• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/47

Click to flip

47 Cards in this Set

  • Front
  • Back
What is the general therapeutic goal with drugs in HF?
-improve contractility (inotropic)
-improve kidney function
-all to improve tissue perfusion
What is inotropic?
increases force of myocardial contraction
What is chronotropic?
increases HR
What is dromotropic?
increases conduction velocity
What do glycosides do to the heart?
mainly increases inotrope (squeeze)
What HF is most common?
left HF
What are the forward effects & backward effects of left HF?
forward: low CO
backwards: pulmonary pooling
What are the indications for glycosides?
-HF**
-Atrial Fibrillation
-Supra-Ventricular Dysrhythmias
What is HF?
syndrome where the heart is unable to pup sufficient blood to meet the metabolic needs of tissues
What are some physiological adaptations the heart makes with HF?
-cardiac dilation: increased venous pressure (larger heart/larger CO)
-activated SNS: stimulated by baroreceptors (increase inotrope & chronotrope)
-water retention: less urine to increase CO
-activation of RAAS
What type of drugs improve inotropic (squeeze)?
-ACEI
-ARB's
-cardiac glycosides
What are the major underlying causes of HF?
-chronic HTN
-MI
What type of drugs reduce preload?
diuretics
What type of drugs reduce afterload?
vasodilators
What type of drug allows for rate control and ventricular restructuring?
beta-blockers
What is the prototype for cardiac glycosides?
digoxin (Lanoxin)
How does digoxin (Lanoxin) work on the heart?
-increase inotrope (inhibits plasma membrane's Na & K pump)
-decrease chronotrope (increase response of SA node to Ach)
-decrease dromotrope (alters the electrical properties of the heart)
How is digoxin first dose given?
Digitalization: higher first dose to reach therapeutic concentrations then normal doses to continue therapeutic range
What are SE of digoxin?
bradycardia
What do we check before giving digoxin?
apical pulse
-if below 45 hold drug. call physician
What is a pulse deficit?
difference between apical & radial pulse
What does digoxin toxicity look like (signs & symptoms)?
early
-n/v
-vision changes
late
-fast dysrhythmias
-halos around lights
What drugs can increase the likelihood of digoxin toxicity?
-drugs that depress cardiac function (BB & CCB)
-hypokalemia (most common cause of dig OD: diuretic)
-antacids, laxatives & cholesterol-lowering agents (ACE & ARB)
What do we use to reverse digoxin toxicity?
-stop doses
-immune fab (Digibind) binds with molecule and excretes it through kidneys.
-hasten elimination by binding (charcoal, cholestyramine)
What is considered to be a toxic serum level of digoxin?
2.2ng/mL
Does digoxin have an extremely narrow therapeutic range?
yes VERY narrow.
What do you need to watch with a pt taking digoxin?
-HR
-dysrhythmias
-hypokalemia (increases risk of toxicity)
-hyperkalemia (may produce dysrhythmias)
-renal insufficiency pt
-pt on diuretics
-take apical pulse for 1 minute
What is digoxin's half life?
36 hours
Why are cardiac glycosides (digoxin) dangerous?
because at therapeutic doses it can cause dysrhythmias.
What is angina?
type of myocardial ischemia, secondary to atherosclerosis of the coronary arteries. angina is a symptoms not a disease.
What is chronic stable angina typically triggered by?
physical activity
What is the underlying cause of chronic stable angina?
CAD (coronary artery disease)
What is acute angina?
-medical emergency
-results from severe CAD complicated by vasospasm, platelet aggregation, and/or thrombi
What are treatments for acute angina?
-sublingual nitroglycerin
-BB
-supplemental O2
-morphine
-ACEI
-ASA
-Heparin
What causes the angina pain?
imbalance between oxygen supply and oxygen demand.
What are the three drugs used to treat chronic stable angina?
-organic nitrate vasodilators
-BB (short term prophylactic only)
-CCB (prophylactic use)
What are the goals of treatment with chronic stable angina?
-relieve pain
-bring balance to MvO2, supply and demand
-prevention of MI
What is MvO2?
myocardial oxygen
What is the organic nitrate vasodilator prototype?
nitroglycerin (NTG)
How does nitroglycerin work?
-vasodilation of peripheral arteries
-dilates coronary arteries
How do we give nitroglycerin (NTG)?
-typically seen in dissolvable tablets and acts in minutes
-nasal spray
-ointments (messy & wear GLOVES)
-IV for emergent use following an MI
Can you give nitroglycerin PO?
you could but pt gets nothing after first pass effect
What are the most common SE of nitroglycerin?
-HA
-hypotension
-reflex tachycardia
How does pt take nitroglycerin at home if experiencing angina?
-take SL tablet
-wait 5 minutes
-if pain continues repeat with 2nd dose
-if pain persists after 2nd call 911 & take 3rd.
What should pt feel under their tongue with nitroglycerin?
tingling. if not tingling then medication has lost potency.
How long is nitroglycerine good for?
6 months after opened
How is nitroglycerin stored?
-in airtight light resistant (brown) glass bottles
-cannot store in pill boxes