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Pharmacology N2100 > Unit 10 - Pharm affecting Perfusion > Flashcards

Unit 10 - Pharm affecting Perfusion Flashcards

1
Q

T/F: medications can replace healthy lifestyle changes

A

F

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2
Q

cardiac output is too low to meet the body’s needs

A

pump failure

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3
Q

Staging of HF depends on symptoms:

- no symptoms during activity

A

stage 1

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4
Q

Staging of HF depends on symptoms:

- “slight limitations” during activity

A

stage 2

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5
Q

Staging of HF depends on symptoms:

- “marked limitations” during activity

A

stage 3

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6
Q

Staging of HF depends on symptoms:

- not able to be active, have symptoms at rest

A

stage 4

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7
Q

Symptoms of Heart Failure for R side

A

JVD and pedal edema

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8
Q

Symptoms of Heart Failure on L side

A

pulmonary edema, cough, ortopnea

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9
Q

First choice drugs used to treat heart failure

A

ACE inhibitors

second choice: ARBs

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10
Q

3 main goals for pharmacology of Heart Failure

A
  1. increase effectiveness of the heart
  2. decrease the workload of the heart
  3. inhibit the RAAS and Sympathetic nervous system
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11
Q

Drugs Used to Treat Heart Failure:
- inhibition of the sodium/potassium pump on heart muscle cells causing increased intracellular calcium concentration and therefore increased efficiency of cardiac muscle fiber contractions

A

Cardiac Glycosides

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12
Q

Cardiac Glycosides direction action on cardiac muscle and electrical conduction system:

A
  • positive inotropic effect
  • negative chronotropic effect
  • ultimate result: increased cardiac output
  • decreased SNS activity, increased PNS activity
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13
Q

saturating the heart muscle tissue so that the s/s of heart failure will decrease or go away…very similar to loading dose

A

Digitalization

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14
Q

T/F: range between therapeutic and toxic effect with Digoxin is narrow

A

T

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15
Q

Digoxin can be given ___ or ___

A

PO, or IV (emergency situation)

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16
Q

What drug:
used to treat HF for those not responding well to ACE inhibitors or in late stages, Atrial flutter, Atrial fibrillation, increased force of contraction, increased cardiac output, increased tissue perfusion, decreased ventricular HR, increase urine production, decreased pulmonary congestion

A

Digoxin

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17
Q

contraindication for Digoxin

A
    • hypokalmeia (= toxic levels of Digoxin)
  • heart block
  • ventricular dysrhythmias related to heart failure problems
  • geriatric pt’s more susceptible to adverse effects
  • renal disease (this med is excreted in urine)
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18
Q

adverse effects of Digoxin

A
  • halo vision, changes in color perception
    • severe bradycardia (causing heart to slow down)
    • dysrhythmias (danger) (K+ deficiencies due to diuretic use = most common)
    • AV block (danger)
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19
Q

Nursing Considerations/pt. teaching for Digoxin

A
  • monitor Digoxin blood levels (draw 6-12 h after last oral dose in administered…therapeutic range 0.5-2.0, toxic - > 2.0)
  • take apical pulse for one whole minute (hold if bpm < 60)
  • monitor electrolyte levels, specifically K+, Ca+. Mg+
  • NEVER give IM (only IV or PO)
  • encourage K+ rich foods
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20
Q

T/F: adults are more prone to toxicity with Digoxin

A

T

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21
Q

Adult toxic effects with Digoxin

A
  • problems with vision: halo, yellow around objects
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22
Q

Warfarin and heparin are examples of _____

A

anticoagulants

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23
Q

the pt. has a thrombus/clot/clotting too much, DVT

A

thrombolytic disorder

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24
Q

pt has hard time coagulating, hemophilia

A

coagulation disorder

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25
Q

route of Warfarin

A

PO

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26
Q

route of heparin

A

SQ

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27
Q

Warfarin:
lab tests involved
route
antidote

A

Lab: PT, INR

route: PO
antidote: vitamin K

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28
Q

Anticoagulants avoid injury:
use soft toothbrush
don’t use straight raiser, only electric
avoid things that will cause nose bleeds

A

…

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29
Q

most common oral anticoagulant

A

warfarin

30
Q

T/F: Warfarin in highly protein bound

A

T = interacts with other drugs

31
Q

What drug:
depression of hepatic synthesis of Vitamin K clotting factors; prevention or slowing of blood clotting; prevent formation of vitamin K = prevent formation of new clotting factors

A

Warfarin

32
Q

Contraindications of Warfarin

A

*- pregnancy

33
Q

Adverse effects of Warfarin

A

*- purple color in feet

34
Q

Nursing Considerations/Pt. teaching of Warfarin

A
    • use barrier method in addition to birth control pills

- avoid alcohol

35
Q

Heparin:
lab tests involved
route
antidote

A

labs: PTT, aPTT
route: SQ
antidote: protamine

36
Q

What drug:
inhibits thrombin, which prevents the conversion of fibrinogen to fibrin; prevention or slowing of blood clotting; prevent a clot from being formed; used for DVT, pulmonary embolism, preventing thombosis

