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Cardiopulmonary Medications Flashcards

AlysSlder (55 cards)

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1
Q

Diuretics act on _______________

A

Kidneys - Increase sodium and water excretion. To decrease fluid in vascular system (decrease load).
Indications: HTN & CHF

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2
Q

Diuretic examples

A

Chlorothiazide (Diuril)
Furosemide (Lasix)
Spironolactone (Aldactone) - K+ sparing

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3
Q

Diuretic rehab concerns

A

-Fluid depletion, electrolyte imbalance
-Orthostatic hypotension
-Weakness, fatigue
-Confusion, mood changes

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4
Q

Sympatholytic: Beta Blockers - main function:

A

-olol
-Bind to heart, block epinepherine & norepinepherine
-Decrease HR & contraction force
-General decrease in sympathetic responses

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5
Q

Beta Blockers indications:

A
  • HTN
  • Angina
  • Arrhythmias
  • Heart Failure
  • Recovery from MI
    Others: Migraine, Raynaud’s, Situational anxiety
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6
Q

Vasodilators Examples

A

hydralazine (Apresoline) minoxidil (Loniten)

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6
Q

Other sympatholytic antihypertensives

A

doxazosin (Cardura), prazosin (Minipress)
-reserpine
-clonidine (Catapres), methyldopa (Aldomet)
-mecamylamine (Inversine), trimethaphan (Arfonad)

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7
Q

Beat Blocker Adverse effects & rehab concerns

A

Bronchoconstriction
Orthostatic hypotension
Psychotropic effects ( depression, lethargy, decreased libido)
Decreased MAXIMAL exercise capacity

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8
Q

Common Beta Blockers:

A

-olol” suffix
Cardioselective:
Atenolol, Metoprolol
Nonselective: Pindolol, Propranolol

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9
Q

Vasodilators main function

A

Act directly on vascular smooth muscle… inhibit contraction
Indications: hypertension, heart failure

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10
Q

Vasodilators adverse effects

A

Reflex tachycardia
Orthostatic hypotension
Dizziness, headaches
Edema, fluid retention
Avoid systemic heat (large whirlpool, Hubbard tank, etc)… true for all drugs that cause vasodilation

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11
Q

Renin-Angiotensin System (RAS) Drugs

A

ACE Inhibitors
Angiotensin 2 Receptor Blockers
Direct renin inhibitors
Function: To help regulate BP, decrease HTN

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12
Q

ACE Inhibitors

A

Indications: HTN & Heart failure
Drugs end in “-pril”
captopril (Capoten)
enalapril (Epaned, Vasotec)
fosinopril (Monopril)
lisinopril (Prinivil, Zestril)

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13
Q

Angiotensin 2 Receptor Blockers

A

“-sartan” drugs
May be fewer side effects & as effective as ACE inhibitors
Examples: losartan (Cozaar), eprosartan (Teveten)

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14
Q

RAS drugs adverse effects & rehab concerns

A
  • Some nausea, dizziness, possible allergic reaction
    ACE inhibitors: dry cough
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14
Q

Calcium channel blockers examples

A

Diltiazem (Cardizem, others)
Verapamil (Calan, Isoptin, others)
Nifedipine (Adalat, Procardia, others)
Other “-ipine” drugs

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15
Q

Calcium channel blockers function

A

Limits calcium into vascular smooth muscle & cardiac muscle. Promotes vasodilation, stabilize HR
Indications: HTN, angina pectoris, arrhythmias

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16
Q

Calcium Channel blockers adverse effects & rehab concerns

A

-Swelling in feet, ankles
-Orthostatic hypotension
-Altered HR
-Avoid systemic heat
-Can cause arrhythmias

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17
Q

Nitrates - Nitroglycerin main function

A

Dilates peripheral vasculature = venous & arterial dilation & decreases pre & after load on heart
Primary indication: angina pectoris (chest pain)

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18
Q

Nitrate/Nitro administration & adverse effects

A

Typically sublingal (onset 1-3 minutes, lasts 30-60 min) or Transdermal patch (onset 40-60 min, last longer 8-24 hours)
*Continuous administration reduces drugs effects, restored quickly when nitrate discontinued.
AE: Headache, dizziness, orthostatic hypotenstion, vasodilation - exaggerated response to systemic heat.

