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Stack #4558838
| Question | Answer |
|---|---|
| What is considered hypertension in pt 60 years or older? | >150/90 |
| What is considered hypertension in pt 60 years or younger? | >140/90 |
| What is considered hypertension in pt with chronic kidney disease or diabetes? | >140/90 |
| What is a positive inotropic drug? | Increases the force/strength of a contraction |
| What is a positive chronotropic drug? | Increases heart rate |
| What is a negative inotropic drug? | Decreases the force/strength of a contraction |
| What is a negative chronotropic drug? | Decreases heart rate |
| What is the MOA of a vasodilator? | Relaxes vessels |
| How does vasodilators effect preload and afterload? | Decreases both |
| What is the goal of a vasodilator? | Increase supply and decrease demand on the heart |
| What is the indication of vasodilators? | HTN |
| What are two examples of vasodilators? | Hydralazine and nitroprusside |
| When is nitroprusside used? | During hypertension emergencies |
| What are the side effects of vasodilators? | Hypotension, GI upset, headache, and dizziness |
| What is the black box warning for nitroprusside? | Cyanide toxicity |
| When should vasodilators be held? | If SBP <100 |
| What should nurse instruct pt to do while taking vasodilators? | Gradual position changes |
| What do ACE inhibitors end in? | PRIL |
| What is the MOA of ACE inhibitors? | Decreases aldosterone production and reduces BP |
| How does ACE inhibitors effect preload and afterload? | Decreases both |
| What are the indications of ACE inhibitors? | HTN, heart failure, MI, and diabetic nephropathy |
| What is the cardiovascular drug of choice for pt with diabetes? | ACE inhibitors |
| What drugs can ACE inhibitors be combined with? | Thiazide diuretic or CCB |
| What are the side effects of ACE inhibitors? | Hypotension, hyperkalemia, dry unproductive cough, and angioedema |
| What is the black box warning for ACE inhibitors? | Cannot use with pregnancy |
| What is the MOA of ARBS? | Target AFTR1 blocking activation |
| What are the indications of ARBS? | HTN and heart failure |
| What do ARBS end in? | Sartan |
| What are the side effects of ARBS? | Chest pain, hypoglycemia, diarrhea, UTI, anemia |
| What is the black box warning for ARBS? | Don't use during pregnancy |
| What do diuretics do? | Decrease preload and total peripheral resistance |
| What is the MOA of loop diuretics? | Reduce sodium chloride reabsorption in the loop of Henle |
| What are the side effects of loop diuretics? | Dehydration, hypotension, hypokalemia, hyponatremia, and ototoxic |
| What do loop diuretics end in? | Semide |
| What should pt taking diuretics monitor? | Intake and output and their daily weight |
| When should loop diuretic be held? | If potassium <3.5 or SBP <100 |
| When should a diuretic be taken? | In AM |
| What is black box warning for loop diuretics? | Water and electrolyte imbalance |
| What is MOA Of thiazide diuretics? | Inhibition of sodium chloride transporter in the distal convoluted tubule |
| When should aldosterone antagonist diuretics be held? | If SBP <100 |
| What are the side effects of thiazide diuretics? | Dehydration, hypotension, hypokalemia, hyponatremia |
| When should thiazide diuretics be held? | Potassium <3.5 and SBP <100 |
| What is an example of thiazide diuretic? | Hydrochlorothiazide |
| What is the MOA of aldosterone antagonist diuretic? | Blocks aldosterone to decrease sodium reabsorption and potassium excretion |
| What are the indications of diuretics? | HTN, edema associated with heart failure, pulmonary edema, liver cirrhosis, and renal disease |
| What is an example of an aldosterone antagonist diuretic? | Spironolactone |
| What is the MOA of CCB? | Prevents calcium in the heart which decreases HR and causes dilation of blood vessels |
| What is the indication of CCB? | Angina and hypertension |
| What are the contraindications of CCB? | Known drug allergy, acute MI, 2nd or 3rd AV block w/o pacemaker, and hypotension |
| When should a CCB be held? | If SBP <100 or HR <60 |
| What are side effects of CCB? | hypotension, bradycardia, dyspnea, constipation, palpitations |
| What should CCBs not be given with? | Grapefruit juice |
| What type of drug is doxazosin? | A peripherally active alpha1 receptor blocker |
| What is the indication for adrenergic drugs? | HTN |
