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115 Cards in this Set

  • Front
  • Back
Cardiovascular System
consists of what & moves what?
Consists of the heart, major blood vessel and small peripheral blood vessels &
Moves nutrients, waste products, gases, and hormones throughout the body
Coronary Artery Disease (CAD) causes what?
An abnormal condition of the heart’s arterial circulation causing restriction in blood flow to the myocardium

The myocardium must continuously receive nutrients and O2.

The heart does not get nutrients or O2 from the chambers of the heart so blood vessels around the heart that are constricted or narrowed then deprive the heart.
Angina (angina pectoris
Severe chest pain which is caused by the lack of O2 to the myocardium

· Atherosclerosis – common cause of angina. It is the buildup of fatty fibrous material called plaque in the arteries (CAD).
Peripheral Vascular Disease (PVD)
Restriction of blood flow to the peripheral tissues

· Pain occurs where the lack of blood flow occurs
Nitrates
Direct action on vascular smooth muscle and cause it to relax.

Can be administered under tongue, on the skin, and by mouth

Half-life is 1- 4 minutes
Nitro stat (nitroglycerin)
prophylaxis, treatment and management of angia
1 tab SL; repeat in 5 min 3 times as needed.
Nitro bid (nitroglycerin)
topical
prophylaxis& treatment of angia caused by CAD
1 cap or tab q8 - 12 hrs
Nitro-dur (nitroglycerin)
transdermal patch
prevention and treatment of angia caused by CAD
apply pad daily; leave on for 12-14 hr; take off for 10-12 hr
Nitro stat (nitroglycerin)

o Nitro bid (nitroglycerin)

o Nitro-dur (nitroglycerin)

Adverse/side effects
Postural hypotension
Flushing
Tachycardia
Confusion
Dizziness
Fainting
H/A
What could happen to the patient if taken Nitrtates for a long period of time?
tolerance to nitrate may develope over time with repeated use and can be tolerated to othe nitrate meds.
NITRATES uses are what?
Nitro stat (nitroglycerin)
rapid- acting used mostly to relieve pain in acute angina.
Nitro bid (nitroglycerin) &Nitro-dur (nitroglycerin) used for what?
long - acting used to prevent or treat anginal attacks when they are likely to occur; reduce the work of the heart of MI in chronic heart failure relieve of gallbladder, GI, urethral and bronchial smooth muscle pain.
Drug interactions of nitrates is what?
nitrates increases the effects of atropine-like drugs and tricyclic antidepressants and decrease the effects of all choline - like drugs.
Drug interactions of nitrates is what? (cont.)
taking alcohol, beta blockers, antihypertensives, narcotics, and vasodilators with nitrates and nitrites may produce severe hypotension and cariac collapse.
What should the patient report immediately when taking a nitrate?
the drug should be stopped if blurred vision or dry mouth or persistent HA occurs.
what are the patient teaching about the side effects of the nitrates medication?
flushing of the face, brief throbbing headache, increase heart rate, dizziness, and lightheadedness when sitting up rapidly.
When should nitroglycerin be thrown away by the patient?
3 months after the bottle has been opened
Nitroglycerin could cause what in the patient?
hypotension decreases the blood flow to the coronary arteries making the blood pressure even lower if the pt is having a MI
Calcium Channel Blockers
Some of these medications relieve chest pain by acting on the smooth muscle to dilate arteries in the heart.
Dysrhythmias
- irregular heartbeats (rhythm)
· could be a slow or fast rate
· commonly caused by irritation to the heart tissue which was caused by MI, fluid and elctrolyte imbalance, diet problem, hypoxia and reactions from drugs.
Anti dysrhythmics medications
These medications affect cells that are firing irregular by acting on different phases of cell activity

o Class I
o Class II
o Class III
o Class IV
Anti dysrhythmics medications
* Procanbid
* QuinTab
* Xylocaine
* Inderal
* Cordarone
* Tikosyn
* Betapace
* Calan
Most common causes of dysrhythmias is what?
are irritation to the heart tissue after the patient has suffered an MI, fluid & electrolyte imbalances, problems with diet, hypoxia and reaction from drugs.
what does the class I med. do ? (anti dysrhythmics )
* Procanbid/procainamide
* QuinTab/quindine
* Xylocaine/lidocaine
lenghten the effective refractory period of atrial and ventricular myocardium by slowing the fast inward current caused by the sodium electrolyte.
(anti dysrhythmics )what does the class II med do?
* Inderal/propranolol
beta blockers reduce sympathetic excition to the heart.
(anti dysrhythmics )what does the class III med do?
* Betapace/sotalol
* Tikosyn/dofetilde
* Cordarone/amiodarone
lengthen the action potential duration or the lenght of time it takes for one cell to fire and recover
(anti dysrhythmics )what does the class IV med do?
including calcium channel blockers selectively block the ability of calcium to enter the myocardium and prolong the effective refractory period.
calcium Channel Blockers
Calan / supraventricular tachydysrhythmias
What are the two drugs used to treat rapid and irregular dysrhythmias? and what do they do ?
quinidine and procainamide:
to quiet the myocardial cells and make them less excitable and less likely to fire.
What should the pt know if taking Xylocaine/lidocaine?
The pt should know the effects
the med. could cause drowsiness, dizziness, fear, euphoria, tinnitus, blurred or double vision, hypotension,
cardiac collaspe,repsiratory depression, bradycardia, convulsions, and hallucinations
Hyperlipidemia
- High amounts of triglycerides or/and cholesterol

