Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PHARM > Week 5 - Cardiac continued > Flashcards

Week 5 - Cardiac continued Flashcards

1
Q

Mechanism of Cardiac Glycosides `

A

Inhibit sodium/potassium pump to increase intracellular Calcium during depolarization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What effect do cardiac glycosides have on the conduction of SA to AV?

A

Slows conduction - Always check HR before giving!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q 
Cardiac Glycoside have: 
\_\_\_\_\_\_\_ inotropic effect 
\_\_\_\_\_\_\_ chronotropic effect 
\_\_\_\_\_\_\_ dromotopic effect 
\_\_\_\_\_\_\_ stroke volume 
\_\_\_\_\_\_\_ cardiac output 
\_\_\_\_\_\_\_ peripheral and lung fluid retention 
\_\_\_\_\_\_\_ fluid excretion
A
  • Positive inotropic effect
  • Negative chronotropic effect
  • Negative dromotopic effect
  • Increases stroke volume
  • Increases cardiac output
  • Decreases peripheral and lung fluid retention
  • Increases fluid excretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Indications for cardiac glycosides

A

CHF, A Fib/flutter, paroxysmal atrial tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Cardiac glycoside prototype

A

Digoxin (Lanoxin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Digoxin dosage (PO, IV, Elderly, children )

A

PO: 0.5 - 1mg initially in 2 divided doses (digitalization) , then 0.125 - 0.5 mg/day for maintenance

IV: same as PO but given over 5 min

Elderly: 0.125 mg/day
Children: Doses are ordered in mcg in elixir form

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Digoxin absorption (Oral, Liquid)

A

Oral: 60-70%
Liquid: 90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Digoxin distribution (protein bound and its implication)

A

LOW protein bound - means there is a lot of active form circulation and thus higher risk for toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Digoxin half life

A

30-40 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Digoxin excretion

A

70% urine through kidney - thus higher risk for toxicity in renal patients
30% by liver metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Quinidine, Verapamil, Flecainide ______ serum digoxin levels

A

Increase serum digoxin levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Antacids _____ digoxin levels by

A

Antacids decrease digoxin levels by decreasing absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Thiazides and loop diuretics ______ risk for toxicity because

A

Increase risk for toxicity because they can cause hypokalemia, which intensifies effects of digitalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Hypomagnesemia, hypercalcemia _____ risk for toxicity

A

Increase risk for toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Hypokalemia _____ effects of digitalis

A

Hypokalemia intensifies effects of digitalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Digoxin and Ginseng

A

Ginseng - falsely elevates digoxin levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Digoxin and St. John’s Wort

A

St. John’s Wort - decreases absorption and thus serum level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Digoxin and Hawthorn

A

Hawthorn - increases effect of digoxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Digoxin and Aloe

A

Aloe - increases potassium loss, causing hypokalemia which can lead to digitalis toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Digoxin and Ma Huang

A

Ma Huang - increases risk for toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Digoxin and Licorice

A

Licorice - potentiates effects of digoxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Therapeutic serum level of Digoxin

A

0.5 - 2.0 ng/mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

The therapeutic serum level is _______. This plus the low PB indicates ______ risk for ______.

A

The therapeutic serum level is narrow. This plus the low PB indicates high risk for toxicity.

24
Q

Signs and symptoms of digitalis toxicity (8)

A

*Bradycardia, PVC, cardiac dysrhythmias,visual disturbances (green and yellow halos), blurred vision, confusion/delirium H/A, N/V

25
Q

Who are at greater risk for digitalis toxicity?

A

Elderly and renal patients

26
Q

When giving digoxin, always check (4)

A
  • Serum potassium
  • Baseline apical pulse rate (do not give if below 60)
  • BUN and creatinine
  • Signs and symptoms of toxicity
27
Q

Carvedilol (Coreg) classification

A

3rd generation Beta blocker (beta receptor antagonist) - NON-selective

28
Q

Carvedilol mechanism

A

-Blocks beta 1, beta 2, alpha 1
It’s an ANTIOXIDANT
-Protects against free radicals causing damage to nucleic acids, proteins, and lipids (which are linked to CAD, atherosclerosis)
-Protects from further inflammatory damage or change

29
Q

Carvedilol is NOT for… (4)

A

COPD, CHF, Asthma, DM

30
Q

When should Carvedilol be given?

