Pharmacology unit 4 pearls Flashcards
What are the symptoms of right-sided heart failure?
CHF
Systemic congestion, swollen lower extremities, and ascites.
CHF
What are the symptoms of left-sided heart failure?
CHF
Pulmonary congestion.
CHF
What arrhythmias can occur in CHF?
CHF
Atrial fibrillation and tachycardia.
CHF
What should be done if a patient’s pulse is abnormal?
CHF
Hold medication and call prescriber for direction.
CHF
What is the therapeutic serum level for cardiac glycosides?
CHF
0.5 to 2 ng/mL.
CHF
How do cardiac glycosides affect the heart?
CHF
They inhibit the sodium/potassium pump, extend the refractory period, slow down heart rate, and increase cardiac output.
CHF
What are common side effects of cardiac glycosides?
CHF
Bradycardia, tachycardia, nausea, visual disturbances, vomiting, abdominal cramps, confusion.
CHF
What is the purpose of loading a patient with a high dose of cardiac glycoside?
CHF
To raise the blood level of the drug, then maintain it with subsequent doses.
CHF
What is an arrhythmia?
ARRHYTHMIAS
Any disorder of rate and/or rhythm of the heart.
ARRHYTHMIAS
What are the groups of drugs used to treat arrhythmias?
ARRHYTHMIAS
Group 1: fast sodium channel blockers; Group 2: beta blockers; Group 3: fast potassium channel blockers; Group 4: calcium channel blockers.
ARRHYTHMIAS
What defines hypertension?
HYPERTENSION
Persistent elevation of systolic and diastolic reading of 130/80 or above.
HYPERTENSION
What should be done for Stage 1 hypertension?
HYPERTENSION
Conduct a 10-year heart disease and stroke risk assessment with lifestyle changes.
HYPERTENSION
What is syncope?
HYPERTENSION
Temporary loss of consciousness caused by a sudden fall in blood pressure.
HYPERTENSION
What may happen when starting a new hypertension medication?
HYPERTENSION
Dosage may need to be adjusted up or down.
HYPERTENSION
What is a potential side effect of ACE inhibitors?
HYPERTENSION
They can cause bronchoconstriction in some people.
HYPERTENSION
What are two major causes of hypertension?
HYPERTENSION
Excessive vasoconstriction and increased blood volume due to water retention.
HYPERTENSION
How do dihydropyridines affect blood pressure?
HYPERTENSION
They inhibit calcium influx into smooth muscle, causing vasodilation and reduced blood pressure.
HYPERTENSION
What is the effect of nondihydropyridines on the heart?
HYPERTENSION
They slow conduction velocity and heart rate, decreasing oxygen demand.
HYPERTENSION
What can respiratory disorders cause in relation to hypertension?
HYPERTENSION
Bronchoconstriction.
HYPERTENSION
What does myocardial infarction mean?
CORONARY ARTERY DISEASE & MYOCARDIALINFARCTION
Death of tissue due to loss of oxygen.
CORONARY ARTERY DISEASE & MYOCARDIALINFARCTION
What is the procedure for treating chest pain with nitroglycerin?
CORONARY ARTERY DISEASE & MYOCARDIALINFARCTION
Sit down, place one sublingual tablet under the tongue, wait five minutes, and repeat if pain persists.
CORONARY ARTERY DISEASE & MYOCARDIALINFARCTION
What is the risk of combining potent systemic vasodilators?
CORONARY ARTERY DISEASE & MYOCARDIALINFARCTION
It can reduce blood pressure to dangerous levels.
CORONARY ARTERY DISEASE & MYOCARDIALINFARCTION
How can reducing workload on the heart help with chest pain?
CORONARY ARTERY DISEASE & MYOCARDIALINFARCTION
It reduces oxygen demand, which may alleviate pain.
CORONARY ARTERY DISEASE & MYOCARDIALINFARCTION
What side effect can nitroglycerin cause?
CORONARY ARTERY DISEASE & MYOCARDIALINFARCTION
A vascular headache due to dilation of cerebral arteries.
CORONARY ARTERY DISEASE & MYOCARDIALINFARCTION
What is a hematoma?
