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64 Cards in this Set
- Front
- Back
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NAME CLASS 1 MED(S) FOR DYSRHYTHMIAS
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moricizine (Ethmozine)
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BESIDES BLOCKING NA CHANNELS, WHAT IS A CLASS 1 MED USED FOR?
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Used for symptomatic ventricular and life-threatening dysrhythmias
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NAME CLASS 1A MED(S) FOR DYSRHYTHMIAS (3)
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quinidine, procainamide, disopyramide
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WHAT DOES A CLASS 1A MED DO? (3)
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-Block sodium (fast) channels
-Delay repolarization (relaxation) -Increase APD (action potential duration) |
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WHAT IS A CLASS 1A MED USED FOR? (5)
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1. atrial fibrillation (Afib)
2. premature atrial contractions (PAC) 3. premature ventricular contractions (PVC) 4. ventricular tachycardia (VT) 5. *Wolff-Parkinson-White syndrome (WPW) |
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NAME CLASS 1B MED(S) FOR DYSRHYTHMIAS (2)
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phenytoin (Dilantin), lidocaine
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WHAT DOES A CLASS 1B MED DO? (3)
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1. Block sodium channels
2. Accelerate repolarization 3. Increase or decrease APD |
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WHAT IS A CLASS 1B MED USED FOR? (3)
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Ventricular Dysrhythmias Only
1. PVC'S 2. ventricular tachycardia 3. ventricular fibrillation |
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WHEN DO YOU GIVE CLASS 1B MEDS?
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Give after you have defibrillated the pt
Shock them, wait, and give meds to stabilize pt |
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NAME CLASS 1C MED(S) FOR DYSRHYTHMIAS (2)
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flecainide, propafenone
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WHAT IS A CLASS 1C MED USED FOR? (2)
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1. Block sodium channels
(more pronounced effect) 2. Used for severe ventricular dysrhythmias |
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WHAT IS ELSE CAN A CLASS 1C MED ALSO BE USED FOR? (3)
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1. atrial fibrillation/flutter
2. Wolff-Parkinson-White syndrome (WPW) 3. supraventricular tachycardia dysrhythmias |
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WHAT ARE CLASS 2 MEDS?
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beta-blockers
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WHAT DO CLASS 2: BETA-BLOCKERS DO?
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Reduce or block SNS stimulation
(reducing transmission of impulses in the heart’s conduction system) |
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WHAT ARE CLASS 2: BETA-BLOCKERS USED FOR?
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General myocardial depressants for both supraventricular and ventricular dysrhythmias
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NAME CLASS 2: BETA BLOCKER MED(S)
(4) |
atenolol (Tenormin)
esmolol (Brevibloc) metoprolol (Lopressor) propranolol (Inderal) |
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WHAT ELSE CAN CLASS 2: BB
BE USED TO TREAT? |
Also used as antianginal & antihypertensive drugs
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TRUE OR FALSE: CLASS 2 BB ARE GIVEN IN IV FORM FAST
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FALSE; CLASS 2 BB ARE GIVEN IN IV FORM SLOWLY
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NAME CLASS 3 MEDS (3)
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amiodarone (Cordarone)
sotalol (Betapace) ibutilide (Covert) |
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WHAT IS THE ACTION OF A CLASS 3 MED? (2)
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Increase APD
Prolong repolarization in phase 3 |
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WHAT IS THE CLASS 3 MEDS USED FOR? (3)
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1. Used for dysrhythmias that are difficult to treat
2. Life-threatening ventricular tachycardia or fibrillation, atrial fibrillation or flutter—resistant to other drugs 3. Sustained ventricular tachycardia |
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NAME CLASS 4 MED(S) FOR DYSRHYTHMIAS (2)
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Verapamil (Calan)
diltiazem (Cardizem) |
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WHAT IS THE ACTION OF CLASS 4 MEDS? (3)
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1. Calcium channel blockers-Inhibit slow-channel (calcium-dependent) pathways
2. Depress phase 4 depolarization 3. Reduce AV node conduction |
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WHAT ARE CLASS 4 MEDS USED FOR? (2)
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1. paroxysmal supraventricular tachycardia
2. rate control for atrial fibrillation and flutter |
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WHAT ARE SOME OTHER MEDS THAT CAN BE USED FOR DYSRHYTHMIAS?
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Digoxin & adenosine
Have properties of several classes not placed into one particular class |
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DYSRHYTHMIA DRUGS
WHAT IS ADENOSINE (ADENOCARD) USED FOR? |
Used to convert paroxysmal supraventricular tachycardia back to sinus rhythm
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WHAT IS THE ACTION ADENOSINE (ADENOCARD)?
