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Pharm Final > Heart > Flashcards

Heart Flashcards

(39 cards)

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1
Q

How do antiplatelet agents work?

A

-Reduce platelet aggregation
-prevent new thrombus or their growth

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2
Q

How does aspirin work?

A

Prevents the formation of thromboxane A2 which causes platelets to clump together

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3
Q

Antiplatelet agents, name em

A

Aspirin
Clopidogrel(Plavix)
Ticagrelor(Brilinta

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4
Q

Clopidogrel

A

Plavix
300mg loading then 75mg/day for STEMI

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5
Q

Ticagrelor

A

Brilinta

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6
Q

Nitroglycerin Contraindications

A

SBP<90
Right ventricular infarct
Phosphodiesterase Inhibitors within 24 hr for sildenafil; 48 hr for vardenafil/tadalafil

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7
Q

What does morphine do?

A

Opioid pain control and reduces cardiac oxygen demand

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8
Q

How is fentanyl an alternative to morphine?

A

Rapid onset, short duration, less side effects

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9
Q

How do fibrinolytics work?

A

Converts plasminogen to plasmin which degrades fibrin clots(lyses clot)

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10
Q

Alteplase

A

Activase, TPA
Adverse effects are bleeding in the bad places
CINC: there’s a checklist
Also used for PE and ischemic strokes

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11
Q

Class I antidysrhythmic drugs

A

Slow the movement of sodium through channels
Procainamide and lidocaine

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12
Q

Procainamide

A

Suppress spontaneous depolarization, reducing ectopic pacemaker’s automaticity
Indications: can be used in stable monomorphic ventricular tachycardia, reentry SVT, stable wide complex tachycardia
Contraindications: 2nd, 3rd degree heart block
SE: can prolong QRS and QT intervals
Dose: 20-50 mg/min IV infusion up to 17mg/kg
Maint: 1-4mg/min

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13
Q

Lidocaine

A

Indications: stable wide complex tachycardia, alternative to amiodarone in cardiac arrest from VT, VF
Contraindications: 2nd, 3rd degree heart block
SE: hypotension, bradycardia, AV block
Dose: cardiac arrest: 1.5 mg/kg IV; repeat 0.5-0.75 mg/kg IV/IO up to 3mg/kg
Maint: 1-4 mg/min

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14
Q

Class II antidysrhythmic drugs

A

Beta-adrenergic blocking agents (beta blockers)
Metoprolol

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15
Q

Class III antidysrhythmic drugs

A

increase duration of phases 1, 2, 3,
-extends action potential
-prolong absolute refractory period
treats and ventricular tachycardia

Amiodarone

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16
Q

Class IV antidysrhythmic drugs

Study These Flashcards
A

Calcium Channel blockers:
Verapamil
Diltiazem

17
Q

Class V antidysrhythmic drugs

18
Q

Types of beta blockers

Study These Flashcards
A

B1 selective and nonselective

19
Q

Caution with Beta blockers on who?

Study These Flashcards
A

Patients with reactive airway disease/asthma

20
Q

Metoprolol

Study These Flashcards
A

Beta blocker; beta-1 selective; anti-hypertensive; anti-dysrhythmic
MOA: dec HR, dec conduction velocity, dec myocardial contractility, dec CO
Indications: Used to control ventricular response to PSVT, AF, a flutter
Contraindications: heart block; sick sinus syndrome; cardiogenic shock, bradycardia
SE: dizzy, bronchospasm, wheezing, bradycardia, AV blocks, hypotension
Dose: 5 mg IV over 1-2 min; repeat q 5 min up to 3 doses

21
Q

Amiodarone

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A

MOA: blocks sodium, potassium, calcium channels; prolongs action potential and depolarization, decreases AV conduction and SA node function
Indications: can be used to treat
-atrial and ventricular tachycardia
-cardiac arrest from VT, VF
Contraindication: 2nd, 3rd degree heart block; sinus node disease
Dose:
-VF/pulseless VT: initial 300 mg IV push; second dose 150 mg IV push
-Other than VF/pulseless VT: 150 mg IV over 10 minutes then 1 mg/min x 6 hrs, then 0.5 mg/min x 18 hrs

22
Q

How do beta blockers affect the heart?

