Pharmacology-Cardiovascular-Verapamil

Front 1

What Class of antiarrhythmic is verapamil in?

Back 1

Class IV

Front 2

<What kind of agent is verapamil?>

Back 2

<calcium channel blocker
has NEGATIVE inotropic, chromotropic, dromotropic effect>

Front 3

<What is a brand of verapamil?>

Back 3

<Calan
Isoptin>

Front 4

What is the MOA for verapamil?

slows impulse...what does this do to atria?

decreases it

Back 4

slows influx of calcium ions into smooth muscle cells...what does this do to the AV node?

atria do not beat too fast...what does this action do to arterial resistance and oxygen demand?

Front 5

What is the therapeutic use of verapamil? (4)

Back 5

antianginal
antiarrhythmic (class IV)
antihypertensive
vascular headache suppresants

Front 6

What are the indications for the use of verapamil?

Back 6

management of:
hypertension
angina pectoris
and/or vasospastic
(Prinzmetal's) angina
supraventricular arrhythmias
rapid ventricular rates in
atrial flutter or
fibrillation
prevention of migraine
headaches
management of cardiomyopathy

Front 7

MOA of verapamil?

INHIBITS transport of what ion into myocardial and vascular smooth muscle cells?

Back 7

calcium...and subsequently inhibits contraction

Front 8

MOA of verapamil?

What does the med do to the AV and SA node?

Back 8

DECREASES SA and AV conduction and PROLONGS AV node refractory period in conduction tissue

Front 9

Therapeutic effect of verapamil?

Systemic vasodilation that results in?

Back 9

decreased blood pressure

Front 10

Therapeutic effect of verapamil?

Coronary vasodilation resulting in?

Back 10

decreased frequency and severity of attacks of angina

Front 11

Therapeutic effect of verapamil?

Suppression of what kind of tachyarrhythmia?

Back 11

ventricular

Front 12

Verapamil is contraindicated in?

Back 12

hypersensitivity
sick sinus syndrome
2nd or 3rd degree AV block
(unless an artificial
pacemaker is in place)
BP less than 90 mmHg
CHF, severe ventricular
dysfunction, or cardio-
genic shock, unless
associated with supra-
ventricular tachyarrhythmia
concurrent IV beta blocker
therapy

Front 13

What should nurse monitor with verapamil?

Back 13

monitor blood pressure and pulse before, during and after

Front 14

Why should ECG be monitored when taking verapamil?

Back 14

may cause prolonged PR interval

Front 15

What, besides ECG, BP, and pulse rate should be monitored throughout verapamil therapy?

Back 15

I & O
daily weight

Front 16

What should be assessed when taking verapamil?

Back 16

CHF (peripheral edema)
rales/crackles
dyspnea
weight gain
jugular venous distention

Front 17

If patient is taking digoxin concurrently with CCBs, what should nurse be wary of?

Back 17

serum digoxin toxicity

Front 18

What should an ECG be monitored continuously while on verapamil?

Back 18

because of possible bradycardia or prolonged hypotension...notify physician...monitor bp and pulse throughout

Front 19

Are total serum calcium concentrations affected by CCBs?

Back 19

no

Front 20

Monitor serum potassium due to possibility of?

Back 20

hypokalemia which increases the risk of arrhythmias

Front 21

Monitor renal and hepatic functions periodically during long-term therapy...why?

Back 21

possible increase in hepatic enzymes after several days of therapy, which returns to normal on d/c of therapy

Front 22

How should PO verapamil be administered?

Back 22

with meals or milk to avoid gastric irritation

Front 23

Can patient chew, open, crush, break sustained release capsules?

Back 23

no....empty tablets in stool not significant

Front 24

To avoid hypotensive effects, have patient?

Back 24

remain recumbent for at least 1 hour

Front 25

Instruct patient on correct technique for monitoring pulse and to contact hcp if heart rate is less than?

Back 25

50 bpm

Front 26

Teach patient to change positions?

Back 26

slowly

Front 27

It's a good idea for the patient not to drive due to?

Back 27

possible dizziness or drowsiness

Front 28

Dental appointments are advised to avoid?

Back 28

tenderness
bleeding
gingival hyperplasia
(gum enlargement)

Front 29

Avoid ______ esp. cold meds, without consulting hcp

Back 29

alcohol

Front 30

Advise patient to notify physician for the following?

Back 30

irregular heartbeats
dyspnea
swelling of hands and feet
pronounced dizziness
nausea
constipation
hypotension occurs
* headache is severe or
persistent

Front 31

If photosensitivity reactions occur?

Back 31

wear sunscreen and protective
clothing

Front 32

How can patient reduce hypertension?

(medication controls it but does not cure it)

Back 32

weight reduction
low-sodium diet
smoking cessation
moderation of alcohol
consumption
regular exercise
stress management

Front 33

Evaluation.
Effectiveness of therapy can be demonstrated by?

Back 33

decrease in blood pressure
decrease in severity and
frequency of anginal
attacks
decrease in need for nitrate
therapy
increase in activity
tolerance and sense of
well being
suppression and prevention
of atrial tachyarrhythmias

Front 34

<Verapamil (calcium channel blocker) is a potent vasodilator of coronary vessels and peripheral vessels...it has a negative ____, _____ ,_____ effect>

Back 34

<inotropic...reduces myocardial oxygen consummption

chronotropic...frequency of hyperactive tissue is reduced so it decreases arrhythmias and takes out hyperactivity of muscle

dromotropic...slows conduction through AV node and it helps reducs oxygen consumption of heart>

Front 35

Define inotropic?

Back 35

an agent that increases the force of muscular contractions

Front 36

Define chronotropic?

Back 36

influencing the rate of occurrence of an event, such as heartbeat

Front 37

Define dromotropic?

Back 37

affecting the conductivity of nerve or muscle fibers

Front 38

<Case study #8: angina pectoris.
Physician orders Verapamil (Isoptin, Calan) at what dosage, what route, and over how much time to relieve angina pectoris?

Back 38

5 mg IV to be administered over 3 minutes