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Slows conduction through the AV node
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TRUE OR FALSE: ADENOSINE (ADENOCARD) HAS A SHORT-HALF OF LESS THAN 10 SECONDS.
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TRUE; CAN BE PUSHED VERY QUICKLY
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WHAT DOES THE NURSE NEED TO BE ADVISED ABOUT WHEN ADMINISTERING ADENOSINE (ADENOCARD)?
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May cause asystole for a few seconds (3-5secs)
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WHAT ARE THE SIDE EFFECTS OF DYSRHYTHMIA DRUGS? (4)
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1. ALL anti-dysrhythmics can cause dysrhythmias!
2. Hypersensitivity reactions 3. Nausea, Vomiting, Diarrhea 4. Dizziness, Blurred vision, Headache |
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WHAT ARE THE CLASSES OF ANGINA MEDS?
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1. Nitrates/nitrites
2. Beta-blockers 3. Calcium channel blockers |
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WHAT ARE THE GOALS FOR TREATMENT FOR ANGINA MEDS? (5)
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Increase blood flow to ischemic heart muscle
Decrease myocardial oxygen demand-decrease the need by providing blood flow Minimize the frequency of attacks and decrease the duration and intensity of anginal pain Improve the patient’s functional capacity with as few adverse effects as possible Prevent or delay the worst possible outcome: MI |
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ANGINA:
WHAT ARE THE MAIN ROUTES FOR NITRATES? (4) |
Sublingual*
Buccal* IV solutions* Ointments * |
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WHAT ARE THE RAPID ACTING FORMS OF NITRATE USED FOR?
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Used to treat acute anginal attacks
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ANGINA:
WHAT ARE THE LONGER ACTING FORMS OF NITRATE USED FOR? |
Used to PREVENT anginal episodes
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ANGINA:
TRUE OR FALSE: SINCE NITRATES BYPASS THE FIRST BYPASS-EFFECT, RENAL/LIVER PT'S DONT HAVE TO BE WORRIED |
TRUE
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ANGINA
WHAT IS THE MECHANISM OF ACTION FOR NITRATES? (6) |
1. Cause vasodilation because of relaxation of smooth muscles
2. Used for prevention and treatment of angina 3. Vasodilation results in reduced myocardial oxygen demand Result: oxygen to ischemic myocardial tissue 4. Nitrates alleviate coronary artery spasm 5. Nitrates cause dilation of both large and small coronary vessels 6. Potent dilating effect on coronary arteries |
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ANGINA
WHAT IS NITROGLYCERIN USED FOR? |
Used for symptomatic treatment of ischemic heart conditions (angina)
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WHAT IS THE IV FORM OF NITROGLYCERIN USED FOR? (4)
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1. BP control in perioperative hypertension
2. treatment of HF, ischemic pain 3. pulmonary edema associated with acute MI 4. hypertensive emergencies |
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AS THE NURSE, WHAT DO YOU TEACH THE PATIENT TO DO WHEN TAKING NITROGLYCERIN? (4)
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1. Instruct patients in proper technique and guidelines for taking sublingual nitroglycerin for anginal pain
2. Instruct patients never to chew or swallow the sublingual form 3. Instruct patients that a burning sensation felt with sublingual forms indicates that the drug is still potent 4. Teach pt’s how to take Nitro-3 nitro x 3 q 5min |
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TRUE/FALSE: NITRO TEACHING
To preserve potency, meds should be stored in an airtight, dark glass bottle with a metal cap and no cotton filler |
TRUE
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TRUE/FALSE: NITRO TEACHING
AS THE NURSE YOU SHOULD DISCOURAGE THE PT FROM keeping a fresh supply of sublingual medication on hand; potency is lost in about 3 months after the bottle has been opened |
FALSE; AS THE NURSE,
Instruct patients to keep a fresh supply of sublingual medication on hand; potency is lost in about 3 months after the bottle has been opened |
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YOU HAVE A PATIENT WHOSE TAKING NITRO IN THE FORM OF AN OINTMENT. WHAT SHOULD YOU TEACH THE PT ABOUT USING THE OINTMENT?
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ROTATE THE SITE
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TRUE/FALSE: NITRO TEACHING
To reduce tolerance, the patient may be instructed to remove topical forms at bedtime and apply new doses in the morning, allowing for a nitrate-free period |
TRUE
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ANGINA
AS THE NURSE YOU SHOULD NOT Instruct patients to take prn nitrates at the first hint of anginal pain |
FALSE; Instruct patients to take prn nitrates at the first hint of anginal pain
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TRUE/FALSE: NITRO TEACHING
THE NURSE SHOULD Monitor vital signs frequently during acute exacerbations of angina and during IV administration |
TRUE
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If a pt is experiencing chest pain and taking sublingual nitroglycerin what should they do next?
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They should lie down to prevent or decrease dizziness and fainting that may occur because of hypotension
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1ST TIME NITRO USERS WHO GET A HEADACHE SHOULD DO WHAT WITH THE NEXT DOSE?
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Put it somewhere away from the heart like the leg.
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WHAT IS THE ACTIONS DO YOU TAKE IF ANGINAL PAIN OCCURS? (5)
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1. Stop activity and sit or lie down
2. Take a sublingual tablet, and call 911/Emergency Services immediately! 3. If no relief in 5 minutes, take a second sublingual tablet 4. If no relief in 5 minutes, take a third sublingual tablet 5. *Do not try to drive to the hospital |
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NAME SOME NITRATE MEDICATIONS
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Isosorbide dinitrate
(Isordil, Sorbitrate, Dilatrate SR) Isosorbide mononitrate (Imdur, Monoket, ISMO) |
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ANGINA
WHAT IS ISODRIL OR IMDUR USED FOR? |
Acute relief of angina
Prophylaxis in situations that may provoke angina Long-term prophylaxis of angina |
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ANGINA
WHAT IS THE BIGGEST ADVERSE EFFECT OF TAKING NITRATE? (3) |
Headaches
Tachycardia postural hypotension |
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ANGINA
TRUE/FALSE: NITRATE SINCE A TOLERANCE MIGHT DEVELOP, FOR Transdermal forms: remove patch at bedtime for 8 hours, then apply a new patch in the morning |
TRUE
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NAME SOME BETA BLOCKERS THAT ARE USED FOR ANGINA (4)
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atenolol (Tenormin)
metoprolol (Lopressor) propranolol (Inderal) nadolol (Corgard) |
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WHAT IS THE MECHANISM OF ACTION FOR BB USED FOR ANGINA? (3)
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1. Block beta1-receptors on the heart
2. Decrease HR, resulting in decreased myocardial oxygen demand and increased oxygen delivery to the heart 3. Decrease myocardial contractility, helping to conserve energy or decrease demand |
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Angina:
WHAT ARE SOME CLINICAL INDICATIONS FOR BB? (4) |
1. Angina
2. Antihypertensive treatment 3. Cardiac dysrhythmias 4. Cardioprotective effects-especially after MI |
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ANGINA:
WHAT ARE SOME THINGS AS THE NURSE SHOULD YOU TEACH YOUR PT ABOUT BB? (4) |
1. Patients taking beta-blockers should monitor pulse rate daily and report any rate lower than 60 beats per minute
2. Instruct patients to report dizziness or fainting 3. Constipation is a common problem 4. Instruct patients to take in adequate fluids and eat high-fiber foods |
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ANGINA:
IF A PT STOPS TAKING THE BB ABRUPTLY WHAT CAN HAPPEN? |
REBOUND HYPERTENSIVE CRISIS
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TRUE/FALSE: ANGINA
A PT CAN STOP TAKING BB ONCE THEY HAVE IMMEDIATE RELIEF FROM SYMPTOMS. |
FALSE; Inform patients that these medications are for long-term prevention of angina, not for immediate relief
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ANGINA:
WHAT IS THE MECHANISM OF ACTION FOR CALCIUM CHANNEL BLOCKERS? (3) |
1. Cause coronary artery vasodilation
2. Cause peripheral arterial vasodilation, thus decreasing systemic vascular resistance 3. Reduce the workload of the heart Result: decreased myocardial oxygen demand |
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NAME SOME CCB USED FOR ANGINA (4)
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1. verapamil (Calan, Isoptin)
2. diltiazem (Cardizem) 3. nifedipine (Procardia) 4. amlodipine (Norvasc) |
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ANGINA:
WHAT ARE THE CLINICAL INDICATIONS FOR CCB? (3) |
1. First-line drugs for treatment of angina, hypertension, and supraventricular tachycardia
2. Coronary artery spasms (Prinzmetal’s angina) 3. Short-term management of atrial fibrillation and flutter |
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ANGINA:
WHAT ARE THE ADVERSE EFFECTS OF CCB? (6) |
1.Hypotension
2. Palpitations 3. Tachycardia or Bradycardia 4. Constipation (a common problem)- instruct patients to take in adequate fluids eat high-fiber food 5. Nausea 6. Dyspnea |
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TRUE/FALSE: ANGINA
A NURSE HAS TO TAKE INTO CONSIDERATION PTS WITH ANGINA THAT ARE TAKING CCB IF THEY HAD A PAST Hx OF AN ENDOCRINE DISORDER BECAUSE IT CAN CAUSE EXACERBATIONS. |
TRUE
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