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#PHARM T2 McDermott
Pharm Test 2 Part 2
| Term | Definition |
|---|---|
| In lipids you want your HDL's _____ and your LDL's _____. | high, low |
| What do Antidysrythmic drugs do? | Can prevent irregular rhythms in HR. Does this by changing the hearts electrical conduction. |
| When do you use a Antidysrythmic drug? | ONLY when the dysrythum is effecting cardiac function. |
| What is the expected outcome of an Antidysrythmic? | Prevent or relief of symptoms and prolonged survival. |
| How many Classes of Antidyrythmics are there? | 4 |
| How are antidysrythmics classified into their classes? | According to their effect on the conduction system. |
| Class 1 Antidysrythmics are? | Sodium Channel Blockers (Quinidine, Lipocaine, Flecainide) |
| Class 2 Antidysrythmics are? | Beta-Adrenergic Blockers (Propranolol) |
| Class 3 Antidysrythmics are? | Potassium Channel Blockers (Amiodarone) |
| Class 4 Antidysrythmics are? | Calcium Channel Blockers (Diltiazem) |
| Which class is the drug of choice to treat serious ventricular fib, part of ACLS (advanced cardiac life support)? (name the drug too) | Class 1 Sodium Channel Blockers , Lidocaine (xylocaine) |
| What is the Adverse Effect of Class 1? | Decreased Cardiac Output |
| What population has a lot of cardiac dysrythmias? | Older Adult |
| What do we use Class 2 Beta Blockers for? And what do we use them with? | To decrease mortality in a pt with MI and heart failure, with diuretics |
| What are the adverse effects of Hypotension with Class 3 (potassium channel blockers)? | (have a vasodilating effect) SOB, chest pain, cough, decreased coronary blood flow, syncope, confusion. |
| What are the only 2 approved Class IV Calcium Channel Blockers for Cardiac Dysrythmias? | Tidazem (cardizem), and brocomal kanan |
| With Calcium Channel Blockers you need to always check what? | Serum Drug Levels because they can be potentially life threatening. |
| Where can Cardiac Dysrythmias originate from? | Any part or from atrial or ventricle tissue. |
| What are the CONCEPTS of Antiarythmias? | Oxygenation, Comfort, Perfusion |
| Antianginal drugs are used to treat? | Manage and prevent Chest Pain |
| How do I know if chest pain is from cardiac pain or not? | Check the Triponine Levels, if elevated it is cardian anginal pain. |
| What are the Top concerns for a nurse when giving Antidysrythmic drugs? | pt's with renal impairment |
| What do you always want to monitor when giving Antidysrythmics and what do you monitor it with? | Heart Rhythms with telemetry. |
| How often do you need to monitor blood pressure after giving an antidysrythmic by IV? | 1-5 minutes because the effect is immediate. |
| What do you need to check BEFORE each dose of Antidysrythmics? | Radial and apical pulse, VS, serum levels |
| What is the MOST common dysrythmia? | AFIB (heart failure, heart block) |
| What are the subclasses of Antianginals? | Organic Nitrates, Beta-Adrenergic Blockers, Calcium Channel Blockers |
| Which subclass is the Drug of Choice for Antianginals? | NITRATES |
| What are the benefits of Nitrates compared to other Antianginals? | Inexpensive, easy to take, has a rapid onset. |
| What kind of effect does Nitrates have? | Vasodilation by relaxing the smooth muscles. |
| What is the problem with men taking Nitrates with Viagra? | They can become very Hypotensive |
| What are the Adverse Effects of Nitroglycerin? | Headache, dizziness, palpations. |
| What is the most important thing you need to do when giving nitroglycerin ointment? Why? | Wear gloves, your skin will absorb it and you well get a pounding headache. |
| How often to you give Nitroglycerin? | every 5 mins times 3 |
| How long does Nitroglycerin last given Sub Q? | 30-60mins |
| What's important when giving Oral Nitrates? | Give with full glass of water on an empty stomach. |
| Where do you put the Nitroglycerin spray? | Under the tongue |