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19
Q

Class 1 - Sodium channel blockers function

A

Inhibit Na+ channel opening in cardiac cells, stabilize excitability.
Examples:
IA: disopyramide (Norpace); quinidine (Apo-Quin)
IB: lidocaine (Xylocaine); mexiletine (Mexitil); tocainide (Tonocard)
IC: flecainide (Tambocor); propafenone (Rythmol)

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19
Q

Class 3 - Drugs that prolong repolarization function

A

Lengthen time interval before next AP can be generated.
Examples: amiodarone (Cordarone)*; dofetilide (Tikosyn); dronedarone (Multaq); ibutilide (Covert)

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19
Q

Anti-arrhythmics drugs rehab concerns

Study These Flashcards
A

-Various side effects depending on class
-Primary concern: change in type of arrhythmia (proarrhythmic effect)
-Monitor HR and symptoms, especially during exercise

20
Q

Cardiac Arrhythmia Drugs classes

Study These Flashcards
A

Class 1 - Sodium Channel blockers
Class 2 - Beta Blockers
Class 3 - Drugs that prolong repolarization
Class 4 - Calcium channel blockers

21
Anti-arrhythmics Drug Classes & Primary clinical indications
Class I (Na+ channel blockers): various arr's, esp. PVCs, Vtach Class II (beta blockers): Afib, Vtach Class III (amiodarone): Afib, Vtach, Vfib Class IV: (CCBs): Afib, supraventricular tachycardias
22
Drugs that help treat Heart Failure
Diuretics - Furosemide (Lasix) Beta Blockers "-olol" Vasodilators - hydralazine (Apresoline) minoxidil (Loniten) Renin-Angiotensin Drugs - "-pril" & "-sartan"
23
Positive inotropic drug that helps increase cardiac output, improves cardiac contraction force.
Digitalis Primary indication: Congestive Heart Failure
24
Digitalis Toxicity
GI distress, fatigue, confusion, depression, blurred vision, arrhythmias
25
Drugs for overactive clotting
Anticoagulants - heparin, warfarin (Coumadin), dicumarol Antithrombotics - aspirin, clopidogrel (Plavix); pasugrel (Effient); ticlopidine (Ticlid); ticagrelor (Brilinta) Thombolytics - Activase, Abbokinase, Kinlytic, Retavase, TNKase) *Warfarin - inhibits vitamin K function in liver, pts should not suddenly increase vitamin K consumption while taking drug.
26
Heparin-induced Thrombocytopenia (HIT)
Heparins (given Intravenously) can decrease platelets. Type 1 HIT: asymptomatic, resolves spontaneously Type 2 HIT:immune reaction... causes serious thrombosis, life/limb threatening
27
Thrombolytics given for _________ can decrease mortality by 50% if given within 1 hour after symptom onset.
MI, Myocardial Infarction *In Ischemic stroke MUST tule out hemorrhage prior to aministering.
28
Anticlotting drugs rehab concerns
-Primary concern: risk of hemorrhage -Use care when administering: dressing changes, debridement, aggressive manual techniques (chest percussion, joint mobilization, etc.)
29
Treatment of Hyperlipidemia
- Statins: "-statin" -Fibric Acids: Fenofibrate (Fenoglide, TriCor, others), Gemfibrozil (Lopid)
30
Working with a patient on a statin complaining of acute general weakness, must be concerned for:
Statin-induced myopathy
31
Antilipid agent adverse effects & rehab concerns
-Gastrointestinal: nausea, diarrhea, bloating, etc. -Others: liver toxicity, pancreatitis, blood dyscrasias, arrhythmias -Watch for signs of myopathy (muscle pain, weakness)
32
Inhaled drugs are ....
Much better at delivering drug directly to the lungs. Main delivery options: Metered dose inhaler (MDI), nebulizer, dry powder inhaler
33
Antitussives are:
Opioids that suppress cough reflex at the brainstem. Examples: Codeine, Dextromethorphane, Hydrocodone
34
Primary problems & rehab concerns with Antitussives:
