Heart Failure
What are symptoms of left sided heart failure?
Pulmonary symptoms (SOB, Cough, Fatigue)
What is stable vs. unstable angina?
Stable occurs with activity or and is relieved with rest. Unstable occurs at any time (including times of rest in late stages) and is not relieved within 15 min of rest.
Adverse effect of sodium channel blocker
Dysrhythmias
T/F: HDL is considered GOOD cholesterol while LDL is considered BAD cholesterol
True, keep HDL levels above 60 and LDL levels below 100
Describe the sequence of events for a patient NOT at the hospital who is experiencing chest pain and has nitroglycerin tablets
BONUS: what is the max amount of nitro tablets a patient can take
Sit/lie down --> doesn't resolve --> place tablet under tongue & wait 5 minutes --> doesn't resolve --> call 911, place tablet under tongue & wait 5 minutes --> doesn't resolve --> give third tablet & hope EMS is there soon
Max = 3 tablets within 15 minutes
What is the difference between compensated vs. decompensated heart failure?
Compensated is asymptomatic or minimal symptoms and decompensated is symptomatic
What drugs should not be taken with Nitrates/ Nitrites?
Erectile dysfunction drugs
What is the half-life of Adenosine?
Very short half-life (less than 10 seconds)
What is the common ending for most antilipemic agents?
-statins
T/F: Educate patients to take statins in the morning
False, these should be taken at night - this matches when the body is processing cholesterol
What is a normal digoxin level?
0.5-2.0
What causes angina?
When the supply of oxygen and nutrients in the blood is insufficient to meet the demands of the heart. Also can be from the buildup of lactic acid stimulating pain receptors.
Name the each class of the antidysrhythmic agents
Sodium channel blockers, Beta blockers, Potassium channel blockers, Calcium channel blockers, unclassified antidysrhythmics
What vitamin does niacin contain and list the two side effects with taking niacin?
-vitamin B3
-flushing & pruritus
What TWO drug classes are CONTRAINDICATED for heart failure?
Calcium Channel Blockers & NSAIDs
What are the most common adverse effects of digoxin?
Nausea, vomiting, and drowsiness
What is the difference between rapid-acting and long-acting Nitrates/ Nitrites?
Rapid-acting forms are used to treat acute anginal attacks. Long-acting forms and used to prevent anginal episodes.
What medication is used to treat bradycardia?
Atropine
What do you call yellow spots seen around a patient's eyelids that is caused by high cholesterol levels?
Xanthelasma
Describe rhabdomyolysis and what medication group can you see this with?
Rhabdo - breakdown of muscle tissue that goes to the kidneys for excretion; this is hard on the kidneys and can cause damage; patients will have dark urine and complain of muscle weakness
Seen with statins
Does Digoxin have a positive or negative chronotropic and inotropic effect?
Positive inotropic effect and negative chronotropic effect.
What are the 2 medications classified as calcium channel blockers for chronic stable angina?
Non-dihydropyridines: Verapamil, Diltiazem
What classes of antidysrhythmics slow HR and should be held if a patients HR is <60bpm?
Calcium channel blockers and beta blockers
There are 6 conditions that can result from high cholesterol that a patient can take an antilipemic agent to reduce their risk, name them
MI, Stroke, HTN, PVD, PAD, Type II Diabetes
Describe the administration process of adenosine, why a patient might be given adenosine and what you will see following administration
Adenosine is given for SVT (pt HR = super high), slammed through IV access then immediately flushed with normal saline due to the short half-life; patient NEEDS to be on a cardiac monitor, they will flatline for a few seconds, the goal of the medication is to return the rhythm to normal sinus