A

Heparin

37
Q

Contraindications of Heparin

A

…

38
Q

Adverse effects of Heparin

A
    • fever, chills (allergic reaction)
    • hemorrhaging (higher dose, higher risk for bleeding)
    • heparin-induced thrombocytopenia
39
Q

Nursing considerations/pt. teaching for Heparin

A
  • don’t massage SQ site after administration
  • watch for petechia or purpura of skin
  • NEVER IM!
40
Q

T/F: anticoagulants break up existing clots

A

F! The just prevent the clot from growing

41
Q

what is the preferred anticoagulant used in pregnancy

A

Heparin (doesn’t cross BBB), discontinue 1 wk before delivery date

42
Q

T/F: you can take NSAIDS for pain when on Heparin

A

F!!!

43
Q

What drug:

Directly inhibits thrombin to prevent clot formation; prevention or slowing of blood clotting

A

Dabigatran

44
Q

Contraindications of Dabigatran:

A

*- valvular problems

45
Q

Adverse Effects of Dabigatran:

A
    • bleeding

* - hemorrhage

46
Q

Nursing Considerations/pt. teaching of Dabigatran:

A
  • monitor for bleeding
  • encourage to utilize practices that decrease risk for bleeding
  • monitor KF labs
47
Q

clopidogrel is an example of…

A

an antiplatelet

48
Q

What drugs:
prevent platelets from sticking together; ex. aspirin; work by inhibiting platelet aggregation, used to prevent clot formation in arteries, used to prevent complications of a stroke or MI, usually change platelet membrane irreversibly, can cause life-threatening bleeding especially when used with anti-coagulants

A

Antiplatelets

49
Q

Antiplatelets prevent clots from forming in _____

A

arteries

50
Q

anticoagulants prevent clots from growing in ____

A

veins

51
Q

What drug:

inhibits platelet aggregation; prevention of arterial thromboembolism to reduce risk of MI or stroke

A

Clopidogrel

52
Q

Contraindications of Clopidogrel:

A
  • any drugs that affect liver metabolism (ex. NSAIDS)

- any meds that increase risk for bleeding

53
Q

Adverse effects of Clopidogrel:

A
  • bleeding
  • flulike symptoms
    • hemorrhage
54
Q

s/s of bleeding

A

black, tarry stools, oozing injuries

55
Q

s/s of bleeding

A

black, tarry stools, oozing injuries

56
Q

drug used for hyperlipidemia

A

atorvastatin

57
Q

what drug:

used to lower LDL & VLDL cholesterols & triglycerides, used to prevent MI & stroke

A

atorvastatin

58
Q

Contraindications of atorvastatin:

A
    • hepatic impairment
    • pregnancy
    • lactation
  • interaction: antibiotics increase levels = increase risk of rhabdmyolysis
59
Q

Adverse effects of atorvastatin:

A
    • rhabdomyolysis
    • joint or muscle pain
  • liver failure
60
Q

Nursing considerations/pt. teaching for atorvastatin:

A
  • s/s severe myopathy/rhabmyolysis

* - report muscle/joint pain/weakness

61
Q

route of atorvastatin

A

PO

62
Q

Q: Which is NOT an effect of digoxin?
A. increased heart muscle contraction strength
B. decreased heart rate
C. increased diuresis of fluid
D. decreased sympathetic nervous system activity

A

C. increased diuresis of fluid

63
Q 
Q: Which condition requires cautious use of digoxin?
A. hyperglycemia
B. hypokalemia
C. tachycardia
D. liver dysfunction
A

B. hypokalemia

64
Q 
Q: What is the antidote for warfarin?
A. protamine sulfate
B. flumazenil
C. potassium
D. vitamin K
A

D. vitamin K

65
Q 
Q: What is the antidote for heparin?
A. protamine sulfate
B. flumazenil
C. potassium
D. vitamin K
A

A. protamine sulfate

66
Q 
Q: What is a potential life-threatening adverse affect of dabigatran?
A. stroke
B. suicidal thoughts
C. bronchospasm
D. hemorrhage
A

D. hemorrhage

67
Q

Q: True or False: anticoagulants such as heparin and warfarin dissolve existing clots.
A. True
B. False

A

B. False

68
Q

Q: How does the medication, clopidogrel, work to prevent blood clots?
A. It inhibits the formation of clotting factors.
B. It prevents clotting factors from binding to receptors on platelet membranes.
C. It irreversibly binds to platelet membranes and inhibits platelet aggregation.
D. It prevents fibrinogen from converting to fibrin, therefore preventing the aggregation of platelets and red blood cells.

A

C. It irreversibly binds to platelet membranes and inhibits platelet aggregation.

69
Q 
Q: What symptom related to a serious adverse effect of atorvastatin should the nurse warn the patient about who is taking it?
A. joint or muscle pain
B. hearing loss
C. urinary retention
D. dilated pupils
A

A. joint or muscle pain

70
Q

Q: What is the class of medication that is the first-line drug for heart failure?

A

ace inhibitors

Pharmacology N2100 (26 decks)

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