Term
| What would lidocaine (xylocaine) be used for in a cardiac patient? |
|
Definition
| First line drug for ventricular arrhythmias |
|
|
Term
| What route would lidocaine (xylocaine) be given for a cardiac patient? |
|
Definition
|
|
Term
| what is the action of lidocaine (xylocaine) when used for a cardiac patient? |
|
Definition
| supress automaticity and spontaneous depolarization of the ventricles during diastole with little or no effect on the heart rate. |
|
|
Term
| IV lidocane (xylocaine) is contraindicated for what patients? |
|
Definition
| patients with 3rd degree heart blocks |
|
|
Term
| IV lidocane (xylocane) should be used cautiously in patients with: (6 answers) |
|
Definition
Liver failure
Heart failure
Bradycardia
Respiratory depression
Shock
Heart Block |
|
|
Term
| therapeutic class of lidocaine (xylocaine) |
|
Definition
|
|
Term
Pharm Class of metoprolol (lopressor)
Therapeutic class of metoprolol (lopressor) |
|
Definition
Pharm class Beta-Blockers
Therapeutic class antianginals & antihypertensives & off label as an anti-arrhythmic |
|
|
Term
| How does metoprolol (lopressor) work? |
|
Definition
| blocks stimulation of beta1 (myocardial) adrenergic receptors. Doesn't affect beta2 (pulmonary, vascular, uterine) receptors. |
|
|
Term
| What conditions would metoprolol (lopressor) be prescribed for? |
|
Definition
hypertension
angina
Prevention of MI & decreased mortality in patients with recent MI
Heart failure
Possibly ventricular arrhythmias/tachycardia |
|
|
Term
| What is an important consideration when starting a patient on metoprolol (lopressor) |
|
Definition
| orthostatic hypotension. Possible initial dose reduction. |
|
|
Term
| What sexual side effects may be seen from metoprolol (lopressor)? |
|
Definition
|
|
Term
| Should metoprolol be given with or without food? |
|
Definition
|
|
Term
Drug class for
amiodarone (Cordarone) |
|
Definition
|
|
Term
| What is amiodarone (Coradone) indicated for? |
|
Definition
| life threatening ventricular arrhythmias unresponsive to less toxic agents |
|
|
Term
| Action of amiodarone (Coradone) |
|
Definition
Prolongs action potential
Inhibits adrenergic stimulation
Slows sinus rate
Increased PR & QT intervals
Decrases peripheral vascular resistance through vasodilation |
|
|
Term
| Contraindications for amiodarone (Coradone) |
|
Definition
cardiogenic shock
SA node dysfunction
2nd & 3rd degree AV block
Bradycardia
hypersensitivity to iodine |
|
|
Term
| Use amiodarone (Coradone) cautiously in patients with |
|
Definition
HF
Thyroid disorders
Pulmonary or liver disease |
|
|
Term
| Vital assessments when administering amiodarone (Coradone) |
|
Definition
Monitor EKG - particularly QT prolongation. Report Bradycardia or increased arrhythmias promptly
Assess for signs of pulmonary toxicity (ARDS) |
|
|
Term
| Neurotoxicity, ARDS, pulmonary toxicity,vision changes, and thyroid dysfunction are all possible side effects of what drug? |
|
Definition
|
|
Term
| therapeutic class for adenosine (Adenocard) |
|
Definition
|
|
Term
| When would adenosine (Adenocard) be indicated? |
|
Definition
| conversion of paroxymal supraventricular tachycardia (PSVT) to normal sinus rhythm when vagal maneuvers are unsuccessful. |
|
|
Term
| How does adenosine (Adenocard) work? |
|
Definition
interrupts re-entrant pathways in the AV node.
Slows conduction time through the AV node
Produces coronary artery vasodilation |
|
|
Term
| What might adenosine (Adenocard) cause? |
|
Definition
bronchospasm
Caution with patients who have a history of asthma |
|
|
Term
| What patients should not get adenosine (Adenocard) ? |
|
Definition
| Patients with 2nd or 3rd degree AV block |
|
|
Term
| storage considerations for adenosine (Adenocard) |
|
Definition
| crystals occur if refridgerated. Warm to room temperature to disolve crystals. |
|
|
Term
| Therapeutic class for nitroglycerin |
|
Definition
|
|
Term
|
Definition
dialates coronary arteries.
