Cardiovascular Drugs Flashcards
(250 cards)
1
Q
Cardiotonic and inotropic indication
A
Used on people that still have symptoms after using ACE inhibitors, diuretics and beta blockers, but can be used in acute situations of heart failure, however their use is decreasing. Used for heart failure and atrial fibrillation
2
Q
Cardiotonic/inotropic ex
A
Digoxin, ivabradine, milrinone (inotropic), amrinone
3
Q
Cardiotonic/inotropic considerations
A
Stop if low blood pressure, monitor blood pressure and heart rate, caution in patients with electrolyte imbalance
4
Q
Left ventricular heart failure symptoms
A
Decreased cardiac output, orthopnea, moist cough, frothy pink sputum, dyspnea, decreased ejection fraction
5
Q
Right ventricular heart failure symptoms
A
Neck vein distension, peripheral edema, weight gain, haptic engorgement, nocturia
6
Q
Cardiotonic/inotropic side effects
A
Arrhythmia, weakness, drowsy, visual disturbances, arrhythmias, anorexia, nausea
7
Q
Cardiotonic/inotropic aren’t for people with
A
Ventricular failure, fast heart rate, cardiac tamponade, AV block, digoxin toxicity, restrictive cardiomyopathy
8
Q
Cardiotonic/inotropic: what to monitor
A
Edema, weight gain, lung sounds, jugular veins for distension, sputum, electrolytes, renal function
9
Q
Cardiotonic/inotropic signs of digoxin toxicity
A
Anorexia (usually the first sign), nausea, vomiting, diarrhea, weakness, lethargy, headache, drowsiness, visual disturbances, confusion, disorientation, delirium, changes in pulse rate them, electrocardiograph changes, Bradycardia, tachycardia, premature ventricular contractions
10
Q
Cardiotonic/inotropic administration
A
IM or IV, and also give potassium supplement
11
Q
Cardiotonic/inotropic toxicity antidote
A
Digibind
12
Q
Anticoagulants indications
A
Prevention and treatment of DVT, prevention and treatment of atrial fibrillation with embolization, prevention and treatment of PE, adjuvant treatment of MI, prevention of thrombus formation after valve replacement surgery
13
Q
Anticoagulants ex
A
Warfarin (oral, most common), heparin (available in low weight, mid of other drugs)
14
Q
Anticoagulants side effects
A
Nausea, abdominal cramps, alopecia, urticaria, hepatitis, diarrhea, jaundice, thrombocytopenia, blood dyscrasias, bleeding (most common)
15
Q
Anticoagulants are not for people with
A
Active bleeding (except when caused by DIC), TB, leukemia, high BP, ulcers, renal or hepatic disease, pregnancy (oral is cat X, and parenteral is cat C), hemorrhagic disease, lactation, aneurysms, recent eye or CNS surgery
16
Q
Anticoagulants interactions
A
Aspirin, acetaminophen, NSAIDs, chloracne hydrate, some antibiotics, some GI drugs
17
Q
Anuria
A
Cessation of urine production
18
Q
Azotemia
A
Absence of urine production
19
Q
Diuresis
A
Production of urine
20
Q
Edema
A
Accumulation of a excess water in the body
21
Q
Gynecomastia
A
Male Breast enlargement
22
Q
Hyperkalemia
A
Increase in potassium levels in the blood
23
Q
Hypokalemia
A
Low blood potassium level
24
Q
Hypertension is frequently treated by
A
Antihypertensive drug and a diuretic (loop or thiazide)
25
Diuretics MOA
Altering the excretion or reabsorption of electrolytes (sodium and chloride) in the kidney,
26
Loop diuretics MOA
Inhibit reabsorption of sodium and chloride in the distal and proximal tubules in the kidney and in the the loop of henle
27
Thiazide diuretics MOA
Inhibit the reabsorption of sodium and chloride ions in the ascending portion of the loop of henle and the early distal tubule of the nephron. Sodium, chloride, and water are excreted
28
Potassium sparing diuretics MOA
Blocking reabsorption of sodium in the kidney tubules, reducing the excretion of potassium
29
Potassium sparing diuretics ex
Spironolactone,
30
Spironolactone MOA
Antagonize the action of aldosterone, sodium and water are excreted
31
Osmotic diuretics MOA
Increase the density of the filtrate in the glomerulus, sodium and chloride excretion is increased
32
Carbonic anhydride inhibitors MOA
Sulfonamides, Without bacteriostatic action that inhibit carbonic anhydride enzymes, and result in the excretion of sodium, potassium, bicarbonate, and water
33
Diuretics uses
