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Pharmacology > Lipid Meds, Antianginals, Anticoagulents > Flashcards

Lipid Meds, Antianginals, Anticoagulents Flashcards

(76 cards)

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1
Q

What organ produces lipoproteins?

A

The liver

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2
Q

How do LDL go through circulation (molecule type)?

A

Triglycerides, cholesterol, lipids

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3
Q

What is LDL used for?

A

Used as energy or stored for future energy use

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4
Q

How do HDL travel through circulation? (Molecule type)

A

enter circulation as loosely packed lipids

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5
Q

What is HDL used for?

A

Used for energy

Pick up fat/cholesterol remenants from LDL breakdown

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6
Q

What things may cause hyperlipidemia?

A

Excessive intake of fats

Genetics: altered fat metabolism (causes high fat content in blood)

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7
Q

What do lipid lowering agents do? (Action)

A

Lower serum levels of cholesterol and lipids

Prevent CAD

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8
Q

What are some modifiable risk factors of CAD

A 
Gout
Smoking 
Sedentary lifestyle 
High stress 
HTN
Obesity 
Diabetes 
Untreated bacterial infections
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9
Q

What are non-modifiable risk factors for CAD

A

Genetics
Age
Gender

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10
Q

How do HMG-CoA inhibitors work (action)?

A

Enzyme HMG-CoA is involved in synthesis of cholesterol. Drug blocks enzyme action = decreased cholesterol, LDL, triglycerides and increased HDL levels

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11
Q

What are indications of HMG-CoA inhibitors?

A

Hyperlipidemia

Prevent CAD

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12
Q

Nursing considerations for HMG-CoA inhibitors

A

Do not give to: liver disease, pregnant/breastfeeding, under 10 y.o.
CAUTION with geriatrics

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13
Q

What are some adverse effects of HMG-CoA inhibitors

A

Flatulence, abdominal pain/cramps, N/V, constipation
Blurred vision, insomnia, fatigue
Liver failure, rhabdomyolysis (muscle break down releases molecule damaging to kidneys)
Yellowed skin/eyes

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14
Q

Patient teaching for HMG-CoA inhibitors

A

No grapefruit!!!

Report muscle weakness or tenderness

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15
Q

Nursing assessments for HMG-CoA inhibitors

A

Liver disease or alcoholic liver disease
Pregnancy/lactation
BS, neuro status, VS, elimination patterns, labs (liver enzymes)

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16
Q

What is action of cholesterol absorption inhibitors?

A

Inhibit absorption of cholesterol in small intestine

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17
Q

What are indications for cholesterol absorption inhibitors?

A

Lower serum cholesterol

Familial hypercholesterolemia

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18
Q

What are contraindications for cholesterol absorption inhibitors

A

Pregnancy or lactation if combined with statins

Allergy

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19
Q

What patients do we need to take precautions with for cholesterol absorption inhibitors

A

Elderly and liver disease

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20
Q

Adverse effects of cholesterol absorption inhibitors

A

Abdominal pain, diarrhea
Dizzy, fatigue, upper respiratory infection,
Muscle aches, back pain, yellowing skin/eyes

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21
Q

Nursing considerations for cholesterol absorption inhibitors

A

Assess for pregnancy

/lactation, allergies, liver function, blood sugar, elimination patterns, lab values (liver enzymes) RR

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22
Q

Action of nitroglycerin

A

Acts on smooth muscle to relax capillaries, veins, arteries = lowered systemic BP

