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Pharmacology > Test 3 - Cardiovascular > Flashcards

Test 3 - Cardiovascular Flashcards

(56 cards)

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1
Q

What is Cholesterol

A

Helps maintain Vitamin D levels and hormones

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2
Q

Gemfibrozil teaching

A

*Class - Fibric Acid Agent
Lowers triglycerides and LDL levels
Combine with Statins for greatest decrease
TEACHING:
—May potentiate warfarin (warfarin prevents blood clots)
—monitor GI effect - TEACH TO TAKE WITH FOOD
—pregnancy B

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3
Q

Non pharmacological cholesterol reduction

A 
Lifestyle changes
monitor blood lipid levels
maintain weight at optimum level
exercise
low fat diet and cholesterol
increase fiber
decrease tobacco use
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4
Q

Statin side effects

A 
*Class - HMG-CoA Reductase Inhibitor
first drug of choice to lower cholesterol
should be taken in the evening
SIDE EFFECTS
muscle or Jt pain

RHABDOMYOLISIS

  • Muscle fiber breakdown
  • rare but serious
  • coca cola urine
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5
Q

Statin side effects

A

*Class - HMG-CoA Reductase Inhibitor
first drug of choice to lower cholesterol
should be taken in the evening
SIDE EFFECTS
headache, fatigue, MUSCLE OR JT PAIN, and heartburn

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6
Q

Types of Lipids

A

LDL - Bad Cholesterol <100 liver—>tissues
HDL - good cholesterol >40 Tissues—>liver
Triglycerides <150 - stored fat energy

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7
Q

Diuretic adverse effects

A

Hypokalemia
Hyponatremia
Ototoxicity
SIDE EFFECTS: Dehydration, thirst, dry mouth, weight loss, headache, hypotension, dizziness, fainting
Teach safety with orthostatic hypotension

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8
Q

Loop Diuretic

A

Most effective
Block reabsorption of Na and Cl in Loop of Henle
Increase UO even when kidney blood flow is diminished
FLUROSEMIDE most frequent
BUMETANIDE 40x more potent, shorter duration

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9
Q

Thiazide Diuretic

A

Most frequently prescribed class
— less effective than loop but less side effects (does not cause ototoxicity)
Treats mild to moderate HTN
Ineffective in severe renal failure
If allergic to sulfa, may be allergic to Thiazide and Loop
May need K+

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10
Q

Drugs that are Nephrotoxic

A 
NSAIDS
ACE inhibitors
Radiographic Dyes
Aminoglycosides (antibiotics)
Amphotericin B (anti fungal)
Cancer Drugs
Immunodepressants
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11
Q

During renal failure

A

Dose reduction
Discontinue Nephrotoxic drugs

OSMOTIC DIURETICS (mannitol) - used in acute renal failure —– Administered through a filtered IV

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12
Q

Hyperkalemia Treatment

A

Hyperkalemia: Kidneys unable to adequately excrete K+
>5 mEq/L
Administer Insulin and Glucose
Ca+ and Sodium Bicarbonate to correct acidosis
Kayexelate po or rectal

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13
Q

Hypokalemia signs and symptoms

A

Dysrthymias, cardiac arrest

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14
Q

Hyponatremia plan of action

A

<135 mEq/L
If from fluid overload —> Loop Diuretics
Oral sodium chloride if mild
Parenteral NS or LR if <130

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15
Q

K+ IV administration

A

NEVER IV PUSH

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16
Q

Solution Tonicity

hypotonic, isotonic, hypertonic

A

Tonicity: Ability of a solution to cause a cell to lose or gain water

Hypotonic: Treat dehydration with normal B/P (water moves into the cell)
Isotonic: Does not change tonicity of blood - treat dehydration w/ low B/P
Hypertonic: Treat cellular edema - Cell shrinks

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17
Q

Beta blocker contraindications

A

Asthma or Chronic Bronchitis

HR<60

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18
Q

Beta blocker mechanism of action

A 
Decrease BP and HR (second line drug)
Decreases workload (negative inotropic effect)
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19
Q

Antihypertensive Drugs

A 
ABCD
Ace inhibitors/Angiotensin II blockers
Beta blockers
Calcium channel blockers
Diuretics
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20
Q

Beta blocker side effects

A

Bradycardia.. do not give to pt with HR <60

Heart block

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21
Q

HCTZ teaching

A

Hydrochlorothiazide - Diuretic
Used or Mild to Moderate HTN
Adverse effects: Electrolyte imbalance (esp K+)
—May need potassium
Ineffective in severe renal failure
Allergy to sulfa may have allergy to thiazide and loop diuretics

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22
Q

Loop diuretics lab tests

A

Lab Test Considerations: Monitor electrolytes (especially potassium), blood glucose, BUN (blood urea nitrogen), and serum uric acid levels before and periodically throughout course of therapy.

