What is the relationship between diuretics and PREload? - ANSWER-Diuretics decrease preload by decreasing fluid volume
What are the precautionary
... [Show More] interventions when using IV Verapamil? (3) - ANSWER-IV Verapamil can cause severe adverse cardiovascular effects.
1. Blood pressure and and ECG should be monitored
2. Equipment for resuscitation should be immediately available
3. Administer beta blockers several hours before verapamil
How are ACE inhibitors and Angiotensin II Receptor blockers different? - ANSWER-ACE inhibitors blocks the production of angiotensin II, while ARBs block the actions of angiotensin II
What is the anginal effect of calcium channel blockers? - ANSWER-Reduces contractility of coronary artery spasms (Variant) and peripheral arteries (stable)
(Decreases afterload)
What is the antidysrhythmic effect of sodium channel blockers? - ANSWER-Blocking sodium channels slow impulse conduction in the atria, ventricles, and His-Purkinje fibers
What is the relationship between potassium and Digoxin? - ANSWER-Potassium should be kept within normal range (3.5-5.5)/
Elevated K levels can impair therapeutic response, while low K levels can cause digoxin toxicity
Which medications cause reflex tachycardia? (2) - ANSWER-1. Nifedepine
2. Hydralazine
(Combine with beta-blockers to prevent)
What is the action of ACE inhibitors? - ANSWER-Decreases afterload
What are the adverse effects of ACE inhibitors? - ANSWER-1. First-dose HTN
2. Fetal injury (Never give in pregnancy)
3. Cough
4. Angioedema
5. Hyperkalemia
What are the therapeutic uses of Verapamil? - ANSWER-1. Angina
2. Essential HTN
3. Cardiac dysrhythmias
4. Migraine
Why is constipation an adverse effect of Verapamil? - ANSWER-Blocks calcium channels in the smooth muscle of the intestine
Does Nifedipine treat dysrhythmias? (T/F) - ANSWER-False
What is the target level of Digoxin? - ANSWER-0.5-0.8 ng/mL
What is the standard dose of Digoxin? - ANSWER-0.125-0.25 mg/day
What are the indications for ACE inhibitors? (4) - ANSWER-1. HTN
2. Heart failure (decreases afterload)
3. Nephropathy
Suffix for ACE inhibitors - ANSWER--pril
1. Lisinopril
2. Captoprill
3. Enalapril
What are the adverse effects of Angiotensin II recpetor blockers (ARBs)? - ANSWER-Same as ACE inhibitors, except no cough or hyperkalemia (Does not increase levels of bradykinin)
What is the MOA and therapeutic uses of aldosterone antagonists? (3) - ANSWER-Block receptors for aldosterone
1. Retains potassium
2. Increases excretion of sodium & water.
3. Decreases BP
Suffix for aldosterone antagonists - ANSWER--one
1. Spironolactone
2. Eplerenone
What are the indications for aldosterone antagonists? (2) - ANSWER-1. HTN
2. Heart failure (prevents remodeling)
What is the adverse effect of aldosterone antagonists? - ANSWER-Hyperkalemia
What factors affect preload? - ANSWER-1. Total blood volume,
2. Force of venous return, atrial kick, stiffness and thickness of heart walls
What factor affects afterload? - ANSWER-Peripheral resistance (constriction/dilation of arterioles)
What are the 5 hemodynamic effects of calcium channel blockers? - ANSWER-1. Block @ peripheral arterioles: Reduces arterial pressure
2. Block @ SV node: Reduces heart rate
2. Block @ myocardium: Reduces contractility
3. Block @ AV node: Decreases AV nodal conduction
What are the indications for calcium channel blockers? - ANSWER-1. HTN
2. Angina
3. Cardiac dysrhythmias (Except nifedipine)
What is the difference between Verapimil and Nifedipine (Calcium channel blockers)? - ANSWER-Nifedipine only acts on blood vessels, whereas Verapimil acts on calcium channel in the blood vessels and the heart.
Nifedipine cannot be used to treat dysrhythmias
What are the adverse effects of Verapamil? - ANSWER-1. Constipation (Severe in older adults)
2. Cardiac dysfunction exacerbation
What is IV Verapamil used for? - ANSWER-Dysrhythmias
What is the MOA and therapeutic effects (3) of Hydralazine? - ANSWER-Elective dilation of arterioles
1. Decreased afterload
2. Decreased BP and HR
3. INcrease
Which medications cause postural hypotension? (2) - ANSWER-1. Vasodilators
2. Loop diuretics
What are the interventions for a patient at risk for postural hypotension? (3) - ANSWER-1. Inform pts about symptoms
2. Advise to sit or lie down
3. Advise pts to change positions slowly
How does tachycardia affect cardiac output? - ANSWER-An increased HR does not allow enough time for ventricular filling, resulting in decreased cardiac output.