| What are the contraindications for Nitroglycerin? | Myocardial Ischemia, avoid alcohol, use caution in hepatic impairment because they metabolize through the liver. |
| Before each dose of Nitro check ___ and ____. | BP and HR |
| With Nitro if systolic bp is less then ______ withhold the medication. | 90 |
| CONCEPTS of Nitro are? | Oxygenation, Perfusion, Safety, Comfort |
| What are the subclasses of Diuretics? | Thiazides, Loop Diuretics, and k+ sparing diuretics |
| What is the number 10 most prescribed med in America? | Hydrochlorothiazide |
| If someone is allergic to sulfonamide are they also allergic to Hydrochlorothiazide? why | Yes, because they are similar |
| What do Diuretics do? | get rid of fluid, increase renal excretion of water, sodium, and other electrolytes, increase urine output |
| What do Diuretics treat? | Heart failure, HYPERTENSION, also in combinations with Hypertension meds, Edema (peripheral and pulmonary) |
| Expected Outcome of Diuretics? | Increased Urine, decreases circulating blood volume , decreases blood pressure, decreases edema. |
| Thiazide is chemically related to _____ and _____. | Sulfonamide, Hydrochlorothiazide |
| HCTZ (Hydrochlorothiazide) is the most common for ___ term treatment for _____ and ______ and edema caused by the liver. | Long, Hypertension, heart failure |
| HCTZ (Hydrochlorothiazide) CAN be given by which route? | IV |
| What are the Adverse Effects of HCTZ (Hydrochlorothiazide)? | Hypotension, electrolyte imbalances |
| Hydrochlorothiazide is not used for _______ use. | Immediate |
| What things are important to check everyday on a pt receiving Diuretics? | Check electrolyte levels, VS, BP, DAILY WEIGHT, |
| HCTZ loses ____ and _____ . | K+ and Salt |
| _______ increases Blood glucose, so in a diabetic person you need to check blood sugar levels to prevent ____. | HCTZ (Hydrochlorothiazide), Hyperglygemia |
| What are the Contraindications of Hydrochlorothiazide? | Allergy to Sulfonamide, Pregnancy |
| What foods to pt taking Hydroclorothiazide need to avoid and why? | Salty Foods because they retain fluid. |
| What are Loop Diuretics used for? | Rapid effects or Renal Impairment |
| What is the most commonly used Loop Diuretic? | Furosemide (Lasix) |
| Lasix is ___ times more potent then HCTZ. | 10 |
| Lasix occurs with in ____ mins of IV. | 5!!!! |
| Lasix ______ blood pressure and could have a drastic effect if given too ____. | drop, fast |
| Lasix peaks at ____ mins and lasts ____ hrs and can be used in ______. | 30, 2, children |
| A loop diuretic is losing water fast, but what else is being lost? | Potassium K+ |
| What is the normal reference range for K+? | 3.5-5 |
| What do you need to be concerned with when pt is taking diuretic? | HYPOkalmia, and SOB and other electrolytes |
| What things as a nurse are you going to check on a pt taking loop diuretics? | Daily Body weight, Electrolytes like K+, Na+ and Cl+, and BP |
| A pt is bipolar and taking a diuretic. What drug drug interaction can happen? | Lithium toxicity. |
| What is our main concern about K+ sparing diuretics? | pt geting HYPERkalemia (range greater then 5) |
| What medication is given to help treat Hyperkalemia to get K+ out? | Kexalate |
| What are you going to do as a nurse if a pt has Hypokalemia (3 or less)? | Check labs, and notify Dr. first then he may put them on K+ supplements or maybe a IVPB |
| Population more effected by diuretics? | Older Adult |
| Drug-drug interaction | Diuretics and digoxigen (be in risk for diuretic induced hypokalemia. |
| What drug classification is the Prototype Warfarin (Coumadin) from? | Anticoagulant |
| What kinds of food should a pt avoid eating when taking Warfarin (coumadin)? | Foods containing high K+, Green Leafy Vegetables |
| What is the most commonly used ORAL Anticoagulant? | Warfarin (Coumadin) |
| What do Anticoagulants do? | Prevent formation of blood to clot and form new clots or extension of clots already present, treat afib, ect. |
| What is the Therapeutic Effect of Anticoagulents? | prevent embolism, prevent formation of new clots |
