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Quiz 5 HTN, Antianginals, Heart Failure, Antidysrhythmia Drugs

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created 4 years ago by Boosh_75
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updated 4 years ago by Boosh_75

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9th grade, 10th grade, 11th grade, 12th grade

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1

This is when the heart is unable to pump blood in sufficient amounts from the ventricles to meet the body's metabolic needs.

Heart failure

2

Heart failure can be caused by these cardiac defects.

Myocardial Infarction or valve deficiencey

3

Heart failure may be caused by a defect outside of heart such as:

CAD (Coronary Artery Disease), pulmonary hypertension, or diabetes

4

Heart failure can be caused by supraventricular dysrhythmias such as:

Atrial fibrillation or atrial flutter

5

What kind of drug influences the rate of the heartbeat?

Chronotropic drugs

6

What kind of drug influences the conduction of electrical impulses?

Dromotropic drugs

7

These drugs influence the force of cardiac contractions.

Inotropic drugs

8

These drugs prevent sodium and water resorption by inhibiting aldosterone secretion resulting in diuresis which decreases preload and work of the heart.

ACE inhibitors

9

Many ACE inhibitors end in what ending?

-pril

10

These drugs are potent vasodilators. They decrease systemic vaxular resistance (afterload).

Angiotensin II Receptor Blockers

11

Many angiotensin II receptor blockers have this ending.

-artan

12

This beta blocker can be used for heart failure and has a negative inotropic, chronotropic, dromotropic effect and is used mainly as a vasodilator which causes a decrease in the afterload and blood pressure

Carvedilol (Coreg)

13

This aldosterone antagonist drug used to treat heart failure is potassium-sparing.

Spironolactone (Aldactrone)

14

This aldosterone antagonist used to treat heart failure is a selective aldosterone blocker.

Eplerenone (Inspra)

15

this heart failure drug was the first drug approved for a specific ethnic group, namely African Americans.

Hydralazine/isosorbide dinitrat (BiDil)

16

This B-type natiuretic peptide is used in severe, life-threatening heart failure.

Nesiritide (Natrecor)

17

This B-type natiuretic peptide works like a human hormone released by ventricles in response to fluid and pressure overload. It reduces preload, after-load, and indirectly increases cardiac output. It helps to excrete Na and water, should only be given IV and hypotension is the most common side effect.

Nesiritide (Natrecor)

18

These heart failure drugs work by inhibiting the enzyme phosphodiesterase and results in positive inotropic response and vasodilation.

Phosphdiesterase inhibitors

19

These drugs are phosphodiesterase inhibitors and are describes as inodilators.

Inamrinone (Inocor) and Milrinone (Primacor)

20

The indication for this type of drug is for short-term management of heart failure. It is given when a patient does not respond to treatment with digoxin, diuretics, and/or vasodilators. AHA and ACC advise against long term infusions.

Phosphodiesterase inhibitors

21

These drugs are no longer used as a first-line treatment for heart failure. They were originally obtained from the Digitalis plant foxglove and is used to control ventricular response to atrial fibrillation or flutter.

Cardiac gycosides

22

The mechanism of action for these drugs is increased myocardial contractility, change in the electrical conduction properties of the heart by decreasing rate of electrical conduction and prolonging the refractory period between the SA and AV node resulting in reduced heart rate and improved cardiac efficiency.

Cardiac glycosides

23

The effects of these type of drugs have a positive inotropic effect (increased force and velocity of myocardial contraction), negative chronotopic effect (reduced heart rate), and negavie dromotropic effect (decreased automaticity at the SA node, decreased AV node conduction, and other effects.

Cardiac glycosided

24

The effects of these drugs increase stroke volume, reduce heart size during diastole, and decreases in venous BP and vein engorgement. They increase coronary circulation and promote diuresis due to improved blood circulation and helps with nighttime paroxysmal dyspnea, cough, and cyanosis.

Cardiac glycosides

25

This cardiac glycoside has a long half-life and therapeutic concentration may not be achieved for a week or longer. Drug levels must be monitored and it has a very narrow therapeutic window. It is frequently administered by giving a loading dose and then decreasing to a maintenance dose. It is giving PO or IV. Giving IM can be irritating.

