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9 Cards in this Set

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(P) QUINIDINE
4:
ATRIAL arrhythmias

MECH:
Blocks Na+ channels --> confusion-->seizures-->myocardial block (Depresses myocardial excitability, conduction velocity, & contractility. The effective refractory period prolonged-->increasing conduction time.)

CONTRAS:
Hypersensitivity, several cardiac conditions, and myasthenia gravis

ADVERSES:
A & N & V
GI: CHINCONISM: abdominal pain, diarrhea
cardiotoxicity

- Assess 4 adequate potassium intake

- Adjust the dose to get 2 to 6 mg/mL

- monitor serum K+

- Give a test dose of a single 200-mg tablet or IM to find if they'll have idiosyncratic Rxs

- take at same time every day
(P) AMIODARONE
4:
ONLY in life-threatening arrhythmias

MECH:
prolongation of phase 3 (repolarization), reduction in membrane excitability of all myocardial tissue.

CONTRAS:
Severe sinus-node dysfunction, 2nd and 3rd degree AV block

ADVERSES:
Pulmonary toxicity, exacerbation of the arrhythmia, and liver disease

-must monitor respiratory rate (b/c pulmonary toxicity)

-Absorbed slowly (ONLY 50% available)

- must put in glass bottle (interacts with plastic bags)

-
(P) VERAPRAMIL
4:
Atrial fib / flutter

MECH:
Inhibits the movement of calcium ions across the cardiac and arterial muscle cell membrane. (lowers BP)
CONTRAS:
Constipation, dizziness, headache, nausea, hypotension, and peripheral edema

ADVERSES:
Sick sinus syndrome, 2nd or 3rd degree heart block and hypotension

- Do not admin with IV Beta blockers --> hypOtens
(P) SODIUM POLYSTYRENE SULFONATE
4:
hyperkalemia

MECH:
Releases sodium ions that are replaced with potassium ions.

- get serum K+ level b4 & after (normal = 3.5-5 mEq/L)

- do not give with cation-donating antacids and laxatives, (magnesium hydroxide and aluminum carbonate)
(P) HEPARIN
4:
Parenteral anticoagulant (Interferes with final clotting cascade steps)

MECH:
疾apidly inactivates factor X, which prevents conversion 之f prothrombin to thrombin

ADVERSES:
BLEEDING and thrombocytopenia

- SAFE for pregnant women

- aPPt is the "clotting 時ime" - it is the way they monitor how 井ell heparin is working

- 可AN be a prophylactic also

- 勿OT 皆LL HEPARIN IS THE 同AME (諸arious sizes & weights) - low molec weight (fractionated) hep = easier 2 剤ose & fewer 側ide effects

- ** ANTIDOTE = PROTAMINE SULFATE ** (乃rom salmon sperm - but pts w/vasectomies may have Abs to it)
When you give clotting factor IV, it is called______
chryoprecipitate
(P) *** WARFARIN ***
4:
ORAL PROPHYLACTIC 4 pts with 長ong term thrombus formation 冒isk

-highly protien bound (albumin & alpha- glycoprotien)

- Competitively blocks vitamin K at its sites 之f action

- variations 之f P-450 may alter drug response

- ** ANTIDOTE = VITAMIN K ** (phytonadione)

- also RAT 毒OISON (decreases clotting-->intracerebral bleed--> 死eath)

- monitored w/ PT & INR (prothrombin 時ime & intrnt'l normalized 率atio)
(P) *** CLOPIDROGEL ***
(PLAVIX)
ANTI-PLATELET

4:
to reduce atherosclerotic events 中n 民eople at high 冒isk for these - have stents, 等tc. (when aspirin isn't enough)

MECH:
Inhibits activation 之f IIb/IIIa platelet antagonists

ADVERSES:
SEVERE NEUTROPENIA

- 取ake it with food
(P) ALTEPLACE RECOMBINANT
4:
Pre-existing clots (4: acute MI; a PE; or acute ischemic stroke) (NOT for hemorrhagic stroke - will make it worse)

- put on cardiac monitor