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B SL ext. > 1 Pharmacology of Angina > Flashcards

1 Pharmacology of Angina Flashcards

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1
Q

Cxr

A

Measure size contour and positioning of heart

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2
Q

12 lead ekg

A

Electrical activity

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3
Q

Holter monitoring

A

Continuous ambulatory monitoring (regular activities in 24hr period)

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4
Q

Transtelephonic monioring

A

At home patient over the phone

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5
Q

Wireless mobile

A

Advantage over holter Lightweight can monitor 24/7 don’t have to use phone Only transmit when dysrhythmias detected

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6
Q

Cardiac dress testing

A

Determine presence of CAD and what’s causing chest pain

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7
Q

Exercise stress test

A

Treadmill or bike Ends at target hr or because of chest pain

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8
Q

Pharmacologic stress test 2 meds

A

Patient is disabled or unable to exercise Dipyridamole Adenosine Vasdialate artery to mimic exercise

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9
Q

Fake exercise 1med

A

Increases HR, contractility, BP increases demand of the heart

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10
Q

Nursing implementation for diagn test

A

No food 4hrs and avoid stimulants (coffee and drugs)

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11
Q

Echocardiogram

A

Non invasive ultrasound Examine shape size and motion. Also determine ejection infraction which is usually 50-70%

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12
Q

Transesophageal echocardiograph TEE

A

Ultrasound and endoscopy. Transducer attach to gastroscope goes onto esophagus to take pictures of posterior heart

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13
Q

Potential comps with TEE

A

Inspired swallowing airway Esophagus injury

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14
Q

Radionuclide imaging (Thallium scan)

A

Evaluated myocardial blood flow after iv injection of r.thallum 201 (tissue perfusion) Goes to the heart and lights up areas. Where thallimus taken up good blood flow , where it’s not bad blood flow

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15
Q

CT scan with contrast

A

Reveals calcium and fat deposits in arteries. Indicates blockage

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16
Q

PET SCAN

A

Severity of CaD by myocardial perfusion Radioisotopic Administer IV 3D image

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17
Q

Myocardial rupture What is it Treatment

A

Infarcts myocardial wall become thin and bulges during contracting then ruptures

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18
Q

Cardiac failure What does it do

A

Right or left ventricle fails as a pump resulting in back up of blood into tissues, vericera, and lungs

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19
Q

Cardiac arrest vs Mi How does cardiac differ

A

Sudden cessation of heart and circulation May have asychronized twitching during v. Fib Immediate loss of consciousness and no hear sounds

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20
Q

Cardiac rehab stages

A
  1. S/s call 911, meds , rest, follow up apt 2. After discharge outpt rehab 3x / week or more. Monitor during exercise and control risk factors 3. Long term output. Usually self directed. Maintain cardiac stability
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21
Q

Acute coronary syndrome ACS

A

Unstable angina- pain but no ECG or biomarker abnm Stemi- ST elevated in 2leads -significant heart damage NSTEMI- non ST elevated. High bio markers but no signage change ECG

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22
Q

Stool softeners

A

Docusatw -not strain bm

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23
Q

Beta Blockers (End in)

