Quiz 2 Flashcards

1
Q

Cardiac Function is regulated by…

A

The Autonomic Nervous System

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2
Q

ANS controls involuntary functions including..

A
  • Contraction and relaxation of smooth muscle
  • Heart rate and contractility
  • Endocrine secretions
  • Blood pressure
  • Digestion
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3
Q

2 main divisions of the autonomic nervous system

A
  • SNS (sympathetic nervous system)
  • PNS (parasympathetic nervous system)
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4
Q

SNS is responsible for what response via alpha/beta receptors?

A

“fight or flight”

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5
Q

PNS is responsible for what response via muscarinic acetylcholine receptors?

A

Puts body back in calm state for “rest and digest”

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6
Q

Therapy concerns with Cholinergic drugs

A
  • cardiovascular effects
  • syncope ***
  • generalized vasodilation
  • abdominal pain/ diarrhea
  • frequent urination
  • bronchoconstriction
  • increased secretions
    examples: drugs used to treat urinary retention and insecticide poisoning
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7
Q

Drugs that antagonize PNS

A

Anticholinergics
- compete for ACh binding sites BLOCK PNS ACTIVITY

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8
Q

SNS

A

Fight or flight
encourage norepinephrine or epinephrine release and activate alpha and beta receptors

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9
Q

What is epinephrine used for

A

to treat anaphylactic or cardiogenic shock
activates alpha 1 receptors the most

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10
Q

Alpha Agonists

A

clonidine- agonist at alpha 2 - DECREASES blood pressure

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11
Q

Leading cause of cardiovascular morbidity and mortality

A

Hypertension
African Americans most affected

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12
Q

ACE ( angiotensin converting enzyme)

A

Primary target of drug class
converts angiotensin I into angiotensin II which is a very potent vasoconstrictor

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13
Q

Prostaglandins

A

Help counteract vasoconstriction in the kidneys

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14
Q

Examples of thiazide diuretics ADR’s

A

dizziness, orthostatic hypotension

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15
Q

Examples of loop diuretics ADR’s

A

low potassium
dehydration

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16
Q

Example of potassium- sparing diuretics ADR’s

A

high potassium

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17
Q

Therapeutic concerns with diuretics

A

orthostatic hypotension

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18
Q

What blocks renin release from kidneys?

A

vasodilation

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19
Q

Examples of beta blockers ADR’s

A

bradycardia (slow heart rate)
dizziness
mask low blood sugar

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20
Q

Examples of Alpha 1A ADR’s

A

orthostatic hypotension

21
Q

Examples of central acting alpha 2 agonists ADR’s

A

rapid return of HTN and tachycardia with abrupt withdrawal

22
Q

Example of calcium channel blockers ADR’s

A

bradycardia

23
Q

ACE inhibitors stands for..

A

Angiotensin Converting Enzyme

24
Q

Examples of ACE inhibitor ADR’s

A

dry cough (primary reason for discontinuation of treatment)

25
Q

Therapeutic concerns for anti - HTN drugs

A

orthostatic hypotension

26
Q

What should we avoid on patients taking vasodilators

A

heat therapy

27
Q

Beta blockers, CCB’s, vasodilators, and diuretics all do what to exercise capacity?

A

decrease exercise capacity

28
Q

Pathophysiology of the heart

A

Low - density lipoprotein (LDL) = “bad” cholesterol
thrombin converts fibrinogen into fibrin - LARGE CLOT

29
Q

For acute heart attacks use what?

A

sublingual nitroglycerin tablets
- almost immediate relief of symptoms

30
Q

Nitrates

A

keep in ORIGINAL glass container
place tablet under tongue and let dissolve 20-30 sec
if chest pain is not relieved after 5 minutes after 1st dose call 911

31
Q

Example of Aspirin ADR

A

bleeding especially in GI tract if not enteric coated

32
Q

High alert medication = Heparin

A

an error in does can result in death

33
Q

Example of heparin ADR

A

bleeding ( antidote: protamine sulfate)

34
Q

Enoxaparin (Lovenox)

A

low molecular weight heparin
given subcutaneously

35
Q

Warfarin (Coumadin)

A

Vitamin k antagonist

takes 4-5 days to obtain anticoagulant effect
green leafy vegetables can cause significant decrease in INR

compliance is HUGE

36
Q

Example of Warfarin ADR

A

bleeding - can give vitamin k to help reverse bleeding
Do not use in pregnancy - crosses placenta and is teratogenic

37
Q

Therapeutic concern with Antithrombotics

A

BLEEDING
caution when working around wounds or dressings

38
Q

Triglycerides

A

HDL: high density lipoprotein
LDL: low density lipoprotein
VLDL: very low density lipoprotein

39
Q

TX of Hyperlipidemia
STATINS =

A

Gold standard
main action is DECREASING LDL

40
Q

Statin adverse effects

A

myopathy - muscle pain
rhabdomyolysis - muscle breakdown
liver function abnormalities

41
Q

Example of Fibrates ADR

A

increased risk of muscle pain/ myopathy when combined with statins

42
Q

PCSK9 Inhibitor

A

relatively safe and low incidence of adverse effects
most common complaint is muscle pain/weakness

43
Q

Example of Cardiac Glycosides ADR

A

significant bradycardia with toxic levels

44
Q

Loop Diuretics =

A

Lose water
examples = ide ( furosemide etc.)

45
Q

beta blockers

A

examples = lol (metoprolol)

46
Q

Alpha blockers

A

examples = zosin (Prazosin)

47
Q

ACE inhibitors

A

examples = pril (lisinopril)

48
Q

Angiotensin receptor blockers (ARBs)

A

Examples = sartan (Valsartan)

49
Q

Aspirin mechanism of action

A

binds irreversibly for the life of the platelet