· Leads to atherosclerosis
Hydroxymethylglutaryl Coenzyme A ( HMG – CoA )
* Lipitor
* Zocor
- Expensive
· Best tolerated
· Highly effective at lowering LDL levels
· Monitor liver labs
Fibric Acid Derivatives
* gemfibrozil
* Tricor
- Highly effective at lowering triglycerides and increasing HDL levels
· Monitor liver labs
· Can cause cholelithiasis (gallstones)
Bile Acid Sequestrants
* Questran
* Cholestid
- Decreases LDL and cholesterol blood levels
· Will increase triglyceride levels
· Adverse GI effects
Niacin
Most effective at lowering triglycerides and increasing HDL level
Adverse effect: flushing
o Reduced by taking aspirin 30 minutes prior to administration
o Increasing dose from 500 mg to 1000 mg TID slowly
· Used cautiously in patient with gout and diabetes
· Cheapest anti hyperlipidemic
When taking Hyperlipidemia meds. the patient should do what?
Diet- low in cholestrol and saturated fats, reducing calories and increasing fluids and fiber.
Cardiotonics
Increase the strength of contraction (+ inotropic) of the heart muscle
Slow heart rate
Cardiotonics are used to treat what?
Treat heart failure or dysrhythmias
Cardiotonic
what is the drug & patient teaching?
Lanoxin (digoxin)

o + inotropic
o Toxicity could occur
Extreme fatigue
Anorexia
N/V
Yellow or green vision
Double vision
Seeing halos
H/A
weakness
o Apical pulse required prior to administration
o Take after meals
o Educate patient and family about apical pulse and toxicity
Hypertension
Blood pressure is elevated above “normal” values.

§ 120-139/80-89 is considered a pre-hypertensive BP range

§ Blood pressures above 140/90 are commonly associated with organ damage.

§ Damage occurs to organs

o Brain
o Kidneys
o Heart
Diuretics
used to treat what and why are they used?
Usually first line of medications when treating hypertension

§ Well tolerated, least expensive, and considered quite safe
Diuretics divided into which 4 groups?
o Loop diuretics
lasix

o Thiazide-like sulfonamide
Zaroxolyn

o Thiazides
HCTZ

o K+ sparing
Aldactone
Adrenergic Inhibitors
Beta blockers (abrupt stop can result in chest pain and rebound HTN)
o Tenormin
o Lopressor

Alpha blockers
o Cardura

Combination
o Trandate

Central blockers
o catapres
Angiotensin-Converting Enzyme Inhibitors
· Capoten

· Vasotec

· Zestril

· Altace
Angiotensin-Converting Enzyme Inhibitors
o Inhibits angiotensin I from converting to angiotensin II (potent vasoconstrictor), which then stops the increase of aldosterone.

o Produces hacking cough
Angiotensin II Receptor Antagonist
· Atacand

· Avapro

· Cozaar

· Diovan
Angiotensin II Receptor Antagonist
Blocking the angiotensin II receptors, which then blocks its potent vasoconstriction properties
Vasodilators
Decrease PVR by reducing systolic and diastolic blood pressure. It is done by direct relaxation of vascular smooth muscle.

Apresoline (hydralazine)
Calcium Channel Blockers

Norvasc
Cardizem
Calan
Blocking calcium ions through specific channels of the cell membrane in heart, blood vessels and smooth muscle cells.

