Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
204 Cards in this Set
- Front
- Back
|
First line of treatment for hypertension is what?
|
lifestyle modification – 1) Weight loss, 2)Sodium restriction, 3) Alcohol restriction, 4) Aerobic Exercise, 5) Smoking cessation, 6) Maintenance of K & Ca intake
|
|
|
First line med used for uncomplicated hypertension
|
Diuretics- Thiazide
|
|
|
What class of med is Hydrochlorothiazide (HydroDIURIL)
|
Diuretics - Thiazide
|
|
|
ACTION of Diuretics - Thiazide
|
Promotes urine production by blocking reabsorption of Na and Cl in the early segment of distal convoluted tubule.
|
|
|
10% of Na and Cl is normally absorbed here and therefore lower output than high-ceiling diuretics
|
Early segment of distal convoluted tubule. Hydrochlorothiazide (HydroDIURIL)
|
|
|
THERAPEUTIC: Essential HTN- Primary indication for use
|
Diuretics - Thiazide
|
|
|
Preferred for mobilizing edema associated with mild to moderate heart failure
|
Diuretics - Thiazide
|
|
|
ADVERSE EFFECTS of Diuretics – Thiazide (4 things)
|
1) Hypokalemia, 2) Hyponatremia, 3) hypochloremia, 4) dehydration
|
|
|
CT EDUCATION for what class of drugs: Monitor weight (same time daily), Monitor BP, Change positions slowly, Monitor for hypokalemia, Eat K rich foods, Take in am to reduce nocturnal voiding
|
Diuretics – Thiazide & Loop Diuretics (Lasix)
|
|
|
ACTION: Blocks Na and Cl preventing reabsorption of H20 leading to profound diuresis
|
Furosemide (Lasix)
|
|
|
ACTION: 20% of Na and Cl is normally absorbed here and therefore this produces a high output
|
Furosemide (Lasix)
|
|
|
What routs can Lasix be given
|
PO, IV, IM
|
|
|
Furosemide (Lasix): PO Begins in __ hour and lasts___hrs
|
1, 8
|
|
|
Furosemide (Lasix): IV Begins in ___ minutes and lasts ___ hrs
|
5, 2
|
|
|
Furosemide (Lasix): How should IV be given?
|
Inject IV slowly (about 20 mg/min)
|
|
|
Rapid or massive mobilization of fluid r/t: Pulmonary edema assoc with CHF
|
Diuretics – Loop, Furosemide (Lasix)
|
|
|
Rapid or massive mobilization of fluid r/t: Edema of hepatic, cardiac, or renal origin that is not responsive to less intense diuretics
|
Diuretics – Loop, Furosemide (Lasix)
|
|
|
What medication given for HTN not controlled with milder diuretics
|
Diuretics – Loop, Furosemide (Lasix)
|
|
|
Useful in cts with renal failure because it promotes diuresis even when renal blood flow and GFR is low
|
Diuretics – Loop, Furosemide (Lasix)
|
|
|
ADVERSE EFFECTS: Ototoxicity
|
Diuretics – Loop, Furosemide (Lasix)
|
|
|
CT EDUCATION: Monitor use with other ototoxic drugs
|
Diuretics – Loop, Furosemide (Lasix)
|
|
|
CT EDUCATION:: Watch for Digoxin interaction
|
Diuretics – Loop, Furosemide (Lasix)
|
|
|
Spironolactone (Aldactone)- What class of medication?
|
Diuretics – Potassium Sparing
|
|
|
Where does aldosterone work?
