Heart Failure, Dysrhythmias, and Coagulation Therapy Pharmacology

Comprehensive practice questions covering heart failure medications, anti-dysrhythmics, and coagulation therapy based on the Potions Podcast Episode 3 transcript.

According to Professor Morini, what is the heart's number one job?

To pump blood.

What are the three main goals in treating heart failure?

1. Increase contractility (inotropy), 2. Decrease preload, and 3. Decrease afterload.

When educating a heart failure patient on weight monitoring, what specific daily gains should be reported to a provider?

$1$ to $2\,lbs$ in a day or $3$ to $5\,lbs$ in $7\,days$.

Which drug class is described as the cornerstone of heart failure therapy and should be taken by every heart failure patient unless contraindicated?

ACE inhibitors.

Why should patients on ACE inhibitors avoid salt substitutes?

Salt substitutes are often made with potassium, which increases the risk for hyperkalemia when combined with ACE inhibitors.

What is the maximum duration for a Milrinone infusion, and why is it used?

It is used for no more than $72\,hours$ for acute decompensated heart failure to increase contractility and cardiac output.

What is the primary indicator that a Milrinone drip is effectively perfusing the vital organs?

An increase in urine output, showing the kidneys are being perfused.

What should a nurse assess before administering a beta blocker, and when should the dose be held?

Assess for heart rate and respiratory conditions (COPD, asthma). Hold for a heart rate less than $60$ or if the patient is wheezing.

What is a potential danger of giving a beta blocker to a diabetic patient?

Beta blockers can mask the symptoms of hypoglycemia, such as tachycardia, nervousness, and sweating.

Why must IV loop diuretics be administered slowly?

To prevent ototoxicity.

What are the target levels for Total Cholesterol, LDL, and HDL?

Total cholesterol $< 200$, LDL $< 100$, and HDL $> 60$.

Why are statins typically administered at night?

The liver produces the majority of cholesterol at night.

What life-threatening condition is associated with muscle pain and dark urine in patients taking statins?

Rhabdomyolysis.

What specific adverse effect is associated with Gemfibrozil, requiring patients to monitor for right upper quadrant pain?

Gallstones.

Which assessment is required before administering Digoxin?

The apical pulse must be auscultated with a stethoscope for one full minute; hold if the heart rate is less than $60$.

What are the classic signs of Digoxin toxicity?

Nausea, vomiting, and visual disturbances, specifically yellow-green halos.

What electrolyte imbalance significantly increases the risk of Digoxin toxicity?

Hypokalemia.

What are the primary toxicities to monitor for in a patient taking Amiodarone?

Pulmonary toxicity (fever, cough, shortness of breath), photosensitivity, and thyroid changes.

What type of dysrhythmias is Lidocaine specifically used to treat?

Ventricular dysrhythmias only (such as V-tach or V-fib).

How is Adenosine administered, and what effect does it have on the heart rate?

It is slammed IV (half-life of $3$ to $10\,seconds$) to treat SVT by causing a brief period of asystole to slow the heart down.

How long before a scheduled surgery must a patient stop taking Clopidogrel?

$7\,days$.

What is the therapeutic INR range for a patient on Warfarin therapy?

Between $2$ and $3$.

What is the antidote for Warfarin, and what is its mechanism of action?

Vitamin K; it acts as a Vitamin K antagonist.

What lab value is used to monitor Heparin, and what is the antidote for Heparin overdose?

PTT is used for monitoring; Protamine sulfate is the antidote.

Match the following anticoagulants to their antidotes: Rivaroxaban and Dabigatran.

Rivaroxaban: Andexanet alfa. Dabigatran: Idarucizumab.

What is the primary use for Alteplase (TPA)?

It is a thrombolytic/fibrinolytic used IV for acute ischemic stroke or to restore patency to a clotted central line (Cathflo).

What is the most serious adverse effect associated with Lisinopril?

Angioedema (swelling of the lips, face, tongue, or throat) which can compromise the airway.