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Pharmacology- Keiser > Prototypes > Flashcards

Prototypes Flashcards

1
Q

What is ZidovuDINE?

A

NRTI (nucleoside reverse transcriptase inhibitor)

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2
Q

What is the classification EfaVIRENZ under?

A

NNRTI
(Nonnucleoside reverse transcriptase inhibitors)

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3
Q

What classification is DoluteGRAVIR under?

A

Integrase strand transfer inhibitor

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4
Q

What classification is Acyclovir under?

A

Nucleoside analog

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5
Q

What is the classification of CyclophosPHAMIDE?

Hint: PHAMIDE sandwich, yellow with no acid

A

Alkylating agent; nitrogen mustard

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6
Q

What is Methotrexate?

A

Antimetabolite; folic acid analog

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7
Q

What is DoxoRUBICIN used to treat?

A

Antitumor/antineoplastic; antibiotic

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8
Q

VinCRISTINE

A

Vinca alkaloid, mitotic inhibitor, natural product

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9
Q

TamoXIFEN

A

Estrogen receptor antagonist

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10
Q

Lorazepam
(Ativan)

A

Therapeutic class: Sedative-hypnotic; anxiolytic; anesthesia adjunct

Pharmacologic class: Benzodiazepine; GABAa-receptor agonist

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11
Q

Escitalopram
(Lexapro)

A

Therapeutic class: Antidepressant; Anxiolytic

Pharmacologic class: SSRI (selective serotonin re-uptake inhibitor

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12
Q

Zolpidem
(Ambein, edluar, intermezzo)

A

Therapeutic class: sedative-hypnotic

Pharmacologic class: Nonbenzodiazepine GABAa receptor agonist; nonbenzodiazepine, nonbarbiturate CNS depressant

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13
Q

What is the prototype for anticholinergics?

A

Atropine

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14
Q

What are antibiotics?

A

Chemicals inhibiting specific bacteria

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15
Q

What are the 2 types of antibiotics?

A

Bacteriostatic
Bactericidal

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16
Q

What are bacteriostatics?

A

Prevents bacterial growth

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17
Q

What is bactericidals?

A

Directly kills bacteria

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18
Q

What are gram + bacteria characteristics?

A

Cell wall retains stain
Commonly associated w/ infections of respiratory & soft tissue
Example: strep

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19
Q

What are characteristics of gram - bacteria?

A

Cell wall loses stain
Associated with infection of GU/GI
Example: E. Coli

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20
Q

What are the gram + bacteria?

A

Staph
Strep
Enterococcus

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21
Q

What is the gram - bacteria?

A

All the rest

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22
Q

What are aerobic bacteria?

A

Depend on O2

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23
Q

What is anaerobic bacteria?

A

Doesn’t use O2

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24
Q

What does synergistic mean?

A

Combined effect is greater than their effect given individually

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25
Q

What are interferons?

A

Released by host in response to viral invasion & prevents replication

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26
Q

What is the prototype for herpes & cytomegalovirus?

A

Acyclovir

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27
Q

What is the pharmacological action of acyclovir?

A

Inhibits viral DNA replication

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28
Q

What are the adverse effects of acyclovir?

A

Headache
Vertigo
Tremors
Nausea/ vomiting
Rash

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29
Q

What is the prototype for nonnucleoside reverse transcriptase inhibitors ( NNRTIs)?

A

Nevirapine

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30
Q

What is the Pharmacologic action of nevirapine?

A

Blocks HIV-1 replication by changing enzyme structure

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31
Q

What are the adverse effects of nevirapine?

A

Headache
Nausea/vomiting
Diarrhea
Rash
Liver dysfunction
Chills
Fever

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32
Q

What is the prototype for nucleoside transcriptase inhibitors (NRTIs)?

A

Zidovudine

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33
Q

What is the pharmacological actions of zidovudine?

A

Inhibits replications of retroviruses

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34
Q

What are the adverse effects of zidovudine?

A

Headache
Insomnia
Dizzy
Nausea
Diarrhea
Fever
Rash
Bone marrow suppression

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35
Q

What is the prototype for protease inhibitors?

A

Fosamprenavir

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36
Q

What are antineoplastic agents?

A

Alkalyting agents
Antimetabolites
Antineoplastics
Mitotic inhibitors
Hormones & hormone modulators
Cancer specific agents

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37
Q

What is the pharmacological action of alkylating agents?

