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Pharm Ch 15
| Question | Answer |
|---|---|
| medications used to treat chest pain from angina and problems with diseases causing blockage of arteries, mostly in legs | antianginals and peripheral vasodilators |
| narrowing or constriction of smooth muscle in the coronary arteries and peripheral vascular system reduces the: | amount of blood circulated |
| vasoconstriction causes: | chest pain |
| antianginals and vasodilators - causes direct relaxation of teh smooth muscle layer of blood vessels to increase blood flow; used to treat angina | nitrates |
| examples of nitrates | nitroglycerin (Nitrobid, Nitrostat); isosorbide dinitrate (Isordil); isosorbide mononitrate (ISMO, Imdur) |
| adverse effects of nitrates | HA; hypotension, dizziness, weakness, flushing |
| Dose of nitroglycerine may be repeated ever _____ minutes for up to ______ minutes. If third dose is given, should be on the way to the hospital. | 5; 15 |
| nursing considerations for nitrates: | protect meds from sunlight; use gloves when administering; monitor vital signs; avoid foods that also stimulate heart; do not exert self |
| antianginals and vasodilators that inhibit the movement of calcium ions across cell membranes | calcium-channel blockers |
| examples of calcium-channel blockers | Amlodipine (Norvasc); nifedipine (Procardia); diltiazem (Cardizem); verapamil (Calan), felodipine (Plendil) |
| uses of calcium channel blockers | prevent angina pain, essential hypertension |
| adverse effects of calcium channel blockers | primarily vasodilating effects, dizziness, light-headedness, nausea, vomiting, diarrhea, constipation, peripheral edema, headache, bradycardia, flushing, dermatitis, nervousness |
| antianginals and vasodilators - used to relax smooth muscles in arterioles and lower PVR (peripheral vascular resistance); used in treatment of HTN | direct vasodilator |
| examples of direct vasodilators | hydrazaline (Apresoline); minoxidil (Loniten) |
| adverse effects of direct vasodilators | throbbing HA, profuse hirsutism (hair) on face and body, sodium and water retention, palpitations, reflex tachycardia (heart rate will go up and down) |
| disturbance or irregularity in the heart rate, rhythm, or both | cardiac dysrhythmia |
| cardiac antidysrhythmic agents are classified according to: | the effects on the heart's electrical conduction |
| The middle layer of the heart myocardium work together with the _______________ in the SA node. | pacemaker |
| When the rhythm of the heart is working normal it is called: | NSR (normal sinus rhythm) |
| electrical graph of the heartbeat | electrocardiogram (ECG) |
| antidysrhythmic that lengthens the effective refractory period of atrial and ventricle myocardium (makes atria and ventricles work better) | Class 1-A Anti-Dysrhythmics |
| Class 1-A Anti-Dysrhythmic that has membrane-stabilizing effect on the myocardial cells | Quinidine (Quinidex) |
| Class 1-A Anti-Dysrhythmic that decreases the rate of diastolic depolarization in the ventricles, decreases the rate and height of the action potential, and increases fibrillation threshold | porcainamide (Pronestyl) |
| Class 1-A Anti-Dysrhythmics that decreases the rate of depolarization of myocardial fibers during the diastolic phase of the cardiac cycle | disopyramide (Norpace) |
| antidysrhythmic that can slow the heart down and can help it restart; acts by raising the ventricular myocardium threshold | Class I-B Anti-Dysrhythmics |
| examples of Class I-B Anti-Dysrhythmics | lidocaine (Xylocaine), tocaininide (Tonacard), mexiletine (Mexitil), phenyoin (Dilantin) |
| antidysrhythmic that reduce sympathetic excitation; act by blocking stimulation of beta receptors of the heart | Class II Anti-Dysrhythmics - Beta Blockers |
| Examples of Class II Anti-Dysrhythmics | propranolol (Inderal), acebutolol (Sectral), esmolol (Brevibloc) |
| acts to prolong refactory period and increase ventricular fibrillation threshold | Class III Anti-Dysrhythmics |
| Class III Anti-Dysrhythmics that lengthens the action potential duration or length of time it takes one cell to fire and recover | Amiodarone |