Edema associated with heart failure, corticosteroid/estrogen therapy, cirrhosis of the liver, hypertension, renal disease (acute failure, renal insufficiency, nephrotic syndrome), cerebral edema, acute glaucoma, increased intraocular pressure, seizures, altitude sickness
34
Spironolactone use
Male to female hormonal therapy for gender dysphoria
35
Ethacrynic acid use
Short term managemtn of ascites caused by a malignancy, idiopathic edema, or lymphedema
36
Diuretics: what to do if the patient is at risk for potassium loss
Use potassium sparing diuretics in place of or with other diuretics
37
Diuretics neuromuscular system side effects
Dizziness, lightheadedness, headache, weakness, fatigue
38
Diuretics cardiovascular system side effects
Orthostatic hypotension, electrolyte imbalances, glycosuria
39
Diuretics GI system side effects
Anorexia, nausea, vomiting
40
Diuretics general side effects
Rash, photosensitivity, hypokalemia
41
Hypokalemia signs
Extremity paresthesias (numbness or tingling), or flaccid muscles
42
Potassium sparing diuretics side effects
Hyperkalemia
43
Potassium sparing diuretics: Hyperkalemia is most likely to occur in
Inadequate fluid intake and urine output, diabetes, renal disease, elderly, severely ill
44
Spironolactone side effects
Gynecomastia, which is related to both dose and duration of treatment
45
Diuretics contraindications
Electrolyte imbalances, severe kidney or liver dysfunction, anuria
46
Mannitol contraindications
Active intracranial bleeding (except during craniotomy)
47
Potassium sparing diuretics contraindications
Hyperkalemia, pediatric patients
48
Diuretics precautions
Renal dysfunction , pregnancy (cat C), lactation
49
Pregnancy cat B diuretics
Ethacrynic acid, torsemide, isosorbide, amiloride, triamterene
50
Thiazide diuretics pregnancy cat
B
51
Benzthiazide pregnancy cat
C
52
Methyclothiazide pregnancy cat
C
53
Thiazide diuretics precautions
Gout, liver disease, systemic lupus erythematosus, diarrhea, cross sensitivity with sulfonamides, sensitive to tartazine (can cause allergic type reactions or bronchial asthma)
54
Loop diuretics precautions
Gout, liver disease, systemic lupus erythematosus, diarrhea, cross sensitivity with sulfonamides,
55
Potassium sparing diuretics precautions
Liver disease or diabetes
56
Carbonic anhydride inhibitors interactions
Primodone decreases diuretic effectiveness
57
Loop diuretics interactions
I solas tin and aminoglycosides increase risk of ototoxicity, anticoagulants and thrombolytics increase risk of bleeding, digitalis increases risk of arrhythmias, increased risk of lithium toxicity, hydantoins decrease diuretic effectiveness, NSAIDs and salicylates decrease diuretic effectiveness
58
Potassium sparing diuretics interactions
ACE inhibitors and potassium increase risk for Hyperkalemia, NSAIDs, salicylates, and anticoagulants decrease diuretic effectiveness, increased risk of allopurinol hypersensitivity, increased effectiveness of anesthetics, antineoplastics extend leukopenia, and antidiabetics cause hyperglycemia
59
Dehydration signs
Thirst, poor skin turgor, dry mucous membranes, weakness, dizziness, fever, low urine output
60
Hyponatremia signs
(Excessive sodium loss), cold and clammy skin, decreased skin turgor, confusion, hypotension, irritability, tachycardia
61
Hypomagnesemia signs
Leg and foot cramps, hypertension, tachycardia, neuromuscular irritability, tremor, hyperactive deep tendon reflexes, confusion, visual or auditory hallucinations, paresthesias
62
Hypokalemia signs
Anorexia, vomiting, muscle twitching, depression, confusion, bradycardia, impaired thought process, drowsiness
63
Hyperkalemia signs
Irritability, anxiety, confusion, muscle cramps, numbness, tingling, nausea, diarrhea, arrhythmias, flaccid paralysis
64
Loop diuretics ex
Bumetanide, ethacrynic acid, furosemide, torsemide
65
Potassium sparing diuretics ex
Amiloride, spironolactone, triamterene,
66
Thiazide diuretics ex
Chlorothiazide, chlorthalidone, hydrochlorothiazide, indapamide, metolazone, methyclothiazide
67
Carbonic anhydrase inhibitors ex
Acetazolamide, methazolamide
68
Osmotic diuretics
Glycerin, isosorbide, mannitol, urea
69
Atherosclerosis
Disease characterized by deposits of fatty plaques on the inner walls of arteries
70
Catalyst