Digoxin (lanoxin)

26

Side effects of this drug include bradycardia or tachcardia with toxicity, anorexia, N/V, diarrhea, abdominal cramps, and fatigue. Other effects are headache, lethargy, confusion, changes in vision (yellow-blue or yellow-green halo vision).

Digoxin (Lanoxin)

27

Patients with hypokalemia, hepatic dysfunction, hypercalcemia, dysrhythmias, hypothyroid, respiratory or renal disease, use of a pacemaker or advanced age are all predisposed to this cardiac glycoside toxicity.

Digoxin

28

A patient is on digoxin and has an apical pulse of 59 what should be done?

Discontinue the drug due to possible toxicity and contact the physician.

29

Treatment for this include holding the drug and calling the physician, checking lab lytes and levels of the drug, possibly giving potassium, treating any GI symptoms and ECG monitoring.

Digoxin toxicity

30

What are some drug interactions of positive intotropic drugs such as digoxin?

Antacids and milk products (decrease absorption), anticholinergics(increase absorption increasing effect), diuretics and laxatives (increase toxicity), licorice increases toxicity

31

When should the physician be called when taking an apical pulse on a patient taking digoxin?

When it is less than 60/minute or more than 100/minute

32

This eating disorder may be a sign of digoxin toxicity.

Anorexia

33

A patient taking digoxin should report a weight gain of how much?

2 lbs or more in a day or 5lbs or more in a week.

34

This should be monitored during IV administration of digoxin.

ECG

35

Foods high in this should be encouraged in a patient using digoxin.

Potassium

36

These drugs need to be administered with an infusion pump.

Nesiritide, inamrinone, and milrinone

37

This drug given IV should not be mixed with dextrose and the solution color is true yellow.

Inamrinone

38

What is the antidote for digoxin

digoxin immune FAB (DigiFab, or Digibind)

39

Therapeutic levels of digoxin fall between what?

0.5-2 ng/ml

40

What is the maintenance dose for digoxin?

0.125mg-0.25mg/day

41

Side effect of ACE inhibitor is:

cough

42

This drug also known as an Ino Dilator is used for short term management of CHF.

Phosphodiesterase Inhibitors

43

Thrombocytopenia, dysrhythmia, nausea, hypotension, and elevated liver enzymes with long-term use.

Side effects of inamrinone (Inocor)

44

Dysrhythmia (mainly mentricular), hypotension, angina, hypokalemia, tremor, and thrombocytopenia

Side effects of milrinone (Primacor)

45

What plant gives us the oldest and most effective group of drugs for some patients to treat heart failure?

Foxglove

46

Digibind is an antibody that recognizes digoxin as what?

An antigen

47

Inside a resting cardiac cell there is what kind of charge that is relative to the outside of the cell.

negative charge

48

This is an uneven distribution of ions across the cell membrane.

Resting membrane potential (RMP)

49

This energy-requiring pump is needed to maintain the uneven distribution of ions during RMP.

Sodium-potassium ATPase pump

50

This means "no rhythm"

Arrhythmia

51

What is used to classify antidysrhythmic drugs that is based on the electrophysiologic effect of particular drugs on the action potential.

Vaughan Williams Classification

52

What types of drugs is Class I on the Vaughan William list?

Sodium channel blockers

53

What type of drugs are Class II on the Vaughan William list?

Beta blockers

54

What type of drugs are Class III on the Vaughan William list?

Potassium channel blockers

55

What type of drugs are Class IV on the Vaughan William list?

Calcium channel blockers

56

These Class I drugs are membrane stabilizers, exert their effect on Na fast channels, slow the rate of conduction and has a negative dromotropic effect.

Sodium channel blolckers

57

Class IA drugs stabilize the membrane due to what?

Anesthetic properties

58

Class 1A drugs block sodium channels causing a delayed _________ and increase the ________ __________ duration.

Repolarization, action potential

59

This Class 1A drug has a direct action on the electrical activity and an indirect (anticholinergic) effect. This increases the rate of impulse formation and conduction, a significant adverse effect of asystole and PVCs.

Quinidine (Quinidex)

60

Mild overdose of this Class 1A drug can cause tinnitus, hearing loss, blurred vision and GI upset.