| Other examples of Class III Anti-Dysrhythmics | bretylium (Bretylol), amiodarone (Cardarone), ibutilide (Convert), sotalol (Betaspace) |
| Calcium channel blockers that inhibit movement of calcium through channels across the myocardial cell membrane and vascular smooth muscle | Class IV Anti-Dysrhythmics |
| examples of Class IV Anti-Dysrhythmics | verapamil (Calan) |
| treat or prevent cardiac arrhythmias such as: premature ventricular contractions (PVC), ventricular tachycardia, prematuer atrial contractions (PAC), paroxysmal atrial tachycardia; atrial fibrillation and flutter | uses of anti-dysrhythmics |
| adverse reactions of anti-dysrhythmics | light-headedness; weakness; hypotension; bradycardia; drowsiness; new arrhythmias or worsening of existing arrhythmias |
| Miscellaneous Antidysrhythmics (action is dependent on RX) | adenosine (Adenocard), digoxin (Lanoxin), isoproternol (Isupres) |
| used to treat atrial tachydysrhythmias | Adenocard adn Lanoxin |
| used only if life-threatening V-tach | Isuprel |
| adverse effects of miscellaneous antidysrhythmics | IV adenosine-apprehension, dizziness, HA, SOB, chest pain, flushing, transient dysrhythmias,hypotension; digoxin-fatigue, weakness, HA, dysrhythmias, bradycardia, thrombocytopenia, digoxin toxicity; Isuprel-tachydysrhythmias, sinus tachycardai, chest pain |
| S/S of digoxin toxicity | n/v, yellow green halo around every light |
| When administering digoxin: | take apical pulse for 1 full minute. If >60, give med. If <60, hold med and call doctor. Digoxin makes heart pump more efficiently - doesn't really change rate |
| used to treat hyperlipidemia | antilipidemics |
| increase in the lipids or fat-like substances in the blood | hyperlipidemia |
| cholesterol levels are high if: | >200 |
| triglyceride levels are high if: | >150 |
| inhibit cholesterol manufacture or promote cholesterol breakdown (inhibits cholesterol manufacturer; stops cholesterol before it builds up); used to treat hyperlipidemia in conjunction with diet | HMG-CoA Reductase Inhibitors |
| Examples of HMG-CoA Reductase Inhibitors | lovastatin (Mevacor), simvastatin (Zocor), atorvastatin (Lipitor), pravastatin (Pravachol), rosuvastatin (Crestor) |
| adverse effects of HMG-CoA Reductase Inhibitors | N/V, constipation, abdominal pain, HA |
| binds to bile acids to form insoluble substance that cannot be absorbed; with loss of bile acids, liver uses cholesterol to replace the bile; used in the treatment of hypercholesterolemia (finds a use for cholesterol in the body and letting it work) | Bile Acid Sequestrants |
| examples of Bile Acid Sequestrants: | Cholestyramine (Questran) and colestipol (Colestid) |
| adverse effects of bile acid sequestrants | constipation or diarrhea, vitamin A and D deficiencies, bleeding tendencies, abdominal pain and distention, fecal impaction |
| Fibric Acid Agent that stimulates liver to increase very low-density lipoprotein (VLDL) and low-density lipoprotein (LDL) breakdown and decreases VLDL synthesis and inhibits cholesterol; used when high serum triglyceride levels | clofibrate (Atromid-S) |
| adverse effects of fibric acid agents | n/v, GI upset, diarrhea, cholelithiasis (gall stones) |
| Fibric Acid Agent that acts by reducing VLDL and stimulating triglyceride catabolism (mechanical breakdown); used as adjunctive treatment of reduction of LDL, total cholesterol, and triglycerides | fenofibrate (Tricor) |
| adverse effects of fenofibrate (Tricor) | n/v, GI upset, diarrhea, cholelithiasis, abnormal liver function, respiratory problems, back pain, HA; also causes leg cramps |
| Fibric Acid Agent that increases cholesterol excretion in the feces and reduces triglyceride production; used when there are high serum triglyceride levels | gemfibrozil (Lopid) |
| adverse effects of gemfibrozil (Lopid) | n/a, GI upset, diarrhea, dyspepsia, skin rash, vertigo, headache, cholelithiasis |
| Miscellaneous Antilipidemics used in treatment of high cholesterol | ezetimibe (Zetia) |