Substance that accelerates a chemical reaction without itself undergoing a change
71
Cholecystitis
Inflammation of gallbladder
72
Cholelithiasis
Stones in gallbladder
73
Cholesterols
Fat like substance produced mostly in the liver of animals
74
High density lipoproteins (HDLs)
Macro (big) molecules that carry cholesterol from the body cells to the liver to be excreted
75
Hyperlipidemia
Increase in the lipids in the blood
76
Lipid
Group of fats or fat-like substances
77
Lipoprotein
Macromolecule consisting of lipid, and protein; how fats are transported in the blood
78
Low density lipoproteins
Macromolecules that carry cholesterol form the liver to the body cells
79
Risk evaluation and mitigation strategies
(REMS) a program of the FDA designed to monitor drugs that have a high risk compared to benefit ratio
80
Rhabdomylosis
Condition in which muscle damage results in the release of muscle cell contents into the bloodstream
81
Statins (HMD-CoA reductase inhibitors)
Common name fro drugs that inhibit the manufacture or promote the breakdown of cholesterol
82
Triglycerides
Types of lipids that circulate in the blood
83
Xanthomas
Yellow deposits of cholesterol in tendons and soft tissues
84
Uncontrollable risk factors of hyperlipidemia
Age (men older than 45 and women older than 55), gender (LDL increases in women after menopause), family history of heart disease
85
Hyperlipidemia controllable factors
Diet, weight, ohycial inactivity
86
HMG-CoA reductase inhibitors MOA
Inhibit the manufacture of cholesterol, or promote breakdown of cholesterol, LDLs, and serum triglycerides
87
Statins uses
Hyperlipidemia, primary prevention of coronary events, secondary prevention of cardiovascular events
88
Statins side effects nature
Mild, transient, well tolerated
89
Statins side effects
Headache, dizziness, insomnia, memory and cognitive impairment, flatulence, abdominal cramps, constipation, nausea, hyperglycemia in non diabetic patients
90
Statins contraindications
Serious liver disorders, pregnancy (cat X), lactation, can elevate serum glucose and HbA1c levels in people with diabetes risk
91
Statins precautions
Alcoholism, non alcohol related liver disease, acute infection, hypotension, trauma, endocrine disorder, visual disturbances, myopathy
92
Rosuvastatin side effects
Severe muscle toxicity in people taking cyclosporine, Asian people, and with severe renal insufficiency
93
Statins interactions
Macrolides, erythromycin and clarithromycin increase risk for severe myopathy or rhabdomylosis, amiodarine increases risk of myopathy, niacin increases risk of severe myopathy, protease inhibitors increase plasma levels of statins, verapmil increases risk of myopathy, and increased anticoagulant effect, additive effect with bile acid resins
94
Lovastatin contraindications
Grapefruit
95
Simvastatin contraindications
Grapefruit
96
PCSK9 inhibitors use
Genetic familial hyperlipidemia, or are at a very high risk for cardiovascular disease, and are given if diet changes and statins don’t work
97
PCSK9 inhibitors ex
Alirocumab, evolocumab
98
PCSK9 inhibitors administration
Subcutaneous once or twice a month, but are very expensive
99
PCSK9 inhibitors side effects
Possible cognitive adverse reactions
100
Bile acid resins MOA
Bind to bile acids to form an insoluble substance that can’t be absorbed by the intestine, forcing the liver to use more cholesterol and causing a decrease in cholesterol levels
101
Bile acid resins uses
Hyperlipidemia (When diet and exercise don’t work), gallstone dissolution in patients where surgery isn’t recommended
102
Cholestyramine use
Pruritus associated with partial biliary obstruction
103
Bile acid resins side effects
Constipation , aggravation of hemorrhoids, abdominal cramps, flatulence, and nausea, and increased bleeding tendencies related to vitamin K malabsorption and vitamin A and D deficiencies
104
Cholestyramine interactions
Decreased effects of anticoagulants, loss of efficacy of thyroid and hypothyroidism with thyroid hormones,
105
Bile acid resins interactions
Reduced absorption of fat-soluble vitamins (A, D, E, K) and folic acid. And a decreased serum level of or decreased GI absorption of NSAIDs, penicillin, tetracycline, niacin, digitalis glycosides, furosemide, thiazide diuretics, glipizide, hydrocortisone, methyldopa, propranolol
