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