| Miscellaneous Antilipidemics whose action is not fully understood; used as adjunctive therapy for hyperlipidemia | Niacin (Vitamin B3) |
| Adverse effects of Niacin | N/V, abdominal pain, diarrhea, flushing of the skin, sensation of warmth, severe itching |
| drugs that affect cardiac output | cardiotonics |
| drugs used to increase the efficiency and improve the contraction of the heart muscle | cardiac glycosides |
| examples of cardiac glycosides | digoxin (Lanoxin, Digoxin) |
| act to increase cardiac output through positive inotropic activity and decrease conduction velocity through the AV and SA nodes; used when pt has heart failure and atrial fibrillation (most commonly used for afib) | cardiac glycosides |
| Cardiac glycosides have a ____________ margin of safety. Even ___________ doses may produce toxicity. They have rapid onset and ___________ duration. Dosages are ____________. | narrow; normal; short; individualized |
| series of doses of digoxin given until drug begins to exert full therapeutic effect; may be rapid or gradual; serum digoxin levels ordered daily; patient is monitored closely (gets pt into safe therapeutic range) | Digitalization |
| has inotropic effect on the heart (increases force of myocardial contractility) | phosphodiesterase inhibitor |
| examples of phosphodiesterase inhibitors | amrinone lactate (Inocor), milrinone lactate (Amacor) |
| adverse effects of phosphodiesterase inhibitors | HA, anorexia, n/v, abdominal cramps, hypotension, dysrhythmias |
| drug that increases uring secretion by the kidneys; first line of treatment for hypertension | diuretics |
| increase excretion of sodium and chloride by inhibiting their reabsorption in the distal and proximal tubules and in the loop of Henle; used for CHF edema, cirrhosis, renal disease | loop diuretics |
| examples of loop diuretics | Lasix, Bumex, Demadex |
| adverse effects of loop diuretics | anorexia, nausea, vomiting, dizziness, rash, postural hypotension, orthostatic hypotension, photosensitivity reactions, glycosuria, hypokalemia |
| inhibits reabsorption of sodium and chloride ions in the ascending loop of Henle and early distal tubule; used for HTN, CHF edema, hepatic cirrhosis, corticosteroid and estrogen therapy, renal dysfunction | thiazide-like diuretics (metazon - Zaroxolyn) |
| Thiazides | Hydro-Diuril, HCTZ (hydrochlorothiazide), Diuril |
| inhibits reabsorption of sodium and chloride ions in the ascending loop of Henle and early distal tubule; used for hypertension, CHF edema, hepatic cirrhosis, corticosteroid and estrogen therapy, renal dysfunction | Thiazide-like diuretics: metazone (Zaroxolyn) |
| Thiazide and thiazide-like diuretics adverse effects: | fluid and electrolyte loss; gastric irritation, abdominal bloating; reduced libido; dizziness, headache; photosensitivity; weakness |
| depress sodium reabsorption in the kidney tubules or antagonize action aldosterone | potassium sparing diuretics |
| potassium sparing diuretic used to treat CHF and HTN | Amiloride |
| potassium sparing diuretic used to treat HTN (do not have to have potassium supplement); when used with other antihypertensive drugs, adverse reactions are associated with both drugs | Spironolactone and triamterene |
| adverse effects of potassium sparing diuretics | hyperkalemia; gynecomastia |
| interfere with the renin-angiotensin-aldosterone system; lowers B/P | ACE Inhibitors (-prils) |
| examples of ACE inhibitors | catopril (Capoten), benazepril (Lotensin), enalapril (Vasotec), quinapril (Accupril), ramiprile (Altace), lisinopril (Prinvil, Zestril) |
| adverse effects of ACE inhibitors | most common: dry, hacking cough "ACE cough"; others - HA, dizziness, fainting, weakness, hypotension, rash, dry skin, dry mouth |
| selectively block stimulation of postsynaptic a1 receptors that regulate vasomotor tone; used in treatment of HTN | a1-Adrenergic Blockers (not used very often) |
| Examples of a1-Adrenergic Blockers | prazosin (Minipress), doxazosin mesylate (Cardura - most common), terazosin (Hytrin) |
| adverse effects of a1-Adrenergic blocker | 1st dose phenomenon, slushing, HA, dizziness, fainting, weakness, edema, tachycardia, palpatation, dysrhythmias |