Produces vasodilation (venous greater than arterial)
Decreases pre-load
Reduces myocardial oxygen consumption |
|
|
Term
| Who should not get nitroglycerin |
|
Definition
constrictive pericarditis
pericardial tamponade |
|
|
Term
| What should be done with trans-dermal nitro before cardioversion? |
|
Definition
|
|
Term
Pharm Class for nadolol (Corgard)
Therapeutic class for nadolol (Corgard) |
|
Definition
Beta Blocker
antianginal
antihypertensive |
|
|
Term
| what is nadolol (corgard) indicated for? |
|
Definition
hypertension
angina
Off label: arrhythmias |
|
|
Term
| What is the action of nadolol (corgard) ? |
|
Definition
| blocks stimulation of beta1 (myocardial) and beta2 (pulmoary, vascular, and uterine) receptor sites |
|
|
Term
| Contraindications for nadolol (corgard) |
|
Definition
Uncompensated HF
Pulmonary edema
cardiogenic shock
bradycardia or heart attack |
|
|
Term
| who should get nadolol (Corgard) with caution? |
|
Definition
Renal impairment
hepatic impairment
pulmonary disease (INCLUDING ASTHMA)
Diabetes |
|
|
Term
| what consideration should be given when starting nadolol (Corgard) ? |
|
Definition
| may cause orthostatic hypotension. Consider lower initial dosing. |
|
|
Term
| what are some particularly dangerous possible side effects of nadolol (Corgard) ? |
|
Definition
| arrhythmias, bradycardia, HF, pulmonary edema. |
|
|
Term
| what should be monitored for in a patient getting nadolol? |
|
Definition
| evidence of fluid overload (HF) |
|
|
Term
| Pharm class for diltiazem (cardizem) |
|
Definition
|
|
Term
| therapeutic class for diltiazem (Cardizem) |
|
Definition
antianginals
antiarrhythmics
antihypertensives |
|
|
Term
| What would diltiazem (Cardizem) be indicated for? |
|
Definition
hypertension
angina
supraventricular tachyarrhythmias
rapid ventricular rates in a-fib or a-flutter |
|
|
Term
| action for diltiazem (Cardizem) |
|
Definition
| inhibits transport of calcium into myocardial and vascular smooth muscle cells, resulting in inhibition of contraction |
|
|
Term
| what patients would diltiazem (Cardizem) be contraindicated? |
|
Definition
2nd or 3rd degree AV block
Systolic BP < 90
Recent MI or pulmonary congestion |
|
|
Term
| important drug- interactions for diltiazem (Cardizem) |
|
Definition
increases digoxin levels
decreased effectiveness when used with NSAIDS
Increased levels of cardiomyopathy with statins |
|
|
Term
| Food interactions with diltiazem (Cardizem) |
|
Definition
| grapefruit juice increases levels & effect |
|
|
Term
| drug class dobutamine (intropin) |
|
Definition
|
|
Term
| therapeutic class dobutamine (inotropin) |
|
Definition
|
|
Term
| indications for dobutamine (inotropin) |
|
Definition
| short term (<48hrs) managemennt of heart failure caused by depressed contractility from heart disease or surgery |
|
|
Term
| action of dobutamine (intropin) |
|
Definition
| stimulates beta1 adrenergic receptors with little effect on heart rate or peripheral blood vessels, thereby increasing cardiac output |
|
|
Term
| halflife of dobutamine (intropin) |
|
Definition
|
|
Term
| what assessments are important with dobutamine (intropin)>? |
|
Definition
bp, hr, ekg, pcwp, co, cvp, urinary output. report significant changes to MD.
Palpate peripheral pulses and assess appearance of extremities routinely. notify MD if pulse deteriorates or if extremities get cold/mottled. |
|
|
Term
| atorvastatin (lipitor) indications |
|
Definition
| primary hypercholesterolemia & mixed dyslipidemia. high LDL and low HDL |
|
|
Term
| atorvastatin (lipitor) action |
|
Definition
| inhibits HMG-CoA reductase, which is an emzyme responsible for catalyzing synthesis of cholesterol |
|
|
Term
| How is atorvastatin excreted |
|
Definition
| by the liver. (caution w/ liver disease ex: alcoholics) |
|
|
Term
what food should be avoided when taking atorvastatin?
Should med be given with or without food? |
|
Definition
grapefruit juice
can take with or without food - doesn't matter. |
|
|
Term
| what shoudl a patient taking atorvastatin (lipitor) report to their doctor? |
|
Definition
| If they have unexplained muscle pain, tenderness, or weakness, especially if accompanied by fever or malaise. |
|
|
Term
| Indications for gemfibrozil (lopid) |
|
Definition
| management of hyperlipidemia for patients who do not yet yave coronary artery disease & have failed with diet, exersice, weight loss, & other drugs |
|
|
Term
| What effect does gemfibrozil (lopid) have on warfarin? |
|
Definition
| increases the effects of warfarin |
|
|
Term
| When should gemfibrozil (lopid) be taken? |
|
Definition
| twice daily, 30 min before breakfast and dinner |
|
|
Term
| What pharm class & drug class is alteplase (t-PA) ? |
|
Definition
plasminogen activator
thrombolytic |
|
|
Term
|
Definition
|
|
Term
|
Definition
plasminogen activators
thrombolytics |
|
|
Term
Clopidogrel (Plavix)
class |
|
Definition
anti-platelet agents
platelet aggregation inhibition |
|
|
Term
|
Definition
|
|
Term
| What should be given concurrently with clopidogrel? |
|
Definition
|
|
Term
|
Definition
anticoagulants
antithrombotics |
|
|
Term
| What lab value needs to be followed closely for a patient on heparin therapy? |
|
Definition
aPTT
activated partial thromboplastin time.
and hematocrit
and platelet count |
|
|
Term
| Warfarin (Coumadin) class |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Foods to be aware of with warfarin administration |
|
Definition
|
|
Term
What lab tests need to be evaluated for a patient on warfarin therapy?
What are the therapeutic levels? |
|
Definition
PT, INR.
PT 1.3-1.5 times greater than control
INR 2.5-3.5 (normal 0.8-1.2) |
|
|