| What are the side effects of adrenergic drugs? | Orthostatic hypotension, first dose syncope, sedation, sexual dysfunction, and rebound hypertension with abrupt discontinuation |
| What is MOA of beta blockers? | Decrease HR and contractility |
| How are beta blockers helpful after an MI? | Blocks the harmful effects of catecholamines |
| What are the indications of Beta Blockers? | Angina, HTN, dysrhythmias, MI, and heart failure |
| What are the contraindications of beta blockers? | Systolic HF, asthma, diabetes mellitus, and peripheral vascular disease |
| Why can beta blockers impact diabetes? | Can mask hypoglycemia-induced tachycardia |
| When should beta blockers be held? | HR <60 and SBP <100 |
| What are side effects of beta blockers? | Bradycardia, hypotension, dizziness, erectile dysfunction |
| What is black box warning for beta blockers? | Rebound tachycardia and hypertension if stopped abruptly |
| What is the MOA of nitrates? | Causes vasodilation |
| How does nitrates effect preload and afterload? | Decreases both |
| What is indication for nitrates? | Angina prevention and tx |
| How can nitrates be given? | Sublingual, chewable tabs, oral tabs, transdermal patches, ointments, and translingual sprays |
| How many sublingual nitrate tabs can you give? | 3 tabs 5 minutes apart |
| How do you know sublingual nitrates are working? | Tingling sensation |
| What should nurse tell her pt about nitrate transdermal patch? | Remove patch at bedtime and apply a new patch in the am to prevent tolerance |
| What is an example of a nitrate? | Nitroglycerin |
| What are the side effects of nitrates? | Headaches, hypotension, reflex tachycardia, postural hypotension |
| What are the contraindications of nitrates? | Anemia, glaucoma, hypotension, severe head injury, and use of erectile dysfunction drugs |
| What is MOA of phosphodiesterase inhibitors (PDI)? | Increase contractibility and vasodilate |
| What are the indications of PDI? | Heart failure |
| What are the side effects of PDIs? | Dysrhythmia, hypotension, angina, hypokalemia, thrombocytopenia, elevated liver enzymes |
| What drugs can PDIs not be given with? | Diuretics and digoxin |
| What is example of a PDI? | Milrinone |
| What is the MOA of cardiac glycosides? | Positive inotropic and negative chronotropic effect |
| What does cardiac glycosides promote? | Tissue perfusion and diuresis |
| What are the indications of cardiac glucosides? | Heart failure and atrial fibrillation |
| When are cardiac glycosides used? | When no other drugs are effective |
| What is the prototype cardiac glycoside? | Digoxin |
| What are the side effects of cardiac glycosides? | Bradycardia, visual changes, hypotension, anorexia |
| What needs to be assessed prior to giving a cardiac glycoside? | Apical pulse for 1 full minute |
| What should be monitored in elderly when taking a cardiac glycoside? | Creatine |
| What can an increase of creatine do when taking a cardiac glycoside? | Toxicity |
| What electrolyte be monitored for pt taking cardiac glycoside? | Potassium levels |
| What can low potassium levels do to cardiac glycosides? | Increase toxicity |
| What is important to monitor with digoxin and why? | Levels because it has a very small therapeutic window of 0.5- 2 ng/ml |
| What does thrombus mean? | Blood clot |
| What is fibrin? | A clot forming substance |
| What is fibrinolysis? | Formed thrombi are lysed to prevent clot formation |
| What is plasminogen? | A circulating protein that fibrin binds to |
| What does plasminogen convert to? | Plasmin |
| What is plasmin? | A protein that breaks down the fibrin thrombus |
| What is hemophilia? | A rare genetic disorder that no coagulation facts are present |
| What are the three major risk factors for a DVT? | Immobilty, trauma, and increased coagulation |
| What is the MOA of an antiplatelet drug? | Prevents platelets from clumping together |
| What are two examples of antiplatelet drugs? | Aspirin and clopidogrel |
| What are the side effects of antiplatelet drugs? | Increased bleeding risk, GI upset with aspirin, and Reyes syndrome with aspirin |
| What is the MOA of anticoagulants? | Prevents the formation of new clots |
| What are the side effects of anticoagulants? | Increased bleed risk and heparin induced thrombocytopenia (HIT) |
| What is heparin induced thrombocytopenia (HIT)? | Immune reaction to heparin that causes low platelet levels and clot formation |
| What is petechiae? | Little dots that indicate bleeding from small vessels |