· Gradual drug withdrawal due to rebound angina attacks.
Drugs for Urinary Problems
· To treat urinary incontinence
· To treat benign hyperplasia
- To treat pain or bladder spasms
· To treat urinary infections
Ditropan (oxybutynin chloride)
To treat urinary incontinence

· Used to relieve involuntary bladder contraction/spasms
Detrol (tolterodine
To treat urinary incontinence

· Used to control urine frequency, urgency and bladder over activity.
Proscar (finasteride
Treat symptoms of BPH

· Adverse/side effects

o Impotence

o Decreased libido
Flomax (tamsulosin)
Treats symptoms of BPH

· Adverse/side effects

o Postural hypotension

o Somnolence

o Rhinitis

o Diarrhea

o Abnormal ejaculation
Pyridium (phenazopyridine)
Urinary tract analgesic

· Stains urine orange or red
Fluid and Electrolytes
Administered when oral intake has been prevented or stop.

o Before surgery

o After surgery

o NPO status
Fluid and Electrolytes
Administered when there is lack of body fluid due to inadequate intake, excessive loss or both

o Dehydration

o Vomiting

o Diarrhea
Peripheral vasodilators does what in the body?
Peripheral vasodilators relax smooth muscles in the arteries located in peripheral arterial circulation.
The usual path of the flow of information made by the heart is what?
the usual path of the heart's information flow is it begins in the SA node, passes through the atrium to the atrioventricular (AV node), through the bundle of His, through the right and left bundle branches, and out through the Purkinje fibers of the myocardium.
When giving Anti- dysrhythmics medications what should the nurse do first?
take the pat. vital signs . then make sure to teach the pt about the med and electrolytes levels needs to be monitor and the ECG
What should the nurse teach the pt. about the Anti- dysrhythmics medications ?
The nurse should teach the pt. to take the med as schedule and not to double up on the med. Regular check-ups should be done. Pt should be careful when driving, avoid alcohol. do not take OTC drug w/o talking to MD first.
Antihyperlipidemia is taken for a long time what else might the pt need?
Might need vitamin A, D, & K
What are the pt teaching the nurse should do when giving antihyperlipidmia meds?
-take meds with meals
-powder drug (bile acid sequestrant) should be added to a liquid or put into a cereal, fruits, allow to dissolve for 1 minute and then stir and rinsed with water and the pt. should drink this to get all med.
-drink at least 2 quarts of fluid each day and high-bulk fiber diet.
What should the nurse do before giving a carditonic drug and what should the nurse teach the pt.?
-check apical heart rate if below 60 hold med.
-also check for symptoms of digitalis toxicity.
-use warm packs to relieve painful swelling at the injection
-rotate sites
-wear a Medic Alert bracelet
-eat foods rich in potasium bananas, citrus or dried fruits,dried beans and lentils and all-bran cereals
What should the nurse teach the pt when giving antihypertensive, &diuretic med.?
-encourage the pt. to lose weight, lower sodium intake, avoid stress emotional pressures, exercise routine, and good self esteem.
-good eye exam to determine B/P high or low
-potassium rich foods
-wear a medalert id tag
Drugs for Urinary Problems what should the nurse teach the pt?
-keep a bladder diary
-color of urine will be changed
The Nervous System is does what and composed of what 2 parts?
The Nervous System
• Complex system of the human body that regulates and coordinates the body’s activities.
Two Parts of the Nervous System
• Central N.S.
o The Brain
o The spinal cord

