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Pharmacology > Test 3 - Cardiovascular > Flashcards

Test 3 - Cardiovascular Flashcards

1
Q

What is Cholesterol

A

Helps maintain Vitamin D levels and hormones

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2
Q

Gemfibrozil teaching

A

*Class - Fibric Acid Agent
Lowers triglycerides and LDL levels
Combine with Statins for greatest decrease
TEACHING:
—May potentiate warfarin (warfarin prevents blood clots)
—monitor GI effect - TEACH TO TAKE WITH FOOD
—pregnancy B

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3
Q

Non pharmacological cholesterol reduction

A 
Lifestyle changes
monitor blood lipid levels
maintain weight at optimum level
exercise
low fat diet and cholesterol
increase fiber
decrease tobacco use
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4
Q

Statin side effects

A 
*Class - HMG-CoA Reductase Inhibitor
first drug of choice to lower cholesterol
should be taken in the evening
SIDE EFFECTS
muscle or Jt pain

RHABDOMYOLISIS

  • Muscle fiber breakdown
  • rare but serious
  • coca cola urine
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5
Q

Statin side effects

A

*Class - HMG-CoA Reductase Inhibitor
first drug of choice to lower cholesterol
should be taken in the evening
SIDE EFFECTS
headache, fatigue, MUSCLE OR JT PAIN, and heartburn

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6
Q

Types of Lipids

A

LDL - Bad Cholesterol <100 liver—>tissues
HDL - good cholesterol >40 Tissues—>liver
Triglycerides <150 - stored fat energy

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7
Q

Diuretic adverse effects

A

Hypokalemia
Hyponatremia
Ototoxicity
SIDE EFFECTS: Dehydration, thirst, dry mouth, weight loss, headache, hypotension, dizziness, fainting
Teach safety with orthostatic hypotension

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8
Q

Loop Diuretic

A

Most effective
Block reabsorption of Na and Cl in Loop of Henle
Increase UO even when kidney blood flow is diminished
FLUROSEMIDE most frequent
BUMETANIDE 40x more potent, shorter duration

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9
Q

Thiazide Diuretic

A

Most frequently prescribed class
— less effective than loop but less side effects (does not cause ototoxicity)
Treats mild to moderate HTN
Ineffective in severe renal failure
If allergic to sulfa, may be allergic to Thiazide and Loop
May need K+

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10
Q

Drugs that are Nephrotoxic

A 
NSAIDS
ACE inhibitors
Radiographic Dyes
Aminoglycosides (antibiotics)
Amphotericin B (anti fungal)
Cancer Drugs
Immunodepressants
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11
Q

During renal failure

A

Dose reduction
Discontinue Nephrotoxic drugs

OSMOTIC DIURETICS (mannitol) - used in acute renal failure —– Administered through a filtered IV

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12
Q

Hyperkalemia Treatment

A

Hyperkalemia: Kidneys unable to adequately excrete K+
>5 mEq/L
Administer Insulin and Glucose
Ca+ and Sodium Bicarbonate to correct acidosis
Kayexelate po or rectal

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13
Q

Hypokalemia signs and symptoms

A

Dysrthymias, cardiac arrest

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14
Q

Hyponatremia plan of action

A

<135 mEq/L
If from fluid overload —> Loop Diuretics
Oral sodium chloride if mild
Parenteral NS or LR if <130

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15
Q

K+ IV administration

A

NEVER IV PUSH

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16
Q

Solution Tonicity

hypotonic, isotonic, hypertonic

A

Tonicity: Ability of a solution to cause a cell to lose or gain water

Hypotonic: Treat dehydration with normal B/P (water moves into the cell)
Isotonic: Does not change tonicity of blood - treat dehydration w/ low B/P
Hypertonic: Treat cellular edema - Cell shrinks

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17
Q

Beta blocker contraindications

A

Asthma or Chronic Bronchitis

HR<60

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18
Q

Beta blocker mechanism of action

A 
Decrease BP and HR (second line drug)
Decreases workload (negative inotropic effect)
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19
Q

Antihypertensive Drugs

A 
ABCD
Ace inhibitors/Angiotensin II blockers
Beta blockers
Calcium channel blockers
Diuretics
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20
Q

Beta blocker side effects

A

Bradycardia.. do not give to pt with HR <60

Heart block

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21
Q

HCTZ teaching

A

Hydrochlorothiazide - Diuretic
Used or Mild to Moderate HTN
Adverse effects: Electrolyte imbalance (esp K+)
—May need potassium
Ineffective in severe renal failure
Allergy to sulfa may have allergy to thiazide and loop diuretics

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22
Q

Loop diuretics lab tests

A

Lab Test Considerations: Monitor electrolytes (especially potassium), blood glucose, BUN (blood urea nitrogen), and serum uric acid levels before and periodically throughout course of therapy.

