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60 Cards in this Set

  • Front
  • Back
Recognize examples of local and general anesthesia.
LOCAL Med end in --- ine
GENERAL Med end in --- ane
At the cellular level, what is the mechanism of action of local anesthetics
Block sodium channels
Know the characteristics are of each of the 4 stages of general anesthesia.
1. Loss of pain; but awake
2. Patient delirious HR and Breathing irregular, BP increases
3. Surgical Anesthesia skeletal muscles relax delirium stabilizes HR and breathing stabilizes, eye movements slow patient becomes still .
4. Paralysis of the medulla region in the brain ( responsible for controlling respiration and cardiovascular activity usually avoided during general anesthesia
What is the usual cause of hypertension?
Cardiac output
Peripheral resistance
Blood volume
What is the most common type of hypertension?
ISH is the most common type of hypertension
Isolated Systolic Hypertension
What is the most serious consequence of chronic hypertension?
It can lead to stroke, heart attack and heart failure
Be able to recognize an abnormally high or low blood pressure reading.
Normal 119 / 79 or less
Pre hypertension 120-139 / 80-89
Stage 1 Hypertension 140-159 / 90-99
Stage 2 Hypertension 160 / 100 or higher
Recognize the common treatment of “resistant” hypertension.
Treatment ; Use Calcium channel blockers
Nifedipeni ( Procardia ) selective for arteriolies
Verapamil ( Calan ) non selective affect arterioles and myocardium
Caution: Reflex tachycardia
What is the definition of heart failure?
Cessation of normal heart function. The inability of the heart to pump blood at an adequate rate, resulting in congestion in the lungs, shortness of breath, edema in the lower extremities, and enlargement of the liver
Know how medications can relieve the symptoms of heart failure.
Slowing the heart rate,
Increasing contractility
Reducing its workload
Recognize the classifications of drugs for heart failure and example of drugs within the classification.
ACE Inhibitors Medication ending in ---- pril Pr lisinopril ( Zestril )
Beta Adrenergic Blockers Medication ending in ---- lol Pr carvedilol ( Coreg )
Cardiac Glycosides Medication ending in ---- oxin Pr digoxin ( Lanoxin )
Diuretics Medication ending in ---- ide, one, ene Pr furosemide ( Laxis )
Phosphodiesterase Inhibitors Medication ending in ---- one Pr inamrinone ( Primacor )
Vasodialators Medication ending in ---- ine Pr isosorbide dinitrate ( Apresoline )
What is meant by an inotropic effect on the heart?
The ability to increase the strength of contraction
( Drug Cardiac Glycosides )
Know the signs of Digoxin toxicity
Dysrithmias, Visual disturbances such as seeing halos
Hypokalemia, Nausea, Vomiting, Anorexia
Describe what a dysrhythmia is.
Abnormalities of electrical conduction that may result in disturbances in heart rate or cardiac rhythm resulting in fibrillation
Discuss whether dysrhythmias are harmful or life-threatening.
Types are:
PVS premature ventricular contractions; not normally serious
Atrial or ventricular tachicardia; heart rate 150 bpm ventricular is more serious than atrial
Atrial or ventricular flutter and/ or fibrillation; very rapid uncoordinated beats require treatment not fatal
Sinus bradycardia; slow heart rate less than 50 bpm may require a pacemaker
Heart block non-conduction in the myocardium classified as first, second and third degree
Where in the heart do dysrhythmias originate?
In the SA node or Sinoatrial node
List the classifications of anti-dysrhythmic drugs.
Sodium channel blockers Class I
Beta-adrenergic blockers Class II
Potassium channel blockers Class III
Calsium channel blockers Class IV
Miscellaneous antidysrhythmic drugs.
Name the purpose of an electrocardiogram (ECG).
To measure the electrical activity across the myocardium three distinct waves are produced by a normal ECG this are P waves, QRS waves and T waves changes to the wave pattern or in the their timing can reveal certain pathologies, for example an exaggerated R wave suggest enlargement of the ventricles and a flat T wave indicates ischemia to the myocardium
What is the usual cause of hypertension?
Cardiac output
Peripheral resistance
Blood volume
What is the most common type of hypertension?
ISH is the most common type of hypertension
Isolated Systolic Hypertension
What is the most serious consequence of chronic hypertension?
It can lead to stroke, heart attack and heart failure
Be able to recognize an abnormally high or low blood pressure reading.
Normal 119 / 79 or less
Pre hypertension 120-139 / 80-89
Stage 1 Hypertension 140-159 / 90-99
Stage 2 Hypertension 160 / 100 or higher
Recognize the common treatment of “resistant” hypertension.