106
Fenofibrate MOA
Reducing very low density lipoproteins and stimulating the catabolism of triglyceride rich lipoproteins, which decreases plasm triglycerides and cholesterol
107
Gemfibrozil MOA
Increases the excretion of cholesterol in the feces, and reduced the production of triglycerides by the liver, lowering serum lipid levels
108
Gemfibrozil use
Very high serum triglyceride levels who are at risk for abdominal pain and pancreatitis and when diet and exercise don’t work
109
Fenofibrate use
Adjunctive treatment for reducing LDLs, total cholesterol, and triglycerides in patients with hyperlipidemia
110
Fibric acid derivatives side effects
Nausea, vomiting, upset GI, diarrhea, cholelithiasis (if this is found they might discontinue), or cholecystitis
111
Fibric acid derivatives contraindications
Significant hepatic or renal function, primary biliary cirrhosis, lactation
112
Fibric acid derivatives precautions
Pregnancy (cat C)
113
Fibric acid derivatives interactions
Enhanced effects of anticoagulants, statins increase risk of rhabdomylosis
114
Gemfibrozil interactions
Decreased effects if cyclosporine, increased hypoglycemic effects of sulfonylureas
115
Ezetimibe MOA
Inhibits absorption of cholesterol in the small intestine, leading to decrease of cholesterol in the liver
116
Niacin use
Adjunctive therapy for lowering very high serum triglyceride levels in patients who are at risk for pancreatitis and for whom diet control doesn’t work
117
Ezetimibe use
In combinations with other antihyperlipidemics in lipid-lowering treatments
118
Misc antihyperlipidemics side effects
Nausea, vomiting, abdominal pain, diarrhea, flushing, warmth, itching, tingling
119
Niacin contraindications
Active peptic ulcer, hepatic dysfunction, arterial bleeding
120
Niacin precautions
Renal dysfunction, high alcohol consumption, unstable angina, gout, pregnancy (cat C)
121
Ezetimibe contraindications
Pregnancy and lactation
122
Mipomersen use
When TLC, statins, and adjuvant Drugs don’t lower LDL levels in people with genetic disorders, but carry severe hepatic Side effects, and are only prescribed as part of REMS
123
Lomitapide use
When TLC, statins and adjuvant Drugs don’t lower LDL in people with a genetic disorder, but they have severe hepatic reactions, and are only prescribed as a part of REMS
124
Severe hyperlipidemia signs
Xanthomas
125
Bile acid resins elderly considerations
Elderly prone to constipation
126
Statins ex
Atorvastatin, fluvastatin, lovastatin, pitavastatin, pravastatin, rosuvastatin, simvastatin
127
PCSK9 inhibitors ex
Alirocumab, evolocumab
128
Bile acid resins ex
Cholestyramine, colestipol, colesevelam
129
Fibric acid derivatives ex
Fenofibrate, gemfibrozil
130
Angina
Acute pain in the chest resulting from decreased blood supply to the heart muscle
131
Buccal
Space in the mouth between the gum and the cheek in either the upper or lower jaw
132
Pulmonary arterial hypertension (PAH)
High blood pressure in the pulmonary artery (heart to lungs), which can result in heart failure if not treated
133
Sublingual
Under tongue
134
Primary treatment for angina
CCBs
135
How to treat PAH
Peripheral vasodilator
136
Nitrates MOA
Relaxes the smooth muscle layer of blood vessels, increasing the lumen of the artery or arteriole, and increases the amount of blood flowing through the vessels
137
What do CCBs do to the heart
Slow conduction velocity of the cardiac impulse, depress myocardial contractility, dilate coronary arteries and arterioles, which deliver more oxygen to cardiac muscle
138
Antianginal drugs use
Relieve pain of acute anginal attacks, prevent angina attacks, treat chronic, stable angina pectoris
139
Nitrates use
Relieve symptoms when an anginal attack happens
140
CCBs as an antianginal drug use
Prevent angina from occurring (take on a regular basis)
141
Nitroglycerin use
Control perioperative hypertension associated with surgical procedures (IV)
142
Verapmil use
Cardiac arrhythmias, and affects conduction system of the heart
143
CCBs side effects nature
Not usually serious and don’t require discontinuation
144
Nitrates side effects