A

Early stages of HF to slow progression to CHF

31
Q

What is the primary line of therapy for majority of patients with HF?

A

Diuretics

32
Q

Three categories of diuretics

A

Thiazides, Loop, Potassium sparing

33
Q

Diuretic mechanism

A

Produce net loss of sodium and water acting directly on the kidney to decrease acute symptoms of HF that result from fluid retention (such as dyspnea, edema)

34
Q

Thiazide mechanism

A

Inhibits active transport of Cl-Na in the cortical diluting segment of the ascending limb of the Loop of Henle

35
Q

Thiazide example

A

Hydrochlorothiazide (HCTZ)

36
Q

Loop mechanism

A

Inhibits active transport of Cl-Na-K in the thick portion of the ascending limb of the Loop of Henle

37
Q

Loop example

A

Furosemide (Lasix)

38
Q

Potassium sparing mechanism

A
  • Inhibits REABSORPTION of Na in the distal convoluted and collecting tubules
  • BLOCKS aldosterone production
39
Q

What kind of effect do potassium sparing diuretics have on the heart?

A

Cardioprotective effect - blocks aldosterone in the heart and blood vessels to promote cardiac remodeling (repair inflammation)

40
Q

What can use of potassium sparing diuretics lead to?

A

Hyperkalemia

41
Q

Potassium sparing example

A

Spironolactone (Aldactone)

42
Q

What is carbonic anhydrase?

A

Enzymes found in the proximal convoluted tubule in the kidney that helps maintain balance of hydrogen ion and bicarbonate in our bodies

43
Q

Carbonic Anhydrase Inhibitors - mechanism

A

Inhibits action of carbonic anhydrase - causes Na, K, HCO excretion to make pH of kidney tubules alkaline and alkalinizes the urine

44
Q

Carbonic Anhydrase Inhibitors - uses (2)

A
  • Primarily used to decrease IOP in chronic open angle glaucoma
  • Can also alkalinize urine in rhabdomyolisis (alkalinizing = protects integrity of tubules)
45
Q

Carbonic Anhydrase Inhibitor protoype

A

Acetazolamide (Diamox)

46
Q

Acetazolamide (Diamox) classification

A

Carbonic Anhydrase Inhibitor

47
Q

Acetazolamide (Diamox) side effects (5)

A

Fluid and electrolyte imbalances, metabolic acidosis, N/V, confusion, orthostatic hypotension

48
Q

Acetazolamide (Diamox) adverse reactions (3)

A

Hemolytic anemia, renal calculi, crystalluria

49
Q

Osmotic Diuretic mechanism

A

Pulls large amounts of fluid into the urine by osmotic effect

50
Q

Osmotic Diuretic uses (2)

A
  • Decrease IOP or intracranial pressure

- Prevent kidney failure in Cisplatin chemotherapy

51
Q

Osmotic Diuretic prototype

A

Mannitol (Osmitrol)

52
Q

Mannitol mechanism

A

As a sugar, pulls large amounts of fluid into the urin by osmotic pull of the sugar

53
Q

Mannitol side effects (3)

A

N/V, fluid and electrolyte imbalance, pulmonary edema

54
Q

Mannitol contraindications (2)

A
  • HF - because if you’re increasing intravascular volume, you further congest the HF patient
  • Renal Failure - they’re not making urine so they cannot get rid of the fluid you’re pulling out
55
Q

Mannitol can ______ in vial if exposed to ________. Do not infuse if ______ are present.

A

Mannitol can crystallize in vial if exposed to low temperature. Do not infuse if crystals are present.

PHARM (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions