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Flashcards in Exam 2 Meds Deck (63):
1

What med would you hold before a stress test? Why?

- Beta blocker
- Because it would inhibit raising the HR

2

What med would you administer to a patient with sinus bradycardia?

Atropine

3

Medicines that cause sinus tachycardia

- Beta agonists
- Adrenergics
- Anticholinergics

4

What medicines would you administer for a patient with sinus tachycardia? (2)

- Beta blockers
- Calcium channel blockers

5

What medicines would you administer to a patient with atrial flutter (3)?

- Beta blockers
- Digoxin
- Calcium channel blockers

6

What medicines would you administer to a patient of rapid ventricular response (Afib over 100) (3)

- Beta blockers
- Digoxin
- Calcium channel blockers

7

What medication would you administer to a patient with ventricular standstill

Atropine

8

What medication would you administer for treating weinkebach

Atropine

9

Versed: Indication

Pre-op sedation

10

Nitroglycerine: Indcation

Angina pain

11

Methods of nitroglycerine administration (4)

- Sublingual
- Topical
- IV Tridil
- PO

12

Two characteristics of sublingual nitroglycerine

- Works within three minutes
- Burning sensation under tongue is normal

13

Three characteristics of IV Tridil (Nitroglycerine)

- BP must be within parameters
- Watch for headache, drop in BP
- Works very quickly

14

Four characteristics of PO Nitroglycerine (Isosorbide)

- Long acting
- Helps patient carry on with ADLs
- Brown bottle: Deactivated by light
- Should be taken if pain lasts more than ten minutes

15

Two characteristics of Topical Nitroglycerine

- Taken off at night so body doesn't acclimate
- Keep out of reach of children

16

Mechanism of nitroglycerine (3)

- Nitro dilates vessels (decreased preload)
- Dilates myocardial arteries (increases blood supply to heart.)
- Dilates other arteries (decreases BP and afterload)

17

Other meds (besides nitroglycerine) used for angina: 6

- Beta blockers
- Calcium channel blockers
- Ace inhibitors
- ARBs
- Anticoagulants
- Cholesterol lowering drugs

18

Mechanism of beta blockers

Reduce the myocardial oxygen demand by lowering the heart rate, BP

19

What do beta blockers block?

The SNS. (Negative Inotropic)

20

When should beta blockers NOT be used? (3)

- During acute exacerbation (use only when patient is stabilized)
- If systolic BP is <60

21

Patient teaching for beta blockers (1)

Do not stop suddenly

22

Beta blocker drugs (2)

- Propanalol (Inderal)
- Ateolol (Tenormin)

23

Mechanism of calcium channel blockers (3)

- Slow the SA-AV node conduction
- Slow depolarization and HR
- Decrease BP

24

Three Calcium channel blocker drugs

- Verapamil (Calan)
- Nifedipine (Procardia)
- Dilitazim (Cardizem)

25

ACE Inhibitors mechanism (2)

- Inhibits angiotensin I from becoming angiotensin II
- Decreases afterload by reducing PRESSURE.

26

ACE inhibitors - 3 ADEs

- Little cough
- Hypotension
- Fluid retension (usually on thiazide or loop diuretic also)

27

ACE Inhibitor Drugs (2)

Captopril (Capoten)
Vasotec

28

ARB Mechanism

Block angiotensin II receptors

29

ARB drug (1)

Losartan (Cozaar)

30

Mechanism of anticoagulants

Reduces platelet action

31

Three anticoagulant drugs and one note on each

- Asprin (81 mg or 325 mg)
- Ticlopidine (if ASA not tolerated)
- Heparin (check PTT)

32

For Heparin, you check _____
For Warfarin, you check ______

HEPARIN: PTT
WARFARIN: PT/INR

33

Two cholesterol lowering drugs

- Atorvastatin (Lipitor)
- Lovastatin (Mevacor)

34

What meds wouldl you give for MI

1) Asprin - antiplatelet
2) Nitro - pain relief
3) Morphine - pain relief
4) Antiarrhythmics
5) Thrombolytics

35

Benefits of Morpine for an MI or PE patient

- Relieves pain
- Decreases anxiety
- slight vasodilatation effect (decrease preload)

36

IV push of morphine dose

2-4 mg q 5-15 minutes

37

Door to needle time for thrombolytics (MI)

30 minutes. After that, risks begin to outweigh benefits.

38

Contraindicatiosn of thrombolytics (3)

- Major trauma / surgery within past six weeks
- Active bleeding
- Pregnancy or one month post partum

39

What drugs are given post PTCA? (3)

- Nitroglycerine
- Anticoagulatns (Heparin, Aggrastat)

40

_____ is given during CABG surgery, _____ reverses this.

Heparin
Protamine

41

Meds administered for pulmonary edema (4)

1) Positive inotropics
2) Morphine
3) Diuretics
4) Other meds, depending on condition

42

Three positive inotropics

1) Digoxin
2) Dopamine / Dobutamine
3) Primacor, Inocor

43

Which of morphine's adverse drug effects should you be especially careful of when using it for pulmonary edema?

May slow respiratory rate

44

Drug categories used for CHF (5)
+ 3 others

- ACE inhibitors
- ARBs
- Diuretics
- Beta blockers
- Digitalis

Also:
- Positive Inotropics
- Antihypertensive
- Antianginal

45

When would you give a CHF patient ACE inhibitors?

With mild sxs of failure

46

ACE inhibitor indications (2)

MI
CHF

47

ACE inhibitor administration (2)

- Can be given IV at a hospital or PO at home

48

If a patient is on an ACE inhibitor, you may also expect to see them on a _________ because of the _______.

Diuretic (loop or thiazide
Fluid retension

49

What CHF patients get ARBs?

Patients who can't tolerate ACE inhibitors -- very similar results as ACE but without the captopril cough

50

What CHF patients get beta blockers?

STABILIZED patients

51

Why do you need to be careful with beta blockers in CHF patients?

They are negative inotropics. We don't want to decrease the pumping ability during an acute exacerbation

52

Why DO we give beta blockers to cHF patients

Blocks CNS; prevents cyclical compensatory mechanisms.

53

Symptoms of dig toxicity

- Vision problems
- Halos
- Arrhythmias

54

ADE of dig

Bradycardia

55

Why do we give digitalis to CHF patients

Doesn't lower mortality rates, but does reduce symptoms and allow for ADLs

56

Indication for milrinone (primacor)

Positive inotropi, given IV over several hours at a clinic 2 days per week for CHF patients.

57

Benefits of milrinone (primacor) (2)

- Improves quality of life
- Decreases readmission rates

58

What meds would you administer to a patient at risk for DVTs / PE? (4)

PROPHYLACTIC

- Asprin
- Plavix
- Heparin
- Lovanox

59

Three drugs used to treat PE

- Anticoagulant (Heparin)
- Thrombolitic

60

Medications indicated for CHF (5)

- Epinephrine
- Atropine
- Lidocaine
- Amidorone
- Dopamine

61

What drugs would you initially put a HTN patient on? (2)

- Diuretics
- Beta blockers

62

What drugs would you add LATER after a HTN patient has already been on meds

- ACE inhibitors
- ARBs
- Calcium channel blockers

63

What are the medications of choice in hypertensive crisis?

- Sodium nitropursside
- Nitroglycerine