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23
Q

Non pharmacological HTN treatment

Study These Flashcards
A 
Increase exercise
Low fat, low sodium diet
limit alcohol consumption
weight reduction
eliminate tobacco use
reduce stress
24
Q

Ace inhibitor side effects

Study These Flashcards
A 
Anti Hypertensive
Nephrotoxic
"Prils"
SIDE EFFECTS
Dry persistent cough
Most dangerous angioedema
25
Digoxin Therapeutic Effects
Used for HF THERAPEUTIC EFFECTS Causes heart to beat more forcefully and slowly (Positive Inotropic effect)
26
Milrinone administration alerts
Used for HF, positive inotropic effect IV pump, microdrip set only use for 2-3 days Davis Drug Guide: - High Alert... heightened pt risk with error - ----Ventricular Arrhythmia's - ----Monitor ECG continuously during infusion
27
Angina vs MI diagnosis
``` ANGINA chest pain caused by insufficient O2 Short duration - goes away with stress reduction RELIEVED BY NTG (vasodilator) stable-exertion unstable-no exertion ``` MI Heart attack NOT RELIEVED BY NTG
28
Calcium Channel Blockers Mechanism of Action
Relax arteriolar smooth muscle thus lowering BP Dilate coronary arteries Reduce workload Stop dysrhythmias
29
MONA
``` Immediate treatment of MI MORPHINE - treat pain, reduce stress OXYGEN - given b/c lacking O2 in tissues NITROGLYCERINE - vasodilation ASA (aspirin) - Anti-platelet, makes less sticky ```
30
NTG side effects
Hypotension | Severe Headache
31
NTG teaching
Take sublingual Q5 min x 3 PRN for pain
32
Retaplase Therapeutic Indication
Retaplase is a Thrombolytic | Dissolves clots obstructing coronary artery disease
33
Albumin Teaching
Most common colloid used | May cause fluid overload - distended neck veins, pulmonary edema, cough, HTN, tachycardia
34
Colloid Administration Assessment
Listen for crackles in the lungs
35
Chrystalloids and Colloids Defined
``` CHYRSTALLOIDS IV solutions contain electrolytes similar to plasma Mimic body's extracellular fluid Trauma Pt's NS, LR, D5W, HS ``` COLLOIDS Proteins pull water into vessels - hypertonic Proteins, starches or other large molecules Albumin most common
36
Dopamine administration
IV only May cause dysrhythmias Increase BP and force of contraction
37
Shock Treatment Priority
ABC's of life support Airway Breathing Circulation
38
Antidysrhythmic side effects
``` Palpitations Chest Pain Weakness Fatigue New Dysrhythmias ```
39
Beta Blocker Client Teaching
``` Check pulse and call if <60 Do not discontinue abruptly May mask hypoglycemia Don't give with pulmonary problems, may cause bradycardia Used to prevent MI and Angina ```
40
Cardiac Output and Tachycardia
cardiac output DECREASES with tachycardia
41
Cardioversion Rationale
Electrodes placed on chest, send electrical shocks to restore normal rhythm Safer with less side effects
42
Dysrhythmias Pathophysiology
Abnormal electrical conduction Symptoms (none to sudden death) Atrial fibrillation most common
43
Heparin Side effects
``` Heparin - Anticoagulant SIDE EFFECTS Watch for bleeding ---Internal s/s--- low BP High HR Pallor Weakness Low Hgb/Hct ```
44
Heparin Outcomes
Goal: - No bleeding - No unusual clot formations
45
INR values
Ideal 2-3
46
Lovenox Administration (enoxaparin)
Fewer follow up lab tests More stable response Less thrombocytopenia (low blood platelet count) SubQ in abdomen only Protamine sulfate - Reverse Anticoagulant.. DVT
47
Warfarin lab tests
``` Oral anticoagulant Prothrombin times (PT) or INR frequently, 2-3 ideal ```
48
Warfarin Overdose Treatment
Warfarin - Oral anticoagulant Immediate reversal is Vit. K Blood and plasma if severe bleeding occurs If not bad, withholding a dose is usually sufficient
49
Warfarin Teaching
``` Warfarin - Oral anticoagulant Avoid Vit. K Serious side effects - bleeding No alcohol, other Rx, otc or herbal products Frequent INR testing ```
50
Alcoholism and Folic Acid
Folic Acid - Needed for RBC production | Alcoholism interferes with folate metabolism in the liver
51
Epoetin Assessment Post Admin
Common adverse effect is HTN - Beta blockers can be given concurrently CHECK BP BEFORE AND AFTER
52
Epoetin Teaching
Secreted by kidneys, TRAVELS TO BONE MARROW, interacts with stem cells to INCREASE ERYTHROCYTE PRODUCTION HTN common adverse effect. Beta blockers given concurrently
53
Filgrastim Mechanism of Action
Increase neutrophil production
54
Iron Administration Teaching
Free iron is toxic - common cause of poison in children IRON DEFICIENCY MOST COMMON CAUSE OF ANEMIA TAKE WITH FOOD STAY UPRIGHT FOR 30 MINUTES AFTER TAKING DON'T TAKE BEFORE BEDTIME
55
Oprelvekin Teaching
Platelet enhancer Stimulates production of megakaryocytes and thrombopoietin Increases platelet count
56
INR
International Normal Ratio - Determines clotting rate >6 Give Vit. K Normal 2-3

Pharmacology (7 decks)

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