A

Chemically react with RNA/DNA

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38
Q

What is the Pharmacologic actions of antimetabolites?

A

Inhibits DNA production in cells

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39
Q

What are the Pharmacologic actions for antineoplastics?

A

Cytotoxic; interfere w/ cellular DNA synthesis

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40
Q

What is the Pharmacologic actions of mitotic inhibitors?

A

Kills cells when mitosis begins inhibiting DNA synthesis

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41
Q

What are cancer cell specific agents?

A

Protein tyrosine kinase inhibitors
Proteasome inhibitors
Monoclonal antibodies

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42
Q

What is the Pharmacologic action of protein tyrosine kinase inhibitors?

A

Acts on protein building tumor cells

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43
Q

What are the Pharmacologic actions of hormones & hormone modulators?

A

Blocks stimulation of growing cancer cells

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44
Q

What do antimalarials do?

A

Attacks parasite at various stages of development

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45
Q

Types of antimalarials?

A

Schizonticidal
Gametocytocidal
Sporontocidal

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46
Q

What does schizonticidal antimalarials do?

A

Act against RBC phase of life cycle

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47
Q

What does gametocytocidal antimalarials do?

A

Acts against gametocytes

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48
Q

What do sporontocidal antimalarials do?

A

Acts against parasite developing into mosquito

Or

Against tissue schizonts

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49
Q

What is the prototype for antimalarials?

A

Quinine

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50
Q

What is quinine’s Pharmacologic action?

A

Prevent acute malaria

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51
Q

What is the pharmacological action of antiprotozoal drugs?
Hint: stop replicating easy targets

A

Inhibit DNA synthesis in susceptible Protozoa

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52
Q

What is antihelmintic drugs?

A

Anti worm/parasitic meds

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53
Q

What is Azole antifungals for?

A

Systemic & topical fungal infections

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54
Q

What is the prototype for antifungals?

Hint: Fungals hate F-ing Azoles

A

Fluconazole

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55
Q

What is another prototype for antifungals?

A

Clotrimazole

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56
Q

What are drugs that have a direct effect in the inflammatory response?

A

Salicylates
Non-steroidal anti-inflammatory (NSAIDs)
Antiarthritic

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57
Q

What is the pharmacological action of salicylates?

Hint: Sali cop Stops Prostas

A

Inhibit synthesis of prostaglandin

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58
Q

What is the pharmacological action of NSAIDs?

A

Relief of RA/osteoporosis S&S; relief of mild—moderate pain

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59
Q

What are immune modulators for?

A

Modify immune system actions

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60
Q

What are immune stimulants used for?

A

Used in immune exhaustion

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61
Q

What are immune suppressants used for?

A

Block normal immune effects

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62
Q

What is the prototype for immune stimulants?

A

Interferon alfa-2b

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63
Q

What is the pharmacological action of interferon alfa-2b?
Hint: fero seems 2b stoping all Virions

A

Interferes w/ virus particle replication inside cells

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64
Q

What is the prototype for interleukin immune stimulants?

A

Aldesleukin

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65
Q

What is the pharmacological actions of aldesleukin?

Hint: skiing; stimulating to go up the mountain, the height inhibits my excitement growth

A

Stimulates cellular immunity and inhibits tumor growth

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66
Q

What is the prototype of colony-stimulating immune stimulants?
Hint: Fil grabs stims land

A

Filgrastim

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67
Q

What is the pharmacological action of filgrastim?

A

Increases neutrophil production
or
Increases proliferation & differentiation of hematopoietic progenitor cells & active mature granulocytes/monocytes

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68
Q

What should not be combined in use with colony- stimulating immune stimulants?

A

Lithium & corticosteroids

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69
Q

What is the prototype for T & B cell immune suppressants?

Hint: what comes after B but before T, C!

A

Cyclosporine

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70
Q

What are monoclonal antibodies?

A

Single B cell clone, reacts to specific antigens

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71
Q

What is the prototype for monoclonal antibodies?

A

Bevacizumab
(Hint)b cells

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72
Q

What is the action of bevacizumab?
Hint: b-mab grabs Abony specifically before anything happened

A

attaches Antibodies to specific receptor sites being developed

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73
Q

What are vaccines and immune sera used for?

