibits the metabolization of the drug which causes an increased effect= could lead to TACHYCARDIA

101
Q

Describe (ACE) inhibitors and what it stands for? And where it is found?

A

(ACE) Angiotensin converting enzyme that’s found in the pulmonary circulation

102
Q

Describe what ADH stands for and where it is found?

A

(ADH) Antidiuretic Hormone which is found in the posterior pituitary

103
Q

Describe Aldosterone and where it is found? And where it is produced?

A

Aldosterone is found in the kidneys and produced by the adrenal gland

104
Q

What are Antihypertensives Drugs that affect the RAAS system? And their function?

A

-(ACE) Angiotensin Converting Enzyme Inhibitors
-They inhibit the formation of Angiotensin 11
-Persistent DRY COUGH may be triggered by bradykinins proinflammatory action

105
Q

Antihypertensives (ACE) inhibitors usually end in what?

A

PRIL

106
Q

What are side effects of ACE inhibitors?

A
107
Q

What is the Antidote for WARFARIN?

A
108
Q

Monitor blood pressure with NITROGLYCERIN… if you see a patient that is taking nitroglycerin and has hypotension with these symptoms you need to STOP the MED

A
109
Q
A

PHARMACOLOGY (5 decks)

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