front 1 LDL, HDL, Triglycerides, Total cholesterol | back 1 Total Chol - Less than 200 LDL - Less than 100 HDL - Less than 35 Tri - Less than 149 |
front 2 ST segment elevation means what? | back 2 Sign of a MI |
front 3 Atorvastatin (Lipitor) | back 3 Moa: inhibits HMG-CoA reductase. First line of drugs to reduce serum-lipid levels. |
front 4 What are some AE? and what must the nurse asses for? (Atorvastatin) | back 4 AE: Headache, fatigue, muscle or joint pain, Heartburn Assess for complaints of muscle pain, tenderness, and weakness. Can cause Rhabdomyolysis. |
front 5 Bile-acid Resins Cholestyramine (Questran) | back 5 Moa: Bind with bile acids, increasing cholesterol excretion in stool. Primary use: lower serum-lipid levels. |
front 6 What are the AE for Cholestyramine? | back 6 GI tract, such as bloating and constipation. It can bind to other drugs increasing potential for drug interactions. |
front 7 Nicotinic Acid (Niacin) - B-complex Vitamin B3 | back 7 It decreases VLDL and LDL levels. Reduces the triglycerides; increase HDL levels |
front 8 What are the AE for Niacin ? | back 8 Flushing, hot flashes, nausea, excess gas, diarrhea. Serious AE: hepatotoxicity and gout possible (monitor Uric acid) (Pt can take aspirin 30min prior to taking niacin to decrease hot flash side effect) |
front 9 Fibric-Acid Agents (Gemfibrozil) | back 9 Tx severe hypertriglyceridemia. |
front 10 AE for Gemfibrozil (Lopid) | back 10 GI distress, watch for bleeding w/ pts on anticoagulants |
front 11 Beta-Adrenergic Blockers Metoprolol, Atenolol, Labetalol, Propranolol, Sotalol, Carvedilol | back 11 Moa: Block cardiac action of sympathetic nervous system to slow heart rate and BP, reducing workload of heart. Primary use: reduce symptoms of HF and slow progression of disease. |
front 12 AE of Metoprolol | back 12 Fluid retention, worsening of HF, Fatigue, hypotension, bradycardia, heart block. Do not stop abruptly. Hold Med if pulse less than 60 and BP below 90/60. |
front 13 Acebutalol | back 13 can give to pts with asthma or COPD. Maintains satisfactory HR |
front 14 Calcium Channel Blockers Dihydropyridines Nifedipine (Adalat, Procardia), Amlodipine (Norvasc), | back 14 They are the most potent vasodilators. Clevidipine (IV only) |
front 15 Non-Dihydropyridines/Peripheral and Heart Verapamil, Diltiazem | back 15 Both can be given PO or IV. lowers the HR so hold if less than 60 |
front 16 The AE for CCBs | back 16 Dihydropyridines: Dizziness, Headache, flushing, reflex tachycardia Peripheral edema, gingival hyperplasia, |
front 17 AE for non-Dihydropyridines | back 17 Peripheral edema, headache, gingival hyperplasia, Constipation in 10% of pts taking verapamil. |
front 18 ACE inhibitors Lisinopril, Captopril, enalopril | back 18 Moa: Inhibit ACE enzyme and decrease aldosterone secretion Primary use: to decrease BP and reduce blood volume; dilate veins. |
front 19 What are the AE for Ace inhibitors? | back 19 First dose Hypotension, cough, hyperkalemia, renal failure. Edema of tongue, Glottis and Pharynx |
front 20 What is a Black box warning for ACE drugs? | back 20 Can cause injury and death to developing fetus. |
front 21 ARBs - Angiotensin II Receptor Blockers | back 21 It relaxes the smooth muscle to promote vasodilation |
front 22 ARBs Losartan, Olmesartan, Valsartan | back 22 PO only. Higher cost, reserved for pts who develop cough with ACE inhibitors. Indications: Hypertension, MI, HF, Prevention of stroke in pt with high risk of CVD. |
front 23 Alpha 1 blockers Prazosin, Terazosin, Doxazosin, Tamsulosin | back 23 Promotes dilation of arterioles and veins Reduces prostatic symptoms in men. |
front 24 The A2 Agonists Methyldopa, Clonidine | back 24 Meth.- PO Clon- PO, Transdermal patch. MOA: Vasodilation, reduces HR and CO Pregnant women CAN have methyldopa |
front 25 Arteriolar Vasodilators Hydralazine, Minoxidil | back 25 Hydra - Po, IV Minox- PO IV Hydralazine is reserved for pts with Hypertension emergencies. Minoxidil - can be used for alopecia |