BLOOD & ASSOACIATED AGENTS
A localized collection of blood outside of blood vessels.
BLOOD & ASSOACIATED AGENTS
What is a transient ischemic attack?
BLOOD & ASSOACIATED AGENTS
Loss of oxygen to tissue, also known as a mini-stroke.
BLOOD & ASSOACIATED AGENTS
What is low molecular weight heparin?
BLOOD & ASSOACIATED AGENTS
An anticoagulant that does not cause thrombocytopenia.
BLOOD & ASSOACIATED AGENTS
What effect does heparin have on PTT?
BLOOD & ASSOACIATED AGENTS
It extends the partial thromboplastin time (PTT).
BLOOD & ASSOACIATED AGENTS
What is the difference between anticoagulants and anti-platelet agents?
BLOOD & ASSOACIATED AGENTS
Anticoagulants prevent fibrin clot formation; anti-platelet agents prevent platelet aggregation.
BLOOD & ASSOACIATED AGENTS
Why should ASA and Coumadin not be given together?
BLOOD & ASSOACIATED AGENTS
It increases the risk of bleeding and hemorrhage.
BLOOD & ASSOACIATED AGENTS
What is anemia?
ANEMIA
Any disorder that interferes with or decreases the ability of blood to carry oxygen.
ANEMIA
How is anemia classified?
ANEMIA
By size and shape of erythrocytes, amount of hemoglobin, and etiology.
ANEMIA
What is pernicious anemia?
ANEMIA
A type of anemia caused by vitamin B12 deficiency.
ANEMIA
What are common side effects of iron supplements?
ANEMIA
Constipation, black tarry stool, indigestion, stained teeth.
ANEMIA
What tests are used to assess hypercholesterolemia?
HYPERCHOLESTEROLEMIA
Liver enzyme levels and liver function tests.
HYPERCHOLESTEROLEMIA
What does HDL stand for?
HYPERCHOLESTEROLEMIA
High-density lipoprotein, the ‘good’ cholesterol.
HYPERCHOLESTEROLEMIA
What effect does grapefruit juice have on Lipitor?
HYPERCHOLESTEROLEMIA
It inhibits liver enzymes, increasing Lipitor’s strength.
HYPERCHOLESTEROLEMIA
What is the desirable cholesterol level?
HYPERCHOLESTEROLEMIA
Below 200 mg/dL.
HYPERCHOLESTEROLEMIA
What is a common concern with potassium-sparing diuretics?
DIURETICS
Risk of hyperkalemia.
DIURETICS
What is Lasix used for?
DIURETICS
A powerful diuretic used in acute CHF to remove fluid from the lungs.
DIURETICS
What happens when ADH is decreased?
DIURETICS
Polyuria occurs, leading to decreased blood volume.
DIURETICS
What is the role of aldosterone?
DIURETICS
It causes reabsorption of sodium and excretion of potassium.
DIURETICS
What is the relationship between sodium and water balance?
DIURETICS
Sodium is the single biggest determinant of water balance.
DIURETICS
What is the risk of diuretics on glucose levels?
DIURETICS
Increased risk of hyperglycemia.
DIURETICS
What should be monitored in a patient taking diuretics?
DIURETICS
Heart rate, daily weights, and potassium levels.
DIURETICS
What is the serum creatinine clearance test used for?
DIURETICS
To indicate the health of the kidneys.
DIURETICS
What should patients taking diuretics do regarding potassium?
DIURETICS
Take potassium supplements and/or consume potassium-rich foods.
DIURETICS
What should patients do when changing positions while on diuretics?
DIURETICS
Rise slowly from a lying to a standing position.
DIURETICS
What to look out for when using a DIURETIC.
DIURETICS
a. Take diuretic first thing in morning
b. Weight daily at the SAME time every day
c. Keep a record of daily weights. Report any major fluctuation in weight from day to day
d. Most diuretics cause loss of potassium. Take potassium supplements and/or eat/drink foods high in potassium
Loss of potassium can cause cardiac arrhythmias and cramping in skeletal muscles
e. Rise slowly from a lying to a standing position and when making any changes in position
DIURETICS