|
Distal nephron
|
|
|
ACTION: Blocks aldosterone in distal nephron thereby retaining K and increasing excretion of Na
|
Diuretics – Potassium Sparing Spironolactone (Aldactone)
|
|
|
Responses of which medication: Modest increase in urine production w/ Substantial decrease in K excretion
|
Diuretics – Potassium Sparing Spironolactone (Aldactone)
|
|
|
Commonly used in combination with a thiazide or loop diuretic
|
Diuretics – Potassium Sparing Spironolactone (Aldactone)
|
|
|
ADVERSE EFFECTS: Hyperkalemia
|
Diuretics – Potassium Sparing Spironolactone (Aldactone)
|
|
|
Endocrine effects of what class of med: Gynecomastia, Menstrual irregularities, Impotence, Hirsutism, Deep voice
|
Diuretics – Potassium Sparing Spironolactone (Aldactone)
|
|
|
CT EDUCATION: Baseline serum K levels
|
Diuretics – Potassium Sparing Spironolactone (Aldactone)
|
|
|
CT EDUCATION: No K supplements and restrict K rich foods
|
Diuretics – Potassium Sparing Spironolactone (Aldactone)
|
|
|
CT EDUCATION of what diuretic: Caution with ACE Inhibitors
|
Diuretics – Potassium Sparing Spironolactone (Aldactone)
|
|
|
How should Aldactone be taken?
|
Take with or after meals if GI upset occurs
|
|
|
CT EDUCATION: Inform of possible endocrine effects and report
|
Diuretics – Potassium Sparing Spironolactone (Aldactone)
|
|
|
What Antihypertensive Meds: Suppress influence of the Sympathomimetic NS
|
Sympatholytic (Adrenergic Antagonists)
|
|
|
(olol’s): Atenolol, Metoprolol, Propranolol
|
Beta blockers
|
|
|
What Antihypertensive Meds act within the brainstem to suppress sympathetic outflow to the heart ( vasodilation and decrease CO)
|
Centrally acting alpha2 agonists
|
|
|
What Antihypertensive Med: Clonidine
|
Centrally acting alpha2 agonists
|
|
|
What Antihypertensive Med: Methyldopa
|
Centrally acting alpha2 agonists
|
|
|
What Antihypertensive Med: works through norepi depletion or inhibits release
|
Adrenergic Neuron Blockers
|
|
|
What Antihypertensive Med: Reserpine
|
Adrenergic Neuron Blockers
|
|
|
What Antihypertensive Med: (osin’s) – results in vasodilation by preventing vasoconstriction.
|
Alpha1-Adrenergic Blockers
|
|
|
What Antihypertensive Med: Doxazosin
|
Alpha1-Adrenergic Blockers
|
|
|
What Antihypertensive Med: Terazosin
|
Alpha1-Adrenergic Blockers
|
|
|
What Antihypertensive Med: (lol’s) – receptor blockers at the alpha and beta sites.
|
Alpha/Beta Adrenergic Blockers
|
|
|
What Antihypertensive Med: Labetalol
|
Alpha/Beta Adrenergic Blockers
|
|
|
What Antihypertensive Med: – reduce BP by direct action on arterioles:
|
Direct-Acting Vasodilators
|
|
|
What Antihypertensive Med: Hydralazine
|
Direct-Acting Vasodilators
|
|
|
What Antihypertensive Med: Minoxidil
|
Direct-Acting Vasodilators
|
|
|
What Antihypertensive Med: reduce BP by dilating arterioles
|
Calcium Channel Blockers
|
|
|
What Antihypertensive Med: Dihydropyridines (dipine’s)
|
Calcium Channel Blockers
|
|
|
What Antihypertensive Med: Nifedipine
|
Calcium Channel Blockers - Dihydropyridines (dipine’s)
|
|
|
What Antihypertensive Med: Amlodipine
|
Calcium Channel Blockers - Dihydropyridines (dipine’s)
|
|
|
What Antihypertensive Med: Non-Dihydropyridines
|
Calcium Channel Blockers
|
|
|