front 26 What are some AE for Arteriolar Vasodilators? | back 26 AE: Reflex tachycardia, Vascular headache, Lupus-like syndrome (Hydralazine) Minoxidil: Pericardial effusion - reserved for pts who do not respond to first line agents; Hirsutism. |
front 27 What do you need to check before giving Digoxin? | back 27 Apical Pulse for 1min. If less than 60bpm hold the dose and notify Dr |
front 28 Cardiac Glycosides Digoxin (Lanoxin) | back 28 Moa: to cause more forceful heartbeat, slower heart rate Primary use: increases contractility to strength of MI contraction making the heart a more effective pump while decreasing the PR. |
front 29 Milrinone | back 29 Increase cardiac output by increasing the force of myocardial contraction |
front 30 What are the AE for Digoxin ? | back 30 Neutropenia, dysrhythmias, digitals toxicity Digoxin Toxicity: N/V, fatigue, anorexia and visual disturbances like seeing yellow haze and halos or blurring. Antidote: Digibind |
front 31 Nitrates | back 31 Relax both arterial and venous smooth muscle. Short acting - Terminate acute angina episode Long Acting - Decrease severity and frequency of episode |
front 32 Nitrates (Nitroglycerin) What is a common side effect and what can help? | back 32 Headache is common expected Side effect, pt can take Tylenol PRN. It can lead to reflex tachy due to vasodilation and Orthostatic Hypotension. Do not use Viagra and Nitrates Concurrently, |
front 33 What is the first line drug for angina pain? | back 33 Beta-adrenergic blockers, Atenolol, can cause: Fatigue, insomnia, drowsiness, impotence, bradycardia, confusion |
front 34 Troponin I and Troponin T | back 34 To determine MI. |
front 35 Thombolytics Reteplase (Retavase) | back 35 Dissolves clots obstructing coronary arteries. |
front 36 PT,INR, Platelet, aPTT | back 36 PT - 11-12.5 sec INR - 2-3 aptt - 25-35 Platelet - 150,000 - 350,000 |
front 37 Oral Antiplatlet Agents Aspirin | back 37 75mg-325mg Clinical use: Primary and secondary use prevention of MI |
front 38 ADP Antagonists Clopidogrel, Prasugrel | back 38 slightly more effective than ASA for MI but more expensive. AE: Bleeding |
front 39 IV Antiplatelet Agents Eptifibatide, Tirofiban, Abciximab | back 39 Final common pathway for platelet aggregation Short term used to prevent ischemia in pts with acute coronary syndromes AE: Increase risk for major bleeding, possible risk for fatal hemorrhage |
front 40 Anticoagulants Heparin (Parenteral), Warfarin (oral) | back 40 Moa: prevent formation or enlargement or clots Primary use: prevent formation of clots in veins, to treat thromboembolic disorders. |
front 41 what is the antidote for warfarin and heparin? | back 41 Protamine Sulfate - Heparin Vit K - Warfarin |
front 42 What labs do you check when taking warfarin (coumadin)? | back 42 PT and INR |
front 43 Fibrinolysis | back 43 Clot removal |
front 44 ONAM | back 44 Oxygen, Nitroglycerin, Aspirin, Morphine |
front 45 Antidote for Morphine? | back 45 Naloxone |
front 46 Adenosine | back 46 First line drug of choice to tx PSVT AE: Short period of asystole Flushing, dyspnea, chest pain, hypotension, |
front 47 Diltiazem | back 47 2nd line agent after adenosine to tx PSVT Monitor BP, HR and Rhythm AE: Dysrhythmias, bradycardia, Heart block, hypotension |
front 48 Amiodarone | back 48 IV Form is first line agent in ACLS for tx of life-threatening ventricular dysrhythmias and cardiac arrest. AE: Hypotension, Bradycardia |
front 49 Lidocaine | back 49 Tx significant ventricular dysrythmias Lidocaine Toxicity: Confusion, drowsiness, hearing impairments, muscle twitching, seizures, Myocardial depression |
front 50 Magnesium Sulfate | back 50 Tx refractory ventricular tachy and Ventricular fibrillation Magnesium toxicity: Hypotension, bradycardia, flushing, sweating, diarrhea, Resp. Dep., |
front 51 Epinephrine | back 51 tx profound bradycardia and hypotension, asystole, 1:1,000 1:10,000 |