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Stack #439049
Various heart drugs
| Question | Answer |
|---|---|
| What do ARBs do | They are competitive antagonists of angiotensin I receptors The "TAN" drugs |
| Do ARBs block angiotensin action more than ACE inhibitors? | Yes |
| Do ARBs affect bradykinin? | No |
| What do you give a patient who cannot tolerate ACE inhibitors? | ARBs |
| What are the adverse reactions for ARBs? 4 things | postural hypotension, renal insufficiency, hyperkalemia, angioedema |
| What type of activity to B blockers do? | negative inotropic activity. They are the olol and ilol drugs |
| B blockers prevent changes caused by chronic activation of sympathetic nervous system in two ways | decreasing heart rate and inhibiting the release of renin |
| B blockers prevent norephinephrine effects on cardiac muscle fibers which helps to do 3 things | decrease remodeling, hypertrophy and cell death |
| Diuretics do two things for the body | relieve pulmonary congestion and relieve peripheral edema |
| by reducing volume overload, diuretics relieve the following 4 things | orthopnea, paroxysmal nocturnal dyspnea, decrease plasma volume, and decrease venous return to the heart (preload) |
| direct vasodilators do 3 things | decrease cardiac preload, decrease systemic arteriolar resistance, and decrease afterload |
| Why do patients get direct vasodilators? | If pt cannot tolerate ACE inhibitors or B blockers |
| the force or energy of muscular contractions is called | inotropic |
| the rate of the heartbeat is called | chronotropic |
| the conduction of electrical impulses of the heart is called | dromotropic |
| inotropic drugs. The positive inotropic agents (PIA) do what | increase cardiac muscle contractility which increase cardiac output |
| what is the inotropic action a result of | increased cytoplasmic calcium concentration that enhances muscle contractility |
| another name cardiac glycosides | digitalis |
| what ion flows in cardiac muscle are influenced by digitalis | sodium and calcium ion flows |
| explain the steps that occur with digitalis drug in heart | increasing contraction of the atrial & ventricular myocardiumincreases contractility of the cardiac muscle which increases the force of the contraction which increased the ejection fraction |
| What improvements are seen with digitalis use 5 things | improved circulation, reduced sympathetic activity, reduces peripheral resistance, decreased heart rate, oxygen demand diminishes |
| The positive inotropic effect of digitis causes a | increase in force and velocity of myocardial contraction (w/o an increase in oxygen consumption) |
| digitalis causes a reduced heart rate or another name for that is | negative chronotropic effect |
| the negative dromotropic effect of digitalis is 2 things | decreases automaticity at SA node and decreases AV nodal conduction, and other effects |
| What are the symtoms of digoxin toxicity 9 things | arrhythmias, anorexia, nausea, vomiting, diarrhea, HA (headache), fatigue, confusion, visual disturbances (blurred vision, seeing green or yellow halos around objects) |
| What electrolyte disturbances can cause digoxin toxicity 4 things | hypokalemia, hypomagnesemia, hypercalcemia, thiazide or loop diuretics |
| what 4 drugs can cause digoxin toxicity | quinidine, verapamil, amiodorone, corticosteroids |
| what 6 other conditions should be considered to cause digoxin toxicity | use cardiac pacemaker, hepatic dysfunction, hypothyroid, respiratory, renal disease, advanced age |
| what clinical parameters to assess when giving digoxin 5 things | BP, apical pulse for 1 min (do not give if below 60 above 120), heart and breath sounds, weight and I/O, EKG |
| what labs should be checked when giving digoxin6 things | potassium, sodium, magnesium, calcium, renal and liver function tests |
| patients should report what weight gain when taking PIAs | 2 lbs or more in a day, 5 lbs or more in a week |
| what therapeutic effects are seen with PIAs | increased urinary output, (decreased edema, shortness of breath, dyspnea, crackles, fatigue), resolving of paroxysmal nocturnal dyspnea, improved peripheral pulses, skin color, and temperature |
| the PIA b-adrenergic agonists do what 2 things | improve cardiac performance and vasodilation |
| the drug dobutamine is a PIA b-adrenergic agonist and is used where and given how | in acute care and by IV |
| the PIA phosphodiesterase inhibitor does what 3 things | increases intracellular calcium, cardiac contractility, and concentration of cAMP.For short term use only |
| Name 2 phosphodiesterase inhibitors | amrinone and milrinone (must use an infusion pump when giving) |
| what 2 things do you need to know about IV amrinone | do not mix with dextrose and solution color is a true yellow |
| what 4 things does the aldosterone antagonist spironolactone do | prevents salt retention, myocardial hypertrophy, hypokalemia, and promotes potassium retention |
| when is spironolactone used | in advanced cases of HF |
| what are the adverse effects of spironolactone 7 things | peptic ulcer disease (PUD), gastritis, lethargy, confusion, gynecomastia, decreased libido, menstrual irregularities |
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