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Flashcards in Heart Deck (18):
1

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

2

Isosorbide (isordil)

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

3

Digoxin

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.

4

Antidysrhythmics

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.

5

Verapamil

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

6

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.

7

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.

8

Angina

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.

9

Fibrinolytics

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

10

Follow up therapy for MI

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

11

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

12

HF

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

13

ACEI

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

14

ARBS

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

15

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.

16

Diuretics for...

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

17

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.

18

Procainamide

Antiarrhythmic. Observe for hypotension