A

Stimulates antibody production
Provide antibodies for immune reaction
Produces toxins specific to pathogen/venin

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74
Q

What is immune sera?

A

Preformed antibodies found in globulin w/ specific developed antibodies to disease(s)

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75
Q

What is the prototype for vaccines?

A

MMR
Measles, mumps, rubella

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76
Q

What is the prototype for immune sera?

A

Immune globulin IM

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77
Q

What is the use for Anxiolytics & Hypnotic agents?

A

Alter response to environmental stimuli

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78
Q

What is the prototype for Anxiolytics?

A

Diazepam
Benzos (benzodiazepines)

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79
Q

What is the prototype for Anxiolytic-hypnotics?

A

Phenobarbital
(Barbiturates)

Hint: downers

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80
Q

What withdrawal symptoms does Benzos & Barbs treat?

A

Panic attacks
Insomnia
Cravings
Tremors
Confusion
Seizures
Coma
Death

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81
Q

What is the mechanism of action for Benzos?

A

Acts as CNS depressant

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82
Q

What does anxiolytics treat?

A

Relieves anxiety

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83
Q

What does anticonvulsants treat?

A

Manages seizures

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84
Q

What does hypnotics treat?

A

Insomnia

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85
Q

What does Benzos enhance?

A

GABA
Gamma-AminoButyric Acid

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86
Q

What is Biogenic Amine Theory?

A

Results from NE (norepinephrine), Dopamine, Serotonin deficiency

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87
Q

What are the 4 main types of antidepressants?

A

TCAs- tricyclic antidepressant
MAOIs- monoamine oxidase inhibitors
SSRIs- selective serotonin re-uptake inhibitors
SNRIs- serotonin norepinephrine inhibitors

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88
Q

What is the prototype for TCAs?

A

Imipramine

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89
Q

What is the mechanism of action for imipramine?

A

Reduce uptake of serotonin (5HT) & NE (norepinephrine)

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90
Q

What should you NOT do with imipramine?

A

Withdraw abruptly

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91
Q

What is the prototype for MAOIs?

A

Phenelzine

92
Q

What is the mechanism of action for phenelzine?

A

Irreversibly inhibits MAO to breakdown Biogenic amines NE (norepinephrine), dopamine, serotonin (5HT)

93
Q

What is phenelzine toxic to?

A

Tyramine

94
Q

What does phenelzine relieve?

A

Depression

95
Q

What is the prototype for SSRIs?

A

Fluoxetine (Prozac)

96
Q

SSRIs can be referred to as?

A

Happy pills (:

97
Q

What are the 4 SNRIs available?

A

Duloxetine (Cymbalta)
Venlafaxine (Effexor)
Pristiq (desevnlafaxine)
Fetzima

98
Q

What is the mechanism of action for SNRIs?

A

Decreased re-uptake of serotonin (5HT) & NE (norepinephrine); weakly inhibits Dopamine

99
Q

What is psychotherapeutic agents?

A

Drugs used to treat psychoses and behavioral disorder

100
Q

What are the mental disorders?

A

Schizophrenia
Bipolar disorder
Narcolepsy
Attention deficit disorder

101
Q

What is the most common type of psychosis?

A

Schizophrenia

102
Q

What is the action of antipsychotic/Neuroleptic drugs?

A

Block dopamine receptors

103
Q

What are the contraindications of antipsychotic/Neuroleptic drugs?

A

CNS depression
Circulatory collapse
Parkinson’s disease
Coronary disease
Severe hypotension
Prolonged QT intervals
Underlying diseases

104
Q

What are the adverse effects of antipsychotic/Neuroleptic drugs?

A

Sedation
Weakness
Tremors
Constipation
Drowsiness
Extrapyramidal effects
Dry mouth
Nasal congestion

105
Q

What are the extrapyramidal effects of antipsychotic/Neuroleptic drugs?

A

Pseudoparkinsonism
Dystonia
Akathisia
Tardive dyskinesia
Potentially irreversible neuroleptic malignant syndrome

106
Q

What should the nurse assess for when taking antipsychotic/Neuroleptic drugs?