Sever headache, dizziness, weakness, restlessness, hypotension, flushing, rash
145
Sublingual nitroglycerin side effects
Local buringin or tingling
146
Transdermal nitroglycerin side effects
Contact dermatitis
147
Nitrates side effects nature
In many cases, prolonged use causes side effects to lessen, however in other cases, adverse reactions can become more severe, so dose is lowered, until it can be slowly increased
148
Nitrates contraindications
Severe anemia, closed angle glaucoma, postural hypertension, head trauma, cerebral hemorrhage, constrictive pericarditis, people taking phosphodiesterase inhibitors
149
Sublingual nitrates contraindications
Early myocardial infarction
150
Transdermal nitrates contraindications
Allergy to adhesives
151
Nitrates precautions
Severe hepatic or renal disease, severe head trauma, hypothyroidism
152
Peripheral vasodilation drugs contraindications
Pregnancy
153
Nitrates interactions
Aspirin increases nitrate serum concentrations, CCBs increase orthostatic hypotension, dihydroergotamine increases risk of hypertension and decreases antianginal effect, decreased effect of heparin, phosphodiesterase inhibitors and alcohol can cause severe hypotension and cardiovascular collapse
154
Nitrates ex
Isosorbide, nitroglycerin,
155
Misc antianginal drugs ex
Ivabradine, ranolazine, nimodipine
156
Peripheral vasodilator ex
Hydralazine, minoxidil, nitroprusside
157
Drugs used for PAH
Ambrisentan, bosentan, epoprostenol, iloprost, macitentan, riociguat, treprostinil,
158
Aggregate
Clumping of blood element
159
Embolus
Thrombus that detaches from a blood vessel wall and travels through the bloodstream
160
Fibrolytic
Drug the dissolves clots already formed within blood vessel walls
161
Hemostasis
Complex process by which fibrin forms and blood clots
162
Lysis
Dissolution and destruction of cells
163
Petechiae
Pinpoint sized red hemorrhagic spots on the skin
164
Prothrombin
Substance that is essential for the clotting if the blood, clotting factor 2
165
Thrombolytic
Drug that helps to eliminate blood clots
166
Thrombosis
Formation of a blood clot
167
Thrombus
Blood clot
168
Direct thrombin inhibitors (DTIs) ex
Dabigatran (oral), argatroban, bivalirudin,
| Desirudin
169
LMWH ex
Dalteparin, enoxaparin
170
oral anticoagulants ex
Apixaban, edoxaban, rivaroxaban, rivaroxaban, warfarin
171
How did DTIs compare to heparin and warfarin
Don’t have the difficult management properties of heparin or warfarin
172
LMWHs side effects nature
Produce very stable responses, and lab monitoring isn’t needed
173
Apixaban use
Prevent DVT in people with hip, knee, or abdominal surgeries
174
Edoxaban use
Prevent DVT in people undergoing hip, knee, or abdominal surgeries
175
Rivaroxaban use
Prevent DVT in people undergoing hip, knee, or abdominal surgeries
176
Fondaparinux use
Prevent DVT in people undergoing hip, knee, or abdominal surgeries
177
Warfarin MOA
Interferes with the manufacturing of vitamin K dependent clotting factors by the liver, resulting in the depletion of clotting factors 2, 7, 11 and 10
178
Heparin MOA
Inhibits the formation of fibrin clots, inhibits the conversion of fibrinogen to fibrin and inactivated several of the factors necessary for the clotting of blood, can’t be taken orally
179
LMWHs MOA
Inhibit clotting reactions by binding to antithrombin 3, which inhibits synthesis factor X and the formation of thrombin (no effect in existing clots)
180
DTIs MOA
Directly inhibit thrombin, and don’t require a cofactor to exert effect
181
Parenteral anticoagulants use
Prevention of postoperative DVT and PE in people undergoing major surgery, prevention of clotting in heart and arterial surgery, prevention of a repeat cerebral thrombosis in people who have had stroke, treatment of coronary occlusion, acute MI, peripheral arterial embolism, disseminated intravascular coagulation (DIC), maintaining latency of IV catheters (low dose)
182
Warfarin risk
Narrow therapeutic window, significant risk of hemorrhage
183
Subcutaneous heparin side effects
Local irritation
184
Anticoagulants allergic reaction signs
Fever, chills, asthma like reaction
185
LMWHs contraindications
People allergic to pork
186
Anticoagulants precautions
