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Cardio Drug
Pharm Cardio/Cardio Drug Quiz
Question | Answer |
---|---|
aPPT | activated partial thromboplastin time: a screening test that helps evaluate a persons ability to appropriately form blood clots |
Hypokalemia | When bloods potassium levels are too low |
Neutropenia | is an abnormally low numbers of neutrophils in the blood |
PT/INR | PT: prothrombin time test; measures how long it take for a clot to form in a blood sample INR: International normalized ratio; a type of calculation based on PT test results |
Positive Inotropic effect | are medicine that change that force of your hearts contractions |
Reye Syndrome | a rare but serious condition that causes swelling in the liver and brain |
thrombocytopenia | deficiency of platelets in the blood, this causes bleeding into the tissues, bruising, and slow blood clotting after injury |
anginal | chest pain |
coagulation | thicking |
Anti-anginal | isosorbide mononitrates & nitroglycerin |
Coagulation modifiers | heparin, warfarin, enoxaparin, clopidogrel, apixaban, tPA, aspirin |
anti- hypertensives | lisinopril, losartan, amlodipine, metoprolol (ACE Inhibitors, ARB's, Calcium channel blocker, beta blockers) |
Cardiac glycosides | digoxin |
antilipemic | atorvastatin, gemfibrozil |
Right side | de-oxygenated |
left side | oxygenated |
Angiotensin-Converting enzyme inhibitors (ACE Inhibitors) | Lisinopril(Prinvil)&Enalapril(Vasotec) Action: Blocks the conversions of angiotensin I to angiotensin II Uses Hypertension, heart failure, those at high risk for cardiac event Route:oral Considerations:Dry cough, hyperkalemia, doNOT use with pregnancy |
All Anti-hypertensives can cause..........????? | Orthostatic Hypotension |
Angiotensin II Receptor Blockers (ARBs) | Losartan (Cozaar) *Action Blocks the action of angiotensin II *Uses: Hypertension, stroke, prevention, delay of diabetic neuropathy *Route: oral *Considerations: do NOT use in pregnancy/lactation, use contraception if using during childbearing years |
Calcium Channel Blockers | Amlodipine( Norvasc) & Diltiazem (Cardizem) Action: Blocks calcium channels in blood vessels leading to vasodilation Uses: Angina &Hypertension, diltiazem can also be used for cardiac dysrhythmias Route :Amlodipine oral/diltiazem oral or IV. |
Calcium Channel Blockers | Amlodipine( Norvasc) & Diltiazem (Cardizem) Considerations: Peripheral edema, orthostatic hypotension Interactions: digoxin and diltiazem combined can cause a reduced ventricular rate |
Beta Adrenergic Blocker | Metoprolol(Lopressor)&Atenolol(Tenormin) Action:beta blockade in the myocardium Uses:hypertension, angina, tachydysrhythmia, & heart failure Route:oral & IV Consids: Red. HR; assess BP/P before administering med- DONOT admin, if HR is less than 50 BPM |
Beta 2 Blockers such as propranolol can cause....... | bronchoconstriction contraindicated with asthma |
Cardiac Glycosides | DIGOXIN(LANOXIN) Action:Positive inotropic effect with decreased HR Uses:Heart Failure & Dysrhythmias Route:Oral Consids:Hypokalemia&Bradycardia, check pulse rate before giving-less than 60, greater than 100, withhold reversal agent: digibind |
Digoxin Toxicity- | Fatigue, weakness, vision changes (halo) |
Anti-Anginals Therapuetic Goals | Increases blood flow through the heart and/or decrease oxygen demand of the myocardium |
Anti-Anginal Routes | sublingual, buccal, chewable tabs, oral caps/tabs, IV solutions, transdermal patches, ointment, translingual sprays |
Anti-Anginal | Actions:causes VASODILATION relaxing vasc. smooth muscle *Vasodilation results in reduced myocardial o2 demand Uses:Treat. Angia*Rapidacting forms(nitroglycerin)Treat acute anginal attacks*Longacting forms (isosorbide mononitrate)prevent anginal episode |