| What labs are monitored for pt taking heparin? | INR and PTT |
| What labs are monitored for pt taking warfin? | INR and PT |
| What do INR, PT, and PTT labs monitor? | Amount of time it takes for blood to clot |
| What are two examples of anticoagulants? | Warfarin and heparin |
| How does heparin work? | Prevents clotting factor from forming |
| How does warfin work? | Prevents the release of clotting factors |
| When are LMWHs contraindicated in pts? | Pts with indwelling epidural catheter risk of epidural hemotoma |
| How is heparin given? | IV or subq |
| What are the two types of heparin? | Unfractionated heparin and low molecular weight heparin (LMWH) |
| What type of heparin is usually given through IV? | Unfractionated heparin |
| What type of heparin is usually given subq? | LMWHs |
| What type of herpin does not require lab monitoring? | LMWHs |
| What is the antidote for LMWHs? | Protamine sulfate |
| What is an example of a LMWHs? | Enoxaparin |
| What is a normal INR without warfarin? | 1.0 |
| What is a therapeutic INR with warfarin? | 2-3.5 |
| What is the antidote for warfarin? | Vitamin K |
| What does warfarin interact with? | Herbal (Gingko) |
| How long does warfarin take to begin working? | Several days |
| What is rivaroxaban (Xarelto) used for? | Prevention of strokes or treatment of DVT and PE |
| What are side effects of rivaroxaban (Xarelto)? | Hematuria and bleeding |
| What is the MOA of thrombolytic drugs? | Break down existing clots |
| What are two examples of thrombolytic drugs? | Alteplase and reteplase |
| What are the indications of thrombolytic drugs? | MI, ischemic strokes, DVT, pulmonary embolus |
| What are the side effects of thrombolytic drugs? | Increased bleeding risk and risk of reperfusion injury |
| When are thrombolytic drugs given? | Emergency situtions |
| What is the MOA of antifibrinolytic drugs? | Inhibits fibrinolysis resulting in clot formation |
| When are antifibrinolytic drugs given? | In controlled enviroments |
| What are the indications of antifibrinolytic drugs? | Surgical procedures, trauma, bleeding disorders |
| What is the MOA of statins? | Reduce cholesterol production |
| What are the side effects of statins? | Myalgia, rhabdomyolysis, and liver enzyme elevation |
| What is rhabdomyolysis? | Breakdown of muscle |
| What should you not give statins with? | Grapefruit juice |
| What is MOA of bile acid sequestrants? | Increased excretion of bile acids |
| What other drug can bile acids sequestrants be given with? | Statins |
| What are the side effects of bile acid sequestrants? | GI discomfort |
| What do bile acid sequestrants effect the absorption of? | Fat soluble vitamins |
| What should pt taking bile acid sequestrants do? | Increase fluid and fiber intake |
| How long before or after taking a bile acid sequestrant should a pt take their bile acid sequestrants? | 1 hr before or 4 hrs after |
| What is the MOA of cholesterol absorption inhibitor? | Inhibit the absorption of dietary cholesterol in the small intestine to reduce the uptake of cholesterol |
| What are the side effects of a cholesterol absorption inhibitor? | GI disturbance (most common), elevated liver enzymes, and muscle pain |
| What is important to monitor for pt taking a cholesterol absorption inhibitor? | Liver function |
| What other drug class can cholesterol absorption inhibitors be given with to enhance LDL reduction? | Statins |
| What is the MOA of niacin? | Reduces the triglycerides and LDL cholesterol and increase HDL |
| What are the side effects of niacin? | Flushing, pruritus, and constipation |
| What should be monitored when taking niacin? | Liver function |
| How long does niacin take to work? | Several weeks |
| What do pt on long term niacin therapy may need? | Supplemental fat soluble vitamins |
| What is the MOA of carbonic anhydrase inhibitors? | Increased excretion of bicarbonate and decreased sodium and water reabsorption |
| What are the side effects of carbonic anhydrase inhibitors? | Metabolic acidosis and hypokalemia |
| What should carbonic anhydrase inhibitors not be combined with and why? | Digoxin because they cause hypokalemia |
| What is MOA of osmotic diuretics? | Increase osmotic pressure to prevent water and electrolyte reabsorption |
| What are indications for osmotic diuretics? | Cerebral edema, acute renal failure, acute glaucoma, and intracranial pressure |
| What is the largest side effect with osmotic diuretics? | Pulmonary congestion |
Created by:
emilychaltraw