Fever, heart failure, diarrhea, diabetes, malignancy, hypertension, renal or hepatic disease, psychoses, depression
187
Apixaban administrating considerations
Monitored by REMS, because a chance of stroke with discontinuation
188
Apixaban interactions
Grapefruit will increase serum levels
189
Rivaroxaban interactions
Grapefruit increases serum levels
190
Anticoagulants interactions
Aspirin, acetaminophen, NSAIDs, chloracne hydrate, penicillin, aminoglycosides, isoniazid, tetracyclines, cephalosporins, beta blockers, loop diuretics, disulfiram, and cimetidine increase risk of bleeding and oral contraceptives, barbiturates, diuretics and vitamin K decrease anticoagulant effectiveness, spinal anesthesia or spinal punctures can cause spinal or epidural hematoma formation, which can lead to paralysis
191
Antiplatelet Drugs MOA
Decrease the platelets ability to stick together in the blood, forming a clot
192
Aspirin MOA as an antiplatelet
Prohibit the aggregation of platelets for the lifetime of the platelet
193
Adenosine diphosphate receptor blockers (ADP blockers) MOA
Alter the platelet cell membrane, preventing aggregation
194
Glycoprotein receptor blocker MOA
Prevent enzyme production, inhibiting platelet aggregation
195
Antiplatelet use
Risk for acute coronary syndrome, MI, stroke, and intermittent claudication
196
Antiplatelet side effects
Palpitations, bleeding, dizzy, headache, nausea, diarrhea, constipation, dyspepsia
197
Antiplatelet Drugs contraindications
Pregnancy, lactation, heart failure,active bleeding, thrombotic thrombocytopenic purpura (TTP)
198
Antiplatelets precautions
Elderly, pancytopenic people, renal or hepatic impairment
199
Antiplatelet pregnancy cat
C
200
Clopidogrel pregnancy cat
B
201
What to do if TTP is diagnosed
Stop antiplatelet treatment immediately
202
Antiplatelets interactions
Aspirin and NSAIDs increase risk of bleeding, increased effectiveness of macrolides, decreased digoxin serum levels, increased phenytoin serum levels
203
Thrombolytic Drugs MOA
Break down fibrin clots by converting plasminogen to plasmin (will have an effect on existing thrombus)
204
Thrombolytic Drugs uses
Acute stroke or MI by lyis of blood clots in coronary arteries, blood clots causing pulmonary embolism and DVT, suspected occlusion in central venous catheters
205
Thrombolytic Drugs side effects
Bleeding, can be internal in GI tract, genitourinary tract and brain, bleeding can also be external and seen where skin is broken (venipuncture sites and recent surgical wounds), allergic reactions
206
Thrombolytic Drugs contraindications
Active bleeding, history of stroke, aneurysm, recent intracranial surgery
207
Thrombolytic Drugs precautions
Recently undergone major surgery (within 10 days), stroke, trauma within the last 10 days, vaginal or C-section delivery, GI bleeding, hypertension, diabetic retinopathy, significant possibility of bleeding, taking oral anticoagulants
208
Thrombolytic Drugs pregnancy cat
C
209
Urokinase pregnancy cat
B
210
Thrombolytics interactions
When given with drugs that prevent blood clots (aspirin, dipyridamole, anticoagulant), there is an increased risk of bleeding
211
Parenteral anticoagulants ex
Heparin, fondapurinux
212
Antiplatelet ex
Abciximab, anagrelide, cilostazol, clopidogrel, dipyridamole, eptifibatide, prasugrel, ticagrelor, ticlopidone, tirofiban, vorapaxar
213
Thrombolytic ex
Alteplase, reteplase, tenecteplase,
214
Anticoagulant antagonists use
Treats heparin/warfarin overdose
215
Anticoagulant antagonists ex
Phytonadione, protamine, idarucizumab
216
Atrial fibrillation
Quivering of the atria if the heart
217
Cardiac output
Volume of blood discharged from the left or right ventricular per minute
218
Digitalis toxicity
Toxic drug effects from te administration of digoxin
219
Heart failure
Condition in which the heart can’t pump enough blood to meet the tissue needs of the body
220
Left ventricular dysfunction
Conduction in which fluids back up previous to the left ventricle of the heart and is characterized by shortness of breath, and moist cough in heart failure
221
Neurohormonal activity
In heart failure, increased secretions of epinephrine and norepinephrine, resulting in arteriolar vasoconstriction, tachycardia, myocardial contractility, resulting in a worsening of heart failure and reduced ability of the heart to contract effectively