What Antihypertensive Med: Verapamil
|
Calcium Channel Blockers - Non-Dihydropyridines
|
|
|
What Antihypertensive Med: Diltiazem
|
Calcium Channel Blockers - Non-Dihydropyridines
|
|
|
What Antihypertensive Med: (pril’s) prevent formation of angiotensin II which prevents vasoconstriction
|
ACE Inhibitors
|
|
|
What Antihypertensive Med: Captopril
|
ACE Inhibitors
|
|
|
What Antihypertensive Med: prevent formation of angiotensin II which prevents vasoconstriction
|
ACE Inhibitors
|
|
|
What Antihypertensive Med: Enalapril
|
ACE Inhibitors
|
|
|
What Antihypertensive Med: – (sartin’s) block action of angiotensin II
|
Angiotensin II Receptor Blockers
|
|
|
What Antihypertensive Med: Losartan
|
Angiotensin II Receptor Blockers
|
|
|
Name 3 General Adverse effects of Antihypertensive Meds
|
1)Hypotension, 2) Sedation, 3) Sexual dysfunction
|
|
|
What Antihypertensive Med: Side effect- May intensify asthma (affects beta 2 receptors)
|
Beta blockers
|
|
|
What Antihypertensive Med: Side effect- May intensify AV block
|
Beta blockers
|
|
|
What Antihypertensive Med: Side effect- Bradycardia
|
Beta blockers
|
|
|
What Antihypertensive Med: Side effect- Reduced contractility
|
Beta blockers
|
|
|
What Antihypertensive Med: Side effect- May mask signs of hypoglycemia
|
Beta blockers
|
|
|
What Antihypertensive Med: Side effect- CNS: depression, insomnia, bizarre dreams
|
Beta blockers
|
|
|
What Antihypertensive Med: Side effect- Dry mouth
|
Centrally Acting Alpha 2 Agonists
|
|
|
What Antihypertensive Med: Side effect- Sedation
|
Centrally Acting Alpha 2 Agonists
|
|
|
What Antihypertensive Med: Side effect- Severe rebound hypertension if abruptly discontinued (clonidine)
|
Centrally Acting Alpha 2 Agonists
|
|
|
What Antihypertensive Med: Side effect- Hemolytic anemia and liver disorders (methyldopa)
|
Centrally Acting Alpha 2 Agonists
|
|
|
What Antihypertensive Med: Side effect- Depression
|
Adrenergic Neuron Blockers
|
|
|
What Antihypertensive Med: Side effect- Orthostatic hypotension
|
Alpha 1-Adrenergic Blockers
|
|
|
What Antihypertensive Med: Side effect- Same as alpha and beta blockers
|
Alpha/Beta-Adrenergic Blockers
|
|
|
What Antihypertensive Med: Side effect- Reflex tachycardia
|
Calcium Channel Blockers
|
|
|
What Antihypertensive Med: Side effect- Compromised cardiac performance… use cautiously in cts with bradycardia, heart failure, or AV block
|
Calcium Channel Blockers
|
|
|
What Antihypertensive Med: Side effect- Persistent cough
|
ACE Inhibitors
|
|
|
What Antihypertensive Med: Side effect- 1st dose hypotension
|
ACE Inhibitors
|
|
|
What Antihypertensive Med: Side effect- angioedema
|
ACE Inhibitors
|
|
|
What Antihypertensive Med: Side effect- Hyperkalemia
|
ACE Inhibitors
|
|
|
What Antihypertensive Med: Side effect- Fetal harm in 2nd/3rd trimester
|
ACE Inhibitors, Angiotensin II Receptor Blockers
|
|
|
What Antihypertensive Med: Side effect- Less effective against African American cts than Caucasian cts
|
ACE Inhibitors
|
|
|
African Americans respond better to what 3 types of hypertensive therapies:
|
Diuretics, CCB’s. Alpha/beta blockers
|
|
|
Monotherapy with beta blockers or ACE I is less effective in this population than in Caucasians.
