1. Chronotropic
    Drugs that affect the heart, increase its rate (positive chronotropic), or decrease its rate (negative chronotropic).
  2. Inotropic
    Drugs affect the force of contraction (positive or negative)
  3. Dromotropic
    Drugs alter the rhythm or electrical conduction through the heart muscle.  A positive dromotropic drug enhances the electrical conduction. Negative dromotropic drugs slow conduction.
  4. Cardiac action potential
    Related to contraction and relaxation of the heart
  5. The cardiac action potential is controlled at the...
    cellular level by ions transporting in and out of cells
  6. The pacemaking and conduction throughout the heart are driven by...
    action potentials that are dependant on sodium, calcium, and Potassium
  7. Depolarization
    Potassium moves out of the cell while sodium moves in  which proceeds contraction
  8. Calcium
    Influences actin and myosin, which contron cardia cell length and muscle contraction
  9. Supraventricular arrthmias
    • Atrial fibrillation or flutter
    • Paroxysmal supraventricular tachycardia
    • autonomic atrial tachycardias
  10. ACE inhibitors for Hear failure
    • Decrease blood levels of vasoconstrictor angiotensin II.
    • No direct positive inotropic effects.
    • Decrease aldosterone secretion, salt and water retention, and vascular resistance.
    • Decrease afterload and alter structural changes in the congested heart by remodeling.
    • Decrease symptoms
    • Prolongs life in patients with HF
  11. Digoxin
    • Inhibits the sodium/potassium exchange in the heart
    • Causes an increase in the contractility of the heart
  12. ACE inhiitors
    Increase the cardiac output by lowering blood pressure and decreasing fluid volume
  13. Acute coronary syndrome with elevated ST segement!
    • Treated with early reperfusion therapy with either primarily percutaneous coronary intervention or adminstration of a fibrinolutic agent
    • Oxygen
    • Aspirin
    • Sublingual nitroglycerin
  14. Patients with no ST segement elevation Acute coronary syndrome
    receive additional Clopidogrel (Plavix) or prasugrel (Effient) and/or glycoprotein IIb/IIIa receptor blockers
  15. Diruetics for Heart failure
    • Used for fluid retention
    • Decrease excess volume and decrease the workload of the heart
    • Doses are usually givin early in the day to prevent nocturnal diuresis
    • It is important to monitor:
    • Weight loss
    • Decrease in edema
    • Breath sounds
  16. Heart failure
    • Occure when ventricles are not able to pump enough blood to supply the body
    • The loss of contractile or pump efficiency makes the blood volume increase whithin the heart and the heart eventually enlarges 
  17. Adenosine (Adenocard)
    An unclassified antiarrhythmic used to convert superventricular tachycardia to a sinus rhythm and at times it aids in the diagnosis of the rhythm disorder
  18. Treatment of angina
    • Pain relief and prevention of recurrent pain
    • Decreasing consumption of oxygen by the heart or increasing the delivery of oxygen to the heart
    • Nitroglycerin SL used for quick relief
  19. Dopamine for Heart failure
    • Precursor of norepinephrine and releases endogenous norepinephrine
    • Dose dependent stimulation of dopaminergic, B1, and a adrenergic receptors
    • Dopamine infusions should not be abruptly discontinued
  20. QRS complex
    Shows ventricular depolarization, which is followed by the mechanical contraction of the right and left ventricles
  21. Phosphodiesterase inhibitors
    • Increase cAMP levels by inhibiting cAMP breakdown of the enzyme phosphodieterase
    • Results in increased vascular smooth muscle relaxation and increased in heart contractility
  22. Resistance vessels
  23. Capacitance vessels
    Veins regulate preload
  24. If hypertension goes untreated...
    Target organ disease (TOD) can result
  25. Beta blockers
    • Inhibits sympathetic activity
    • Decrease the rate and force of contraction, lowering blood pressure
    • B-Blockers can decrease HDL cholesterol, raise triglycerides and elevate plasma glucose
    • Metoprolol (Lopressor)
    • Propranolol (Inderal)
    • Atenolol (Tenormin)
  26. Hypertensive agents for hypokelimia
    • Amiloride
    • Spironolactone
    • Triamterene
    • Eplerenone
  27. Calcium channel blockers
    • Produce arterial relaxation and vasodilation
    • Side effects:
    • Peripheral edema
    • Dizziness
    • Have different effect on heart rate and atrioventricular nodal conduction
  28. What drugs can increase blood pressure?
    • Vasopressor drugs
    • Cardiotonic agents
  29. Warfarin (Coumadin) It is important to monitor for!
    • Bleeding gums
    • Nosebleeds
    • Petechiae
    • Blood in urine or stools
  30. Drugs that inhibit the thrombin release!
    • Anticoagulants
    • Lepirudin (Refludan)
    • Argatroban
    • Bivalirudin (Anginomax)
  31. Prothrombin
    • Thromboplastin fors in the presence of vitamin K
    • Prothrombin in the presence of thromboplastin and calcium forms thrombin
  32. Why we use neuromuscular blocking agents
    • Reduce spontaneous breathing
    • Prevent movement that can dislodge tubes
    • Reduce oxygen consumption
    • Put patient is sync with ventilator
  33. Repolarization
    must take place to bring the muscle back to its resting level so it can again be depolarized.
  34. What drugs can reverse Nondepolarizing Agents
    Can be reversed with cholinesterase inhibitors (neostigmine and pyridostigmine).
  35. Stage 1 of antisia
    Stage 1—“Conscious sedation.” Patient is awake but can not feel pain. Frequently used for scopes and minor procedures.
  36. Stage 2 of antisia
    Stage 2—Loss of consciousness but patient still has reflexes, such as cough.
  37. Stage 3 of antisia
    Surgical anesthesia that progresses to respiratory depression.
  38. Stage 4 of antisia
    Complete loss of respiratory drive, and patient may have loss of cardiovascular tone
  39. Phenobarbital
    could be a good choice for sedation in the ICU.
  40. Postoperative nausea and vomiting
    • Compazine
    • promethazine (Phenergan)
    • Propofol
    • Antiemetic drugs
    • Antimuscarinic
    • Serotonin antagonist
    • Dopamine antagonists
  41. How do you reverse operiods?
    Naloxone (Narcan)
  42. Benzodiazepines
    • The most common drug class with sedative, hypnotic, and anxiolytic pharmacologic effects
    • Can be used as cocktails for antesia
    • work by enhanching the inhibitory effect on the receptor for the neurotransmitter GABA within the brain
    • Versed
  43. Dexmedetomidine (Precedex®)
    • used in the intensive care unit for sedation of mechanically ventilated patients and for sedation prior to and/or during surgical procedures in patients without intubation
    • It works by stimulating central alpha2 receptors resulting in anesthetic and sedative properties
  44. The PTT lab test..
    Is used to make dosage adjustments for heparin
  45. INR
    May be 2 to 3 or higher
  46. Helium
    Effective in treating patients with upper airway obstruction
Card Set
test 3