Quinidine (Quinidex)

61

This Class 1A drug's anticholinergic effects are weaker and used for atrial fib and VT. Significant adverse effects include lupus-like symptoms.

Procainamide (Pronestyl, Procan SR)

62

This Class 1 drug's side effects include anti-cholinergic, i.e. ataxia, dry mouth, tachy, urinary retention. Also dysrhythmia & cardiovascular depression. One should not use with poor LV function,

Disopyramide (Norpace)

63

Class 1B sodium channel blockers act specifically on what? ischemic myocardial issue.

Ischemic myocardial tissue.

64

This Class 1B drug is indicated for ventricular dysrythmias only and is the drug of choice for accute dysrythmias associated with an IM.

Lidocaine (Xylocaine)

65

This Class 1B drug can cause significant CNS toxicity with symptoms presenting as twitching, confusion, seizures, respiratory depression, hypotension, bradycardia, and dyshythmias.

Lidocaine (Xylocaine)

66

This Class 1B drug is more commonly used as an anticonvulsant.

Phenytoin (Dilantin)

67

Class 1C drugs block sodium channels but have little or no effect on what?

Action potential duration

68

This drug is used for sustained ventricular tachycardia and has been used for atrial fibrillation at low doses. Its most common side effect is hypotension.

Propafenone (Rythmol)

69

This Class 1C drug is used for life threatening ventricular dysryhthmias and significantly slows conduction in the heart.

Flecainide (Tambocor)

70

What is catagorized as a Class II heart drug?

Beta blockers

71

This Class II heart drug is ultra short acting and indicated for supraventricular dysrhythmias, is cardioselective, and should only be given IV

Esmolol (Brevibloc)

72

This Class III potassium channel blocker is indicated for life threatening ventricular dysrhythmias, has been used for resistant atrial dysrhythmias, has a long half life but may see side effects for months. Its most serious side effect is pulmonary toxicity.

Amiodarone (Cordarone)

73

This Class III potassium channel blocker is indicated for atrial fib and flutter.

Ibutilide (Covert)

74

This drug works like a Class III potassium channel blocker but is a beta blocker.

Sotalol

75

The action of this class is slow conduction, prolonged refractory period, prolonged repolarizaiton, and inhibition of slow channel pathways.

Class IV calcium channel blockers

76

Verapamil (Calan) and diltiazem (Cardizem) are what class of heart drug?

Class IV calcium channel blocker

77

This is a different kind of antidysrhythmic drug that slows conduction through the AV node and is used to convert supraventricular tachy to normal sinus rhythm. It has an extremely short half life (<10 secs) and is only administered fast IV push. It causes asystole for a few seconds but has minimal adverse effects.

Adenosine (Adenocard)

78

ALL antidysrhythmics can cause what?

Dysrhythmias

79

When giving a patient antidysrhythnics what should always be monitered?

ECGs and vital signs

80

What should be specifically monitored when using Class I heart drugs?

QT length on the ECG

81

When giving patients antidysrhymics electrolytes should be monitored when?

Routinely

82

Positive response to antidysrhythmic therapy includes what?

Decreased BP, decreased edema, and regular pulse

83

This type of HTN is also known as idiopathic HTN. It describes 90% of all cases of HTN and there is no known cause and is know as the "silent killer".

Primary

84

This type of HTN is caused by some other disease, such as pheochromocyoma, pre-eclampsia, or renal artery disease.

Secondary

85

What is the formula for blood pressure?

BP=COxSVR

86

What is the cardiac output from the left ventricle measured against the force the left ventricle has to overcome to eject blood?

Blood pressure

87

What do sympathetic stimulation, atherosclerosis, CHF, and kidney function all have in common?

They are factors effecting BP

88

CAD, CHF, and stroke are all diseases that may develop due to what?

Unchecked HTN

89

What is it called when there is an increase in heart rate from the stimulation of beta 1 receptors or an increase in peripheral vascular resistance secondary to alpha 1 receptors?

Sympathetic stimulation

90

What creates smaller internal vessel lumen and increases systemic vascular resitance?

Atherosclerosis

91

What does the kidney do when it senses a decrease in BP?

Secretes renin

92

What does renin do?

Promotes production of angiotensin I

93

What converts angiotensin I to angiotensin II?

