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71 Cards in this Set

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What is the time where an action potential CANNOT be produced?
absolute refractory period
What is a dysrhythmia?
an abnormality in the rhythm of the heartbeat.
What causes dysrhythmias?
-abnormal automaticity (ectopic impulse)
-abnormal conduction (current moves too fast or too slow)
-block of impulse conduction (dead tissue from MI)
-re-entry phenomenon
What is tachycardia?
HR>100
What is bradycardia?
HR <60
Why do we use antidysrhythmics?
to treat dysrhythmias
Supra -Ventricular
-sinus tachycardia
-atrial flutter
-atrial fibrillation
-premature atrial contractions
Ventricular
-premature ventricular contractions
-ventricular tachycardia
-ventricular fibrillation
What are the BIG SE of antidysrhythmics?
-make dysrhythmic worse
What should be monitored closely with dysrhythmias?
EKG. drugs has narrow therapeutic range.
What should all pt.'s do at home before taking antidysrhythmic medication?
HR
What can the EKG tell us with dysrhythmic pt?
if width of QRS increases by 50% the pt could go into cardiac failure
When using lidocaine to treat dysrhythmias what would be the signs of toxicity?
-dizziness
-visual disturbances
-HA
-sedation
-tinnitus
-seizures
What is the max dose of lidocaine?
3mg/kg
What is the prototype for potassium channel blocker used for dysrhythmias?
amiodarone (Cordarone)
How does amiodarone work?
-prolongs action potential
-increases refractory period
-blocks Na, K, Ca channels
When do we use amiodarone?
life-threatening dysrhythmias
What are the SE of amiodarone?
-pulmonary fibrosis*
-thyrotoxicosis
-blue-grey skin
How does adenosine (Adenocard)?
slows AV node conduction
When do we use adenosine?
PSVT (paraoxysmal supraventricular tachycardia)
What are the SE of adenosine?
-angina
What antidysrhythmia stops the heart and resets it?
adenosine
What is different about adenosine delivery compared to other meds?
must infuse it very fast over 3 seconds
How does atropine work?
-blocks vagal stimulation
-increases HR
-increases conduction thru AV node
When will we use atropine?
bradycardia
What is the action of Digoxin?
-decrease HR
-improve conduction
-increase contractility
What are the tree main types of antihyperlipidemia drugs?
-bile-acid sequestrants
-cholesterol synthesis inhibitors: HMG-CoA inhibitors (statins)
-lower serum triglycerides (fibrates)
What is the prototype for bile-acid sequestrants?
cholestyramine (Questran)
How does cholestyramine (Questran) work?
-binds w/bile so it cannot be reabsorbed
-body responds by making more cholesterol & bile than before
What are the indications to us cholestyramine (Questran)?
-hyperlipidemia
-elevated LDLs
Where does cholestyramine (Questran) solely work in the body?
GI tract
What are the SE of cholestyramine (Questran)?
-constipation (brown baby)
-n/v
-abdominal pain
What is the prototype for cholesterol synthesis inhibitors?
lovastatin (Mevacor)
What does lovastatin do?
-lower LDL
-decreases total triglyerides
-increasing HDL
Which food/drink supplement is not allowed to be taken with statins?
grapefruit juice
What is the indications for lovastatin?
primary hyperlipidemia
What are the SE of lovastatin?
-HA
-GI disturbances
-myalgia
-liver dysfunction
-mm degeneration
What must you check when pt is on statin?
-LFT's (liver)
-CK (mm breakdown)
How are anticoagulants typically used?
prophylactic
What medication works on the intrinsic pathway?
heparin
What medication works mostly on the extrinsic pathway (vitamin K)?
warfarin
What is the risk of using anticoagulants?
the risk of bleeding
What is the prototype of anticoagulants?
heparin
How does heparin work?
direct blocking of intrinsic pathway
What are the indications for heparin?
-prophylatic anticoagulation (low dose)
-full dose anticoagulation (DIC, embolism or thrombus)
What needs to be monitored frequently when administering heparin with IV?
aPTT
What are the SE of heparin?
-bleeding
-hemorrhage (GI< GU)
-allergic reactions (animal product)
-heparin induced thrombocytopenia (HIT)
Does heparin dissolve clots?
no it only prevents them
What is the aPTT goal for pt on heparin?
61-84
What is the antidote for heparin?
protamine sulfate
Why is protamine sulfate (antidote for heparin) black boxed?
can cause severe CV issues
What is the prototype for low-molecular weight heparin?
enoxaparin (Lovenox)
What are the indications for enoxaparin (Lovenox)?
-prevention of DVT (post-op)
-treatment of established DVT
-unstable angina
Who cannot receive enoxaparin (Lovenox)?
renal failure
How is enoxaparin (Lovenox) administered?
subQ in abdomen
What are SE of enoxaparin (Lovenox)?
-local erythema
-pain
-hematoma at injection site
Do you have to check aPTT with enoxaparin (Lovenox)?
no
What is heparin-induced thrombocytopenia (HIT)?
development of thrombocytopenia, due to the administration of various forms of anticoagulant medication, heparin. it is caused by the formation of abnormal Ab that activate platelets
If pt has HIT can they receive heparin?
no, never again!
What can we give a pt with HIT?
thrombin inhibitors Dabigatran (administered PO)
What is the prototype anticoagulant that is administered PO?
warfarin (Coumadin)
How does warfarin work?
-liver to inhibit synthesis of vitamin K dependant clotting factors. (does not work in the blood)
What are the indications for warfarin?
-long-term prophylaxis
-treatment of venous & arterial thrombosis
-PE
-prevention of MI
How is warfarin monitored?
prothrombin/INR time
What are the SE of warfarin?
-bleeding
-decreased dietary vitamin K intensifies effect
What is the antidote for warfarin?
vitamin K
What is prototype for a thrombolytic (clot buster)?
streptokinase (Streptase)
Why is thrombolytic rarely used?
can cause severe intracranial bleeding
What is the prototype for antiplatlets?
aspirin
How does aspirin work?
makes platelets less sticky
Antiplatelet agents are best for prevention of what?
arterial clots