|
African Americans
|
|
|
This population Respond better to diuretic therapy and beta blockers
|
Elderly
|
|
|
What Antihypertensive Med: Inotropic – increase the force of myocardial contraction
|
Cardiac Glycosides - Digoxin
|
|
|
What Antihypertensive Med: Given to improve performance of a failing heart
|
Cardiac Glycosides- Digoxin
|
|
|
Only inotrope that can be given orally
|
Cardiac Glycosides¬- Digoxin
|
|
|
What Antihypertensive Med: Oldest and most frequently used for long-term therapy of heart failure
|
Cardiac Glycosides- Digoxin
|
|
|
What Antihypertensive Med: Also known as Digitalis Glycosides
|
Cardiac Glycosides- Digoxin
|
|
|
What Antihypertensive Med: Naturally occurring compound that has a profound effect on mechanical and electrical properties of the heart
|
Cardiac Glycosides- Digoxin
|
|
|
What Antihypertensive Med: Most widely prescribed and most dangerous, High incidence of toxicity that induces life threatening, Use with respect, caution, and skill!
|
Cardiac Glycosides- Digoxin
|
|
|
What Antihypertensive Med: dysrhythmias
|
Cardiac Glycosides- Digoxin
|
|
|
What Antihypertensive Med: Digoxin (Lanoxin)
|
Cardiac Glycosides- Digoxin
|
|
|
What Antihypertensive Med: Digitoxin (Crystodigin)
|
Cardiac Glycosides- Digoxin
|
|
|
Main difference between digitoxin & digoxin.
|
Has a prolonged half-life and therefore treatment of toxicity is difficult. Therefore it is less prescribed than digoxin.
|
|
|
Cardiac Glycosides is indicated for use with 2 things.
|
Indicated for HF and control of dysrhythmias
|
|
|
ACTION of What Antihypertensive Med: Exerts a positive inotropic action on the heart…ie it increases the force of ventricular contraction and thereby increases cardiac output.
|
Cardiac Glycosides - Digoxin
|
|
|
What is an important component of digoxin levels and must be monitored and kept within normal physiologic range?
|
K is an important component of digoxin levels and must be monitored and kept within normal physiologic range of 3.5-5 mEq/L
|
|
|
Name 4 Benefits of Cardiac Glycosides
|
Increased CO, Decreased sympathetic tone (*), Increased urine output, Decreased renin release
|
|
|
Name 2 ADVERSE EFFECTS of Cardiac Glycosides:
|
Cardiotoxicity, Dysrhythmias
|
|
|
Therapeutic levels of Digoxin - Cardiac Glycosides
|
0.5-2.0 ng/ml. Levels above 2.0 ng/ml are TOXIC!
|
|
|
Name 4 Predisposing Factors for Adverse Effects of using Glycosides
|
1) Hypokalemia (secondary to use of diuretics) 2) Elevated digoxin levels 3) Heart Disease 4) Cardiac Glucosides
|
|
|
What 4 things can be done to Manage Digoxin-Induced Dysrhythmias:
|
1) Withdraw digoxin and potassium-wasting diuretics 2) Monitor serum K 3) Admin antidysrhythmic drug as ordered 4)Digibind can lower severe digoxin levels, but is very expensive.
|
|
|
NON-CARDIAC ADVERSE EFFECTS of Cardiac Glycosides: (GI) 3 things
|
1) Anorexia 2)Nausea 3) Vomiting
|
|
|
NON-CARDIAC ADVERSE EFFECTS of Cardiac Glycosides: (CNS)
|
1) Fatigue 2)Visual disturbances (blurred, yellow tinge, halos around dark objects)
|
|
|
In what forms are Cardiac Glycosides available
|
Available in tablets, pediatric elixir, injection, capsules.
|
|
|
What routs are cardiac glycosides given?
|
Admin orally or IV. IM is painful and can cause tissue damage.
|
|
|
If cardiac glycosides are given by this route, can cause tissue damage
|
IM
|
|
|
Cardiac Glycosides: Monitor HR prior to giving. Hold if less than ___ bpm and notify health care provider
|
60
|
|
|
Cardiac Glycosides: IV admin: monitor continuously for ___ hrs
|
1-2
|
|
|
Cardiac Glycosides: Loading dose may be required if maximal effects are needed ______
|
rapidly (digitalization)
|
|
|
Cardiac Glycosides: CT EDUCATION – What should the nurse teach about salt intake?
|
Limit salt intake to 1-2 gm/day and avoid excessive fluids.
|
|
|
Cardiac Glycosides: CT EDUCATION – What should the nurse teach if a dose is missed?
|
Do not double up on doses if one is missed
|
|
|
Cardiac Glycosides: CT EDUCATION – What should the nurse teach the client about failure to take as directed?
|
Teach that failure to take as directed may result in toxicity or therapeutic failure
|
|
|
Cardiac Glycosides: CT EDUCATION – What should the nurse teach about alcoholic consumption?
|
No more than one alcoholic beverage/day
|
|
|
Cardiac Glycosides: CT EDUCATION – What should the nurse teach about weight lose and exercise?
|
Encourage weight loss and regular mild exercise
|
|
|
What medication gives Angina relief through vasodilation
|
Nitrates
|
|
|
Most familiar organic nitrate
|
Nitroglycerin (NTG) is the prototype
|
|
|
Nitrates Nitroglycerin (NTG) Acts directly on vascular ___ to promote vasodilation
|
smooth muscle
|
|
|
Nitrates /Nitroglycerin (NTG): Acts primarily on ____.
|
VEINS. Action on arterioles is modest
|
|
|
Nitrates /Nitroglycerin (NTG): Decreases _____ thus decreasing pain
|
cardiac oxygen demand
|
|
|
Nitrates /Nitroglycerin (NTG): Relaxes or prevents spasm in coronary artery, thus increasing ____
|
oxygen supply
|
|
|
Nitrates /Nitroglycerin (NTG): Highly lipid soluble and therefore has many routes: What 5 routes?
|
PO, SL, IV, Buccal, Transdermal
|
|
|
Nitrates /Nitroglycerin (NTG): Plasma half-life is ___ minutes
|
5-7
|
|
|
Nitrates /Nitroglycerin (NTG): How is the HA treated?
|
treat with ASA or acetaminophen
|
|
|
ADVERSE EFFECTS: What is the main adverse effect of Nitrates /Nitroglycerin (NTG)?
|
Headache is the main adverse effect and will diminish over the first few weeks of treatment (treat with ASA or acetaminophen)
|
|
|
Nitrates /Nitroglycerin (NTG): Besides HA, what are 2 adverse effects of nitrates?
|
1) Orthostatic hypotension 2) Reflex tachycardia
|
|
|
Nitrates /Nitroglycerin (NTG): Drug interacts with what 4 drugs?
|
1) blockers, 2) verapamil, 3 )diltiazem, 4) viagra (do not take viagra within 24 hrs of taking NTG)
|
|
|
Nitrates /PO & SL: Causes what adverse effects if taken over a long period of time?
|
Tolerance
|
|
|
Nitrates SL: Should be replaced how often?
|
Store in tightly closed dark container and replace 6 months after opening
|
|
|
Nitrates: What Routes?
|
SL, PO (tablets and capsules), Transdermal, Translingual, Buccal, Topical Ointment, IV
|
|
|
Nitrates SL: How is it absorbed?
|
Absorbed directly through oral mucosa into bloodstream
|
|
|
Nitrates SL: Effects in ____ minutes
|
1-3
|
|
|
Nitrates SL: For Chest Pain, take BP, give 1 tab SL, repeat procedure every ______
|
q 5 min x 2.
|
|
|
Nitrates SL: Need to allow tablet to dissolve… may ____ a little
|
tingle
|
|
|
Nitrates SL: How should it be stored?
|
Store in tightly closed dark container and replace 6 months after opening
|
|
|
Nitrates/PO (tablets and capsules): Is it used to terminate ongoing attack or for prophylaxis?
|
Sustained release for long-term prophylaxis
|
|
|
What route: Nitrates that are Slow release & absorbed through skin
|
Transdermal
|
|
|
Which route of Nitrates is used for Prophylaxis
|
Transdermal
|
|
|
Transdermal: Onset is ____ minutes
|
30-60
|
|
|
Transdermal: What must be done with application?
