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Nur 611 > Mod 2- Cardiovascular > Flashcards

Mod 2- Cardiovascular Flashcards

(46 cards)

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1
Q

Nitrates

A

Nitroglycerin
MOA: directly dilates veins
Indication: acute angina and HF
SE/AE: h/a,orthostatic hypotension
Dosing: 0.4mg q5min for 3 doses
Contraindicated if of sildenafil, vardenafil or tadlafil; or if suspected right ventricular myocardial infarction
Treat hypotension with fluids

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2
Q

Beta Blockers

A

Propan-
Metopr-
Labeta- olol
MOA: block beta receptors- decreases heart workload
Indication: angina; HTN, HF, AMI, dysrhythmias, migraines, anxiety
SE/AE: fatigue, bradycardia, hypoglycemia
BB: abrupt discontinuation can cause cardiac events
Propanolol- highest risk for bronchoconstriction
First line for angina prevention
Carvedilol is primarily used for HF
Safest BP med during pregnancy

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3
Q

Ranolazine

A

MOA: unknown- decreases O2 demand
Indication: angina prevention
SE/AE: QT prolongation

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4
Q

Sodium Channel Blockers (class 1a)

A

Procainamide
Slows cardiac conduction
Indication: arrhythmia
BB: lupus like syndrome, blood dyscrasias, proarrythmic effects

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5
Q

Sodium Channel Blockers (class 1b)

A

Lidocaine
MOA: slows cardiac conduction
Indications: arrythmias
SE/AE: CNS effects
Contraindicated for WPW and certain heart blocks

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6
Q

Sodium Channel Blockers (class 1C)

A

Flecainide; Propafenone
MOA: slows cardiac conduction
Indications: arrhythmia
BB: Proarhythmic effects- possible increased mortality

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7
Q

Class 2 antiarrythmics

A

Beta blockers

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8
Q

Potassium blockers- Class 3 antiarrythmics

A

Amiodarone
MOA: prolongs repolarization
Indications: Arrhythmias
SE/AE: bradycardia, hypotension, hepatotoxicity; pulmonary toxicity; skin sensitive to light
BB: pulm toxicity; hepatotoxicity; proarrythmic effects
Not safe for pregnancy
Avoid grapefruit juice
Lasts in body for several months

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9
Q

Calcium channel Blockers: class 4 antiarrythmics

A

Cardizem

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10
Q

Adenosine

A

MOA: decreases automaticity and slows conduction
Indications: tachydysrhythmia treatment and diagnostics
Patients must be on cardiac monitor
Onset in a few seconds
Chemical conversion

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11
Q

Cardiac Glycosides- Digoxin

A

MOA: increased effects of calcium resulting in increased contractility
Indication: dysrhythmias and HF with reduced EF
SE/AE:: n/v; visual disturbances; bradycardia
Antidote for toxicity is digoxin-immune fab

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12
Q

Heparin

A

MOA: indirectly inhibits thrombin
Indication: treatment and prevention of thromboembolic events
SE/AE: hemorrhage; HIT
Reversed with protamine sulfate
Considered safe during pregnancy
Enoxaparin is another drug in this class
Monitor aPTT

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13
Q

Warfarin

A

Vitamin K antagonist
MOA: decreases production of vitamin K clotting factors
Onset is 12-72 hours
Monitor PT and INR- INR should be 2-3 on warfarin
Reversed with vitamin k
Interacts with many meds
Patients cannot increase their vitamin k intake

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14
Q

Dabigatran (praxada)

A

Direct thrombin inhibitors
MOA: directly inhibits thrombin
Indication: DVT PE and prevention of clots with afib
SE/AE: GI upset
BB: abrupt discontinuation increases risk of thromboembolic events
Argatroban- for HIT; is also in this class

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15
Q

Factor Xa inhibitors: Rivaroxaban Apixaban

A

MOA: inhibits factor Xa
Indications: treats DVT, PE and prevention of Afib clots
BB: abrupt discontinuation can lead to thromboembolic events
Reversed with factor Xa

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16
Q

Aspirin

A

MOA: COX inhibition causes suppression of platelet aggregation- irreversible for the life of the platelet (7-10 days)
Indications: prevention of thombotic events, stokes, MI, ACS and more
SE/AE: GI bleeding

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17
Q

Tirofiban (aggrastat)

A

Glycoprotein IIb/IIa inhibitors
MOA: inhibits these glycoproteins resulting in inhibition of platelet aggregation
Indication: prevention of patients having an MI
IV only- considered an antiplatelet

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18
Q

Clopidogrel; Ticagrelor

A

ADP receptor antagonists
MOA: blocking ADP receptors resulting in decreased platelet aggregation
Indications: prevention of thrombotic events in patients having an AMI and reduce risk for hx of MI, stroke, atherosclerosis
Often given with aspirin
Considered an antiplatelet

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19
Q

Thrombolytics

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A

Alteplase; reteplase; tenecteplase
MOA: initiates fibrinolysis
Indications: AMI, CVA, PE
IV only
SE/AE: intracranial hemorrhage
High risk

20
Q

Tranexamic Acid

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A

MOA: inhibits fibrinolysis, inhibits plasmin
Indications: bleeding with associated menstruation, trauma and more