• Peripheral N.S
o The nervous system tissue and nerves outside the Central Nervous System.
What is the Functional divisions of the nervous system?
• Autonomic Branch of The Peripheral Nervous System
Sympathetic Division
o “fight or flight”
o Activation due to stressful conditions or situations
Parasympathetic Division:
o "rest or digest”
o Activation during non stressful conditions or situations.
Neurotransmitters are what?
•Chemical messengers with different certain chemical shapes.
•Targeted to act at certain parts of the body where the chemical shape “fits” specifically.
•Receptors
o Alpha
o Beta
o dopaminergic
• Two major transmitters
o Norepinephrine
o acetylcholine
A nerve impulse travels along the presynaptic neuron, bridges the synaptic cleft, and reaches the receptors in the postsynaptic neuron. There, the impulse is regenerated.
Adrenergic Nerve Fibers are what?
• The nerve fibers that release norepinephrine.
• Accelerated effects
Adrenergic drugs does what in the body?
• Mimic that activity of the sympathetic N.S.
o Sympathomimetic drugs
o Catecholamine (also include epinephrine & dopamine)
• Used for hypovolemic shock, hypotension, Asthma, cardiac arrest.
Adrenergic blocking drugs that block the release of nor epinephrine and epinephrine
Cholinergic Nerve Fibers does what in the body?
• The nerve fibers that release acetylcholine.
• Decelerated effects
Cholinergic drugs does what?
• Mimic the activity of the parasympathetic N.S.
o Parasympathomimetic
o Action similar to acetylcholine
• Anti-cholinergic drugs/agents block the release of acetylcholine
Cholinergic Crisis is what ?
• Overdose of cholinergic drugs or anticholinesterase drugs
• Excessive acetylcholine
Tension Headache
• The most common type of headache.
• Tension – stress
• Usually resolved when stress relieved
• OTC analgesics to treat initially.
Migraines
• The most painful type of headache
• The most effective treatment would be to begin drug therapy before migraine pain is at a severe level.
• Usually vascular in origin (vasodilation)
• Usually preceded by an aura.
Anti-Migraine Agents
• Ergotamine Derivatives
o dihydroergotamine ( DHE, Migranol)
o ergotamine (Ergomar)
• Serotonin Receptor Agonists (5-HT, Triptans)
o sumatriptan succinate (Imitrex)
Anti-Migraine Agents
• Action / Uses
o Adrenergic-blocking agents dilate the veins in peripheral vascular smooth muscle. This decreases blood flow to the brain, which also decreases the arterial pulsing. All this in combination decreases the headache pain.
o Prevention and treatment of vascular headaches/migraine.
Anti-Migraine Agents
Adverse Effects
Heart murmurs
Tachycardia
Confusion
Depression
Dizziness
Drowsiness
Miosis
Paresthesia
Nausea/Vomiting
edema
Pruritus
neutropenia
SEIZURES
Unconscious controlled muscle contractions that are sudden and a symptom of excessive abnormal electrical discharges in the brain.
EPILEPSY
A disorder characterized by recurrent seizures
CONVULSIONS
- Involuntary, rapid, and often violent muscle movement. Involve large skeletal muscle (face, neck, legs and the arms)
Anti-convulsants/Anti-seizure Agents/Anti-epileptic
•Barbiturates
o Phenobarbital
•Benodiazepines
o Klonopin (clonazepam)
•Hydantoins
o Dilantin (phenytoin)
•Other
o Neurontin (gabapentin)
what is the action?
• To depress or slow down the abnormal electrical discharges from the brain (CNS). Treatment can depend on the type of seizure activity; some medications may work better than others.
BARBITURATES what is the action?
o Raise seizure threshold
o Act on brainstem reticular formation which decreases impulses that go to the cerebral cortex
USES:
BENZODIAZEPINES
o Exact action unknown
o There has been speculation of its action.
HYDANTOINS
o Act on motor cortex, controlling sodium ion movement during generation of the nerve impulse
SUCCINIMIDES
o Increase seizure threshold in the cortex and basal ganglia. Reduces synaptic response to repetitive stimulation in low frequency.
Uses
•BARBITURATES
•BENZODIAZEPINES
o Petit mal (clonazepam)
o Used when succinimide are unsuccessful
o Status epilepticus (valium)
o Lennox-Gastaut syndrome
USES:
•HYDANTOINS
o Grand mal seizures
o Psychomotor seizures
USES:
• SUCCINIMIDES
o Control petit mal seizures
Interactions
• BARBITURATES
o With anti-coagulants, corticosteroids, and digoxin.
- May reduce their effects
o With MAOIs
-Increase barbiturates’ effects
o Alcohol
o Antihistamines
o Benzodiazepines
o Narcotics
o Tranquilizers
o HYDANTOINS
o With many different medications, so this must carefully monitor with a patient taking other medications and vitamins.
Interactions
• SUCCINIMIDES
o Other anti-convulsants
o Bone marrow-depressing drugs
Anti-Emetic/ Anti-Vertigo Agents are used for what and the action?
• Agents that are used to prevent and treat motion sickness and nausea/vomiting