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23
Q

Indications of nitroglycerin

A

Chest pain

HTN

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24
Q

Where are nitrates excreted and metabolized

A

Metabolism liver and excretion kidneys

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25
Contraindications of nitroglycerin
anemia, head trauma, cerebral hemorrhage, | Pregnancy/lactation
26
Who are we cautious with for nitroglycerin
Hepatic/renal disease | Hypotension, hypovolemia
27
Adverse effects of nitroglycerin
Headache, GI upset Hypotension, tachycardia, syncope, angina
28
What are some drug/food interactions with nitroglycerin
Ergot derivatives Heparin Sildenafil (and other “fils”)
29
Nursing considerations for nitroglycerin
``` CV and respiratory assessment VS and ECG Monitor during therapy: Hepatic and renal function CBC Electrolytes Assess for chest pain ```
30
How to take SL nitroglycerin and what to do if chest pain is not relieved
Tablet under tongue (every 5 min) 3 tabs total until chest pain relief Call 911 if chest pain not relieved
31
Inpatient consideration for nitroglycerin SL route
Patent IV available
32
Onset of IV nitroglycerin
Rapid onset
33
Duration of nitroglycerin patch
Longer duration than SL tabs
34
Teach patients to do what when taking nitroglycerin
Sit on the floor
35
Stable angina
when you get angina symptoms during moderate physical activity or when pushing yourself physically Go away with rest or meds Can become unstable
36
Unstable angina
you get angina symptoms while doing very little or resting | More dangerous form of angina
37
Which is more dangerous: stable angina or u stable angina?
Unstable angina
38
How does nitroglycerin relieve angina
Improves blood flow to heart by dilation coronary arteries = heart does not have to work as hard
39
What drug class is sildenafil
Erectile agents
40
What is the trade name of sildenafil
Viagra
41
Indications of sildenafil
Pulmonary HTN | ED
42
Nursing considerations for sildenafil
Renal and hepatic patients need dose adjusted | CAUTION with geris
43
Patient education for sildenafil
Do not take with nitrates within 24 hours after taking Seek medical attention with chest pain Report priapism Report dizzy or poor hearing
44
Adverse effects of sildenafil
Hypotension, headache, hearing loss | Priapism > 4 hours (medical attention!!!)
45
Action of anticoagulants
Prevent clot formation by blocking specific clot factors
46
Antiplatelet action
Prevent platelets from clumping and prevent clot formation
47
Heparin routes
SQ and IV
48
What lab is used to titrate heparin doses
ApTT
49
Heparin indications
DVT, stroke, PE, MI, maintain IV patency (smaller dose)
50
Nursing considerations for heparin
Bleeding risk!! Especially over 60 | Contraindicated in HIT
51
Adverse effects of heparin
Bleeding | HIT or HITT
52
Patient teaching for heparin
Teach SXS bleeding and report Let dental and medical staff know on heparin Avoid NSAIDS
53
What is the anecdote for heparin
Protamine sulfate
54
What drug class is enoxaparin (lovenox)
Low molecular weight heparin (LMWH)
55
Indications for enoxaparin
DVT, PE, MI
56
Where to inject enoxaparin and what route
SQ route in abdomen
57
What patients should we be precautious with for heparin
Elderly (increased bleeding risk) | Renal impairment patients
58
Adverse effects of enoxaparin
Spinal hematomas with spinal puncture or nueraxial anesthesia Bleeding HIT or HITT
59
Patient teaching for enoxaparin
Teach SXS bleeding and report Notify dentist or medical staff if taking Avoid NSAIDS
60
What drug class is warfarin
Oral anticoagulant
61
Indications of warfarin
prophylaxis or treat DVT/PE, thromboembolic events with Afib, Mi, stroke
62
Nursing considerations for warfarin
Not for pregnancy Vitamin K is anecdote Monitor PT/INR Many drug interactions
63
What patients cannot have warfarin
History of hemorrhages CNS/eye surgery Large open wound surgery
64
Warfarin adverse effects
Acute kidney injury | Bleeding risk with liver disease
65
Warfarin patient education
``` No grapefruit, alcohol, cranberry INR labs Avoid high impact activities Notify HCP of falls Carry identification that on warfarin Teach SXS bleeding and report ```
66
INR therapeutic range
2.0-3.0
67
Normal range of PT and therapeutic range
10-13 secs (therapeutic is 1.5-2x more or 15-26 secs)
68
What should patients avoid in their diet when taking warfarin
Vitamin K (leafy greens)
69
What is the anecdote for warfarin
VitaminK (phytonadione)
70
What are some examples of anti platelets
``` Acetysalicic acid (aspirin) Clopidogrel (placix) ```
71
How do anti-platelets work
Inhibit platelet aggregation
72
Indications of antiplatelets
Peripheral arterial disease | Decrease stroke risk and MI
73
Nursing considerations for aspirin
Hold med before surgeries Taking plavix and ASA together increases bleeding risk Not for 12 and under
74
Adverse effects of aspirin
Bleeding Tinnitus Bruising
75
Patient education for aspirin
Teach and report SxS bleeding Report tinnitus Avoid alcohol and NSAIDS
76
How long do anti platelets last
7-10 days

Pharmacology (1 decks)

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