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Pharm Week 5
Cardio Agents 3
41
Nursing
Undergraduate 1
06/30/2011

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Cards

Term
What class of drugs has been the tx of choice for many years?
Definition
Cardiac glycosides.
Term
Cardiac glycosides can provide insight into what?
Definition
Heart failure.
Term
What is the prototype drug for cardiac glycosides?
Definition
Digoxin.
Term
What is a inotropic effect?
Definition
Myocardial contraction.
Term
What is a chronotropic effect?
Definition
Heart rate.
Term
What is a dromotropic effect?
Definition
Conduction of heart cells.
Term
What are the 4 effects of digitalis?
Definition
1. Positive (+) inotropic effect.
2. Negative (-) chronotropic effect.
3. Negative (-) dromotropic effect.
4. Increased SV.
Term
What are the 5 effects of positive inotropic effect?
Definition
1. Increases CO. 2. Decreases preload. 3. Improved blood flow to kidneys & periphery. 4. Decreases peripheral and lung fluid retention. 5. Increases fluid excretion.
Term
What are the 4 therapeutic effects/uses of digitalis?
Definition
1. Treat HF.
2. Corrects A-fib.
3. Corrects atrial flutter.
4. Corrects atrial tachycardia.
Term
What is the digoxin dosage via PO for adults?
Definition
1. Initial - 0.5-1mg intially in 2 divided doses.
2. Maintenance - 0.125-0.5mg/day.
Term
What is the digoxin dosage for elderly?
Definition
0.125mg/day.
Term
What is the digoxin dosage for adults via IV?
Definition
Same as PO dose given over 5 min.
Term
How is digoxin given to children?
Definition
Pediatric doses usually ordered in mcg elixir form.
Term
What is the therapeutic serum level for digoxin?
Definition
0.5-2.0 mg/ml.
Term
What is the pharmacokinetics of digoxin?
Definition
1. Absorption - oral: 60-100%.
2. Distribution - PB 25%.
3. Metabolism - t 1/2 30-45 hrs.
4. Excretion - 70% urine & 30% by liver metabolism.
Term
What drug interactions with digoxin results in increased serum digoxin levels?
Definition
1. Quinidine.
2. Verapamil.
3. Flecainide.
Term
What drug interactions with digoxin results in decreased serum digoxin levels?
Definition
1. Antacids.
2. Colestipol.
Term
What drug interactions with digoxin results in increased risk for digoxin toxicity?
Definition
Thiazide & loop diuretics.
Term
What 3 conditions can increase digoxin toxicity?
Definition
1. Hypokalemia.
2. Hypomagnesemia.
3. Hypercalcemia.
Term
What are the adverse reactions/side effects of digoxin toxicity?
Definition
1. Bradycardia.
2. Atrioventricular block.
3. Cardiac dysrhythmmias.
4. N/V.
5. Headache.
6. Blurred vision.
7. Visual illusions.
8. Confusion.
9. Delirium.
Term
The serum level of what enhances digoxin action?
Definition
Potassium.
Term
Vasodilators help to do what 4 things in regards to the heart?
Definition
1. Decrease venous blood return to heart.
2. Decrease cardiac filling.
3. Decrease preload.
4. Decrease oxygen demand.
Term
What 4 things do ACE inhibitors do?
Definition
1. Dilates venules and arterioles.
2. Moderately decrease the release of aldosterone.
3. Reduces sodium and fluid retention.
4. Can increase potassium.
Term
For clients who can't tolerate ACE inhibitors you can use what?
Definition
Angiotensin II Receptor Blockers.
Term
What is Carvedilol?
Definition
1. It is a 3rd generation Beta receptor antagonist.
2. Blocks B1, B2, A1 receptors.
3. Antioxidant protects against free radicals causing damage to nucleic acids, proteins, and lipids.
4. Slows progression of CHF.
Term
Potassium sparing diuretics inhibit what?
Definition
Aldosterone.
Term
Where do potassium sparing diuretics work?
Definition
Work primarily in the collecting duct renal tubules and late distal tubule.
Term
Use of potassium sparing diuretics can lead to what imbalance?
Definition
Hyperkalemia, therefore potassium supplements are not needed.
Term
What is a prototype drug for potassium sparing diuretics?
Definition
Spironolactone (Aldactone).
Term
What do carbonic anyhdrase inhibitors do?
Definition
1. Inhibit action of carbonic anhydrase.
2. Promotes excretion of Na, K, and HC03 in proximal renal tubule.
Term
Prolonged use of carbonic anhydrase inhibitors can lead to what condition?
Definition
Metabolic acidosis.
Term
Carbonic anhydrase inhibitors can be used for what 5 things?
Definition
1. Primary use is to decrease IOP in open-angle (chronic) glaucoma. 2. Metabolic alkalosis. 3. Epilepsy. 4. Edema 2nd degree to CHF. 5. Altitude sickness.
Term
What are the side effects & adverse reactions of carbonic anhydrase inhibitors?
Definition
1. Fluid & electrolyte imbalances.
2. Metabolic acidosis.
3. N/V, anorexia.
4. Confusion.
5. Orthostatic hypotension.
6. Hemolytic anemia.
7. Renal calculi.
Term
What is a contraindication of carbonic anhydrase inhibitors?
Definition
1st trimester pregnancy.
Term
What type of diuretics are contraindicated in HF?
Definition
Osmotic diuretics.
Term
Osmotic diuretics increase the excretion of what?
Definition
Nearly all electrolytes.
Term
What is a prototype drug for osmotic diuretics?
Definition
Mannitol.
Term
What are the 4 uses of Mannitol?
Definition
1. To reduce intracranial pressure
2. To reduce intraocular pressure.
3. Cisplatin chemotherapy.
4. To prevent kidney failure.
Term
What are the 4 side effects of Mannitol?
Definition
1. Fluid and electrolyte imbalance.
2. Pulmonary edema.
3. Nausea.
4. Vomiting.
Term
What are the 2 contraindications of Mannitol?
Definition
1. HF.
2. Pulmonary edema.
Term
Under what conditions do you not administer Mannitol?
Definition
When crystals are present. To prevent crystallization do not expose vial to low temperatures.
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