NURS Clinical Science Spring Exam 2 Study Guide

What drugs are used to treat dyslipidemia?

HMG-CoA Reductase inhibitors (statins), bile acid sequestrants, fibric acid drugs, ezetimibe, niacin, omega-3-acod ehtyl esters (lovaza)

What drugs fall under HMG-CoA reductase inhibitors (statins)?

atorvastatin, fluvastatin, lovastatin, rosuvastatin, simvastatin, pitavastatin

What are serious adverse events of HMG-CoA Reductase inhibitors (statins)?

rhabdomyolysis, myositis, elevated liver enzymes, teratogenicity

What are Bile acid seqeuestrants?

bind to bile acids increasing excretion of cholesterol through the bowel

What drugs fall under bile acid sequestrants?

cholestyramine, colesevelam, coletipol

What falls under fibric acid drugs?

fenofibrate, fenofibric acid, and gemfibrozil

What are serious adverse events of fibric acid drugs?

rhabdomyolysis, gallbladder disease, pancreatitis

What drugs fall under niacin?

vitamin B3 (nicotinic acid)

What are the lipids in the body?

triglycerides, phospholipids, steroids

What are triglycerides?

used for energy; composed of glycerol and other fatty acids

What are phospholipids?

used to build cell membranes

What are steroids?

used to build cell membranes, are also used to make vitamin D, bile acids, cortisol, estrogen, progesterone, and testosterone

What are diuretic medications for hypertension and heart failure?

angiotensin-converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARBs)

What are diuretics?

affect the renin-angiotensin-aldosterone system

What drugs fall under angiotensin-converting enzyme inhibitors (ACEI)?

“prils”; benazepril, captopril, enalapril, lisiniporil

What are serious adverse events of ACEIs and ARBs?

angioedema, acute renal failure, hyperkalemia, teratogenic

What drugs fall under angiotensin II receptor blockers (ARBs)?

“sartans”; valsartan, losartan, olmesartan

What are diuretic medications for heart failure?

osmotic diuretics, carbonic anhydrase inhibitors, loop diuretics, thiazide diuretics, potassium-sparing

What are osmotic diuretics?

mannitol and glycerin

What are carbonic anhydrase inhibitors?

acetazolamide

What are loop diuretics?

furosemide

What are thiazide diuretics?

hydrochlorothiazide

What are potassium-sparing diuretics?

spironolactone

What are common medications that are nephrotoxic?

NSAIDs, some antiviral drugs, some antibiotics, systemic antifungal drugs, ACEI, some chemotherapies, some immunosuppressants, and contrast dye

What is the normal range for a serum pH?

7.35-7.45

What are common assessments used to monitor fluid balance?

measuring intake and output (I/O), daily weight tracking, and physical examinations

What is water distribution in the human body?

water output normally occurs through the kidneys (may also occur through lungs, skin, feces, and sweat)

What is the composition of normal saline?

0.9% NaCl (isotonic)

What are normal serum values for sodium?

135-145

What are normal serum values for potassium?

3.5-5.0

What are normal serum values for calcium?

4-11

What is metabolic acidosis?

occurs due to severe diarhhea, renal failure, diabetes, excessive alcohol intake, starvation (severe CNS depression)

What is respiratory acidosis?

occurs due to lack of breathing (hypoventilation, airway constriction, damage to the respiratory center in the CNS)

What is metabolic alkalosis?

occurs with hypokalemia due to diuretic therapy, severe vomiting, ingestion of substantial amounts of sodium bicarbonate, severe constipation

What is respiratory alkalosis?

occurs due to hyperventilation (below normal CO₂)

What drugs are used to treat hypertension?

diuretics, calcium channel blockers (CCB), adrenergic antagonists, direct vasodilators

What are calcium channel blockers (CCB)?

“pines”; amlodipine, nifedipine and diltiazem and verapamil

What are serious adverse events of calcium channel blockers (CCB)?

liver toxicity, heart failure/attach, angioedema, confusion

What are adrenergic antagonists?

block activation of beta and/or alpha receptors of the sympathetic nervous system

What are the classes of adrenergic antagonists?

beta blockers and alpha blockers

What are beta blockers?

“olols”; propranolol, atenolol, metoprolol, nevicolol

What are serious adverse events of beta blockers?

agrunulocytosis, SJS, larngyospasm, anaphylaxis, rebound hypertension

What are alpha blockers?

“zosins” doxazosin, prazosin, terazosin

What are the serious adverse events of alpha blockers?

first-dose hypotension, tachycardia, dyspnea

What are direct vasodilators?

