Week 6 Cardio Flashcards
What is the flow of electrical impulses?
SA
AV
Bundle of His
two bundle fibers
Purkinje Fibers
What are factors that affect arterial pressure?
RAAS
SNS
amount of fluid volume
amout of blood
blood vessel flexibility
What are the four types of treatment of hypertension?
RAAS supressans
calcium channel blockers
sympatholytics (antidrenergic)
Direct-acting vasodilators
What are some types of RAAS suppressants?
ACE inhibitors
angiotensin two receptor blockers (ARBs)
aldosterone antagonists
direct renin inhibitors (DRIs)
What are three categories of drugs for heart failure?
diuretics
RAAS inhibitors
beta blockers
What are the two categories for CHD?
antilipemics and antianginals
What are the four categories to treat cardiac dysrhythmias?
I. sodium channel blockers
II. beta blockers
III. potassium channel blockers
IV. calcium channel blockers
What are three purposes of taking ACE inhibitors?
MI
HF
decrease progression of diabetick neuropathy
How do ACE inhibitors work?
Blocks the conversion from ANG I to ANG II, so it prevents aldosterone from being made leading to the wasting of sodium and therefore water and makes people pee
What are some things to watch for with ACE inhibitors balance level wise?
hyponatremia
hypotension
hyperkalemia
What are three bad reactions to ACE inhibitors?
hacking cough, renal failure, and swollen tongue
What does heparin and coumadin do?
inhibits clot formation
What should be monitored when people take anticoagulants?
assess for bleeding
What is the antidote to heparin?
antidote: Protamine sulfate
What should be reported when someone is on heparin?
black tarry stools b/c sign of internal bleeding
How soon must Beta-adrenergic Blockers be administered to reduce mortality from MI?
within 8 hours of onset
What are two contraindications for Beta-adrenergic Blockers?
diabetes and asthma
What should be assessed before administering Beta-adrenergic Blockers?
BP and HR
What are three ADR of beta-adrenergic Blockers?
insominia, impotence, bradycardia
What should not be taken with Calcium channel blockers?
avoid grapefruit
How do Calcium channel blockers work?
blocks transport of Ca+ into myocardial cells, relax arteriolar smooth muscle;
some decrease the HR
What should be avoided when taking HMG- CoA reductase inhibitors?
avoid grapefruit and alcohol
Cardiac Glycosides prototype
digoxin ( (Cardoxin® and Lanoxin®)
Is digoxin a positive or negative inotrope?
positive inotrope because it makes the heart contract harder
What are some things to consider before administering digoxin?
check apical pulse for one min before administering and serum levels
What is the max serum level for cardiac glycosides?
2.0
What are five ADR for digoxin?
nausea/vomiting
fatigue
anorexia
visual disturbances/halos
blurring
What should be reported when taking “Statins”?
`weakness and rhabdomyolysis (red/brown urine)
Nitrates do what to the body?
Relax both arterial and venous smooth muscle and dilate coronary arteries.
What are some things to watch out for when someone is taking NTG?
tolerance
orthostatic hypotension
reflex tachycardia due to vasodilation
What is a drug not to take with nitrates?
Viagara because it is also a vasodilator
What are four ADR of nitrates?
headache
dizziness/orthostatic hypotension
tolerance
tachycardia
What is something that someone taking spironolactone should not take?
potassium suplements
What can cause toxicity of digoxin?
too much potassium
What are six ADR of potassium sparing diuretics?
dizziness/headache
GI distress
paresthesia
hyperuricemia
hyperkalemia
muscle weakness
impotence
When should you hold spironolactone?
hyperkalemia- Hold infusion
What are four big effects of electrolyte levels of loop diuretics?
hyponatremia
hypokalemia
hyperglycemia
polyuria
Why should you take lipitor at night?
the liver makes the most amount of cholesterol at night
What is a reportable ADR of furosemide?
ototoxicity
What is a reportable ADR of thiazide?
pulmonary edema, wheezing, and joint tenderness
What drug should be given slowly and why?
furosemide because there could be ototoxicity and other adverse reactions
Should Aspirin be taken with or without food?
with food because it is acidic
How should bile acid sequestrants be taken? (coleveselam and colespitol)
with food and water because it deals with acid
What are some ADR of CCB?
fatigue
headache/dizziness
flushing
hypotension
What drug enhances the action of digoxin?
pines or CCB
When should fibrates be taken?
30 min before meals
What drug increases the risk for bleeding with warfarin?
fibrates
What labs should be monitored with heparin and enoxaparin?
platelet, PT, aPTT, INR, CBC
What is a drug that requires lab assessment of ALT and AST?
HMG-CoA reductase
Painful ADR for niacin can be treated how?
aspirin
What drug should be administered with a subcutaneous injection every 2-4 weeks?
Proprotein convertase Subtilisin/Kexin 9 inhibitors
Why should alteplase be administered slowly?
to prevent hypotension
What is alteplase contraindicated for? (4)
active bleed
PUD
History of stroke
recent trauma