A

Olol

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24
Q

Calcium channel blockers End in 2 uncommon ones

A

ipine Verapamil Diltiazem

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25
Nitrates med names 2 What they do
Nitroglycerin Isorbide dinitrate Sublingual
26
Beta Blockers (End in)
Olol
27
Calcium channel blockers End in 2 uncommon ones
ipine Verapamil Diltiazem
28
Nitrates med names 2 What they do
Nitroglycerin Isorbide dinitrate Sublingual
29
Beta blockers What they do
Block sites in heart in kids (protect them) to prevent sympathetic (stress) response Watch for response in asthma and COPD, DECREASES: HR, contractibility, CO slow conduction through AV node, release of renin
30
Beta blocker Contraindication PC
Contraindicated Bradycardia
31
Calcium channel blockers What do they do
Calms excitable and slows conduction and repolarization
32
Calcium channel blockers Contraindications PC
Contraindicated with heart block low BP and HF PC hypotension, arrhythmia, HF, n/v Cns changes- dizzy weakness fatigue
33
Nitrates What they do
Direct vasodilator Relax smooth muscle improves blood flow and oxygen by pooling blood in periphery Take sublingual or spray
34
Nitrates Contraindications Side effects Instructions
Severe hypotension, severe anemia, head trauma, carebral hemorrhaging, renal and hepatic, use of erectile dysfunction med (decre med) Side effect- skin flush, pulsing headache, interact ETOH (incre hypotension) Instruct sit down before taking & \>3
35
Short acting Acute attack nitrate
Amyl nitrate Nitro glycerin- take q 5min up
36
Long acting nitrates Uses
Prevent angina Nitroglycerin ISO dinitrate ISO mononitrate
37
Nitrate implication
Teach carry all times prevent ischemia Cool dark place Sit down prior to taking No swallow Contact Ems no chest relief after 3 tab Monitor BP prior to taking Take it in anticipation of any action bring it on
38
Anti-platelet agents 2 meds What it does
Aspirin and thienopyrides Prevent platelet agreegation and thrombus that can cause clot
39
Aspirin PC Dosage Teach
Risk for Gi upset and bleeding 81-325 mg daily Take daily even if taking other analgesics (acetominephen)
40
Thienopyrides Effect 2meds
May take few days for effect May be giving with ASA --Grels Clopidogrel Prasugrel- (new used coronary events and intervention )
41
Heparin How to give Implementation Range
Iv bolus or continuous drip titrated aPTT 70-100 Needs to be on own pump
42
LMWH
Enoxaparin Dalteparin parin No lab monitoring
43
Anticoagulant PC Precaution
Bleeding- low BP, hh, increase HR, bruising, pallor, urine and still Precautions: apply pressure to puncture site, NO IM INJ, avoid tissue trauma constrictive devices ( BP CUFF)
44
Valsalva maneuver
Stimulate vagal response increase heart demand w bm and coughing
45
Beta blockers What they do
Block sites in heart in kids (protect them) to prevent sympathetic (stress) response Watch for response in asthma and COPD, DECREASES: HR, contractibility, CO slow conduction through AV node, release of renin
46
Valsalva maneuver
Stimulate vagal response increase heart demand w bm and coughing
47
Anticoagulant PC Precaution
Bleeding- low BP, hh, increase HR, bruising, pallor, urine and still Precautions: apply pressure to puncture site, NO IM INJ, avoid tissue trauma constrictive devices ( BP CUFF)
48
LMWH
Enoxaparin Dalteparin parin No lab monitoring
49
Heparin How to give Implementation Range
Iv bolus or continuous drip titrated aPTT 70-100 Needs to be on own pump
50
Thienopyrides Effect 2meds
May take few days for effect May be giving with ASA --Grels Clopidogrel Prasugrel- (new used coronary events and intervention )
51
Aspirin PC Dosage Teach
Risk for Gi upset and bleeding 81-325 mg daily Take daily even if taking other analgesics (acetominephen)
52
Anti-platelet agents 2 meds What it does
Aspirin and thienopyrides Prevent platelet agreegation and thrombus that can cause clot
53
Nitrate implication
Teach carry all times prevent ischemia Cool dark place Sit down prior to taking No swallow Contact Ems no chest relief after 3 tab Monitor BP prior to taking Take it in anticipation of any action bring it on
54
Long acting nitrates Uses
Prevent angina Nitroglycerin ISO dinitrate ISO mononitrate
55
Short acting Acute attack nitrate
Amyl nitrate Nitro glycerin- take q 5min up
56
Nitrates Contraindications Side effects Instructions
Severe hypotension, severe anemia, head trauma, carebral hemorrhaging, renal and hepatic, use of erectile dysfunction med (decre med) Side effect- skin flush, pulsing headache, interact ETOH (incre hypotension) Instruct sit down before taking & \>3
57
Nitrates What they do
Direct vasodilator Relax smooth muscle improves blood flow and oxygen by pooling blood in periphery Take sublingual or spray
58
Calcium channel blockers Contraindications PC
Contraindicated with heart block low BP and HF PC hypotension, arrhythmia, HF, n/v Cns changes- dizzy weakness fatigue
59
Calcium channel blockers What do they do
Calms excitable and slows conduction and repolarization
60
Beta blocker Contraindication PC
Contraindicated Bradycardia
61
Stable
E.g.: hurts when I go upstairs & stops when I lay down Consistent and relieves with rest or NTG
62
Unstable
Increase in frequency and severity May not be relieved with ntg
63
Intractable
Severe incapacitating chest pain
64
Variant
Aka prinzmetal No precipitating factors Pain at rest With reversible ST segment elevation
65
Silent ischemia
No pain but ecg changes More common with DM or elderly pts

B SL ext. (3 decks)

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