Action
• These types of medications reduce the stimulation, indirectly, of vomiting centers.
• They reduce the levels of dopamine and acetylcholine, which cause vomiting.
Uses of Anti-Emetic/ Anti-Vertigo Agents is what?
• Anti-dopaminergic – almost always used to control nausea and vomiting only.
• Anti-cholinergic – to control motion sickness.
• 5 –HT agonists – used prophylactically for anticipated nausea/vomiting.
o Prior to cancer treatment
Anti-Emetic/ Anti-Vertigo Agents
• Anti-dopaminergic
o Compazine (prochlorperazine)
o Phenergan (promethazine)
• Anti-cholinergic
o Dramamine (dimenhydrinate)
o Antivert (meclizine)
• Other
o Marinol (dronabinol)
Parkinson’s disease
• Chronic (degenerative) disorder that affects that CNS.
• No known cure
• Relieving symptoms and maintaining movement so that the patient may achieve his/her daily activities.
• Symptoms include: fine muscle twitching, slowness in movement, rigidity, shuffling and changes in posture and balance.
• Decreased levels of dopamine and increased acetylcholine.
Anti- Parkinsonian Agents
• Dopaminergic agent
o Sinemet (carbidopa-levodopa)
 Adverse effects – involuntary movements, nausea and vomiting
 Carbidopa – prevents peripheral breakdown of levodopa.
 Levodopa – converts to dopamine in the CNS
Anxiety what is it?
• Natural human emotion
• A person feels helpless, apprehensive, worried and unable to think or make decisions rationally.
• When a person feels this way frequently and it interferes with a person’s activities of daily life, then medication treatment may be necessary.
• Actual reaction in the limbic system
What types of anxiety is there?
• General anxiety disorder
• Panic disorder
• Phobias
• Obsessive compulsive disorder
• Post traumatic stress disorder
•Anti-Anxiety meds.
Benzodiazepines
Benzodiazepines
• Valium (diazepam)
• Ativan (lorazepam)
• Xanax (alprazolam)
• Serax (oxazepam) commonly for alcohol w/d
• Adverse effects – dizziness, drowsiness and lethargy.
Benzodiazepines action
depresses the CNS, enhances the GABA, inhibitory neurotransmitter.
Consider a short term solution due to risk for addiction and drug tolerance.
Never discontinue abruptly! Withdrawal symptoms could occur.
Nonbenzodiazpines
• BuSpar (buspirone)
• Vistaril (hydroxyzine)
- short-term use
- antihistamine for symptomatic relieff of anxiety,
- relief of pruitus
- preoperatively for surgery to decrease anxiety
Depression is what ?
• Natural human feelings such as sadness and loss that does not pass. These feelings are persistent and effect how a person can function in everyday life. Usually unable to interact, work, function or even perform daily activities.
• Depression is usually experience 5 or more classic depressive symptoms what are they?
o Depressed mood
o Decreased interest in life/ or appearance
o Weight loss or gain
o Insomnia or hypersomnia
o Psychomotor agitation or depression
o Tired, fatigued, no energy
o Feelings of guilt
o Unable to concentrate or think
o Suicidal tendencies/thoughts
o Physical pain
o Hallucinations
Anti-depressant Uses are what?
• Manage depression with anxiety.
• Combined with psychotherapy (severe cases)
• OCD
Anti-Depressants
Tricyclic Anti-depressants (TCAs)
- Elavil (amitriptyline)
- Sinequan (doxepin)
• Inhibit reuptake of norepinephrine or serotonin at the presynaptic neuron.
• Primary use: relief of severe symptoms of depression.
• Mild depression caused by factors in the patient’s life. Usually not self limiting and not interfering with life activities.
Selective Serotonin Reuptake Inhibitors (SSRIs)
• Prozac (fluoxetine)
• Paxil (paroxetine)
• Zoloft (sertraline
• Lexapro (escitalopram)
• Celexa (citalopram)
Monoamine Oxidase Inhibitors

Miscellaneous Anti-Depressants
• Nardil (phenelzine)
• Parnate (tranylcypromine)

Wellbutrin (bupropion)
Effexor (venlafaxine)
Psychosis
• Abnormalities of the mind, severe mental illnesses.
o Schizophrenia
o Psychotic
o Depression
o Mania
o Bipolar disorder
Symptoms of psychosis are what ?
• Delusions
• Social withdrawal
• Flattened effect
• Anhedonia
• Disorganized speech
• Behavior disturbance
• Loss of contact with reality
Anti-Psychotic Drug
o Thorazine (chlorpromazine)
o Navane (thiothixene)
o Nonphenothiazines
o Haldol (haloperidol)
o Geodon (ziprasidone)
• Uses involve managing acute and chronic psychosis
• Act by blocking the action of dopamine on the brain.
Manic Depressive Psychosis
Bipolar disorder
Patient experiencing abnormally elevated moods.
Extreme mood swings
• From euphoric type happiness and then to a severe depressive sadness.
Anti-Manic/ Mood Stabilizer
Manic Depressive Psychosis
Anti-Manic/ Mood Stabilizer
• Lithium acts how
o Acts by altering sodium transport in nerve and muscle cells and inhibits the norepinephrine and dopamine release
Sedative/Hypnotic
• Sedative – It produces a calming and relaxing effect that enables the patient to fall asleep.
• Hypnotic – It induces sleep in the patient
Sedative/Hypnotic
o Tranxene (clorazepate)
o Ambien (zolpidem)
o Restoril (temazepam)
o Barbiturates
o Benzodiazepines
 Have addictive potential
 Smoking may decrease the length of time the medication helps with sleep.
 Since short term usage if suggested, alternative methods should be considered.