Hydrazaline and minoxidil

What are serious adverse events of direct vasodilators?

severe hypotension, heart attack, dysrhythmias, shock

What drugs increase blood pressure?

systemic steroids, over-the-counter phenylephrine (OCPs), amphetamines, decongestants, nicotine, erythropoietin

What foods/drinks increase blood pressure?

alcohol, caffeine, foods high in sodium

What is stroke volume?

amount of blood pumped by a ventricle in one contraction

What is heart rate?

the number of times the heart beats in a specified time period

What is cardiac output?

volume of blood pumped/minute

What is ischemia?

loss of oxygen to the heart muscle

What is blood pressure?

cardiac output verus peripheral resistance

Cardiac output calculation?

heart rate x stroke volume

What is angina?

episodes of loss of oxygen to the heart muscle causing chest pain

What is prinzmetal angina?

coronary artery vasospasm

What is CAD?

narrowing or occlusion of coronary arteries

What are causes of CAD?

alochol, intake of food with high saturated or trans-fat, tobacco use, low exervise, and high salt intake

What are diagnostic procedures for CAD?

routine history and physical (H&P), EKG, cardiac stress test, angiogram (cardiac catheterization)

What is an EKG?

shows previous heart attack history

What is an angiogram (cardiac catheterization)?

most specific way to detect CAD and most invasive

What drugs are used to treat CAD?

nitrates

What are nitrates?

coronary artery dilating agents (short and long-acting)

What are short-acting nitrates?

nitroglycerin

What are long-acting nitrates?

isosorbide

What are severe adverse events of nitrates?

severe hypotension and syncope

What are common causes of heart failure?

CAD, mitral valve stenosis, MI/heart attack, chronic unconrolled hypertension, diabetes, dyslipiemia, thyroid disorders

What medication are used to treat heart failure specifically?

cardiac glycosides, entresto, phosphodiestera inhibitors and beta-adrenergic agonist, sacubitril-neprilysin inhibitor, dapagliflozin

What are cardiac glycosides?

digitalis/digoxin

What is digoxin?

increases the strength of myocardial contraction, increases cardiac output and suppresses the elctrical conductivity of the heart

What is entresto?

valsartan/sacubril

What are phosphodiesterase inhibitors and beta-adrenergic agonists?

“fils”; sildenafil (viagra), vardenafil, and tadalafil

What is sacubitril-neprilysin inhibitor?

vasodilatory

What is dapagliflozin?

farxiga; inhibits SGLT2

What is this?

second-degree (partial) block

What is this?

atrial fibrillation

What is this?

ventricular tachycardia

What is this?

ventricular fibrillation

What is this?

third-degree block

What is this?

ST elevation

What is this?

reciprocal change

What is this?

Atrial flutter

What are common causes of dysrhythmia?

hypertension, cardiac valve disease, CAD, medications (digoxin), hypokalemia/hypomagnesemia, MI, CVA, DM, heart failure

What drugs are used to treat dysrhythmia?

sodium channel blockers, beta-adrenergic blockers, potassium channel blockers, calcium channel blockers, oral arrhythmia adrugs

What are sodium channel blockers?

prainamide, lidocaine, flecainide

What are beta-adrenergic blockers?

propranolol

What are potassium channel blockers?

amiodarone

What are calcium channel blockers?

verapamil, diltiazem

What are oral arrhythmia drugs?

amiodarone, flecainide, propafenone, beta adrenergic antagonist, and calcium channel blockers

What oral arrhytmia drugs have black box warnings?

amiodarone, flecainide, propafenone, beta-adrenergic antagonist

What are beta adrenergic antagonist?

sotalol

What are parental antiarrhythmics?

atropine, lidocaine, procainamide

What is atropine?

bradycardia; antagonise acetylcholine receptors

What is lidocaine?

ventricular arrhythmia (inhibits sodium ion channels)

What is procainamide?

ventricular/supraventricular arrhythmia (stabilizes membranes)

What is an anaphylatic shock?

severe allergic reaction (usual allergens include PCN, nuts, shellfish)

What is cardiogenic shock?

failure of the heart to pump blood to vital organs

What causes cardiogenic shock?

left heart failure, MI, PE dysrhythmia, myocardial infection

What is hypovolemic shock?

severe loss of blood volume

What causes hypovolemic shock?

massive hemorrhage, burns, severe dehydration (excessive diuresis, N&V, diarrhea)