222
Positive inotropic activity
Increase in the force of cardiac contraction
223
Right ventricular dysfunction
Condition in which fluid backs up previous to the right ventricle if the heart and is characterized by peripheral edema and venous congestion in heart failure
224
Neurohormonal responses affecting heart failure
Increased secretion of the neurohormonal compensatory mechanisms, which results in increased secretion of the neurohormones, activation of the renin-angiotensin-aldosterone system (RAA), and remodeling of cardiac tissue
225
Ventricular heart failure
Typically left side is affected first, followed by right ventricular involvement
226
Heart failure symptoms
Left ventricular dysfunction, shortness of breath with exercise, dry, hacking cough or wheezing, orthopnea, restlessness, anxiety, right ventricular dysfunction, swollen ankles, legs or abdomen, anorexia, nausea, nocturia, weakness, weight gain, tachycardia, palpitations, fatigue or pain when performing normal activities, irregular heart rate, dizziness, conduction
227
Digoxin is continued to be used for
Elderly who have been in the drug for many years, patients using symptoms after using other drugs, and in some cases of atrial fibrillation
228
Ivabradine use
Slowly replacing digoxin to treat heart failure, and when used with a beta blocker, can reduce hospitalization
229
milrinone use
Short term, acute management of heart failure when it isn’t controlled by digoxin
230
Cardiotonic MOA
Increase cardiac output through positive inotropic activity, and slow conduction velocity through the AV node in the heart, don’t cure heart failure, but only control symptoms
231
Ivabradine MOA
Blocks the If channel and inhibits the pacing of the SA node of the heart
232
Milrinone MOA
Inotropic actions
233
Digoxin side effects
Blurred or yellow halo around lights
234
Ivabradine side effects
Increased brightness
235
Cardiotonic precautions
Electrolyte imbalance, thyroid disorders, sever carditis, heart block, myocardial infarction, severe pulmonary disease, acute glomerulonephritis, and impaired renal or hepatic function
236
Digoxin pregnancy cat
C, caution in pregnancy and lactation
237
Ivabradine contraindications
Pregnant or lactating
238
Cardiotonics interactions
Absorption slowed when taken with food, but if taken with high fiber meals, absorption is decreased, thyroid hormones require a larger dosage of digoxin, thiazide and loop diuretics increase risk of digoxin induced arrhythmia
239
Digoxin interactions
Amiodarone, benzodiazepines, indomethacin, itraconazole, macrolides, propafenone, quinidine, spironolactone, tetracyclines, verapmil, and aminoglycosides increase serum digoxin levels (can lead to toxicity), and antacids, antineoplastics, charcoal, cholestyramine, neomycin and rifampin decrease serum digoxin levels
240
Cardiotonics pediatric considerations
Drug is withheld if pulse in child is below 70, or if pulse in infant is below 90
241
Who is at higher risk for digoxin toxicity
People with hypokalemia (on diuretics)
242
Digoxin elderly considerations
Elderly ar more prone to digoxin toxicity, and conditions such as dementia can have similar signs to digoxin toxicity
243
Action potential
Electrical impulse that passes from cel to cell in the myocardium of the heart and stimulates the fibers to shorten, causing the heart muscle to contract
244
Depolarization
Movement of ions in a nerve cell from inside to outside and vice versa
245
Myocardium
The striated, muscle tissue of the heart
246
Polarization
Status of a nerve cell at rest, with positive ions on the outside of the cell membrane and negative ions in the inside
247
Proarrhythmic effect
Creation of new arrhythmia or worsening of existing arrhythmia, resulting from administration of an antiarrhythmic Drug
248
Refractory period
Quiet period between the transmission of nerve impulses along a nerve fiber
249
Repolarization
Return of positive and negative ions to their original place in the nerve cell after an impulse has traveled along the nerve fiber
250
Threshold
Any stimulus if lowest intensity that will give rise to a response in a nerve fiber