Treatment ; Use Calcium channel blockers
Nifedipeni ( Procardia ) selective for arteriolies
Verapamil ( Calan ) non selective affect arterioles and myocardium
Caution: Reflex tachycardia
What is the definition of heart failure?
Cessation of normal heart function. The inability of the heart to pump blood at an adequate rate, resulting in congestion in the lungs, shortness of breath, edema in the lower extremities, and enlargement of the liver
Know how medications can relieve the symptoms of heart failure.
Slowing the heart rate,
Increasing contractility
Reducing its workload
Recognize the classifications of drugs for heart failure and example of drugs within the classification.
ACE Inhibitors Medication ending in ---- pril Pr lisinopril ( Zestril )
Beta Adrenergic Blockers Medication ending in ---- lol Pr carvedilol ( Coreg )
Cardiac Glycosides Medication ending in ---- oxin Pr digoxin ( Lanoxin )
Diuretics Medication ending in ---- ide, one, ene Pr furosemide ( Laxis )
Phosphodiesterase Inhibitors Medication ending in ---- one Pr inamrinone ( Primacor )
Vasodialators Medication ending in ---- ine Pr isosorbide dinitrate ( Apresoline )
What is meant by an inotropic effect on the heart?
The ability to increase the strength of contraction
( Drug Cardiac Glycosides )
Know the signs of Digoxin toxicity
Dysrithmias, Visual disturbances such as seeing halos
Hypokalemia, Nausea, Vomiting, Anorexia
Describe what a dysrhythmia is.
Abnormalities of electrical conduction that may result in disturbances in heart rate or cardiac rhythm resulting in fibrillation
Discuss whether dysrhythmias are harmful or life-threatening.
Types are:
PVS premature ventricular contractions; not normally serious
Atrial or ventricular tachicardia; heart rate 150 bpm ventricular is more serious than atrial
Atrial or ventricular flutter and/ or fibrillation; very rapid uncoordinated beats require treatment not fatal
Sinus bradycardia; slow heart rate less than 50 bpm may require a pacemaker
Heart block non-conduction in the myocardium classified as first, second and third degree
Where in the heart do dysrhythmias originate?
In the SA node or Sinoatrial node
List the classifications of anti-dysrhythmic drugs.
Sodium channel blockers Class I
Beta-adrenergic blockers Class II
Potassium channel blockers Class III
Calsium channel blockers Class IV
Miscellaneous antidysrhythmic drugs.
Name the purpose of an electrocardiogram (ECG).
To measure the electrical activity across the myocardium three distinct waves are produced by a normal ECG this are P waves, QRS waves and T waves changes to the wave pattern or in the their timing can reveal certain pathologies, for example an exaggerated R wave suggest enlargement of the ventricles and a flat T wave indicates ischemia to the myocardium
Name the specific food that should be avoided in patients receiving Verapamil (Calan).
Because Verapamil can cause bradycardia patient with heart failure should be carefully monitored
Grapefruit and herbal supplements such as hawthorn which may have additive hypotensive effects
List some “clotting disorders”.
Thromboembolic disorders
Thrombocytopenia
Hemophilia
Von Willebrand’s disease ( vWD )
What is the action of the anti-coagulant drugs?
These are used to prevent the formation of clots either by inhibiting specific clotting factiors in the coagulation cascade or by diminishing the clotting action of the platelets, anti-coagulant drugs are used to prolong bleeding time.
Discuss the need or the purpose of overlapping heparin and warfarin.
Heparin has a brief half-life ( 90 minutes ) and warfarin has a long one ( 1 to 3 days ) since an aPTT returns to normal within 2 to 3 hours following discontinuation of heparin concomitant pharmacotherapy is necessary to ensure continuous therapeutic anticoagulation
aPTT is activated partial thromboplastin time thrombin time or clotting time.S
What is angina?
Acute chest pain caused by insufficient oxygen reaching a portion of the myocardium
What is the primary action of the organic nitrates?
Is their ability to relax both arterial and venous smooth muscle, with venous vasodilation the amount of blood returning to the heart ( Preload ) is reduced and the chambers contain a smaller volume.
What is the goal of thrombolytic therapy in MI patients?
Primarily to dissolve blood clots obstructing the coronary arteries, thus restoring circulation to the myocardium.
Discuss the timeframe that thrombolytic therapy may be used for thrombotic CVA.
Thrombolytic therapy is most effective if administrated within the first 3 hours of the attack
Cerebral Vascular Accident ( CVA )
Discuss shock and its outcome if left untreated.
