Workman 13-15 review.txt

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Author:
wdgassett
ID:
272482
Filename:
Workman 13-15 review.txt
Updated:
2014-04-30 00:02:05
Tags:
pharmacology
Folders:
hypertension,heart failure,antidysrhythmic
Description:
pharmacology Workman chapters 13-15
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  1. ACE inhibitors
    • (drugs for hypertension, heart failure)
    • enalapril (Vasotec)
    • lisinopril (Zestril)
  2. Intended responses of ACE inhibitors are:
    • Production of angiotensin II is decreased.
    • Vasodilation of blood vessels is increased.
    • Excess tissue water and salt are decreased.
    • Blood pressure is lowered.
    • Workload on the heart is decreased.
  3. ACE inhibitor side effects are:
    • hypotension
    • taste disturbances
    • increased blood potassium level (hyperkalemia)
    • headache
    • persistent, dry cough
  4. Should ACE inhibitors be used during pregnancy and breastfeeding?
    • NO: pregnancy category D and can cause birth defects.
    • Pass into breast milk and can lower blood pressure and lead to kidney damage in the infant.
  5. losartan (Cozaar) is what kind of drug?
    Angiotensin-II Receptor Antagonists
  6. The intended responses for losartan are:
    • Vasodilation of blood vessels is increased.
    • Excess body water and salt are decreased.
    • Blood pressure is lowered.
    • Workload on the heart is decreased.
  7. losartan (Cozaar) does what to potassium in blood?
    It reduces potassium excretion by the kidneys.
  8. What is a heart sign of high potassium level?
    Increasing height of T waves.
  9. Name two common beta blockers and what purpose used.
    • metoprolol (Lopressor)
    • metoprolol (Toprol XL)
    • atenolol (Tenormin)
  10. What are the intended responses to beta blockers?
    • Heart rate is decreased.
    • Force of heart contraction is decreased.
    • Work of heart is decreased.
    • Blood pressure is lowered.
  11. How do beta blockers work?
    They block the effects of epinephrine on the heart, decrease heart rate and force of heart contractions.
  12. What are the side and adverse effects of beta blockers?
    • Impotence, dizziness, drowsiness, insomnia, fatigue or weakness;
    • Very slow heart rate, chest pain
    • Increased sensitivity to sunlight and cold
    • Depression
  13. What is the effect of nitroglycerin?
    • [nitroglycerin transdermal patch; nitroglycerin ointment]
    • Vasodilation
    • Blood flow increased.
    • Blood pressure lowered
    • Heart workload decreased.
  14. What to teach about vasodilators (nitroglycerin)?
    Headaches may be relieved by acetaminophen and will decrease or disappear as tolerance developed.
  15. What are the side effects of digoxin (Lanoxin)?
    • Fatigue
    • bradycardia (HR < 60)
    • anorexia
    • nausea
    • vomiting
    • headache, fatigue, drowsiness, confusion, gynecomastia, thrombocytopenia.
    • Seeing halos around lights.
    • Yellow vision
  16. What to do before giving digoxin?
    Always check the apical heart rate for a full minute before giving. If the HR < 60 or irregular, hold the drug and notify the prescriber.
  17. Should digoxin be given to pregnant women, breastfeeding?
    • Category C; passes from mother to fetus.
    • Passes to baby through breast milk; not recommended.
  18. When should side effects of digoxin be reported to prescriber?
    Immediately, because they are probably signs of digoxin toxicity (life threatening).
  19. How does digoxin work?
    • For atrial fibrillation, helps slow HR by blocking number of electrical impulses through AV node.
    • Helps strengthen the contractions in ventricles.
  20. What is the therapeutic range of digoxin?
    0.8 – 2 ng/mL
  21. Name a positive inotrope
    dobutamine (Dobutrex) – given IV
  22. How do positive inotropes work?
    • Make the heart muscle contract more forcefully and relax blood vessels.
    • For people with severe heart failure symptoms.
  23. What are signs of potassium overdose?
    • slow and irregular heart rhythm
    • fatigue
    • muscle weakness
    • paresthesia (numbness and tingling)
    • confusion
    • difficulty breathing,
    • ECG changes.
  24. What are signs of increased magnesium levels?
    • Decreased reflexes (neuromuscular depression)
    • muscle and generalized weakness
    • abnormal cardiac rhythm
    • drowsiness
    • decreased alertness and concentration
    • decreased rate of breathing/respiratory paralysis
    • CNS depression
    • coma
  25. Dietary sources of potassium
    • baked potato
    • bananas
    • beet greens
    • clams
    • halibut, tuna, cod fish
    • molasses
    • prune, carrot, tomato juice
    • soybeans
    • spinach
    • sweet potato
    • tomato paste, sauce, puree
    • white, lima beans
    • winter squash
    • yogurt
  26. What drugs may be given ty ET tube?
    • NAVEL
    • Narcan
    • atropine
    • Valium
    • epinephrine
    • lidocaine
  27. What is atropine used to treat?
    Atropine is used to treat abnormally slow heart rhythms (bradydysrhythmia)
  28. How does atropine work?
    Atropine blocks the actions of the vagus nerve on the heart.
  29. What are side and adverse effects of atropine?
    • urinary retention
    • ventricular fibrillation
  30. What to teach about using atropine:
    • Use mouth rinses and frequent mouth hygiene to help relieve dry mouth and prevent tooth decay.
    • Avoid strenuous activity in a hot setting.
  31. What does lidocaine do?
    Lidocaine is used to treat ventricular tachycardia and PVCs that cause patient symptoms.
  32. What is propafenone (Rythmol) used for?
    Propafenone is used to treat life-threatening ventricular tachycardia or fibrillation and supraventricular tachycardia.
  33. For what is adenosine (Adenocard) used to treat?
    Adenosine is used to treat supraventricular tachycardia.
  34. How is adenosine given?
    Adenosine is given as a rapid IV bolus injection (over 1-2 seconds). After given, there will be a very brief period of asystole; than normal rhythm.
  35. For what is magnesium used?
    • Magnesium is used IV to prevent ventricular dysrhythmia torsades de points from returning after defibrillation.
    • Given during labor to lower risk of seizures for patients with eclampsia.
  36. Signs of magnesium levels < 4 mg/dL:
    • Seen in the cardiac, central nervous and neuromuscular systems:
    • bradycardia
    • drowsy or lethargic
    • deep tendon reflexes reduced or absent.

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