Anti-Anginal | Contraindications: *Head injury d/t increased ICP *Caution with decreased renal/liver function Interaction: *Severe Hypotension: Sildenafil, ETOH, beta blockers, calcium channel blockers, diuretic |
Anti-Anginal | Side Effect: *Headache: use ASA or acetaminophen to relieve pain.should resolve after about 2 weeks of use*Orthostatic Hypotension:avoid sudden position changes. DANGLE *Reflex tachycardia: monitor vital signs, administer betablocker if sym occur |
Nitrate/Nitrite Tolerance | Occurs with around the clock or long acting form prevented by allowing a reg nitrate free period to allow enzyme transdermal forms: remove 10-12 hr sign of tolerance- more episodes of angina or advance cardiac dysfunction |
How to administer nitroglycerin | stop activity, sit or lie down take one sublingual tab if no relief in 5 min, call 911 take a 2nd sub.tab if no relief in 5 min, take a 3rd sub.tab never chew or swallow, do not drive to hospital, NO MORE THAN 3 DOSES |
How to store nitroglycerin | Store in airtight, dark glass bottle with metal cap, no cotton filler, instruct patient to keep fresh supply, potency is lost about 3 mon. after bottle open. if burning sensation felt with sub for drug is still potent |
Anti-Anginals: Nursing Considerations | monitor VS frequent during acute exacerbation, if experiencing chest pain, pt should lie down, iv forms must be given with special non pvc tubing, pt keep record of anginal attacks |
Antilipemics | Help lower cholesterol especially LDL's Raise LDL's Requires baseline monitoring of total cholesterol |
Statins | Atrovastatin(Lipitor) Simvastatin(Zocor) Action:decreases manufactures of LDL and VLDL cholesterol, increases manufactures of HDL USES: Hypercholesterolemia ROUTE: Oral CONSIDER:monitor liver function, doNOT use Preg, myopathy INTERACT: grapefruit juice |
Coagulation Modification | *Used to prevent blood clots which leads to: -Increase perfusion -decrease pain -prevention of further tissue damage *all have an increased bleeding risk |
Anticoagulant- Heparin | Uses:prompt anticoagulation such as stroke, DVT, PE Measured in UNITS Route: IV & SUBCUT High Alert Drug Monitor aPTT REVERSAL AGENT: PROTAMINE SULFATE |
Anticoagulant-Enoxaparin | Uses: Prevention of DVT & PE often post-op Monitor Platelet Count Route: Subcut REVESAL AGENT: PROTAMINE SULFATE |
Vitamin K Inhibitors- Coumadin(Warfarin) | Uses: Prevention of ischemic effects, such as TIA, DVT, & PE Route: PO Monitor: PT/INR Expected Range 2-3 |
Vitamin K Inhibitors- Coumadin(Warfarin) | Consider: Takes 3-5 days to achieve therap effect, consistent intake of veggies needed, keep lab appoint, monitor for signs of bleeding, use soft bristle toothbrush & safety razor REVERSAL AGENT: VITAMIN K |
Anti- Platelets | Clopidogrel (Placvix) ASA (Aspirin) Action: inhibits platelet aggregation uses:prevention of infarct & ischemic events route:oral Consid: ASA DONOT give to children may lead to reye syndrome: clopidogrel may cause dyspepsia |
Xa Inhibitor | Apixaban(Eliquis) & Rivaroxaban(Xarelto) action:prevents formation of thrombin uses: stroke prevent. DVT & PE prevent. Route:oral Interactions:ginko biloba, ginger, garlic, glucosamine, can increase risk of bleeding No special diet or specific lab |
Thrombolytics | Dissolve clots already formed IV only, usually by the RN |
Alteplase (tPA) | Uses: massive PE & Acute ischemic stroke, restore patency to central cath. benefit in an ischemic emerg. must be given w/ 3hr of onset of sympt. Minimize bleeding reducing # of inject, IV insert, ABG insert-may require direct press. up to 30 min after |