|
Must rotate site, Must have free time, ie time when patch is off
|
|
|
Which route of Nitrates is a Metered dose spray?
|
Translingual
|
|
|
Translingual: Do not ____.
|
inhale
|
|
|
Buccal: Tablet placed in between ___ and _____
|
gum and cheek
|
|
|
What route of nitrates is used terminate ongoing attack or short term prophylaxis prior to exertion
|
Translingual, Buccal
|
|
|
Buccal: Dissolves over _____hours
|
3-5
|
|
|
Nitrates: Topical Ointment is sustained protection. It can be applied to what locations?
|
Applied to chest, back, abdomen, or anterior thigh
|
|
|
Nitrates: Topical Ointment - Effects in ___minutes and last up to ___ hrs
|
20-60, 12
|
|
|
Nitrates: Topical Ointment - Ordered by in ___ increments (or less) and is dispensed on a small sheet of paper
|
Inch - WEAR GLOVES!!!!
|
|
|
Nitrates: Which route is used for cts who have failed to respond to other meds
|
IV
|
|
|
Nitrates: Which route is Used for CHF assoc with acute MI, perioperative HTN and for controlled hypotension for surgery
|
IV
|
|
|
IV Nitrates: Continuous infusion needed with continuous monitoring of ____ and ¬¬¬¬____.
|
HR and BP
|
|
|
IV Nitrates: What kind of contained should be used?
|
Glass bottle for infusion because it is absorbed into polyvinyl chloride tubing
|
|
|
IV Nitrates: How should preparations be discontinued.
|
Discontinue long-acting preparations slowly
|
|
|
What class of drug is Isosorbide Dinitrate?
|
Other organic nitrates
|
|
|
What class of drug is Amyl nitrate?
|
Other organic nitrates
|
|
|
Treatment for hemophilia B: plasma or factor IX concentrate
|
(Konye or Proplex)
|
|
|
Treatment for hemophilia A:
|
regularly scheduled or intermittent IV administration of factor VIII cryoprecipitate 10-15 mL/unit; usually given I.V. push over three minutes
|
|
|
ACTION of what med: Inactivates thrombin in the clotting cascade
|
Heparin
|
|
|
Anticoagulants disrupt coagulation cascade by suppressing ____ formation
|
fibrin
|
|
|
ACTION: Antagonist of Vitamin K - Vitamin K critical component in clotting cascade (affects factor VII, IX, X, PT) - Blocks synthesis.
|
Warfarin (Coumadin)
|
|
|
•
|
Review clotting cascade in Lehne
|
|
|
Coagulation is production of ____ a substance that reinforces a platelet plug
|
fibrin
|
|
|
Anticoagulants disrupt coagulation cascade by suppressing ___ formation
|
fibrin
|
|
|
What is a Rapid-acting anticoagulant administered only by injection.
|
Heparin
|
|
|
Name the anticoagulant - SOURCE: Cattle lung & Pig intestine
|
Heparin
|
|
|
ACTION of what medicine: Inactivates thrombin in the clotting cascade
|
Heparin
|
|
|
How long is the ½ life of heparin?
|
½ life 1.5 hrs (longer if hepatic or renal dysfunction)
|
|
|
Heparin is THERAPEUTIC for 5 conditions:
|
1) Pulmonary embolism (PE) 2) Evolving stroke (embolic) 3) Deep vein thrombosis (DVT) 4) Open heart surgery 5) Renal Dialysis
|
|
|
Which type of heparin: Prevent post-op DVT, disseminated intravascular coagulation (DIC) and as and adjunct to acute MI. Is the dose of heparin used to treat these conditions, Therapeutic or lower doses of Heparin?
