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Flashcards in Heart Deck (18):

Cardiac catheterization

Radiopaque catheter inserted through peripheral blood vessel into chamber of heart, usually used w/ angiography, purpose is diagnostic or intervention in congenital heart defects. Post-procedure: assess pulses, temp, bleeding, pain/hematoma, paresthesia, paralysis, and color of extremity, HR q15 for a min. Hydration. Hold Metformin for 48 hrs post procedure, worried about kidneys


Isosorbide (isordil)

Sublingual. Antianginal. Nitrate vasodilator. SE- HA, dizziness, weak, postural HTN, syncope, flushing, n/v. Overdose can be fatal. Don't drink alcohol



Cardiac glycosides. Inc the force of myocardial contraction. Slows the HR. CO inc. SE- bradycardia, asystole. Toxicity- anorexia, n/v, arrhythmias and vision changes. Maintenance dose- 0.125 to 0.5mg. Check pulse before. Hypokalemia + dig= toxicity.



A- interfere w/ electrical excitability of heart. Use- A-fib and flutter, tachycardia, PVCs. Ex- atropine sulfate, lidocaine, pronestyl (procainamide), quinidine, isuprel (isoproterenol). SE- lightheadedness, hypotension, urinary retention. Nx- v/s, rhythm.



CCB. Prevention of angina. Dec BP by causing vasodilation of coronary arteries. Dec after load and inc oxygen to heart. Tx of supraventricular tachycardias. Check HR prior to admin


Furosemide (lasix)

Prevents systemic overload. Causes diuresis and vasodilation which traps more blood out in the arms and legs and reduces preload and afterload. Slow IV push 1-2 min to prevent hypotension and ototoxicity.


Amiodarone (cordarone)

Tx of PVCs, v-tach w/ a pulse, (pulseless vtach, v-fib: resistant to tx), a-fib and atrial flutter. Prevent second episode of vfib. Antiarrhythmic, contains high levels of iodine and may affect thyroid function. SE- hypotension that can lead to further arrhythmias.



Nitroglycerin (dec pre/after load; peripheral artery dilation). BB(prevention): propranolol, metoprolol, atenolol, carvedilol (Block beta cells which are receptor sites for catecholamines (epi/norepi)). CCB(prevention): nifedipine, verapamil, amlodipine, diltiazem (dec BP, vasodilator, dec afterload). Acetylsalicylic acid- keep blood flowing, doesn't dec pain.



Given to dissolve the clot blocking blood flow to the heart. Streptokinase, alteplase, tenecteplase (one time push), reteplase. Should be administered within 6-8 hrs of onset of MI pain. Complication- bleeding


Follow up therapy for MI

Antiplatelets (inhibit platelet aggregation)- acetylsalicylic acid, clopidogrel (plavix), abciximab (reopro), eptifibatide (integrilin)


Nesiritide (natrecor)

hBNP- allows blood vessels to relax for better blood flow to heart. Hold 2 hrs prior to drawing a BNP- false high. BNP can be positive for HF when CXR does not indicate a problem



ACEI (drug of choice) and ARBS. Both block aldosterone. Result is loss of Na and water, retain K+. Watch for hyperkalemia. Pt will be sent home with ACEI and/or BB. This dec afterload and inc CO



Drug of choice for HF. Suppress the renin angiotensin system (RAS). Prevent conversion of angiotensin I to II. Results in arterial dilation and inc stroke volume



Block angiotensin II receptors and cause a dec in arterial resistance and dec BP


Digitalis (lanoxin), digoxin

Used with sinus rhythm or a-fib and accompanying chronic HF. Given w/ ACEI, ARB, BB or diuretics. Makes contractions stronger, HR slows down, CO inc, kidney perfusion inc. First dose is higher. Normal 0.5-2 ng/ml. SnS- early: anorexia, n/v. Late: arrhythmias and vision changes (halos, yellow). Before admin check apical pulse (5th IC space left MC line). Watch for hypokalemia + dig= toxicity.


Diuretics for...

HF. Dec preload. Furosemide (lasix), hydrochlorothiazide (hctz), bumetanide (bumex), hydrochlorothiazide/triamterene (dyazide), spironolactone (aldactone). Give in morning


Pulmonary edema

furosemide (40mg push over 1-2 min), bumetanide (1-2mg push over 1-2 min). Nitroglycerin. Morphine (vasodilation, dec agitation). Nesiritide- IV infusion short term therapy less than 48 hrs. Vasodilator and has diuretic effect.



Antiarrhythmic. Observe for hypotension