A

Hx & physical
Allergies
Brain damage
Severe hypotension
Glaucoma
Respiratory depression
Diabetes
Urinary/intestinal obstruction
Thyrotoxicosis
Seizures
Bone marrow suppression
Pregnancy/lactation
Myelography w/in 24hr/scheduled in 48 hrs
VS
CNS orientation
Affect
Reflexes
Renal/hepatic tests

107
Q

What are the actions of lithium?

A

Alters NA+ transport
Stops NE & dopamine release from stimulated neurons
Increases NE storage in intra-neuronal stores; dopamine slightly
Decreases content of 2nd messengers

108
Q

Where is lithium absorbed?

A

GI tract

109
Q

T/F: Does lithium cross the blood-brain barrier, slightly?

A

True

110
Q

How much of lithium is reabsorbed by the kidneys during excretion?

A

80%

111
Q

What are the contraindications for lithium?

A

Allergy
Renal/cardiac disease
Leukemia
Metabolic disorders
Pregnancy/lactation

112
Q

What are the adverse effects of lithium?

A

Effects lithium serum level directly

113
Q

What does a lithium serum level of less 1.5 cause?

A

Lethargy
Slurred speech
Muscle weakness
Nausea/vomiting

114
Q

What does lithium serum level of 1.5 to 2 cause?

A

Above reactions
ECG changes

115
Q

What does lithium serum levels of 2-2.5 cause?

A

Ataxia
Clonic movements
Hyperflexia
Seizures

116
Q

What does a >2.5 lithium serum level cause?

A

Complex multi organ toxicity
Significant risk of death

117
Q

What are the drugs that interact w/ lithium?

A

Haloperidol
Carbamazepine
Thiazide diuretics

118
Q

What should the nurse assess for when taking anti manic drugs?

A

Hx & physical
Allergy
Renal or CV disease
Dehydration
NA+ depletion
Diuretic use
Protracted sweating
Diarrhea
Suicidal/impulsive w/depression
Pregnancy/lactation
Infection w/ fever
Urinary output
Renal function tests
Serum lithium levels

119
Q

What are the actions of CNS stimulants?

A

Increase postsynaptic neuron stimulation

120
Q

What is the indication for use for CNS stimulants?

A

Treatment for narcolepsy & attention deficit disorders

121
Q

Where does CNS stimulants get rapidly absorbed?

A

GI tract

122
Q

Where are CNS stimulants get metabolized & secreted?

A

Liver= metabolized
Kidneys= excreted

123
Q

What is the half life of CNS stimulants?

A

2-15 hrs

124
Q

What are the contraindications for CNS stimulants?

A

Allergy
Marked anxiety
Agitation
Tension
Severe fatigue
Glaucoma

125
Q

What are adverse effects of CNS stimulants?

A

Nervousness
Insomnia
Dizziness
Headache
Blurred vision
Anorexia
Nausea
Weight loss

126
Q

What are the drug interactions of CNS stimulants?

A

MAOI
Guanethidine
Tricyclic antidepressants
Phenytonin

127
Q

What should the nurse assess for when taking CNS stimulants?

A

Hx & physical
Allergies
Glaucoma
Anxiety
HTN
Tension
Fatigue
Seizure
Cardiac disease
Pregnancy/lactation
Hx of leukemia
Hx of drug/alcohol dependency
Urinary output
VS including lung sounds
CBC

128
Q

What is the prototype for antiparkinson agents?

A

Levodopa

129
Q

What does levodopa do?

A

Increase effects of dopamine receptor sites

130
Q

What is the prototype for anticholinergic drugs?

A

Benxtropine

131
Q

What are adjunctive agents?

A

Improves pt response to traditional therapy

132
Q

What are all adjunctive agents used with?

A

Carbidopa-levodopa

133
Q

What is drug therapy aimed at for Parkinson’s?

A

Restoring dopamine-acetylcholine balance

134
Q

What are anticholinergics used for?

A

Blocking excitatory receptors

135
Q

What are dopaminergic drugs used for?

A

Increase dopamine levels/directly stimulate dopamine receptors

136
Q

What does dopamine do?

A

Allows you to feel pleasure, satisfaction, motivation

137
Q

What is the most prevalent neurologic disorder?

A

Epilepsy

138
Q

T/F: epilepsy is a single disease, not a collection of different syndromes characterized by the same feature?

A

False.

139
Q

What is the same feature characterized by epilepsy?

A

Sudden discharge of electrical energy; leads to seizure

140
Q

What is a syndrome?