|
Lower doses of Heparin
|
|
|
ADVERSE EFFECTS of Heparin:
|
1) Hemorrhage, 2) Heparin induced thrombocytopenia (low platelet), 3) Hypersensitivity reactions (antigen contamination resulting in allergic response), 4) Chills, 5) Fever, 6) Urticaria
|
|
|
Name 3 ADVERSE EFFECTS of Subcutaneous administration Heparin: 2 short term and 1 long term
|
1) Local irritation 2) Hematoma 3) Osteoporosis
|
|
|
People who have the the follow conditions should not use what medication: Hemophilia, Risk for bleeding, increased capilliary permeability, dissecting aneurysm, peptic ulcer disease, severe hypertension, threatened abortion
|
Heparin
|
|
|
Contraindications for Heparin
|
Thrombocytopenia, uncontrolled bleeding, during after surgery of eye, brain, spinal cord, lumbar anesthesia
|
|
|
Drug interactions of Heparin:
|
ASA (caution d/t depressed plt function), ibuprofen
|
|
|
What is the antidote for heparin?
|
Protamine sulfate, Give 1 mg for each 100U heparin in the body
|
|
|
Labs for Heparin & what is the value:
|
Activated partial thromboplastin time (aPTT) Normal 40 sec
|
|
|
Therapeutic range of Heparin
|
1.5-2 times normal (60-80 seconds)
|
|
|
Heparin: the therapeutic range should be 1.5-2 x normal (60-80 sec) Allows for correction of dose. Monitor every ¬¬¬¬¬______until therapeutic, then daily
|
q4-6hrs
|
|
|
Enoxaparin (Lovenox) is what class of med
|
Low-Molecular Weight Heparin
|
|
|
Dalteparin (Fragmin) is what class of med?
|
Low-Molecular Weight Heparin
|
|
|
What route should low molecular weight heparin be given?
|
Subcutaneous only
|
|
|
•
|
Cost about $14/day (compared to heparin at $3/day… lab cost savings with LMW)
|
|
|
Warfarin antidote
|
Vitamin K
|
|
|
Vitamin K critical component in clotting cascade: affects which factors?
|
VII, IX, X, PT
|
|
|
Which med-THERAPEUTIC: Long term prophylaxis of thrombosis, Venous thrombosis associated with PE, Prevention of thromboembolism in prosthetic heart valves, Prevention of thromboembolism in atrial fibrillation, Decreases risk for TIA’s and recurrent MI
|
Warfarin
|
|
|
What anticoagulant should you NOT USEFUL IN EMERGENCIES!!!
|
Warfarin
|
|
|
•
|
Warfarin
|
|
|
What 2 LABS are used for Warfarin?
|
PT-12 seconds & INR-2-3
|
|
|
What is the normal range for PT?
|
10-13 seconds
|
|
|
Normal therapeutic range for INR is:
|
2-3, Target may be 3-4.5 in some cases.
|
|
|
Warfarin: Check labs how often for the 1st 5 days
|
Daily
|
|
|
Warfarin: Check labs daily for the 1st 5 days, then how often for 1-2 wks
|
2x/wk times 1-2 wks
|
|
|
Warfarin: Check labs daily for the 1st 5 days, 2x/wk times 1-2 wks, then how often for thereafter
|
Q2-4 wks thereafter
|
|
|
What is Coaguchek & ProTime Microcoagualation System?
|
Warfarin Home monitoring systems available
|
|
|
Fetal hemorrhage (teratogenic during pregnancy) is an adverse effect of what med?
|
Warfarin
|
|
|
What med has these DRUG INTERACTIONS? Heparin, ASA, Acetaminophen, & Vitamin K
|
Warfarin
|
|
|
What medication has these CONTRAINDICATIONS: Vitamin K deficiency, Liver disease, Alcoholism, Pregnancy, lactation, and also the same contraindications as heparin
|
Warfarin
|
|
|
How is an OVERDOSE of Warfarin Treated:
|
Treat with Vitamin K (oral or slow diluted IV)
|
|
|
What Medications may be needed to increase the clients blood pressure during the acute phase (increase force of contraction) due to hypotension which decreases cardiac output related to heart failure
|
Dopamine–Dobutamine
|
|
|
How is Pulmonary Edema Treated?
|
MAD DOG Morphine, Airway, Digitalis----Diuretics(Lasix), Oxygen, blood Gases (ABCs)
|
