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74 Cards in this Set
- Front
- Back
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What is a sign of a toxic reaction when lasix and dig are mixed?
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Yellow halos are a sign of a toxic reaction when lasix and dig are mixed
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Monitor for _____ while taking ace inhibitors
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hyperkalemia
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K-sparing diuretics are contraindicated with _____ due to a possibility of heart failure.
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ace inhibitors.
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How does Dig affect heart rate?
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Dig does not increase heart rate - is not a s/s.
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How is pain associated with stable angina relieved?
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To relieve pain associated w/stable angina, decrease O2 demands.
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How do Ca channel blockers decrease afterload & pain?
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Ca channel blockers decrease afterload & pain by dilating arterioles (vessels)
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For acute angina attacks the drug of choice is what?
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organic nitrates (nitro)
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How should sublingual Nitro be admin?
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Nitro can be given in 5 min intervals, but at 2nd sublingual tab - call 911/M.D. (up to 3 tabs)
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How should nitro patches be admin?
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Put nitro patch on areas with no hair, be sure to rotate sites. Take patch off @ bedtime. (wear 12-14hrs. nitro patch @ 800; Remove @ 10pm before bed, 10-12 hr "patch-free" period)
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Nitro's vasodilator effects are what?
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decreasing(changing) preload. (Nitro affects preload- stable angina decrease venous return; Preload)
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Why is sublingual nitro given in a lower dose?
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Sublingual nitro is in a lower dose because it bypasses (has no effect on) liver.
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The front line therapy for heart failure is what?
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ace inhibitor, beta blocker & a diuretic.
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When should ECG or cardiac function be monitored post Dig admin?
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Monitor ECG (cardiac function) for 2 hrs post digoxin admin for heart failure.
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What should be given in the event of Dig toxicity?
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If digoxin toxicity occurs give Digibind. (Admin. Digibind when? dig 10n/ml / serum potassium 6.2)
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A common side effect of nitro is what?
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HA
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What tolerance risks are associated with sublingual nitro?
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There is no risk for tolerance with sublingual nitro.
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Before admin nitro ask pt if they have taken what?
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any ETOH use or (pills) medication taken for erectile dysfunction.
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Patients should screen for high cholesterol (LDL)how often?
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every 5yrs after 20y/o.
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What tool should be used to calculate risks every 10yrs?
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Use the Framingham Risk Prediction tool to calculate risks every 10yrs.
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How quickly do statin drugs lower serum cholesterol(LDL)?
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in 2-4 weeks.
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Zocor should be admin. when?
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@ bedtime or w/the evening meal.
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When giving Gemfibrozil(lopid) & warfarin together, watch for what?
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watch for an increase in anticoagulent effects.
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What is a common reaction seen w/the admin of niacin?
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A common reaction w/the admin of niacin is flushing. (hot, red face)
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Gemfibrozil(lopid) has what associated side effects?
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have associated muscle pain or weakness = myopathy.
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A common side effect of questran is what?
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is constipation. Patients should up fiber and fluid intake to combat it.
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What affect does lidocane have on ECG (or heart)?
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lidocane has no effect on ECG (or heart)
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All antidysrithmics can what?
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raise the risk for creating new dysrythmias or worsen current ones
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The first line drug for ventricular premature beats (super ventricular tachycardia) are what?
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beta blockers.
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Dig induced dysrythmias should be treated what?
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w/ phenytoin.
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Procainamide's adverse effects are?
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are lupus like syndrome
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____ is the drug of choice for terminating paroxymal supraventricular tachycardia.
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Adenosine
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How would you treat Atrial Flutter?
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Treat atrial flutter w/dig
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Give _____for lidocaine induced convulsions?
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diazepam
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Monitor for _____ when giving Dig for SVT.
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hypokalemia
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What does the activity of the "P" wave mean/equal?
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atrial depolarization
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What body system is affected by amiodarone toxicity?
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The body system affected by amiodarone toxicity is the pulmonary system.
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How does Heparin lower coagulation?
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Heparin lowers coagulation by inactivating Thrombin & Xa.
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What should be monitored to be sure hep therapy is effective?