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23
Q

Non pharmacological HTN treatment

A 
Increase exercise
Low fat, low sodium diet
limit alcohol consumption
weight reduction
eliminate tobacco use
reduce stress
24
Q

Ace inhibitor side effects

A 
Anti Hypertensive
Nephrotoxic
"Prils"
SIDE EFFECTS
Dry persistent cough
Most dangerous angioedema
25
Q

Digoxin Therapeutic Effects

A

Used for HF
THERAPEUTIC EFFECTS
Causes heart to beat more forcefully and slowly (Positive Inotropic effect)

26
Q

Milrinone administration alerts

A

Used for HF, positive inotropic effect
IV pump, microdrip set
only use for 2-3 days

Davis Drug Guide:

  • High Alert… heightened pt risk with error
  • —-Ventricular Arrhythmia’s
  • —-Monitor ECG continuously during infusion
27
Q

Angina vs MI diagnosis

A 
ANGINA
chest pain caused by insufficient O2
Short duration - goes away with stress reduction
RELIEVED BY NTG (vasodilator)
stable-exertion
unstable-no exertion

MI
Heart attack
NOT RELIEVED BY NTG

28
Q

Calcium Channel Blockers Mechanism of Action

A

Relax arteriolar smooth muscle thus lowering BP
Dilate coronary arteries
Reduce workload
Stop dysrhythmias

29
Q

MONA

A 
Immediate treatment of MI
MORPHINE - treat pain, reduce stress
OXYGEN - given b/c lacking O2 in tissues
NITROGLYCERINE - vasodilation
ASA (aspirin) - Anti-platelet, makes less sticky
30
Q

NTG side effects

A

Hypotension

Severe Headache

31
Q

NTG teaching

A

Take sublingual Q5 min x 3 PRN for pain

32
Q

Retaplase Therapeutic Indication

A

Retaplase is a Thrombolytic

Dissolves clots obstructing coronary artery disease

33
Q

Albumin Teaching

A

Most common colloid used

May cause fluid overload - distended neck veins, pulmonary edema, cough, HTN, tachycardia

34
Q

Colloid Administration Assessment

A

Listen for crackles in the lungs

35
Q

Chrystalloids and Colloids Defined

A 
CHYRSTALLOIDS
IV solutions contain electrolytes similar to plasma
Mimic body's extracellular fluid
Trauma Pt's
NS, LR, D5W, HS

COLLOIDS
Proteins pull water into vessels - hypertonic
Proteins, starches or other large molecules
Albumin most common

36
Q

Dopamine administration

A

IV only
May cause dysrhythmias
Increase BP and force of contraction

37
Q

Shock Treatment Priority

A

ABC’s of life support
Airway
Breathing
Circulation

38
Q

Antidysrhythmic side effects

A 
Palpitations
Chest Pain
Weakness
Fatigue
New Dysrhythmias
39
Q

Beta Blocker Client Teaching

A 
Check pulse and call if <60
Do not discontinue abruptly
May mask hypoglycemia
Don't give with pulmonary problems, may cause bradycardia
Used to prevent MI and Angina
40
Q

Cardiac Output and Tachycardia

A

cardiac output DECREASES with tachycardia

41
Q

Cardioversion Rationale

A

Electrodes placed on chest, send electrical shocks to restore normal rhythm

Safer with less side effects

42
Q

Dysrhythmias Pathophysiology

A

Abnormal electrical conduction
Symptoms (none to sudden death)
Atrial fibrillation most common

43
Q

Heparin Side effects

A 
Heparin - Anticoagulant
SIDE EFFECTS
Watch for bleeding
---Internal s/s---
low BP
High HR
Pallor
Weakness
Low Hgb/Hct
44
Q

Heparin Outcomes

A

Goal:

  • No bleeding
  • No unusual clot formations
45
Q

INR values

A

Ideal 2-3

46
Q

Lovenox Administration (enoxaparin)

A

Fewer follow up lab tests
More stable response
Less thrombocytopenia (low blood platelet count)
SubQ in abdomen only

Protamine sulfate - Reverse

Anticoagulant.. DVT

47
Q

Warfarin lab tests

A 
Oral anticoagulant
Prothrombin times (PT) or INR frequently, 2-3 ideal
48
Q

Warfarin Overdose Treatment

A

Warfarin - Oral anticoagulant
Immediate reversal is Vit. K
Blood and plasma if severe bleeding occurs
If not bad, withholding a dose is usually sufficient

49
Q

Warfarin Teaching

A 
Warfarin - Oral anticoagulant
Avoid Vit. K
Serious side effects - bleeding
No alcohol, other Rx, otc or herbal products
Frequent INR testing
50
Q

Alcoholism and Folic Acid

A

Folic Acid - Needed for RBC production

Alcoholism interferes with folate metabolism in the liver

51
Q

Epoetin Assessment Post Admin

A

Common adverse effect is HTN - Beta blockers can be given concurrently

CHECK BP BEFORE AND AFTER

52
Q

Epoetin Teaching

A

Secreted by kidneys, TRAVELS TO BONE MARROW, interacts with stem cells to INCREASE ERYTHROCYTE PRODUCTION
HTN common adverse effect. Beta blockers given concurrently

53
Q

Filgrastim Mechanism of Action

A

Increase neutrophil production

54
Q

Iron Administration Teaching

A

Free iron is toxic - common cause of poison in children
IRON DEFICIENCY MOST COMMON CAUSE OF ANEMIA

TAKE WITH FOOD
STAY UPRIGHT FOR 30 MINUTES AFTER TAKING
DON’T TAKE BEFORE BEDTIME

55
Q

Oprelvekin Teaching

A

Platelet enhancer
Stimulates production of megakaryocytes and thrombopoietin
Increases platelet count

56
Q

INR

A

International Normal Ratio - Determines clotting rate
>6 Give Vit. K
Normal 2-3

Pharmacology (7 decks)

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