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Blood/HTN Drugs
Pharmacology
| Question | Answer |
|---|---|
| Example of an (Injected) Anticoagulant Drug | heparin (Heplock) and enoxaparin (Lovenox) |
| Example of (Oral) Anticoagulant Drug | warfarin (Coumadin) |
| Example of Antiplatelet Agent | ticlopidine (Ticlid) |
| Example of Thrombolytic Drug | streptokinase (Streptase) |
| Example of Antifibrinolytic Drug | aminocaproic acid (Amicar) |
| Example of a (Non-Postassium Sparing) Diuretic Drug | furosemide (Lasix) |
| Example of a (Potassium Sparing) Diuretic Drug | spinonolactone (Aldactone) |
| Example of Calcium Channel Blocker Drug | diltiazem (Cardizem) |
| Example of ACE Inhibitor Drug | enalapril maleate (Vasotec) |
| Example of Adrenergic Beta-1 (Selective) Blocker Drug | metaprolol tartrate (Toprol or Lopressor) |
| Example of Cardiac Glycosides (Digitalis) Drug: (POSITIVE Inotrope) | Digitoxin |
| Example of Cardiac Glycosides (Digitalis) Drug: (NEGATIVE Chronotrope) | digoxin (Lanoxin) |
| Definition of Thrombus? | Collection of clotting elements attached to the walls of veins or arteries (thrombosis) |
| Definition of Embolus? | Air, gas, fat, or thrombus circulating in vessels that eventually become lodged. |
| Definition of Thromboembolism? | Blocked vessel impeding blood flow. |
| Define Fibrinolysis? | The process of clot removal. |
| Define Anticoagulants? | Used to prevent blood clot formation or growth of existing blood clots. They act by a number of different mechanisms. |
| Define Antiplatelet Agents? | Inhibit platelet aggregation |
| Define Thrombolytics? | Dissolve clots that have ALREADY been formed. (Clot busters) |
| Define Antifibrinolytics? | Opposite action of anticoagulates. |
| Define Hypertension? | Abnormally high blood pressure which can lead to strokes, heart attack and kidney disease. >140/90 is considered high. Also known as the "Silent Killer" and is the leading cause of death and disability in U.S. |
| Define diuretics? | Lower blood pressure by decreasing fluid volume through increased urine production. |
| Define Calcium Channel Blockers? | They decrease blood pressure by decreasing Ca+. (Contraction of muscle is regulated by the amount of calcium ion inside the muscle cell.) |
| Define ACE Inhibitors? | ACE= angiotensin converting enzyme |
| What is a Chronotropic effect? | Change in heart rate (timing of heart...how fast) |
| What is an Inotropic effect? | Change in strength or contractility of the heart. |
| What is Preload? | Degree of stretch of the cardiac muscle fibers just before they contract. |
| What is Afterload? | Pressure in the vessels that the ventricles must overcome to eject the blood. (What it has to push against). |
| What happens in Left Heart Failure? | 1. Fluid backs up into pulmonary veins. 2. Pulmonary edema. 3. Sometimes called Congestive Heart Failure (CHF) |
| What happens in Right Heart Failure? | 1. Fluid backs up into the peripheral veins. 2. Peripheral edema (Pedal edema or Ascites). 3. Sometimes called Cor Pulmonale. |
| What do Cardiac Glycosides (Digitalis) do? | Allows the heart to beat more forcefully and slowly. |
| What is the process of Coagulation (3 steps) | 1. Injured cells release prothrombin activator. 2. Converts prothrombin to thrombin. 3. Converts fibrinogen to fibrin. |
| What is the process of Fibrinolysis? | 1. After the fibrin clot is formed blood vessels near the site release tissue plasminogen activator (tPA). 2. Converts plasminogen that is in the clot to plasmin. 3. Digest fibrin strands to remove the clot. |
| What disorders can contribute or cause Coagulation Disorders? | 1. Vitamin K deficiency (Liver used Vit K to make 4 different clotting factors. 2. Liver disorders. 3. Afib |
| Cardiac Output is determined by what equation? | Heart Rate x Stroke Volume = Cardiac Output |
| Relationship between Vitamin K and anticoagulants? | Oral anticoagulants (Warfarin-Coumadin) prevent conversion of vitamin K, thereby decreasing its production in the liver. This reduction of vitamin K production also reduces several clotting factors, thereby prolonging the clotting process. |
| Name several conditions why Coumadin may be prescribed? | They are used to manage clients with actual, potential and recurrent health conditions such as DVT, PE, Acute MI, Afib and antiphospholipid syndrome. |
| Why must patients on Coumadin be closely monitored? | 1. Its narrow therapeutic range, frequent dose adjustments due to individual dose response, high potential for the development of interactions (food and drug) that can lead to ineffective therapy or toxicity. |
| What is Coumadins onset of action (how long does it take for it to start working)? | Coumadins onset of action is slow and its full anticoagulant effect is not seen until after approx. 1 week. |
| What is the antidote that reverses the action of Coumadin? | Vitamin K |
| Drugs that potentiate action of Coumadin? | 1.Acetaminophen and aspirin, 2. Antibiotics, 3. Histamine antagonists, 4. NSAIDs, 5. Vitamin E, 6. Sulfonamides, 7. Loop diuretics. |
| Drugs that decrease action in Coumadin? | 1. Alcohol, 2. Barbiturates, 3. Estrogens/oral contraceptives, 4. Vitamin K, 5. Thyroid drugs, 6. Thiazide diuretics |
| T or F. Coumadin has significant food and drug interactions? | TRUE |
| What two tests are used in conjunction to monitor patients response to therapy while on Coumadin? | Prothrombin Time (PT)-blood test used to measure extrinsic clotting response, and International Normalized Ratio (INR)- a standard reference range used to establish consistency in reporting PT levels |
| Why is Heparin the drug of choice for clients who have DVT, PE and embolism resulting from atrial fibrillation? | Because of its immediate action. |
| How is Heparin administered? | Intravenously (IV) or subcutaneously (SubQ) |
| T or F. Hypersensitivity or allergic reactions can be seen in clients receiving heparin, so epinephrine 1:1,000 should be readily available if a reaction develops? | TRUE |
| What 3 factors are truly responsible for determining blood pressure? | 1. Cardiac output, 2. Peripheral resistance, 3. Blood volume |
| What is cardiac output? | The volume of blood pumped per minute. |
| What is peripheral resistance? | The dragging and friction of blood in the arteries. |
| T or F. High sodium diets cause water to be retained by the arteries, thus increasing blood volume and raising blood pressure? | TRUE |
| Systolic pressure occurs when... | the heart ejects blood, creating high pressure in the arteries. (When written, it is the TOP number) |
| Diastolic pressure occurs when... | the heart relaxes, resulting in less pressure in the arteries. (When written, it is the BOTTOM number) |
| What is the vasomotor center? | It is a cluster of neurons in the medulla oblongata that regulates blood pressure on a minute-to-minute basis. Nerves travel from the vasomotor center to the arteries, where smooth muscle is directed to either constrict (raise BP) or relax (lower BP). |
| What is Angiotensin and what does it do? | It is a potent vasoconstrictor that increases resistance and ↑BP. It also stimulates the release of Aldosterone from the adrenal cortex. |
| How do Angiotensin-converting enzyme (ACE) Inhibitor Drugs work in lowering blood pressure? | Because it blocks the effects of angiotensin II, it decreases BP through 2 mechanisms: Dilating arteries and decreasing blood volume. |
| What is the first line of drugs used to try and lower blood pressure? | Diuretics |
Created by:
mamcdonald
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