Pharm Ii Unit 7 Ch. 24,25, 26, & 27

Front 1

Dysrhythmia

Back 1

any rhythm other than normal sinus rhythm

disturbances in the electrical conduction of the heart

Front 2

Drugs to treat dysrhythmias

Back 2

adenosine (Adenocard)
phenytoin (Dilantin)
beta-blockers- olols
calcium channel blockers- diltiazem (Cardizem)

Front 3

Drugs to treat dysrhythmias cont.

Back 3

Lidocaine- should be labeled for cardiac arrhythmia's and have no preservative or epinephrine-treats ventricular arrhythmia's

Front 4

Drugs to treat dysrhythmias cont.

Back 4

digoxin- atrial fib
quinidine- atrial fib

Front 5

what nursing assessments should be monitored for patients on drugs to treat dysrhythmias

Back 5

monitor apical rhythm and rate
telemetry
pain assessment
O2 status- O2 sat., cap. refill, and pulses

Front 6

Narrowing pulse pressure

Back 6

difference between systolic and diastolic pressure

Front 7

Narrow pulse pressure may be indicators of

Back 7

shock
severe aortic stenosis
constrictive pericarditis

Front 8

CAD

Back 8

coronary artery disease- impaired blood flow in the coronary arteries

Front 9

Moderate restriction of blood flow due to CAD causes

Back 9

angina pectoris

Front 10

Severe impairment or complete loss of blood flow due to CAD causes

Back 10

MI

Front 11

What is the most common cause of anginal pain

Back 11

atherosclerosis

Front 12

What are modifications that can be done to reduce angina pain

Back 12

lifestyle changes-reduce sat. fat
medically supervised exercise program
quit smoking
eat foods high in potassium
reduce stress

Front 13

HmgCoA reductase inhibitors (statins) are prescribed to

Back 13

lower LDLS- bad cholesterol

(increased HDLS are also important)

Front 14

treatment assessments for pt with angina

Back 14

*******

Front 15

Pain associated with angina is

Back 15

variable-different presentations occur

Front 16

what are the drug classes prescribed to treat angina

Back 16

nitrates (universal dilators)
beta blockers (olols)
calcium channel blockers
angiotensin converting enzyme inhibitors (ACE)

Front 17

Nitrates are the

Back 17

universal dilators

Front 18

Nitrates are available how

Back 18

sublingual
translingual spray (under the tongue)
Amyl nitrate (inhaled)
IV NTG- drip (LPN's can't admin)

Front 19

Sustained release nitrates are used/admin when/ how

Back 19

used to prevent attacks
PO q 8-12 h
on empty stomach

Front 20

Transdermal nitrates

Back 20

common
removed at night to prevent nitrate tolerance

Front 21

Sublingual tabs Nitrates used/admin/ dose/

Back 21

under the tongue
1 tab q 5 min X 3 - after 1 tab to ED/911-Continued pain notify primary MD
Unstable must be replaced q 3-6 months and store in cool dark place
Tingle with application

Front 22

Topical nitrate ointment

Back 22

wear gloves to apply and don't shave to apply
wipe off old
rotate sites (usually upper chest/arm
may oil or stain clothing

Front 23

IV NITRO

Back 23

LPN cant admin-CCU or ER drug

Front 24

Common side effects of Nitro

Back 24

HA
hypotension
especially with initiation

Front 25

Beta adrenergic blockers

Back 25

beta blockers olols

Front 26

Beta blockers are not explicitly

Back 26

cardio selective

Front 27

Beta blockers used to treat angina

Back 27

Inderol- propranolol
Tenormin- atenolol

both are also used for HTN

Front 28

Beta blockers block the stimulation of _______ & ________ reducing myocardial oxygen demands

Back 28

norepinephrine
epinephrine

Front 29

Contraindications for beta blockers are

Back 29

bronchoconstrictive disorders
PVD
diabetes

Front 30

Beta blockers should never be abruptly discontinued because they can cause

Back 30

rebound angina

Front 31

Smoking while taking beta blockers does what

Back 31

reduces the drugs efficiency

Front 32

Calcium channel blockers used to treat angina

Back 32

Cardizem- diltiazem
Procardia- nifedipine
Calan- verapamil

Front 33

Calcium channel blockers may also be used to treat

Back 33

HTN
dysrhythmias

Front 34

Angiotensin converting enzymes (ACE)

Back 34

prils- dilate coronary arteries and minimize platelet cell aggregation.