What are the general adverse effects of vasodilators? - ANSWER-1. Postural hypotension
2. Reflex tachycardia
3. Expansion of blood volume
What are the adverse effects of Diltiazem? - ANSWER-Same as verapamil, except less constipation
What is the interaction between beta-blockers and Verapamil and Diltiazem? - ANSWER-Beta blockers intensify the adverse cardiac effects of Verapamil and Diltiazem
What is the interaction between beta-blockers and Nifedipene? - ANSWER-Beta blockers decrease the adverse cardiac effects of Nifedipine
What is the MOA of digoxin? - ANSWER-Increases the force of myocardial contraction --> Increased cardiac output
Name the drugs used for heart failure (5) - ANSWER-1. Diuretics (Thiazide, loop, K-sparring)
2. RAAS inhibitors (ACE, ARBs, ALDs, Renin Inhibitors)
3. Beta Blockers (propranolol)
4. Inotropic agents (Digoxin)
5. Vasodilators (Hydrlazine, nitroglycerine)
What are the classes of antidysrhythmic drugs? - ANSWER-1. Sodium channel blockers
2. Beta Blockers
3. Postassium channel blockers
4. Calcium channel blockers
5. Other: Adensosin & Digoxin
What is the most dangerous dysrhythmia? - ANSWER-Ventricular fibrillation (no cardiac output)
What are the causes of dysrhythmias? (5) - ANSWER-1. Electrolyte imbalance
2. Coronary Artery Disease (CAD)
3. MI
4. Age
5. Surgery
What should be monitored with the use of spironolactone? - ANSWER-Potassium levels
(Avoid using ACE Inhibitors and ARBs)
What is the major benefit of spironolactone in heart failure? - ANSWER-Help to prevent remodeling that occurs in heart failure.
What is the relationship between diuretics and AFTERload - ANSWER-Diuretics decrease afterload by reducing blood volume
What is the adverse interaction between K-sparring diuretics and ACE/ARBs? - ANSWER-ACE & ARBs already can cause hyperkalemia, and K-sparring diuretics increases the risk.
What is the potential complication with thiazide/loop diuretics and digoxin? - ANSWER-Thiazide & loop diuretics can cause hypokalemia, which increases the risk of digoxin toxicity
What are the s/s of digoxin toxicity? - ANSWER-1. Bradycardia
2. N/V
3. Visual changes
Who is most a risk for digoxin toxicity and why? - ANSWER-Patients w/ renal failure are at risk for digoxin toxicity because it is primarily excreted by the kidneys.
What is the major adverse effect of digoxin? - ANSWER-Elevated levels = Digoxin toxicity
What precautions are taken when withdrawing beta blockers? - ANSWER-Withdraw gradually. Abrupt withdrawal may result in MI.
How do beta blockers treat angina? - ANSWER-Lowers HR to decrease oxygen demand
Which dysrhythmia is adenosine used for? - ANSWER-To stop Supraventricular tachycardia (SVT)
What is the common adverse effect of adenosine? - ANSWER-It causes asystole, but only for a brief period.
Why must adenosine be only administered intravaneously? - ANSWER-Short half life - less than 10 seconds.
Which potassium channel blocker is under distrubution restricted in the U.S.? - ANSWER-Tikosyn
What should be monitored while using amioderone? - ANSWER-1. Monitor pulmonary function
2. Chest x-ray and pulmonary tests
Why is amiodarone only approved for life-threatening ventricular dysrhythmias? - ANSWER-Pulmonary toxicity is common
What is the antidysrhythmic effect of potassium channel blockers (Amiodarone) ? - ANSWER-Delay repolarization and prolong action potential
What is the antidysrhythmic effect of calcium channel blockers? - ANSWER-Same as beta blockers
What is the antidysrhythmic effect of beta blockers? - ANSWER-1. Reduce automaticity in the SA node
2. Reduces conduction in the AV node
3. Reduces contractility in the atria and ventricles
What is the primary indication for Verapamil? - ANSWER-Angina pectoris
Which drugs should be avoided in the management of heart failure? - ANSWER-1. Antidysrhythimic drugs
2. Calcium channel blockers
3. NSAIDS
Which type of angina can beta blockers treat? - ANSWER-Stable angina
Suffix for ARBs - ANSWER--sartan
(Losartan, valspartan)
Which drugs prevent heart remodeling? - ANSWER-1. ACE inhibitors
2. ARBS
3. Aldosterone antagon [Show Less]