Angiotensin converting enzyme (ACE)

94

What is a potent vasoconstrictor?

Anggiotensin II

95

Angiotensin II stimulates the release of what?

Aldosterone

96

What is the hormone that causes sodium and water retension?

Aldosterone

97

What is considered normal BP?

SBP <120 DBP <80

98

What is considered prehypertension?

SBP 120-139 DBP 80-90

99

What is known as stage I hypertension?

SBP 140-159 DBP 90-99

100

What is known as stage 2 hypertention?

SBP >160 DBP >100

101

According to what entity an increased DBP is no longer considered more dangerous than an increased SBP?

Joint National Commity

102

Studies show that an increased SBP is associated with what?

Heart failure, stroke, and renal failure

103

For patients 50 and older increased SBP is greater risk for this than increased DBP?

Cardiovascular disease

104

What type of drugs were used initially for HTN?

Thiazide-type diuretics

105

What types of HTN drugs are more effective in white patients?

Beta-blockers and ACE inhibitors

106

What type of HTN drug is more effective in African American patients?

Calcium channel blockers and diureticsAl

107

What is the most commonly prescribed alpha-2 receptor agonist?

Clonidine (Catapress)

108

What alpha-2 receptor agonist can be used for HTN during pregnancy?

Methyldopa (Aldomet)

109

What type of drug is used in conjunction with cardiac glycosides and diuretics for treatment of CHF?

Peripheral alpha-1 blockers/agonists

110

This peripheral alpha-1 blocker causes 1st dose effect.

Prazosin (Minipress)

111

When using the beta-blockers nadolol (Corgard) or propranolol (Indural) you should check if the patient has what disease before administering?

Lung

112

Atenolol (Tenormin), metoprolol (Lopressor), bisoprolol (Zebeta), and nebirolol (Bystolic) are beta-blockers that are also what?

Cardio-selective

113

What dual action alpha-1 and beta receptor blocker is indicated for reflex tachycardia/bradycardia occurrence, has a 1st pass effect.

Labetalol (Normodyne)

114

What dual action alpha-1/beta receptor blocker should never be used in a patient that has asthma or COPD?

labetalol (Normodyne)

115

What type of HTN drug is used most often for patients with diabetes?

ACE inhibitors

116

What type of drug has side effects of URI, insomnia, diarrhea, dyspnea, heartburn, nasal congestion, back pain, and hyperkalemia?

Calcium channel blockers

117

What HTN drug causes a decrease in blood vessel tone and blocks calcium.

Calcium channel blockers

118

What HTN drug is a treatment for angina, migraine, dysrhythmia, and Reynaud's disease?

Calcium channel blockers

119

What are two calcium channel blockers slowly decrease heart rate?

Diltiazem (Cardizem) and verapamil (Calan)

120

This calcium channel blocker increases vasodilation.

Nifedipine (Procardia)

121

Adverse reactions of this type of HTN drug may include rash, flushing, peripheral edema, and dermatitis.

Calcium channel blockers

122

What type of HTN drug decreases plasma and extracellular fluid volumes resulting in decreased preload, cardiac output and total peripheral resistance?

Diuretics

123

What type of diuretic is the most commonly prescribed for HTN?

Thiazides

124

What type of HTN drug directly relaxes arteriole and/or venous smooth muscle resulting in decreased systemic vascular response, decreased afterload, and peripheral vasodilation?

Vasodilators

125

What two vasodilators are used for acute HTN emergency?

Diazoxide (Hyperstat)and sodium nitroprusside (Nipride, Nitropress)

126

What vasodilator should shows rapid results in about 2 minures, has a short half life should only be given in a bag covered IV due to light sensitivity?

Sodium nitroprusside

127

What should levels should be monitored when giving a patient sodium nitroprusside for an extended period of time?

Cyanide levels

128

This happens when the supply of O2 and nutrients in the blood is insufficient to meet the demands place upon it.

Angina Pectoris

129

What causes arteries to calcify causing increased O2 demand secondary to the arteries lack of dilation?

Coronary artery disease (CAD)

130

Tissue becomes ischemic due to lack of O2 secondary to CAD. This can build up in the tissues due to metabolism being converted to anaerobic.

