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Cardiac meds
Pharmacology NRTC
| Question | Answer |
|---|---|
| Digoxin is contraindicated when | HR<60BPM |
| Digoxin is used for what 2 heart abnormalities | Heart failure, arrhythmias... afib |
| This electrolyte imbalance increases the effect of digoxin | Hypokalemia |
| Normal potassium level | 3.5-5.0 |
| Normal digoxin level | 0.5-2.0 |
| Classic s/s of digoxin toxicity | Visual disturbances... Halos around objects |
| Digoxins action | Increased contractility.... Positive inotrope |
| Digoxins anecdote | Digibind |
| Nitrates action | Vasodilation |
| Nitrates are used for what | Angina |
| Side effects of nitrates | headache hypotension dizziness and syncope |
| Nitroglycerin comes in what form | Sublingual transdermal patch extended release tablet and trans lingual spray |
| How is nitroglycerin stored | Dark glass bottle not childproof |
| Client should feel this when nitro is put under the tongue | A tingle or burning sensation |
| How is nitro taken for angina | Can take one tablet under the tongue every 5 minutes for a total of 3 doses |
| What signs and symptoms may the client have after taking nitro | Headache dizziness syncope client can take Tylenol or aspirin for headache |
| When discontinuing A nitro patch what is the procedure | Taper down over several weeks |
| What is important to know about IV nitroglycerin | Must use specialMust use special tubing |
| What is the action of beta blockers | Block epinephrine and cause peripheral vasodilation |
| Beta blockers are used for what heart conditions | hypertension some tachy arrhythmias and angina |
| What are the side effects of beta blockers | Bradycardia hypotension erectile dysfunction |
| What can beta blockers mask the signs of that is important for diabetics to know | Hypoglycemia client should do more finger stick blood sugar tests |
| What do all clients need to know before taking beta blockers | Check apical pulse do not take if less than 60 beats per minute |
| What can occur if beta blockers are stopped abruptly | Rebound hypertension |
| Beta blockers may cause this type of dysfunction | Sexual |
| What are important teaching topics for clients taking CCBs | Take BP and pulse and watch for orthostatic hypotension and edema |
| name one centrally acting alpha agonist | Clonidine |
| What can happen if clonidine is stopped suddenly | rebound hypertension |
| What is the action of ACE inhibitors | Blacks the production of angiotensin ll vasoconstrictor and blocks release of aldosterone |
| What side effects of ACE inhibitors should be reported to the PCP | Persistent dry cough |
| What diuretic can cause ototoxicity when administered too fast with IV infusion | Lasix furosemide |
| What group of diuretics is commonly combined with ACE inhibitors | Thiazide diuretics |
| What is a common electrolyte imbalance with thiazide diuretics | Hypokalemia |
| Thiazides are contraindicated in what patients | Renal failure patients ...unlike loop diuretics |
| What must a nurse monitor for in patients taking thiazides | Vs wait I / O's E-Lites especially K+ |
| What are signs of hypokalemia to teach patients | Muscle weakness leg cramps dysrhythmias |
| Loop diuretics are more potent than thiazides why are they not prescribed as often | Less effective as an anti hypertensive |
| What drug do loop diuretics have a major interaction with | Digoxin can cause digoxin toxicity because of hypokalemia |
| clients should take diuretics at what time of the day | Early morning to prevent nocturia |
| What is important to teach about potassium sparing diuretics | Monitor potassium levels periodically, do not take potassium supplements or salt substitutes |
| Potassium sparing diuretics should not be taken with what class of heart medications? | ACE inhibitors both can cause hyperkalemia |
| What do platelet inhibitors do,? | Inhibit aggregation of platelets, decrease clotting |
| What are the side effects of platelet inhibitors | Uncontrolled bleeding |
| Do platelet inhibitors affect existing clots | No effect on thrombi |
| What platelet inhibitor is commonly given after an acute MI | Aspirin |
| When are anticoagulants used | After MI, PE, DVT and ischaemic CVA |
| Name a common LMWH | Enoxaparin, lovenox |
| What are some advantages to LMWH | No need to monitor PTT |
| What is the antidote for heparin | Protamine sulfate |
| What is the antidote for coumadin, warfarin | Vitamin K |
| What lab is monitored for heparin | aPTT |
| What labs do we monitor for coumadin, warfarin | PT / INR |
| What should INR be | 2.0- 3.0 |
| Plan teaching for clients taking anticoagulants? | Tell dentist, use soft toothbrush, use electric razor, Cary Medical ID, do not smoke, do not take aspirin, do not take herbs, may interact with anti- coagulant, avoid EtOH |
| If clients experience bleeding when taking anticoagulants what do they need to do? | Apply firm, direct pressure for 5 - 10 minutes |
| If you are taking an anticoagulant what food must you avoid | green leafy vegetables, high in vitamin K |
| What do thrombolytics do | Directly break up blood clots |
| What drugs must be avoided when taking thrombolytics | NSAIDs |
| Total cholesterol level goal | <200 |
| triglyceride level goal | <150 |
| LDL goal | <130 |
| HDL goal | >40 |
| What are serious side effects of statins | Elevation of liver enzymes and rhabdomylosis |
| How long does it take for full therapeutic effects of statins | 2 - 4 weeks |
| When taking statins what food must be avoided | Grapefruit, leads to statin toxicity |
| What lab values are to be expected while on statins | Liver function studies, LFTs, lipid profile |
| Gemfibrozil may increase the risk of what | Gallstones |
| What is a potential side effect of niacin that is not well tolerated | Flushing |
| Important patient teaching in regards to all cholesterol lowering medications includes | Take 1 hr before or 4-6 hrs after meals to avoid interference with absorption |
Created by:
Annettekeith
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