It is a condition in which vital tissues are not receiving enough blood to function properly, it is considered a medical emergency failure to reverse the causes may lead to irreversible organ damage and death.
Discuss the various types of shock and their origin
Hypovolemic shock ------- volume depletion
Neurogenic shock --------- Distributive shock caused by a sudden loss of nerve impulse communication
Cardiogenic shock loss of adequate cardiac output due to pump failure
Septic shock cause by the presence of bacteria and toxins in the blood
Anaphylactic shock onset symptoms following food or drug intake most severe is type I allergic response.
Know the first goal in treating shock.
Maintain basic life support ABC quiet warm physiological support reassurance Oxygen at 15 L/min
Rapid identification of the underline cause
Followed by an aggressive treatment
List blood products
Whole blood
Plasma protein fraction
Fresh frozen plasma
Packed red blood cells
In discussing the various lipid components (cholesterol, triglycerides, HDL, LDL), describe the goals for avoiding cardiovascular disease.
The Goal is to maximize the HDL ( High-density lipoprotein ) and minimize the LDL ( Low-density Lipoprotein ) some times stated as a ratio of LDL to HDL’ read as follows ratio number is the number of times greater of LDL to the HDL so the goal is to bring this number to be as low as possible.
Name the drugs most predominantly used today for high lipids.
Statins which inhibit HMG-CoA reductanse, Medication ending in ------ statin
Bile acid –binding agents Medication beginning in ------ coles
Fibri Acid Agents Medication ending in ------ ate, ozil
Other Agents Medication ending in ------ etia
Describe the side effects of Nicotinic acid.
Flushing, Hot flushes, Nausea, Excess gas, Diarrhea,
Hepatotoxity and gout.
List any lab tests necessary for patients taking statins.
Liver function tests
CPK test Creatine Phosphokinase blood test to determine damage to the heart muscle, skeletal muscles, and brain.
Other side effects are nausea, vomiting, heartburn, dyspepsia, abdominal cramping, diarrhea.
What is the process of blood cell formation called?
Hematopoiesis or hemopoiesis
What is the purpose of erythropoietin and where in the body is it formed
Is the process of red blood cell formation regulated by the hormone erythropoietin it is segregated by the kidney travels to the bone marrow where it interacts with receptors on hematopoietic stems cell with the message to increase erythrocytes production and it is triggered first by a low level of oxygen to the kidney
Discuss actions and uses of Epoetin Alfa (Epogen), Oprelvekin (Neumega), and Filgrastim (Neupogen).
Epoetin Alfa (Epogen), same as erythropoietin that the body creates
Oprelvekin (Neumega), platelet enhancer
Filgrastim (Neupogen). Is a human G-CSF it increases neutropil production in the bone marrow and to enhance phagocytic and cytotoxic functions of existing neutrophils Colony Stimulating Factor
What are the three classes of bronchodilators used for asthma?
1 Aerosol is a suspension of minute liquid droplets or fine solid particles suspended in a gas it gives immediate relief of bronchospasm
2 Nebulizers vaporize liquid medication into a fine mist and for solid powder
Dry Powder inhaler ( DPI )
3 Metered Dose Inhalers ( MDI ) Propellant that deliver with each breath
How do opioids act as antitussives?
These are most efficacious antitussives, acting by raising the cough threshold in the Central Nervous System.
List the diseases that are included in COPD (chronic obstructive pulmonary disease)
Asthma acute bronchospasm, causing intense breathlessness, coughing and gasping for air.
Chronic bronchitis excess of mucus is produced in the bronchial tree due to inflammation, and irritation from smoke and pollutants
Emphysema this is the terminal stage the bronchioles lose their elasticity and the avioli dilate to a maximum size to allow more air in to the lungs patient suffers from dyspnea
What is the purpose of the lymphatic system in the body?
To protect the body from pathogens, it consists of the spleen, thymus, tonsils, and lymph nodes.
What is the goal of vaccine administration?
To prevent serious infections by life-threatening pathogens
What is the action of an expectorant?
Increase bronchial secretions by reducing the thickness or viscosity of bronchial secretions, thus increasing mucus flow that can be removed easily by coughing.
What is the action of a mucolytic?
Break down the chemical structure of mucus molecules the mucus becomes thinner and more able to be removed by coughing used by patients who have cystic fibrosis, chronic bronchitis, or other disease that produce large amounts of thick bronchial secretions.
What type of immunity is achieved through the administration of a vaccine?
Active immunity, in it the patient’s immune system is stimulated to produce antibodies due to exposure to the antigen ( Vaccine )