A

Group of symptoms consistently occurring together
Or
Condition characterized by set of associated symptoms

141
Q

What are the symptoms of seizures?

A

Confused speech
Muscle contraction
Wandering
Blank stare
Chewing

142
Q

T/F: accurate DX of seizures is important for determining correct meds.

A

True.

143
Q

What are the 2 classifications of seizures?

A

Partial- involves one hemisphere
Generalized- involves both hemispheres; loss of consciousness

144
Q

What are the two sub classifications for partial seizures?

A

Simple- consciousness, not impaired
Complex- consciousness, impaired

145
Q

What are the sub classifications for generalized seizures?

A

Tonic-clonic
Atonic
Status epilepticus
Absence
Myoclonic
Febrile

146
Q

What are the drugs used to treat epilepsy?

A

Antiepileptics
Anti seizure
Anticonvulsants

147
Q

T/F: Drug of choice in treatment for epilepsy is not dependent on type, age, specific characteristics.

A

False.

148
Q

T/F: treatment of epilepsy will never use more than one drug.

A

False.

149
Q

What does drugs for generalized seizures do?

A

Stabilize nerve membranes by blocking channels in cell membrane
Or
Altering receptor sites

150
Q

T/F: seizure medications generally work on the CNS & affect the entire brain to reduce the chance of sudden electrical outbursts

A

True

151
Q

What do these seizures meds include?

A

Hydantoins
Barbiturates
Barbiturate like drugs
Benzodiazepines
Succinimides

152
Q

What is the prototype for hydantoins?

A

Phenytoin (Dilantin)

153
Q

T/F: hydantoins are less sedative, making it the drug of choice for pts not wanting to be drowsy or tolerate sedation.

A

True

154
Q

T/F: hydantoins have significant adverse effects, so Benzos have replaced them for most situations.

A

True.

155
Q

Barbiturates & Barbiturate like drugs prototype is?

A

Phenobarbital (Solfoton, Luminal)

156
Q

What is does Barbiturates & Barbiturate like drugs do?

A

Stop impulse conduction in ascending RAS

157
Q

What is the prototype of Benzos?

A

Diazepam (Valium)

158
Q

What are the effects of Benzos?

A

Potentiate GABA effects

159
Q

T/F: Benzos have limited toxicity and are well tolerated by most people.

A

True

160
Q

T/F: succinimides are most frequently used to treat absence seizures.

A

True

161
Q

What is the mechanism of action for succinimides?

A

Unknown

162
Q

T/F: it is only known succinimides suppress abnormal electrical activity in the brain

A

True

163
Q

What is the prototype for succinimides?

A

Ethosuximide (Zarontoin)

164
Q

What is the prototype for other drugs treating absence seizures?

A

Valproic acid (Depakene)

165
Q

T/F: treating partial seizures maybe simple or complex.

A

True

166
Q

What does the drugs treating partial seizures do?

A

Stabilize nerve membranes either:
Directly- altering NA+ channels
Indirectly- increasing GABA acvtivity

167
Q

T/F: carbamazepine, felbamate, oxcarbazepine are used in mono therapy, the remaining 4 drugs are used as adjunctive therapy.

A

True

168
Q

What is the prototype for partial seizure drugs?

A

Carbamazepine (Tegretol, Epitol)

169
Q

What is the fun fact about gabapentin (Neurontin)?

A

Gabapentin- not a controlled substance; mainly used for diabetes
Neurontin= controlled substance

170
Q

What is a seizure?

A

Electrical energy from nerve cells located w/in the brain

171
Q

T/F: pts being treated with antiepileptics should be advised to carry a medical alert notification to alert emergency persons.

A

True

172
Q

T/F: pts being treated w/ anti epileptic are often long-term therapy & require compliance w/ drug regimen/restrictions associated w/ disorder and drug effects.

A

True

173
Q

What are anxiolytics used to treat?

A

Seizures
Anxiety

174
Q

What are the anxiolytic drugs?

A

Benzos
Barbs
Buspirone

175
Q

T/F: the DANGEROUS anxiolytic meds are Benzos & Barbs

A

True

176
Q

Why are Benzos/Barbs dangerous as anxiolytics?

A

They are sedatives
Vitals= low/slow

177
Q

T/F: buspirone sedates.

