Week 9 - Cardiovascular part 2

Question 1

• back to normal rhythm
• get them out of rhythm

Answer 1

all antiarrhythmic therapeutic effects

Question 2

What medications affects heart rhythm and heart rate?

Answer 2

digoxin, lidocaine, propranolol, amiodarone

Question 3

What medications only affects heart rhythm?

Answer 3

quinidine, procainamide, flecainide, verapamil

Question 4

• Hold off to K+ : used for patient with problems of getting potassium
• blocks aldosterone receptors in kidneys reducing odium and fluid retention
• Not losing potassium
• ADR: hyperkalemia (muscle weakness, fatigue, paralysis, arrhythmia, chest pain, difficulty breathing, n/v/d, abd pain, numbness/tingling)
• Nur con: monitor renal patients as they are already hyperkalemic

Answer 4

Potassium-Sparing Diuretic: spirolactone

Question 5

• Positive inotropic effect = increase force of contraction of the heart, lowers heart rate
• Therapeutic range 0.5-2.0
• Digoxin toxicity: confusion, fatigue, dizziness, vision changes (yellow “halos” around things, blurry vision), nausea, anorexia
• Check digoxin lvls prior administer
• Antidote for toxicity: Digibind or Digifab
• Hypokalemia can lead to increased drug toxicity

Answer 5

Cardiac Glycoside: digoxin

Question 6

• Anti rhythmics
• Class 1A Na channel blocker - inc action potential and QT intervals (slows the heart down)
• Monitor for increased bleeding if on warfarin
• ADR: torsades de point (abnormal heart rhythm that can lead to sudden cardiac death) v tach - PROLONGED QT (ventricular depo/repolarization)
• Nur con: put on continuous tele/ECG; embolus/thrombus

Answer 6

Sodium Channel Blocker Class 1A: quinidine

Question 7

• used to treat supraventricular arrhythmias: calcium does not exchange with sodium, so does not enter into the cell and cause the action potential to occur
• monitor their BP and HR; monitor calcium lvls for hypercalcemia
• no grapefruit

Answer 7

Calcium Channel Blocker Class 4: verapamil