Nur 326 Midterm (Cv Part 2)

Front 1

What is the pharm class of Digoxin (Lanoxin)?

Back 1

digitalis glycoside

Front 2

What is the therapeutic class of Digoxin (Lanoxin)?

Back 2

antiarrythmic
positive inotrope

Front 3

something that increases the force of cardiac contraction

Back 3

positive inotrope

Front 4

something that decreases heart rate

Back 4

negative chronotrope

Front 5

What 2 things should you check before giving Digoxin (Lanoxin)?

Back 5

apical HR
EKG (PR interval)

Front 6

What are the adverse effects of Digoxin (Lanoxin)?

Back 6

fatigue
bradycardia
arrhythmias

Front 7

Who should get lower doses of Digoxin (Lanoxin)?

Back 7

older adults
people in renal failure

Front 8

What is the pharm class of Nesiritide (Natrecor)?

Back 8

vasodilator
(Human B type natriuretic peptide)

Front 9

What is the antidote for Digoxin (Lanoxin)?

Back 9

Digibind

Front 10

What is Bosentan (Tracleer) used to treat?

Back 10

pulmonary hypertension

Front 11

a common condition that occurs when the heart cannot pump enough blood to meet tissue needs for oxygen and nutrients

may result from impaired contraction during systole or impaired filling during diastole

Back 11

heart failure

Front 12

dilation, hypertrophy, and changes in the shape of the heart

Back 12

ventricular remodeling

Front 13

In ____________ heart failure, patients usually have no symptoms at rest and no edema; dyspnea and fatigue occur only with activities involving moderate or higher levels of exertion.

Back 13

compensated (asymptomatic)

Front 14

Patients with ___________ heart faiure have symptoms that occur with minimal exertion or at rest and are accompanied by ankle edema and distention of the jugular vein

Back 14

decompensated (symptomatic)

Front 15

Acute, severe cardiac decompensation is manifested by:

Back 15

pulmonary edema, a medical emergency that requires immediate treatment

Front 16

Digoxin exerts a positive inotropic effect which is helpful in treating:

Back 16

heart failure (it improves the pumping ability of the heart)

Front 17

Digoxin exerts a negative chronotropic effect which is helpful in treating:

Back 17

atrial dysrhythmias (fib and flutter)

(it depresses the AV node and stimulates the vagus nerve)

Front 18

What are some factors that may lead to Digoxin (Lanoxin) toxicity?

Back 18

- accumulation of larger-than-necessary maintenance doses
- rapid loading (digitalization)
- impaired renal function
- age extremes (young or old)
- electrolyte imbalance (hypokalemia, hypomagnesemia, hypercalcemia)
- hypoxia due to heart or lung disease
- hypothyroidism
- concurrent treatment with other drugs affecting the heart

Front 19

If digoxin causes a serious cardiac dysrhythmia (PVC) and the serum potassium level is low, what should be given?

Back 19

potassium chloride...to decrease myocardial excitability

**contraindicated in renal failure though!

Front 20

Blurring of vision with yellow spots in the visual field while taking digoxin may indicate:

Back 20

acute toxicity

Front 21

What are some causes of heart failure?

Back 21

hypertension/CAD
diabetes
hyperthyroidism
excess IV fluids or blood products
negative inotropic drugs (ex. calcium channel blockers)
drugs promoting sodium/water retention

Front 22

What is the therapeutic serum level of Digoxin (Lanoxin)?

Back 22

0.5 - 2.0 ng/mL

above 2.0 is toxic

Front 23

How are adrenergic drugs used in heart failure?

Back 23

to strengthen myocardial contraction and increase CO (positive inotrope)

Front 24

How are ACE inhibitors used in heart failure?

Back 24

prevent activiation of renin-angiotensin system

improve cardiac function, decrease mortality, and delay progression of disease

drug of first choice in chronic HF

Front 25

How are ARBs used in heart failure?

Back 25

addition of an ARB to a regimen that includes ACE inhibitors may decrease hospitalizations but does not reduce mortality rate

Front 26

How are beta blockers used in heart failure?

Back 26

decreases morbidity and mortality
regression of ventricular remodeling

*not recommended to treat acute HF

Front 27

How are aldosterone antagonists used in heart failure?

Back 27

reduces the aldosterone-induced retention of sodium and water

improves cardiac function and reduces symptoms, hospitalizations, and mortality

Front 28

How are vasodilators used to treat heart failure?

Back 28

vasodilation decreases preload and afterload

Front 29

Angina occurs when there is a deficit in ________________ in relation to _________________.

Back 29

myocardial oxygen supply
myocardial oxygen demand

Front 30

What causes angina?

Back 30

atherosclerotic plaque in the coronary arteries usually

also caused by coronary vasospasm

Front 31

type of angina that occurs when atherosclerotic plaque obstructs coronary arteies and the heart requires more oxygenated blood than the blocked arteries can deliver

usually caused by physical exertion, exposure to cold, and emotional upset

Back 31

classic (stable/typical)

Front 32

type of angina that is caused by spasms of the coronary artery that decrease blood flow to the myocardium

usually occurs during rest or with minimal exercise and often occurs at night

Back 32

variant (atypical)

Front 33

type of angina that falls between classic angina and MI

usually occurs in patients with advanced CAD and produces increased frequency and intensity of symptoms

Back 33

unstable angina

Front 34

What drug should you NOT take at the same time as Nitroglycerin?

Back 34

Viagra (or other ED drugs)

Front 35

Why is smoking harmful to people with angina?

Back 35

it increases catecholamines, which increase HR and BP

it decreases delivery of oxygen to heart, decreases myocardial contractility, and increases risk of ventricular fibrillation

it promotes thrombosis

it increases the risk of MI, stroke, and HTN

it decreases HDL

Front 36

How do beta blockers help people with angina?

Back 36

they decrease HR and force of myocardial contraction, which decreases myocardial workload and oxygen demand

Front 37

What 3 adjunctive drugs are used to help treat angina?

Back 37

aspirin - antithrombotic
antilipemics - lower serum cholesterol
anti-hypertensives - lower blood pressure

Front 38

What are the indications for using antidysrhythmic drugs?

Back 38

To convert atrial fib or atrial flutter to normal sinus rhythm

To maintain NSR after conversion from atrial fib or flutter

To slow the ventricular rate if it is so fast or irregular that it impairs CO

To terminate dangerous ventricular dysrhythmias

Front 39

What are the class I antidysrhythmic drugs, and how do they work?

Back 39

Sodium channel blockers - block movement of sodium into cells, which decreases formation and conduction of electrical impulses

Front 40

What class of antidysrhythmic drugs are being used less frequently today because of the risk of ventricular fibrillation and mortality?

Back 40

Class I

Front 41

What are the general CI for using antidysrhythmic drugs?

Back 41

uncompensated heart failure
heart block
bradycardia
cardiogenic shock

Front 42

What is the most common dysrhythmia?

Back 42

atrial fib

Front 43

How are children with dysrhythmias treated?

Back 43

Digoxin and a beta blocker

Front 44

_______________ is used for dysrhythmias caused by digoxin toxicity.

Back 44

Phenytoin (Dilantin)