21
Q

Antihypertensives: 1st Line

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A

ACEI/ARB; Thiaszide Diuretics; Calcium Channel Blockers

22
Q

ACE-Inhibitors

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A

Lisinopril, captopril
MOA: inhibit angiotensin 1 to angiotensin 2
Indications: HTN, ACS, CKD, stroke prevention, HF
SE/AE: kidney injury, angioedema, cough, hyperKalemia
Captopril can cause neutropenia
Teratogenic

23
Q

ARB

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A

Losartan, Valsartan
MOA: inhibits angiotensin two receptors
Indications: kidney disease
SE/AE: kidney injury and hyperkalemia
Less likely to have cough and angioedema vs ACEI
Teratogenic

24
Q

Thiazide Diuretic

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A

Hydrosholorthiazide; chlorthalidone
MOA: blocks reabsorption of sodium and chloride
Indications: HTN and edema
Most prescribed class of diuretics

25
Calcium channel blockers- dihydropyridines
Amlodipine; Nicardipine- dihydropyridines- do not affect HR MOA: inhibits calcium resulting in relaxation of vascular smooth muscle and vasodilation Indications: angina and HTN Used a first line for african american
26
Calcium channel blockers- non-dihyropyridines
Verapamil; diltiazem MOA: relaxation of vascular smooth muscle and vasodilation and also decrease cardiac cellular excitability and contractility Indications: angina, afib, HTN, SVT SE/AE/ dysrhythmias Contraindications: 2nd and 3rd degree AV blocks, SSS, hypotension Not first line for HTN
27
Hydralazine
Direct vasodilators MOA: directly dilates arteries Indications: HF, hypertensive urgency, HTN SE/AE: lupus like syndrome, refles tachy and hypotension Very common to get headache Isosorbide dinitrate is another vasodilator that is often given together along with bidil as well
28
Sodium Nitroprusside
MOA: directly dilate arteries and veins Indications: acute HF and acute HTN SE/AE: cyanide toxicity and hypotension IV only
29
Clonidine Methyldopa: alpha two agonist
MOA: stimulates alpha two adrenergic receptor reducing sympthetic stimulation Indications: hypertension SE/AE: drowsiness Clonidine often used PRN Methyldopa is considered safe during pregnancy
30
Aliskiren
Renin blocker MOA: inhibits renin indications: HTN Alternative agent; never first line Teratogenic
31
Doxazosin prazosin
Alpha one adrenergic antatgonists MOA: inhibits alpha one receptors indications: BPH and HTN SE/AE: orthostatic hypotension and reflex tachy Tamsulosin is alpha 1 agonist used only for BPH
32
HF dose of carvedilol
Much lower than hypertensive dose
33
Phosphodiesterase Inhibitor
Amrinone; milrinone MOA: inhibiting phosphodiesterase resulting in increased contractility and vasodilation Indications: HF with reduced EF SE/AE: dysrhythmias and hypotension Parenterally only
34
Sacubitril-valsartan (entresto)
MOA: inhibits neprilysin which increases vasodilation plus blocks the RAAS Indication: heart failure Also referred to as an ARNI Not safe during pregnancy
35
Bidil
Isosorbide dinitrate- hydralazine MOA: dilates veins and arteries Indications: HF with reduced EF SE/AE: hypotension and headache
36
Dobutamine
MOA: beta one agonist Indications: acute decompensated HF IV only Considered vasopressor but not vasoconstrictor
37
Epinephrine/norepinephrine - vasopressor
Vasopressors; alpha and beta-adrenergic activation
38
Phenylephrine- vasopressor
Alpha adrenergic activation
39
Dopamine- vasopressor
Low dose: dopaminergic activation- increased flow to kidneys Medium Dose:; dopaminergic and beta-adrenergic activation High Dose: alpha adrenergic activation
40
Isoproterenol/dobutamine- Vasopressor
Beta adrenergic activation (does not cause vasoconstriction)
41
Vasopressors
MOA: activate according receptors Indication: shock SE/AE: tachycardia palpitations BB: IV extravasation- give phentolamine to treat/ give through central line
42
Loop Diuretics
Bumetanide; furosemide MOA: blocks reabsorption of sodium and chloride in loop of henle Indications: edema r/t HF, liver failure, kidney failure, alternative for hypertension SE/AE: ototoxicity BB: fluid and electrolyte imbalances Most potent diuretics
43
Potassium Sparing Diuretics (aldosterone antagonist): Examples; MOA; indications; SE/AE
Spironolactone MOA: blocks aldosterone Indications: HTN, edema, HF Caution with drugs that increase potassium
44
Osmotic Diuretic: examples, MOA, indications
Mannitol Interferes with water reabsorption in the kidneys, acts as hypertonic solution Indications: reduction of ICP and IOP, increase diuresis related to renal failure
45
Antidiuretic Hormone: MOA, indications; off-label use
Decreases urine output and vasoconstriction Indication: shock and cardiac arrest Off label: Diabetes Insipidous
46
Carbonic Anhydrase Inhibitor: Examples, MOA, Indications
Drug: Acetazolamide MOA: increased renal excretion of sodium, potassium, bicarbonate and water Indications: Glaucoma, acute mountain sickness

Nur 611 (3 decks)

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