48 Multiple choice questions
- losartan (cozaar), valsartan (diovan), candesartan (atacand), irbesartan (avapro), telmisartan (micardis)
hypotension (bc it's a dilator). Extreme caution if systolic BP < 90
and w/RV infarction, limit drop to 10% if pt normotensive, limit drop
to 30% if pt hypertensive. Watch for HA, syncope, tachycardia.
- give "low & slow." 2 to 4 mg every 5-10 min titrated to effect. no cap on the dose. given IV push over 5 min.
- used for DVT, PE, MI (STEMI & NSTEMI), DIC, A-Fib, post PTCA or CABG with some lytics if < 48 hrs. For STEMI with/without reperfusion up to 8 days.
- door to drug time - 30 minutes!
- death from brain (intracerebral) hemorhage esp. if over age 75,
reprofusion arrhythmias (PVB, PAB, Afib/Aflutter) - has plenty of O2
all of a sudden, go away on their own (means the drug is working!)
- electrolyte imbalances (especially hypokalemia - which makes a person more likely to have digoxin toxicity if on that as well)
- bleeding from ALL sites - urine, stool, sputum, puncture sites, nosebleeds. Monitor labs - Hb, Hct, platelets
- slows ventricular rate. decreases afterload. more of an antiarrhythmic. Used for HTN, Afib, Aflutter.
of ventilation (consult MD), N/V common (can premed w/zofran),
bradycardia, drop in BP (increase fluids, elevate feet, lower head)
w/NO ST segment elevation (NSTEMI), non-Q wave MI, UA, CA reocclusion
post PCI or with fibrinolytics given 24 hrs before balloon/stent.
- hypotension (orthostatic hypotension early on) - Monitor BP!, hyperkalemia, persistent cough (have to get off drug)
- overall mortality from AMI, nonfatal reinfarction, nonfatal stroke. will not do anything to clot already there!
MI, HTN, CHF, shock. consider early admin. in select pts: suspected
ischemic chest pain, UA (change in angina pattern), acute pulm. edema
(if BP > 90 systolic).
- Watch for bleeding especially when given with NSAIDs, ASA, heparin, or coumadin
- Increased BP
- diuretics used for HTN, CHF, renal failure
- used for STEMI, consider in NSTEMI, evidence of acute pulmonary edema. also if systolic BP > 90 and no hypovolemia.
- hypotension (don't give if SBP < 100), bradycardia, AV block, extreme fatigue/lethargy, impotence
- decreased BP bc it vasodilates, but can also increase BP by increasing CO
- used for HTN, MI. side effect - hypotension, so monitor BP!
- antiplatelet - inhibits platelet aggregation by selectively preventing binding of ADP to its receptor. Prolongs bleeding time.
- antiplatelet (PREVENTS clot formation & from getting bigger)
(dopamine), dobutamine (dobutrex), milrinone (primacor), digitalis
(lanoxin) - used for CHF & shock to increase contractility - to
the tablet. standard therapy for new pain suggestive of AMI. better to
use baby aspirin bc it's flavored. if allergic give plavix.
- used for angina, MI (standard of care for all post MI pts indefinitely), CHF (only stable, chronic - not early mgmt), tachyarrhythmias.
or without lytics for 14 days, with or without reperfusion, NSTEMI -
give for 6-9 mos, STEMI - gie for 1 year. ALL STEMIs and NSTEMIs get
- ALL NSAIDs except ASA (aspirin) must be DC'd for good.
pain of ischemia, venous blood return to heart, preload & cardiac
O2 consumption. Increases venous dilation and cardiac collateral flow.
Dilates coronary arteries.
- hypotension - monitor BP, HR, rhythm closely. may need to reduce dosage.
- goal is to ELIMINATE pain (ZERO on the pain scale)
- they inhibit/block the SNS response - decrease HR, contractility, stroke volume, CO, BP, AV node conduction
- PREVENTS clot formation & from getting bigger.
- used for HTN, for all post MI pts indefinitely, CHF. reduces mortality & CHF from AMI. Prevents scarring of LV that leads to HF (LV remodeling).
- diuretics used to decrease preload (volume)
- monitor BP & HR. contraindicated if HR < 60 bpm, insulin dependent DM (monitor sugar more often), asthma, PVD
- increases force of contraction (squeeze). particularly used for acute exacerbations of CHF where BP has fallen.
- brings BP down really quickly - monitor BP every minute! drug of choice for hypertensive crisis (malignant HTN)
diuresis - opposes renin so it causes excretion of sodium & water
to treat fluid overload. used for ACUTE episodes of CHF.
- STEMI and NSTEMI, in combination with fibrinolytics. PREVENTS clot formation.
- potassium sparing diuretic used in MI and CHF
afterload by preventing vasoconstriction, decreases preload by
preventing sodium & water retention (inhibits aldosterone),
of choice for acute pain d/t MI. decreases pain of ischemia, decreases
anxiety (gives feeling of euphoria), decreases extension of ischemia by
decreasing O2 demands.
that PREVENTS clot formation, prevents platelet aggregation and
vasoconstriction. used for CAD, post MI (STEMI and NSTEMI).
UP clots already formed. Used in MI (STEMI ONLY: w/chest pain > 20
min & < 12 hrs), CVA, PE. Max age for use - 75.