Lactic acid

131

When heart has poor blood supply due to atherosclerosis, CAD or myocardial infarction it becomes what and can cause necrosis or death to tissue becoming fatal.

Ischemic

132

This type of angina is known as "classic" or "effert" angina. It can be predictable as it is sometimes brought on by things such as caffeine or exercise.

Chronic stable angina

133

This type of angina is known as "preinfarction" or "crescendo" angina and is less predictable than chronic stable angina and may be a warning of an impending heart attack.

Unstable angina

134

This type of angina is also known as "Prinzmetal" or "variant" angina and is due to spasms of the coronary artery.

Vasospastic

135

What drugs work by increasing O2 supply to the myocardium and decrease O2 demand overall?

Antianginal drugs

136

What antiangina drugs relax smooth muscle of blood vessels, dilate peripheral arteries and veins, decrease preload and O2 demand, and alleviate coronary artery spasms?

Nitrates

137

This is the prototypical nitrate, has a large 1st pass effect with oral forms, is used for symptomatic treatment of ischemic heart conditions and is used sublingual for acute attacks.

Nitroglycerin

138

These meds are used for the acute relief of angina and as a prophylaxis in situations that may produce angina.

Imdur, Monoket, and Ismo (isosorbide mononitrate)

139

This antianginal nitrate when used IV should never be mixed with other drugs, should be given IV push from a glass bottle (due to its absorption into plastic bottles) and with a paper bag to cover the bottle due to its photosensitivity.

Nitroglycerin

140

This antianginal nitrate when used IV should not be used with a filter and should be administered with non-pcp tubing due to its absorption of plastics.

Nitroglycerin

141

Nitroglycerin is stable for how long after preparation?

96 hours

142

What should a nurse advise a patient to do at the first sign of anginal pain?

Stop activity and sit or lie down.

143

A patient has had an anginal attack and has taken a sublingual dose of nitroglycerin. What is the next thing they should do?

Call 911

144

If there is no relief with one dose of nitroglycerin when should a nurse direct a patient to take a second dose?

5 minutes

145

How often should a nurse advise a patient to replace their nitroglycerin tabs?

Every 3-6 months

146

Why should a nurse advise a male patient to keep their nitroglycerin in their shirt pocket and not their pants?

It will dissintergrate

147

What should a nurse advise a patient in when staring a nitroglycerin patch?

Site rotation and removal of old patches

148

To decrease tolerance to nitroglycerin patches a nurse should instruct her patient to do what?

Remove it at bedtime and reapply in the morning

149

When administering a nitroglycerin patch to a patient what should a nurse always do?

Wear gloves and date the patch

150

Beta-blockers work on angina by having what negative effects?

Inotropic and chronotropic

151

Beta-blockers block the affects of these during an MI?

Catecholamines

152

The use of ED medication with beta-blockers can cause severe what?

Hypotension

153

Beta-blocking drugs such as atenolol (Tenormin), metoprolol (Lopressor), and nadalol (Corgard)that are used for angina are more reliable and consistent in this type of patient?

Elderly

154

Anticholinergics, antihypertensives and phenothiazines should not be used with this type of antianginal medication?

Beta-blockers

155

Calcium channel blockers are indicated for angina because of this behavior?

They cause coronary artery and peripheral arterial vasodilation decreasing systemic resistance and workload on the heart.

156

Calcium channel blockers are 1st line drug for treatment of angina, HTN, and what?

Supraventricular tachycardia

157

Calcium channel blockers are used for short-term management of what?

Atrial fibrillation and flutter

158

What calcium channel blocker is used for angina, vasospastic and chronic stable angina, HTN, and atrial dysrhythmias/

Diltiazem (Cardizem)

159

What calcium channel blocker was once administered by the unapproved method of "squeezing under the tongue"?

Nifedipine (Procardia)

160

This calcium channel blocker is used to treat angina, HTN, and PSVT (paroxsysmal supraventricular tachycardia).

Verapamil (Calan, Isoptin)

161

A nurse should advise a patient taking amlodipine ((Norvasc) to avoid drinking this citrus beverage due to its ability to decrease the metabolism of the drug?

Grapefruit juice

162

What is the best way to advise a patient to discontinue taking a beta-blocker?

Wean


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