Problems: sedation, dizziness, GI upset Rehab concerns: Overuse/dependence, may limit "productive" cough, effectiveness?
35
Antihistamines function:
Block H1 receptor & decrease effects of histamine on upper respiratory tract for coughing, sneezing, irritation. Use: seasonal allergies, colds etc. Examples: Benadryl, Dramamine, Unisom, Zyrtec, Allegra, Claritin
36
Decongestants problems & rehab concerns:
Problems: headache, nausea, nervousness, cardiovascular stimulation Rehab concerns: dependence, overuse, abuse, cardiac palpitations, increased BP
36
Antihistamine problems & rehab concerns
Problems (If drug crosses BBB): Sedation, fatigue, incoordination, blurred vision *Newer agents, non-sedating Rehab concerns: sedative effects, dry-out respiratory tract, limit "productive" cough
36
Decongestants function
Alpha-1 receptor agonists, vasoconstrict nasal mucosa. Administer locally when possible.
36
Mucolytics & Expectorants function
Mucolytics: break up, ↓ viscosity of mucous; make it easier to raise and expel secretions. Expectorants: increase production of a thinner, more liquid phlegm; enhance effects of mucolytics
37
Mucolytic examples
Acetylcysteine (Mucomyst) Dornase alfa (Pulmozyme) "DNA-ase" *Helpful in those with CF pts
38
Expectorant examples
Guaifenesin OTC: Mucinex, Triaminic Chest Congestion
39
Bronchodilators (Beta-adrenergic agonists)
Albuterol (Proventil, Ventolin, others) Formoterol (Foradil, Perforomist) Metaproterenol (Alupent) Salmeterol (Serevent) Terbutaline (Brethine) Nonselective: Epinephrine, isoproterenol
39
Mucolytic & Expectorant problems & Rehab concerns:
Primary problems: usually well tolerated, may have nausea, vomiting, irritation of mouth with excessive use Rehab concerns: no major concerns, beneficial during postural drainage, vibration, percussion
40
Bronchodilators function
-Stimulate beta-2 receptors on airway smooth muscle -Increase intracellular production of cyclic AMP (2nd messenger) -cAMP initiates smooth muscle relaxation
41
Bronchodilators (Beta-adrenergic agonists) problems & rehab concerns:
Primary problems (excessive use): bronchial irritation/constriction, cardiac stimulation, CNS stimulation (nervousness, etc.) Rehab concerns: use before postural drainage, look for signs of overuse
42
Bronchodilator - Xanthine derivatives, Theophylline
-theophylline toxicity Signs: Nausea, confusion, irritability, restlessness Cardiac arrhythmias, seizures *Increased risk is metabolism is impaired pts: liver disease, CHF, age >55, infections like pneumonia, concomitant use other drugs.
42
Bronchodilators (Xanthine derivatives)
Drugs that are chemically similar to caffeine, other "methyl xanthines" Primary examples: Theophylline (Theolair, Theo-24, many other names), Aminophylline (Phyllocontin, Truphylline)... converted to theophylline in body
43
Bronchodilators (Anticholinergic drugs)
Acetylcholine stimulates bronchial smooth muscle contraction. Anticholinergics block acetylcholine receptors. Examples: ipratropium (Atrovent) tiotropium (Spiriva
44
Anti-inflammatory steroids problems & rehab concerns
Problems: general catabolic effects (muscle wasting, osteoporosis, etc.), many other metabolic effects (altered glucose metabolism, adrenal suppression, others) Rehab concerns: severe side effects minimized if inhaled at limited daily dosage
45
Anti-inflammatory steroids examples
Beclomethasone Budesonide Flunisolide Fluticasone *Can be combined with a beta-2 bronchodilator
46
What are some oxygen toxicity S&S ? (signs and symptoms)
muscle twitching; dizziness; confusion; nausea; incoordination; loss of consciousness; convulsions

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