Pharm Final

CHF vs MI
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Terms in this set (39)
CHF vs MI
CHF is lowering blood supply (no chest pain) while MI cuts off blood flow to a part of the heart = heart pain.
Cause of CHF
1. MI
2. Age
3. Valve Problems
4. Coronary Arteries
What happens when the heart can't pump enough blood into the following areas of the body?
1. Less Blood to Kidneys
2. Less blood to Brain
3. Less blood to Lungs
4. Less Oxygen to cells
5. Less blood to Heart Muscles
1. Build up of waste in the blood
2. Disorientation/lack of concentration
3. SOB, Gasping on exertion, drowning in fluid
4. Slowing of cellular processes
5. (Myocardium)> Poorer and Poorer Pumping
Lack of blood to Vital Organs makes the heart pump slower or faster?
Faster
What 2 elements are needed to pump the heart?
Na+ (Sodium) & Ca2+ (Calcium)
Name the Cardiac Glycoside MED
Digoxin (Lanoxin)
Cardiac Glycosides inhibit _____________ increasing the Na+ and Ca2+ in the myocardial cells. WHICH slows and ____________ the hearts pumping ability
Na+/K+ Pump; strengthens
Cardiac Glycosides (Digoxin) - Increases the force of ____________
Decreases HR
Delays impulse from _____ node to ______ node
contraction
SA; AV
Why are Cardiac Glycosides (Digoxin) taken?
Decreased in waste buildup
Increased mental alertness
Better breathing
Better O2 to cells
More blood to heart muscle itself
What are side effects of Digoxin (Cardiac Glycosides)?
..... Narrow
Narrow Theraputic level
Easy to become toxic
Constant monitoring of blood levels
Women complain of Vaginal Dryness; treat with KY Jelly
s/s of toxicity for Digoxin (cardiac glycosides) 1. arythmia/Dysthrhythmia 2. 3. Change in vision (yellow halos around lights)- really late sign 4. 5. High K+ Level2. GI upset/Diarrheal 4. HeadacheIMPORTANT Nursing Considerations for Digoxin (Cardiac Glycosides)1. Take Apical Pulse for a full minute 2. Don't give Digoxin if HR is less than 60 3. Don't switch brands or miss a dose 4. Don't give with Antacids or milk 5. Don't give with grapefruit JuiceAntidysrhythmics agent Classes1. Membrane Stabilizing Agents 2. Beta-Blockers 3. No specific name/Miscellaneous 4. Calcium Channel BlockersAntidysrhythmic agents Agent (Class 1)- Membrane Stabilizing Agent Med to RememberQuinidine (PO) & Lidocaine (IV only- good for ventricular problems)Membrane stabilizing agents Effect? Which phase does it prolongSlows electrical conduction of the heart by blocking Na+ channels. Prolongs phase 0S/S of toxicity for membrane stabilizing agentExaggerated action of the desire effect. (bradycardia, hypotension, cardiac arrest)Beta Blocker for Antidysrhythmic agents MedsPropranolol (Inderal)Class 3 MedsAmiodarone & Corvert (ibutilide)Class 4- Calcium Channel blocker medsVerapamil (calan) & Diltiazem (Cardizem)Chest Pain/Angina Classifications1. Nitrates (Anti-anginal) 2. Beta Blockers 3. Calcium Channel BlockersNitrates MedNitroglycerinBeta Blockers (Chest Pain) MedsMetoprolol (lopressor) & Atenolol (tenormin)Calcium Channel Blockers (chest Pain)Nifedipine (procardia) - rapid effect on BPLoop Diuretic MedFurosemide (Lasix)Osmotic Diuretics - Inhibiting reabsorbtion of water + solutesOsmitrol (Mannitol)Potassium SparingSpironolactone (Aldactone)Thiazide(HCTZ - Hydrochlorothiazide)antilipidemic Med - StatinAtorvastatin (Lipitor)Eye Med MioticConstrict the pupil + treats glaucomaEye Med MydriaticDilate the pupil + to examine the retinaWhat is pharmacokinetics?Action of med (Absorption)- Getting med in body in bloodCholinergic Toxicity: SLUDGE MeaningSalivation Lacrimation Urinary Incontinence Diarrhea GI Cramps EmesisAdrenergic Blockers (Relax SNS meds)Clonidine (Catapress) & Prazosin (Minipress)Beta Blocker MedsPropranolol (Inderal) Metoprolol (Lopressor) Atenolol (Tenormin )Warning about Beta Blockers Use with AsthmaNOT GIVEN WITH ACUTE ASTHMA.Cholinergic Med (Stimulate PNS)Bethanechol (Urecholine) - Increase Bladder tone, relax sphincter.Cholinergic-Blocking Agents (Anticholinergics) blocks whatBlock action of AcetylcholineAnticholinergic medsAtropine (used in surgery to dry secretions) Scopolamine (Prevent Motion Sickness) Tolterodine ("gotta go"- cause urgency)Anticholinergics actions/useDilate Pupils for eye exam Decrease GI motility Increase HR Decrease Bladder constriction Decrease sweating (could be bad) Dries mucus membranes before Surgery Relax Muscles Opens airways Balance acetylcholine and norepinephrine