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WVC 2 Acute Coronary
Meds for M. Wolcott's test
| Question | Answer |
|---|---|
| Therapeutic Range for heparin therapy | 45 – 75 seconds (1.5 – 2.5 x MEAN NORMAL) |
| C-reactive protein normal levels | inflammatory such as RA. A level less than 1 mg/dL is considered low risk; a level over 3 mg/dL places the patient at high risk for heart disease. The most useful time to measure CRP appears to be for risk assessment in middle-aged or older persons. |
| A rise in homocyctein can indicate | risk of MI. Homocysteine is an amino acid that is produced when proteins break down. A certain amount of homocysteine is present in the blood, but elevated values may be an independent risk factor for the development of CVD. |
| Priority nursing assessment following an abdominal aortic aneruism resection | urine output. The greatest risk is occlusion or dissection |
| Dilated cardiomyopathy is related to | left sided heart failure and presents with activity intolerance |
| Digoxin and Lasix are used to manage | SOB, an adverse reaction is light headedness |
| Procainamide hydrochloride (Pronestyl) therapeutic uses/class/SE | Class 1A, used in AF, WPW, PVC & VT. Decreases automaticity & prolong QT |
| Lidocaine | Class I B. Used to treat VT, VF & PVC’s. Shortens repolarization. Confusion, slurring of speech, drowsiness & paresthesia |
| Isoproterenol (Isuprel) | Used for bradycardia and torsades de pointes. Increases myocardial oxygen demand, ventricular irritability (hypokalemia & dig) Used for cardiac arrest |
| Beta blockers (lol) used in | Atrial flutter and A-Fib, PVC & PSVT. Bradycardia is the expected result Class II drug |
| Which antiarrhythmic is used for life threatening VF | Sotalol hydrochloride (Betapace). Has both Class II and III effects. |
| Metoprolol | used for HTN & management of CAD, VT. • Management of stable, symptomatic (class II or III) heart failure due to ischemic, hypertensive or cardiomyopathc origin (may be used with ACE inhibitors, diuretics and/or digoxin; Toprol XL only) |
| Amiodarone hydrochloride (Cordarone) | Antiarhythmic Class III, used for AF, PAF, PSVT life threatening vent dysrhythmias. In cardiac arrest-return of rhythm and pulse |
| Verapamil hydrochloride (Calan) | AF, Atrial flutter, PSVT. Class IV, calcium channel blocker. Bradycardia & hypotension common SE. Antidote CaCl-. Works via vasodilation SE-cough & dizziness |
| Diltiazem (Cardizem) | Class IV calcium channel blocker. AF, atrial flutter and PSVT. SE-cough & dizziness. Bradycardia & hypotension |
| Adenosine (Adenocard) | PSVT & WPW. Restn of normal sinus rhythm. Common to have a short period of asystole after admin. Orthostatic hypotension, facial flushing, SOB, dyspnea & chest px. Slows AV nodal conduction to interrupt re-entry pathways. Can cause tosades de pointes |
| Atropine | anticholinergic. Used to treat vagally induced symptomatic bradydysrhythmias. Initial dose is .5-1 mg IV repeated q3-5 mins MAX .04 mg/kg. Asystole: 1mg IV bolus q3-5 mins. |
| MgSo4 | Used for torsades de pointes, refractory VT or VF. Causes vasodilation, respiratory and CNS depression. |
| Digoxin | (digitalis glycosides)CHF, AF, atrial flutter & PSVT. ↓HR expected response, but bradycardia can indicate toxicity. Increased cardiac output (positive inotropic effect) and slowing of the heart rate (negative chronotropic effect) |
| First line of drugs used for cardiac arrest | epinephrine. Vasopressin used with VF and pulseless VT. |
| Dopamine hydrochloride (Intropin) | adrenergic. Increased cardiac output, increased blood pressure, and improved renal blood flow . Used for hypotension, chock, CHF & renal failure. Monitor urine output |
| Dobutamine hydrochloride (dobutrex) | beta andrenergic agent used to improve myocardial contractility and increase cardiac output. |
| Norepinephrine | vasopressor resulting in increased cardiac output and BP |
| Aspirin | salicylates, used for decreased platelet aggregation. • Decreased incidence of transient ischemic attacks and MI |
| Enalpril (Vasotec) | ACE INHB • Slowed progression of asymptomatic left ventricular dysfunction to overt heart failure • Increased survival and reduction of symptoms in patients with symptomatic heart failure |
| Heparin | antithrombotics, » Atrial fibrillation with embolization |
| Nitroglycerin | nitrates • Acute ( translingual and SL ) and long-term prophylatic ( oral, transdermal ) management of angina pectoris • SL is repeated q5 mins for 2 times in acute attack. |
| Nitro IV | • IV: Adjunct treatment of acute MI. 5 mcg/min; increase by 5 mcg/min q 3–5 min to 20 mcg/min; if no response, increase by 10–20 mcg/min q 3–5 min (dosing determined by hemodynamic parameters; max: 200 mcg/min). |
| Morphine | ( opioid agonists). Used as last step of MONA. Depresses CNS and relaxes pt to improve O2 during acute MI |
| Furosemide (Lasix) | loop diuretic. • Diuresis and subsequent mobilization of excess fluid (edema, pleural effusions) • Decreased blood pressure **increase potential for dig toxicity** |
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wvc 2
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