| Anticoagulents do not _______ clots. Which drugs do? | it does not dissolve clots, Thrombolync Drugs do. (Alteplase (activase)) |
| You're concerned about a pt with blood clots. Can you give them Heprin and Warfarin (Coumadin) at the same time? How or Why? | YES, because they have different starting effects. Heprin is short acting, subQ takes 20-30mins or Immediate with IV, and Coumadin takes 3-5days to have an effect. |
| Warfarin has a TON of ____ and ____ interactions | herb drug and drug drug |
| What signs are you going to look for for a pt taking Coumadin? | Signs of ANY bleeding, adults have an increased risk, GI ulcers |
| What is the Antidote for Warfarin? | Vitamin K |
| Always check the PT and INR levels for _____ | Coumadin (warfarin) |
| PT stands for ______ and it's ranges are ______. PTT is ______ and ranges are _____. INR is ______ and range is _____. PT and PTT can _____ but INR is always _____. | Prothrombin Time (coumadin), 11.9 - 14.4 Partial Thromboplastin Time (heparin), 24-37 International Normalized Ratio, 2-3.5 Vary, the same |
| Heparin is ONLY given by which route? | Parental (IV or SubQ) |
| What main to things do you check for Heprin? | the PTT and any bleeding (even in stools) |
| _____ is the drug of choice for Pregnant Women because it does not cross the placenta. | Heparin |
| What is the Antidote for Heparin? | Protaminen Sulfate |
| If you counteracted Heparin what are you concerned about now? | Blood clots |
| Heparin and Coumadin are keeping good blood _______. | Circulation |
| Concepts of Anticoagulant. | Safety, Perfusion, Comfort, Circulation |
| Prototypes of Antiplatelets are: | Asprin, Clopidogreal (Plavix) |
| Adverse effects of antiplatelets are: What population is most likely to experience these effects? | Puritius (itching) rash, concerned with bleeding, peptic ulcer disease, population: older adults. |
| Contraindications for Antiplatelet drugs: | Pregnant lactating women, pt with active bleeding |
| Thrombolytic do what to clots? so it reestablishes ____. | dissolves them, blood flow and limit tissue damage |
| What are some signs that a pt may be bleeding internally? | Blood in urine, Abdomen firm and distended, and from Labs Hemogloban and Hematic |
| Thrombolytic has to be administered with in ____ hrs of signs of a stroke. | 6 |
| After a pt is administered Thrombolytic they would put the pt on ____ and ___ to maintain. | Heparin, and warfarin |
| With Thrombolytic use caution in ___ to ____ year olds. | 65-80 |
| What is a prototype for Antilipemic? | Statins |
| Antilipemics are used to treat? | CAD, CDH, Stroke, and manage a pt with high blood lipids |
| What is the Therapeutic Effects of Antilipemics? Where do you want your Chol. LDL, HDL and triglycerides to be? | CHOL < 200, LDL <100, HDL > 40 and Triglycerides <150 |
| ______ is the most widely used drug in the US. | STATIN |
| If ___ and ____ aren't combined all the time in your diet you can lower your triglycerides. | Fat and sugars |
| What is the Treatment for irregular numbers of LDL HDL Trigly, ect | DIET AND EXERCISE |
| Do not give Statins with ______ juice. | Grapefruit |
| Adverse effects of Statin? | can become sensitive to sunlight, don't take with grapefruit juice, hepatic toxicity (can cause liver cancer) |
| Before you go on Statins what kind of test should you take? | A Liver Function Test |
| Some statins are given at night but what happens at night? | That's when our cholesterol is produced so it blocks that production. |
| The most sever adverse effect of Statin is? | Myopythy, (muscle pain and cramps) |
| What are the Top Concerns with statin? | educate pt on Diet, low-fat, and Excercise |
| Contraindications of Statin? | Pregnancy (Class D) |
| ____ and _____ can cancel the effects of statin meds. | Over eating and gaining weight |
| What supplements can help statins? | soy, niocen (b3), Fibrates (serum triglyceride levels) |
Created by:
Jhammond05
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