Reduce the risk incidence of MI's

Front 35

What are lifestyle changes that the patient can make to control/lessen the effects of PVD

Back 35

Smoking cessation
control of diet/weight
b/p
diabetes

Front 36

what are nursing assessments for PVD

Back 36

capillary refill
pulses (pedal, tibial- use doppler if having difficulty palpating

Front 37

Hemorrheolgic agents

Back 37

Trental- pentoxifylline
Pletal- cilostazol

Front 38

Trental- pentoxifylline

Back 38

hemorrheolgic- improves micro-circulation and tissue perfusion by decreasing blood viscosity and improving flexibility of erythrocytes

Front 39

Pletal- cilostazol

Back 39

hemorrheolgic- platelet aggregation inhibitor used for prevention of thromboembolism post-MI and in patients with prostetic devices (valves) and is also prescribed for the prevention of TIA's, and to reduce symptoms of intermittent claudication

Front 40

Side effects of Trental- pentoxifylline & Pletal- cilostazol

Back 40

tachycardia from peripheral vasodilators, related to adrenergic suppression
hypotension if using peripheral vasodilator

Front 41

Patient education for drugs used to treat PVD; Trental- pentoxifylline & Pletal- cilostazol

Back 41

keep extremities warm
don't stand or sit in a dependent position for too long
stop smoking
exercise
reduce intake of saturated fats and RX- statins

Front 42

Thrombotic embolic conditions are major causes of

Back 42

mortality and morbidity

Front 43

Do anticoagulants dissolve clots

Back 43

no

Front 44

Do anticoagulants prevent extension of the clot thus preventing further damage if thrombotic CVA or MI is occurring

Back 44

yes

Front 45

Platelet aggregation inhibitors aid in the prevention of

Back 45

further occlusion and enhance circulation

Front 46

Anticoagulants include

Back 46

heparin
low-molecular weight heparin products- enoxaparin/ Lovenox
warfarin

Front 47

The antidote for warfarin (Coumadin)

Back 47

Vit. K/aquamephytin (vit. K) & (protamine sulfate IV-Heparin)

Front 48

heparin is given

Back 48

only parenterally (IV or SQ) don't aspirate
two inches below umbilicus

Front 49

Lab values to monitor when on anticoagulants

Back 49

PTT- heparin (control-25-40 norm)
Therapeuticity-when used as a anticoagulant-PTT-1.5-2.5x's the control- range should be 80-100

Front 50

PT/INR- Warfarin labs to monitor

Back 50

2-3 INR value should be for anticoag effects
usual PT-12-13

Front 51

Symptoms of toxicity of anticoagulants

Back 51

bleeding;avoid injury, use electric razor, soft toothbrush

Front 52

Diet restrictions for Warfarin

Back 52

Avoid vit. k rich foods:
dark green leafy's broccoli
turnips fish
yogurt cabbage

Front 53

Thrombolytics are

Back 53

clot busters-not admined by LPN- CCU<ICU< ER

Front 54

Thrombolytic examples

Back 54

streptokinase
TPA
urokinase

Front 55

Thrombolytic must be given within _____ hours of presentation of an embolytic obstruction

Back 55

3-6 hours

Front 56

Platelet aggregation inhibitors examples are

Back 56

Ticlid/ ticlopidine
aspirin
plavix

Front 57

Ticlid/ ticlopidine

Back 57

Platelet aggregation inhibitor- used after stent application
used to reduce incidence of CVAs in patients who have had a stroke
Should not be given with NSAIDS/aspirin or to to pt. w/GI bleeding gastritis

Front 58

Aspirin is a platelet aggregation inhibitor

Back 58

JACHO standard -EDS admin to pt.'s with chest pain (unless allergic)

Also used to prevent TIA's

Front 59

Plavix-clopidogrel is

Back 59

antiplatelet agent used to reduce the risk of atherosclerotic events (MI, stroke, vascular death)

usual dose-75 mg po/daily

Front 60

Adverse side effects of Plavix

Back 60

thrombocytopenia
microangiopathic hemolytic anemia
SE bleeding
neutropenia thrombocytopenic purpura