A

False

178
Q

Good and bad of Benzos use as an anxiolytic?

A

Good- acts fast
Bad- addictive, highly

179
Q

What should the nurse teach for pt taking Benzos?

A

Sedation
Sleepy
Suppresses ABCs

180
Q

NCLEX TIP:
What are the key points to remember for Benzos?

A

Take at bedtime
Don’t skip doses
Ween off; NEVER abruptly stop taking
NO alcohol
DON’T operate machines

181
Q

What is the ANTIDOTE for BENZOS?

A

Flumazenil

182
Q

What is the ANTIDOTE for OPIODS?

A

Naloxone

183
Q

What is the good and bad of BARBS as anxiolytics?

A

Good= lasts longer,
Bad= takes longer too get out; HIGH toxicity risk

184
Q

T/F: buspirone is an atypical anxiolytic.

A

True

185
Q

What is the good and bad of buspirone as anxiolytic?

A

Good= no depressant effects
Bad= long time to kick in; slow acting

186
Q

What the key points for buspirone as anxiolytic?

A

2-4 weeks full effect
No withdrawal
No sedation
No tolerance
No addiction
Safe for long term use

187
Q

What should the nurse teach about buspirone to the pt taking as anxiolytic?

A

Can drive
Not for acute attacks
Don’t take PRN
Take continuous

188
Q

NCLEX PRACTICE: pt teaching for Diazepam?(select all that apply)
1. Avoid valerian root
2. Avoid Ginkgo & Ginseng
3. Avoid muscle relaxants
4. Report Hx of reaction to midazolam
5. Naloxone is the antidote for this med
6. Decrease alcohol consumption

A
  1. Avoid valerian root (=Valium)
  2. Avoid muscle relaxants
  3. Report Hx of reaction to midazolam
189
Q

NCLEX PRACTICE: Client on phenobarbital, which of the following should the nurse do? SATA
1. Monitor for HTN
2. Assess for respiratory depression
3. Assess for low BP
4. Teach pt there is NO withdrawal symptoms
5. Teach sedation is an early side effect

A
  1. Assess for respiratory depression
  2. Assess for low BP
  3. Teach sedation is an early side effect
190
Q

What are the 4 antidepressants?

A

SSRIs
SNRIs
TCAs
MAOIs

191
Q

NCLEX PT SAFETY: What are the 4 rules of antidepressants?

A

Increased suicide risk; 1st few weeks into treatment
ALWAYS notify provider if thoughts occur (KEY WORDS: new, unusual, worsening, sudden)

Slow onset & taper off

Never mix:
SSRIs + St. John’s Wart
MAOIs + Antidepressants (TCAS, SSRI, SNRI); leads to deadly serotonin syndrome

ALL psych drugs:
Decrease BP
Cause weight change

192
Q

What is the prototype for class 1 anti arrhythmics?

A

Lidocaine

193
Q

What is the indication for use of lidocaine?

A

Management of acute ventricular arrhythmias during cardiac surgery or MI

194
Q

What is the adverse effects of Lidocaine?

A

Dizzy
Light-headed
Fatigue
Arrhythmias
Cardiac arrest
Vomiting
Anaphylaxis
Hypotension
Vasodilation

195
Q

What is the prototype for class 2 antiarrhythmics?

A

Propranolol

196
Q

What is the indications for use for propranolol?

A

Treats supraventricular tachycardia (in the atrium)

197
Q

What is the actions for use of propranolol?

A

Competitively blocks beta receptors in hear/kidney
Has stabilizing effect
Influences Sympathetic nervous system

198
Q

What is the adverse effects of propranolol?

A

Bradycardia
HF
Cardiac arrhythmias
Heart blocks
CVA (Cerebrovascular accident)
Pulmonary edema
Gastric pain
Gas
Nausea/vomiting
Diarrhea
Impotence
Decreased exercise tolerance
Antibody development

199
Q

What are Class lll anti-arrhythmics drugs?

A

Amiodarone (Cordarone)
Dofetilide (Tikosyn)
Ibutilide (Corvert)
Sotalol (Betapace, Betapace AF)

200
Q

What is the indication for use of a class 3 anti arrhythmias?

A

Life- threatening ventricular arrhythmias
Maintenance of sinus rhythm after conversion of atrial arrhythmias

201
Q

What are the contraindications for use for a class 3 anti-arrythmias?