| block both cardiac and bronchial receptors | B-Adrenergic Blockers (-lols) |
| B-Adrenergic blocker used in treatment of HTN, angina, MI, ventricular dysrhythmias | propanolol (Inderal) |
| B-Adrenergic blocker used in treatment of HTN, angina, MI | atenolol (Tenormin), metoprolol (Lopressor), nadolol (Corgard) |
| adverse effects of B-Adrenergic blockers | HA, flushing, dizziness, bradycardia, postural hypotension, fatigue, drowsiness, confusion, bronchospasm, bronchoconstriction |
| selectively block the binding of angiotensin II to specific AT-receptors found in vascular smooth muscle and adrenal glands; used in treatment of HTN | Angiotensin II Receptor Blocker Agents (-sartans) |
| examples of Angiotensin II Receptor Blocker Agents | Losartan (Cozaar), valsartan (Diovan), irbesartan (Avapro), candesartan cilexetil (Atacand) |
| combine the blocking of selective a-receptors and nonselective blocking of b-receptors; used in treatment of HTN | a-Beta Blocker |
| examples of a-Beta Blockers | labetalol trandate (Normodyne), carvedilol (CoReg) |
| adverse effects of a-Beta Blockers | HA, dizziness, fainting, orthostatic hypotension, drowsiness, dyspnea, fatigue,diarrhea, imparied ejaculation, edema with weight gain |
| stimulate central a2 receptors; used in treatment of HTN | Central a-Adrenergic Agonsists |
| examples of Central a-Adrenergic Agonsists | methyldopa (Aldomet), clonidine -most common-(Catapress); guanabenz (Wytensin) |
| conidine (Catapress) is the most common a-Adrenergic agonist - used to decrease blood pressure quickly | |
| adverse effects of Central a-Adrenergic Agonsists | nasal congestion, dry mouth, constipation, impotence, lowered libido, HA, dizziness, drowsiness, weakness, fatigue, orthostatic hypotension |
| drugs used to treat urinary tract infections (UTIs) caused by susceptible microorganisms | urinary anti-infectives |
| infection caused by pathogenic microorganisms of one or more structures of the urinary tract | urinary tract infection |
| structures affected by UTI | bladder, urethra, prostate, kidney |
| clinical meifestations of bladder infection: | urgency, frequency, burning and pain on urination, pain from the spasms |
| used in treatment of UTIs, prstatitis | urinary tract animicrobial antiseptics |
| examples of urinary tract animicrobial antiseptics | ciprofloxacin (Cipro), ofloxacin (Floxin), trimethoprin-sulfamethoxazole (Bactrim) |
| adverse effects of urinary tract animicrobial antiseptics | n/v, diarrhea, constipation, gastric distress and crystalluria, photosensitivity (Bactrim) |
| bacteriostatic or bactericidal | nitrofurantoin (Macrodantin), Furadantin |
| adverse effects of bacteriostatic or bactericidals | n/v, anorexia, rash, peripheral neuropathy, HA, brown discoloration of uring, hypersensitivity reaction |
| urinary tract antispasmodic analgesics used to relieve symptoms of dysuria, urinary urgency, nocturia suprapubic pain, and urge incontinence; acts to counteract smooth muscle spasm by relaxing the detrusor muscle | flavoxate (Urispas) |
| urinary tract antispasmodic analgesics used to treat bladder instability caused by a neurogenic bladder; acts to relax the bladder muscle and reduce spasm | oxybutynin (Ditropan) |
| adverse effects of oxybutynin (Ditropan) | dry mouth, constipation, diarrhea, decreased production of tears and sweating, GI disturbances, dim vision, urinary hesitancy |
| used as a urinary analgesic; dye that acts to exert topical analgesic effect on the lining of the urinary tract; available OTC | phenazopyridine (Pyridium) |
| used to treat overactive bladder; acts to inhibit bladder contractions and delay the urge to void | tolterodine (Detrol) (similar to Ditropan) |
| adverse effects of tolterodine (Detrol) | dry mouth, drowsiness, decreased sweating, blurred vision, nausea, vomiting, dizziness, abdominal pain |
| medication for the management of Benign Prostatic Hyperplasia (BPH) | Tamsulosin (Flomax) |
| s/e of Tamsulosin (Flomax) | HA |
Created by:
akgalyean
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