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94 Cards in this Set
- Front
- Back
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What are the antihyperlipidemics?
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The statins
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What do the statins do?
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Reduce cholesterol synthesis in the body by inhibiting an enzyme made in the liver.
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How long does a therapeutic level take to reach for a statin?
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8 weeks
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Side effects of a statin
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Lens opacity, headache, myalgia, liver dysfunction, rash and alopecia
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Statins are AKA
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HMG-CoA reductase inhibitors
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Name some statins
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Lipitor, Zocor, Mevacor, Pravachol, crestor
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One lab test to monitor with statins
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Liver function Q3-6 months
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What food to avoid with a statin?
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Grapefruit juice
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What is a statin most effective at lowering?
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LDL
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What is the mechanism of action for Warfarin?
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It interferes with vitamin K production in the liver, hinders synthesis of clotting factors.
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How long to reach therapeutic level of Warfarin?
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4-5 days
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Which lab test to monitor for Warfarin?
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INR- The same reagent is used
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Antidote for Warfarin?
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Vitamin K
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What is the action of Heparin?
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Prevents conversion of prothrombin to thrombin by increasing the antithrombin on factor X. High doses neutralize thrombin, preventing conversion of fibrinogen to fibrin so a clot cannot form.
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Peak, duration, and half life of heparin?
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P= 5 mins H= 1 1/2 hrs D= 2-6 hrs
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Onset and duration of SQ heparin
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O= 20-60 mins D= 8-12 hrs
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What is the benefit of a low molecular wt heparin?
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Longer half life and decreased protein binding. It peaks in 3-6 hrs.
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Adverse reactions to heparin?
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Hemorrhage, hepatitis, anaphylaxis
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Lab test for IV heparin?
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APTT
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Antidote for heparin?
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Protamine sulfate
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What is a good lab test to monitor for heparin?
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Platelet count
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Normal dose of IV heparin?
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20,000-40,000 units/24 hours
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Name two thrombolytic enzymes
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Steptokinase and urokinase
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What do thrombolytic enzymes do?
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Dissolve clot in less than 72 hours. Converts plasminogen in thrombus to plasmin which breaks down ALL clots.
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What is the danger with a thrombolytic enzyme?
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Hemorrhage
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What do vasodilators do?
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Relax the arterial walls and decrease cardiac output.
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Teaching for vasodilators
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Change positions slowly, report tarry stools, avoid OTC meds, Dry toast for nausea, Headache and palpitations
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What does trental do?
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Help RBC's flex and move through capillary bed thereby preventing damage to RBC and clotting.
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What does persantine do?
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Inhibits platelet aggregation
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What does plavix do?
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Prevents platelets from sticking to one another, less risk of gastric irritation.
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What is the action of sympatholytic drugs?
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Decreases bp and HR. Constricts bronchioles.
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Alpha 1 receptors
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Vasoconstriction, decreased mobility of GI
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Alpha 2 receptors
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Inhibits the release of norepinephrine, lowers bp
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Beta 1
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Increases HR and force of contractions. Used in CHF.
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Beta 2
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Dilates bronchioles
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What do the OLOLS do/
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Reduce cardiac output by diminishing the sympathetic nervous system response.
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Some side effects of beta blockers?
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Bronchospasm, worsening CHF, Increased triglycerides, GI disturbances, Sleep disturbances, fatigue
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Centrally acting sympatholytics do what?
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Inhibit cardioaccelerator and vasoconstrictor centers to lower bp.
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Central acting sympatholytics side effects
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Dry mouth, nausea, orthostatic hypotension
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What do calcium channel blockers do?
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Inhibit the flow of calcium ions across the cell membrane of vascular tissue and cardiac cell
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What kind of diet for calcium channel blockers?
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Sodium restricted
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Ace inhibitors action
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Inhibit renin angiotensin aldosterone mechanism. Stimulate vasodilation and can reduce sympathetic nervous system activity.
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Biggest teaching for ACE inhibitors
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Do not skip doses or stop drug. Causes serious rebound in pressure.