Study These Flashcards
A

Negative chronotrope, dromotrope, ionotrope

23
Q

Diltiazem

Study These Flashcards
A

MOA: inhibits Ca influx in cardiac and smooth muscles cells
Indications: stable narrow QRS tachycardia; control ventricular rate with AF or atrial flutter
Contraindication: WPW, hypotension, wide complex tachycardia, 2nd / 3rd degree AV block
Dose: 0.25 mg/kg IV over 2 min; maintenance 5-15 mg/hr

24
Q

Verapamil

Study These Flashcards
A

Same as Diltiazem
Dose: 2.5-5 mg IV, 5-10 mg IV q 15-30 min

25
Adenosine
MOA: slows conduction through AV node -produces several second pause in cardiac activity Indications: used for SVT primarily; can also be used for stable VT Contraindications: 2nd, 3rd degree heart block SE: HA, dizzy, chest pain, nausea
26
Alpha Blockers
Block alpha receptors in smooth muscle of blood vessels🡪 causes vasodilation and decrease in systemic vascular resistance 🡪 decrease BP Clonidine: emergency treatment of hypertension Phentolamine: reverse effects of extravasation of vasoconstrictors Labetalol: emergency treatment of hypertension
27
ACE-I
Angiotensin-Converting Enzyme Inhibitors (Lisinopril, Captopril and other ‐prils) Prevent conversion of angiotensin I to angiotension II by blocking angiotensin converting enzyme (ACE) This blocks the Renin-Angiotension-Aldosterone-System (blocks the vasoconstriction of angiotensin II and blocks fluid retention of aldosterone) Adverse effects: cough, angioedema
28
ARBs
Angiotensin Receptor Blockers Losartan(Cozaar) and - tans Blocks action of angiotensin II
29
Anticholinergic Medications
Atropine Blocks action of ACH Prevents parasympathetic medicated bradycardia and conduction delays Main effect for bradycardia is on the SA node 🡪 so usually not very effective in third degree heart block, because the SA node impulse (p wave) is not going to be conducted to the ventricles anyway Dose: 1 mg IV/IO q 3-5 min
30
Calcium Gluconate
MOA: Counteracts the toxicity of hyperkalemia by stabilizing the membranes of cardiac cells, reducing the likelihood of fibrillation Indications: hyperkalemia, BB overdose, CC overdose Contraindications: hypercalcemia Dose: 1 gram slow IV/IO push
31
Magnesium Sulfate
MOA: Magnesium is the drug of choice for suppressing early afterdepolarizations (EADs) and terminating the arrhythmia. Magnesium achieves this by decreasing the influx of calcium, thus lowering the amplitude of EADs Indications: Torsades de pointes Contraindications: heart block Dose: 1-2 g over 5 min
32
Hydralazine
-dilates arterioles -used for hypertensive emergencies to rapidly decrease blood pressure
33
Catecholamines and Sympathomimetics
Epi Norepi Milrinone Phenylephrine Dopamine Dobutamine
34
Epinephrine
-alpha, beta-1, beta-2 stimulation -vasoconstricton, inc HR/contractility, bronchodilation Uses: cardiac arrest, anaphylaxis, profound hypotension, shock, bradycardia Dose: cardiac arrest 1 mg IV/IO q 3-5 min 2-10 mcg/min
35
Norepinephrine
-alpha > beta-1 -vasoconstriction > inc HR/contractility Uses: sepsis, neurogenic shock Dose: 0.1 to 0.5 mcg/kg/min
36
Dopamine
5-10 mcg/kg/min🡪beta-1 (inc HR/contractility) 10-20 mcg/kg/min🡪alpha (vasoconstriction) Uses: cardiogenic, septic shock, hypotension, bradycardia
37
Dobutamine
-primarily beta-1 -not used much pre-hospital -cardiogenic shock
38
Milrinone
-similar to dobutamine -not used much pre-hospital
39
Phenylephrine
-pure alpha agonist (vasoconstriction) -uses: hypotension from loss of vascular tone -push dose: 50-200 mcg q 2-5 min

Pharm Final (7 decks)

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