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Monitor aPPT to be sure hep therapy is effective.
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What lab values must be monitored with low molecular wt Hep?
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low molecular wt hep requires NO lab monitoring.
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What would you treat Hep overdose with?
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Treat hep overdose w/ protamine sulfate.
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ASA(asprin) lowers coagulation by?
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lowering platelet aggregation (lowers blood clotting)
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During/with Atrial fib. what is the goal lab in association with warfarin?
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(During or with) Atrial fib. the goal lab(warfarin?) is an INR of between 2-3.
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How is atrial thrombosis prevented?
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w/antiplatelet drugs.
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When should Ticlid be given in relation to thrombosis?
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Give ticlid to prevent arterial thrombi when pt cant tolerate ASA.
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How would you admin clopidogrel for a 50 y/o pt in comparison to an 80y/o pt?
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It doesn't matter the age. Pt could be 50 or 80y/o and clopidogrel would be given at the same dose.
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What would you do for a pt who has developed a thrombosis in their port-a-cath?
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Use urokinase (to lyse) in a cath that has been clotted off (want to lyse the port-a- cath's thrombosis)
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MI pts experience severe pain and should be treated with what?
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w/morphine.
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Reperfusion therapy works greatest/best when?
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admin w/in 1 hr of symptom onset.
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Unless contraindicated all pts should be given ____ for an acute MI.
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a beta blocker
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Ace inhibitors are standard Tx for MI because why?
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they potentiate H2O loss.
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The drug of choice for Tx of serious ventricular dysrythmia is what?
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is lidocaine.
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Replacement Tx for Hemophilia A is what?
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is factor VIII
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How should regular immunizations be admin in Hemophilia pts?
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Give regular imunizations SubQ in Hemophilia pts.
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What are the most important vaccines for hemophilia pts?
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Most important vaccines for hemophilia pts are hep A/B
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When admin factor VIII for hemophilia if pt complains of feeling "short of breath" or "tight chest" admin. what?
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Epinephirine (for severe reaction)
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Most common place a hemophilia pt feels pain is where?
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is in their knees.
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What should be done if a hemophilia pt is experincing HA?
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a neurologic assesment should be done.
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Don't give iron with?
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antacids
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How is RDA of iron affected during pregnancy?
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Iron needs double during pregnancy (RDA- x2 during Preg)
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When treating B12 deficiency w/Cyanocobal monitor for what?
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Hypokalemia.
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_____ can mask the signs of B12 deficiency?
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Folic Acid
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Alcoholics often have what type of deficiency?
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Folate deficiency is common in alcoholics.
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Preferred route for Folate admin.
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PO
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What do you do w/ a dig plasma level (dig) of 0.7ng/ml?
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- Check the apical pulse. If w/in safe range then admin. Dig.
- Monitor HR & b/p before giving digoxin. |
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What symptoms do pts see with a chronic B12 deficiency?
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Numbness and tingling
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What do you do with a Dig plasma level of 0.7ng/ml?
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Check apical pulse. If within safe range then admin Dig. (safe range= 0.5-1.8ng/mL) Monitor HR & BP before giving Dig
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Spironolactone (Potass. Sparing Diuretic) prolongs survival by what?
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By blocking the receptors for aldosterone (Improves Heart Failure?)
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When should Warfarin be taken in relation to Bile-acid resin?
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Warfarin should be taken 1hr before or 4hrs after Bile-acid resin
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How does Welchol differ from other bile-acid sequestrants?
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In that it doesnt affect fat soluble vitamin absorption
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Calcium Channel Blockers have not been proven to what?
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decrease mortality in relation to MI
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What happens when taking Dig and Hydrochlorothiazide together?
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Dig and Hydrochlorothiazide together increase the risk of toxicity (predisposed for toxicity)
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When taking antianginal drugs what should NOT be taken?
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DO NOT TAKE antihypertensives
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How do Ca Channel Blockers Help?
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Ca Channel Blockers help by increasing O2 supply and decreasing O2 demand (Help with increased excersize tolerance)
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How do diabetics benefit from statins?
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Because Statins reduce stroke and coronary events (reduce risk of coronary events)
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