HTN, CHF, Other Cardio

Question 1

ACE inhibitors are the DOC for what 2 diseases?

Answer 1

CHF and Diabetes

Question 2

What is the normal digoxin range?

Answer 2

0.5-2.0

Question 3

What is normal INR range?

What is normal for pt’s w/mechanical heart valve?

Answer 3

2. 0-3.0

2. 5-3.5

Question 4

___ is known as the “silent killer” and is usually asymptomatic in pt’s.

Answer 4

HTN

Question 5

True or False: High diastolic b/p is no longer considered to be more dangerous than high systolic b/p.

Answer 5

True

Question 6

Target organs for ___ is the heart, brain, kidneys, peripheral vascular.

Answer 6

HTN

Question 7

Best tx for HTN alone:

Answer 7

thiazie diuretics (HCTZ)

Question 8

Best tx for HTN w/diabetes:

Answer 8

ACE inhibitor (captopril) or ARB

Question 9

Best tx for A-fib:

Answer 9

anticoagulant (warfarin/coumadin) - start on 5mg

Question 10

Best tx for CHF: (1st and 2nd line therapy)

Answer 10

thiazide diuretic (HCTZ) - 1st, ACE inhibitors - 2nd

Question 11

Best tx for HTN in african-americans:

Answer 11

calcium-channel blockers

Question 12

Best tx for fluid overload/edema:

Answer 12

loop diuretic (furosemide/lasix)

Question 13

Antihypertensive categories include:

Answer 13

adrenergics (beta-blockers), angiotensin convering enzyme (ACE inhibitors), angiotensin II receptor blockers (ARB’s), calcium channel blockers, diuretics, vasodilators

Question 14

Adrenergic, aka ___-___ and have suffix of ___. Examples include:

Answer 14

beta-blockers, alol,

propranolol (inderal), atenolol (tenormin), nebivolol (bystolic)

Question 15

True or False: Adrenergics include, cardioselective and nonselective (beta 1 and beta 2 receptors)

Answer 15

True

Question 16

Centrally acting alpha 2 receptor agonists include:___. Use when others have failed d/t adverse effects. They can also be used for tx of dysmenorrhea and glaucoma.

Answer 16

clonidine (catapres), methyldopa (aldomet)

Question 17

Peripheral alpha 1 blockers have the suffix of ___ and include: ___. ___ is used to relieve symptoms of BPH.

Answer 17

zosin, doxazosin (cardura), terazosin (hytrin), tamsulozin (flomax)

Question 18

Dual action alpha 1 and beta receptor blockers are useful in ___ and include:

Answer 18

carvedilol (coreg) and labetalol

Question 19

Clonidine is useful in the management of ___ withdrawal.

Answer 19

opioid

Question 20

Adrenergic drugs have a high incidence of ___ ___.

Answer 20

orthostatic hypotension

Question 21

ACE inhibitors have suffix of ___. They prevent the formation of ___ and inhibit ___.

Answer 21

pril, angiotensin II, aldosterone

Question 22

ACE inhibitors have renal protective properties and are effective in ___ pts. ___ is often used.

Answer 22

diabetic, captopril

Question 23

ACE inhibitors include:

Answer 23

captopril (capoten), enalapril (vasotec), lisinopril (zestril), quinapril (accupril)

Question 24

Hyperkalemia and dry nonproductive cough are adverse effects with ___.

Answer 24

ACE inhibitors

Question 25

Angiotensin II receptor blockers (ARB's) are a ___ class and has suffix of ___. They include:

Answer 25

newer, sartan, losartan (cozaar), valsartan (diovan), irbesartan (avapro)

Question 26

ARB's do not produce the ___ ___ like ACE's do, and are much less likely to cause ___ like the ACE's do.

Answer 26

dry cough, hyperkalemia

Question 27

ARB's can cause ___ hypotension bc they are potent even at ___ doses.

Answer 27

orthostatic, low

Question 28

Calcium channel blockers have suffix of ___, ___, ___ and include:

Answer 28

zem, mil, dipine, diltiazem (cardizem), verapamil, amlodipine (norvasc), nifedipine (procardia)

Question 29

CCB's can cause worsening of ___, so be cautious w/those pts.

Answer 29

CHF

Question 30

Interactions w/ ___ ___ and CCB's can occur, so instruct pt to take either ___ hrs before or ___ hrs after consuming.

Answer 30

grapefruit, 2, 2

Question 31

What drug class is the 1st line agent for tx of HTN? How do they work?

Answer 31

diuretics, decreases workload of heart and decreases b/p

Question 32

___ are used in poorly controlled HTN pts and angina and include:

Answer 32

Vasodilators, diazoxide, hydralazine, sodium nitroprusside (nitropress)

Question 33

Goal for b/p in in pts > 60yrs = ___. | Goal for b/p in pts < 60 yrs = ___.

Answer 33

150/90 | 140/90

Question 34

Instruct pt's to never do what if they miss a dose? Pt's should never abruptly ___ bc this may lead to rebound hypertensive crisis.