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S1 = Lub
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Mitral and tricuspid valves close. Loudest at apex.
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S2 = Dub
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Aortic and pulmonic valves close. Loudest at base.
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S3 often heard..
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During times of fluid excess: Pregnancy, CHF, or in children
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S4 heard...
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In hypertrophy of the ventricle, decreased ventricle compliance, in elderly, HTN, aortic/pulmonic stenosis
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P wave
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Atrial depolarization
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QRS
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Ventricle depolarization < .12 seconds
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Wide QRS
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Hyperkalemia
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Elevation of ST
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Injury
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Depression of ST
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Ischemia, dig toxicity
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T wave inversion
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Ischemia
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Peaked T waves
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Hyperkalemia
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Flattened T wave
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Hypokalemia
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U wave
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Hypokalemia
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Persantine/ Dipyridamole
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Used if unable to perform stress test
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OLOLs are used in...
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SVT, HF, angina, MI, HTN, Migraine
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Beta blockers are used with caution in...
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Diabetics, Asthma, and pregnant women
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Hold beta blockers if...
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AP < 50 or BP too low
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Examples of calcium channel blockers
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Cardizem, Verapamil, Norvasc
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Calcium channel blockers are used in
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SVT, HTN, and angina
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What do calcium channel blockers do?
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Block Calcium entry into cells of vascular smooth muscle and myocardium.
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What is the action of digoxin
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Inhibits the Na/K pump and thereby increases intracellular calcium
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Antidote for Digoxin
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Digibind
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What lab for heparin?
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Aptt
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Antidote for heparin
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Protamine sulfate
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What lab for warfarin
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PT and INR
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Antidote for warfarin
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Vitamin K
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What does NTG do?
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Increases coronary blood flow by dilating coronary arteries and improving collateral flow to ischemic areas.
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Thrombolytics action
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Activate plasminogen that generates plasmin. Plasmin dissolves clots.
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Examples of thrombolytics
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Activase, retavase, and urokinase
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Statins action
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Reduce the production of cholesterol by the liver. Statins block the enzyme in the liver that controls the production of cholesterol.
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Bile acid sequestrants action
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Bile acid sequestrants bind bile acids in the intestine and cause more of the bile acids to be excreted in the stool. The bile is reduced to the liver which if forced to produce more bile by converting cholesterol.
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Examples of bile acid sequestrants
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Questran, Colestid, Welchol
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Most common side effect of BAS
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Ringing in the ears
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Action of fibric acid derivatives
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Inhibits production in the liver of VLDL by speeding up the removal of triglycerides from the blood.
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Examples of fibric acid derivatives
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Tricor and Lopid
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What labs for fibric acid derivatives
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Liver labs. Also increases effects of warfarin and sulfonylurea oral hypolipidemics
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Take lopid when?
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30 mins before breakfast and dinner
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Take Tricor when?
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W/ meals
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Nicotinic acid/VitB3/Niacin most effective in..
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Increasing HDL cholesterol
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Biggest side effects of Nicotinic acid
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Flushing, headache and itching
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Thiazide examples
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Diuril and Hydrochlorothiazide
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Quickest diuretics are
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Loop diuretics
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Examples of loop diuretics
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Lasix and Demadex
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Action of loop diuretics
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Promotes excretion of H2O, Na, Cl and other electrolytes by inhibiting tubular re absorption
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Slowest diuretics
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Potassium sparing diuretics
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K sparing diuretics examples
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Midamor, aldactone, and dyrenium
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Action of potassium sparing diuretics
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Inhibition of Na re-absorption in the kidneys while saving K and H ions by antagonizing aldosterone receptors.
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Do not use ACE inhibitors with
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Potassium sparing diuretics
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Angiotensin II receptor blocker examples
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Sartans
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Sartans are used for...
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HTN, diabetic neuropathy, management of HF
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Action of Sartans
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Blocks vasoconstriction and aldosterone producing effects of angiotensin II at receptor sites including vascular smooth muscle and the adrenal glands
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