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#PHARM T2 McDermott

Pharm Test 2 Part 2

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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