Answer 34

double up, stop

Question 35

Other factors important in lowering b/p:

Answer 35

diet, exercise, stress management, avoid smoking and foods high in sodium

Question 36

Teach pt's to change ___ slowly to avoid a ___ episode.

Answer 36

positions, syncopal

Question 37

Report any significant wt gain of ___ lbs in a day or ___ lbs in a wk. This can indicate an exacerbation of ___.

Answer 37

2, 5, CHF

Question 38

For males, ___ is a s/e of many b/p meds.

Answer 38

impotence

Question 39

___ accelerate the rate of urine formation. Results in the removal of excessive ___ and ___. Useful in management of ___ and ___.

Answer 39

Diuretics, sodium, water, CHF, HTN

Question 40

Where sodium goes, ___ follows.

Answer 40

water

Question 41

Types of diuretics include:

Answer 41

thiazide and thiazide-like, loop, K-sparing

Question 42

Thiazide diuretics have suffix of ___ and include:

Answer 42

zide, HCTZ, chlorothiazide (diurel), metolazone (zaroxolyn)

Question 43

___ ___ should not be used if creatinine clearance is less than 30-50.

Answer 43

Thiazide diuretics

Question 44

___ ___ are used for: HTN, edematous states, hypercalciuria, diab insipidus, HF

Answer 44

Thiazide diuretics

Question 45

Thiazide duiretics can cause ___, but not as bad as ___ diuretics.

Answer 45

hypokalemia, loop

Question 46

Loop diuretics include: ___. Have the biggest potential for depletion of ___ and ___.

Answer 46

bumetanide (bumex), furosemide (lasix), torsemide (demedex), potassium, sodium

Question 47

___ ___ have the adverse effects of hypokalemia, hyperglycemia, hyperuricemia.

Answer 47

Loop diuretics

Question 48

K-sparing diuretics include: ___. Work to inhibit aldosterone. Concerned w/___ bc it spares it.

Answer 48

amiloride, spironolactone (aldactone), triamterene, hyperkalemia

Question 49

Before initiating ___ therapy, get baseline fluid volume status, intake, and output, serum electrolytes, ht/wt.

Answer 49

diuretic

Question 50

The medication ___ can cause gynecomastia, amenorrhea, irregular menses, and postmenopausal bleeding.

Answer 50

spironolactone

Question 51

Instruct pt to take diuretics ___ in day to avoid interrupting ___ patterns. Eat more ___ foods except when on K-sparing diuretic. K-rich foods include:

Answer 51

early, sleep, K-rich, bananas, legumes, oranges, broccoli, green beans, potatoes, fish, raisins

Question 52

Pt's taking diuretics along w/digitalis should be taught to monitor for ___ ___. Signs are ___ in vision, ___ vision, and ___.

Answer 52

dig toxicity, change, halo, anorexia

Question 53

Diabetic pts who are taking ___ and/or ___ diuretics should be told to monitor blood glucose d/t ___.

Answer 53

thiazide, loop, hyperglycemia

Question 54

Pt's who have been ill w/n/v/d should notify provider d/t risk of ___ if continue taking diuretics.

Answer 54

hypovolemia

Question 55

Signs of ___ include: muscle weakness, irregular pulse rate, and lethargy

Answer 55

hypokalemia

Question 56

Excessive consumption of ___ can l/t hypokalemia in pt's taking thiazides.

Answer 56

licorice

Question 57

The heart is unable to pump blood in sufficient amounts from the ventricles to meet the body's metabolic needs is known as:

Answer 57

Chronic Heart Failure (CHF)

Question 58

Drug therapy for CHF include:

Answer 58

ACE inhibitors, ARB's, BB, aldosterone blocking agents, cardiac glycosides

Question 59

___ is the most commonly BB drug used, allowing for more ___ filling.

Answer 59

metoprolol, ventricular

Question 60

Cardiac glycosides, like ___ is no longer used as __-line treatment. They ___ myocardial contractility and ___ rate of electrical conduction and ___ refractory period.

Answer 60

digoxin, first, increase, decreased, prolong

Question 61

___ ___ are used for paroxysmal nocturnal dyspnea, cough, and cyanosis, HF, A-fib or flutter.

Answer 61

cardiac glycosides

Question 62

Digoxin (lanoxin) is highly ___ bound and has a ___ therapeutic window, which is ___-___. Can cause ___.

Answer 62

protein, narrow, 0.5-2.0, dysrhythmias

Question 63

Electrolyte levels must be monitored while on ___. Hypokalemia, hypomagnesemia, and hypercalcemia may l/d ___.

Answer 63

digoxin, toxicity

Question 64

Antidote for dig toxicity is ___. Given if level is > ___.

Answer 64

digibind, 2

Question 65

While taking digoxin, assess apical pulse for ___ minute. For pulse outside of 60-100 parameters, ___ dose. Also check for drug to drug interactions such as ___ diuretics (bc they excrete K).

Answer 65

1, hold, loop

Question 66

Avoid giving digoxin w/high-___ foods bc it binds w/the medication. Take at ___ time every day.

Answer 66

fiber, same

Question 67

Refrain from ETOH, smoking, high-sodium foods while on any ___ meds.

Answer 67

HF