A

None

202
Q

When should you use caution when using a class 3 anti-arrhythmias?

A

Shock
Hypotension
Respiratory depression
Prolonged QT
Renal/hepatic disease

203
Q

What are the adverse effects of class 3 anti-arrhythmias?

A

Nausea/vomiting
Weakness
Dizzy
Arrhythmias

204
Q

What is the drug interaction of class 3 anti-arrhythmias?

A

Digoxin
Quinidine

205
Q

What is the prototype class 3 antiarrhythmics?

A

Amiodarone (CODE BLUE med)

206
Q

What is the adverse effects of amiodarone?

A

Malaise
Fatigue
Dizzy
HF
Cardiac arrhythmias
Cardiac arrest
Constipation
Nausea
Vomiting
Hepatotoxicity
Pulmonary toxicity
Corneal microdeposits
Vision changes

207
Q

What is the prototype of class lV antiarrhythmics?

A

Diltiazem

208
Q

What is the indication for use of diltiazem?

A

Treatment for paroxysmal (sudden) supraventricular tachycardia, a-fib, atrial flutter

209
Q

What are the adverse effects of diltiazem?

A

Dizzy
Light headed
Headache
Asthenia
Peripheral edema
Bradycardia
AV block
Flushing
Nausea
Hepatic injury

210
Q

What are other drug used for arrhythmia treatment?

A

Adenosine

Digoxin

Dronedarone

211
Q

What are the nursing considerations for antiarrhythmics therapy?

A

Hx/physical
Allergy
Impaired kidney/liver function
HF/heart block
Hypotension
Shock
Respiratory dysfunction
Electrolyte disturbance
Pregnancy/lactation

212
Q

What is the prototype of nitrates?

A

Nitroglycerin

213
Q

What are the adverse effects of nitroglycerin?

A

Hypotension
Headache
Dizzy
Tachy
Flushing
Nausea/vomiting
Sweating
Chest pain

214
Q

What is the prototype for cardiac glycosides?

A

Digoxin (lanoxin = brand)

215
Q

what is the prototype for phosphodiesterase inhibitors?

A

Milrinone

216
Q

What is the prototype for HCN blocker?

A

Ivabradine

217
Q

What are contraindications for cardiac glycosides?

A

Allergy
V-tach
A-fib
Heart block
Sick sinus syndrome
Idiopathic hypertrophic subaortic stenosis
Acute MI
renal insufficiency
electrolyte abnormalities
Pregnancy and lactation

218
Q

What are adverse effects of cardiac glycosides?

A

Headache
weakness
drowsiness
vision changes
GI upset
anorexia

219
Q

What is the indications for use for a cardiac glycosides?

A

Treatment of HF & A-fib

220
Q

What are the S&S of digoxin toxicity?

A

Noncardiac: anorexia, nausea/vomitng, abdominal pain, visual disturbance, fatigue/weakness, confusion, delirium, psychosis

Cardiac:
Ventricular arrhythmias
Atrioventricular block
Atrial arrhythmias
Sinus bradycardia

221
Q

What is the action of digoxin?

A

Increases intracellular calcium, allowing more CA+ into myocardial during depolarization

Increases renal perfusion w/ diuretic effects & slowed conduction through AV

222
Q

What electrolyte should you monitor when giving Digoxin?

A

K+

223
Q

How many beats per minutes should the heart BPM be?

A

60

224
Q

What is the toxicity range for digoxin?

A

> 2.5

225
Q

What drugs interact with digoxin?

A

Verapamil
Amiodarone
Quinidine
Quinine
Erythromycin
Tetracycline
Cyclosporine
K+ losing diuretics
Cholestyramine
Charcoal
Colestipol
Bleomycin
Cyclophosphamide
Methotrexate

226
Q

What is an early S*S of digoxin toxicity?

A

Halos, red/green spots

227
Q

What should the nurse assess for cardiac glycosides?

A

Hx/physical
Allergies
Impaired kidney function
Ventricular tachycardia
Heart block
Sick since syndrome
IHSS
Electrolyte abnormalities
Weight
Cardiac status
Skin/mucous membranes
Affect
Orientation
Reflexes
LS
Abdomen
Urinary output
Lab values

Pharmacology- Keiser (5 decks)

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