55 Questions
What is the mechanism of action of ACE inhibitors?
Inhibits ACE, preventing the formation of angiotensin II
What is a potential adverse effect of ACE inhibitors?
Dry cough
What is a contraindication for the use of ACE inhibitors?
Pregnancy
What is the nursing consideration regarding administration of oral forms of ACE inhibitors?
Should be given with food
What is the primary therapeutic effect of ACE inhibitors?
Lowering blood pressure
What is the mechanism of action of ARBS (Angiotensin II Receptor Blockers)?
Blocks angiotensin II receptors
What is a potential adverse effect of ARBS?
Dizziness
What is a contraindication for the use of ARBS?
Pregnancy
Which drug primarily affects blood pressure, not heart rate?
Hydralazine/isosorbide
What is the first-line therapy for older patients?
Low-dose thiazide diuretics
Which drug class is divided into three classes: beta blockers, calcium channel blockers, and nitrate & nitrites?
Nitrate & nitrites
Which drug class reduces myocardial oxygen demand by slowing heart rate and reducing myocardial contractility?
Beta blockers
Which drug class is most effective in treating exer5onal angina, MI, hypertension, and cardiac dysthymias?
Beta blockers
Which drug class is first-line for angina, hypertension, and supraventricular tachycardia?
Calcium channel blockers
Which drug class prevents muscle contraction and promotes relaxation by preventing calcium from entering the excitation-contraction process?
Calcium channel blockers
Which drug class dilates all blood vessels, predominantly affecting venous vascular beds?
Nitrate & nitrites
Which drug class is available in various preparations, including sublingual, chewable, oral tablets, capsules, ointments, patches, translingual spray, and intravenous solutions?
Nitrate & nitrites
Which drug can elevate potassium levels, impacting blood pressure and kidney toxicity?
Thiazide diuretics
Which drug may cause impotency in male patients?
Thiazide diuretics
Which drug should be used for black patients?
Hydralazine/isosorbide
Which adverse effect is associated with amiodarone hydrochloride?
Bradycardia
What is the primary indication for class 4 drugs like diltiazem hydrochloride and verapamil hydrochloride?
Hypertension and angina
What is a common adverse effect of calcium channel blockers?
Constipation
What is the primary nursing implication for amiodarone?
Monitoring for GI upset
Which condition is warfarin primarily indicated for?
Prevention of strokes
What is the primary use of unfractionated heparins, LMWHs, direct thrombin inhibitors, and factor Xa inhibitors?
Prevention and treatment of clot-related events
Which drug is used for paroxysmal supraventricular tachycardia?
Adenosine
What is a common adverse effect of ibutilide fumarate?
Hypotension
Which drug is indicated for rate control for atrial fibrillation and flutter?
Class 4 drugs
What is a general contraindication for antidysrhythmics?
Drug allergy
What is the primary indication for anticoagulants?
Prevent clot formation
What is a common adverse effect of sotalol hydrochloride?
Bradycardia
Which drug class is recommended for early treatment of heart failure?
ACE inhibitors
What is the mechanism of action of digoxin?
Inhibiting the sodium-potassium adenosine triphosphatase pump
What are the effects associated with digoxin use?
Positive inotropic effects, negative chronotropic effects, negative dromotropic effects
Which drug combination is recommended for use in Black patients with heart failure?
Hydralazine and isosorbide dinitrate
What is the primary indication for dobutamine use in heart failure?
To treat heart failure, particularly in acute settings
What are the common adverse effects of nitrates?
Headaches, dizziness, fatigue, tachycardia, orthostatic hypotension
What is the emphasis in the context of heart failure resulting from a heart defect?
Systolic dysfunction
What is the primary effect of nitroglycerin in the treatment of angina?
Vasodilation
What is the primary indication for nitrates in the treatment of angina?
Stable, unstable, and vasospastic angina
What is the primary mechanism of action of phosphodiesterase inhibitors in heart failure?
Inhibition of phosphodiesterase enzyme
What is the effect of positive chronotropic drugs in heart failure therapy?
Increase heart rate
What is the focus of drug therapy for heart failure, along with other drugs such as ACE inhibitors, ARBs, beta blockers, and nitroglycerin?
Phosphodiesterase inhibitors and cardiac glycosides
Which drug is indicated for ventricular dysrhythmias and acts preferentially on ischemic myocardial tissue?
Lidocaine hydrochloride
What is the primary indication for Class 1a antiarrhythmic drugs like procainamide and quinidine?
Ventricular tachycardia
Which drug is indicated for both supraventricular and ventricular dysrhythmias and has both class 2 and class 3 properties?
Sotalol
What is the defined amount of life-threatening digoxin overdose in children?
More than 4 mg
Which drug class decreases heart rate and reduces myocardial contractility?
Class 2 antiarrhythmic drugs
Which drug class produces a more pronounced blockage of the sodium channel and significantly slows conduction in the heart?
Class 1c antiarrhythmic drugs
Which drug is used for life-threatening ventricular tachycardia or fibrillation and atrial fibrillation or flutter resistant to other drugs?
Amiodarone
What are the adverse effects of antiarrhythmic drugs?
Hypotension, dysrhythmia, nausea
What is the mechanism of action of Class 3 antiarrhythmic drugs like amiodarone and dronedarone hydrochloride?
Increase the action potential duration by prolonging repolarization in phase 3
What is the primary indication for Class 1b antiarrhythmic drugs like lidocaine hydrochloride and phenytoin?
Ventricular tachycardia
What is the primary indication for Class 1c antiarrhythmic drugs like flecainide acetate and propafenone hydrochloride?
Ventricular tachycardia
Study Notes
Antidysrhythmic and Coagulation Modifier Drugs Summary
- Adverse effects of amiodarone hydrochloride include pulmonary toxicity, thyroid disorders, bradycardia, hypotension, ataxia, QT prolongation, and dermatologic reactions.
- Ibutilide fumarate adverse effects include ventricular tachycardia, hypotension, and headache.
- Sotalol hydrochloride adverse effects include bradycardia, chest pain, palpitations, and weakness.
- Class 4 drugs, such as diltiazem hydrochloride and verapamil hydrochloride, are calcium channel blockers used for hypertension and angina.
- Class 4 drugs are indicated for paroxysmal supraventricular tachycardia and rate control for atrial fibrillation and flutter.
- Adverse effects of calcium channel blockers include constipation, bradycardia, heart block, and hypotension.
- Unclassified antidysrhythmic drugs, like adenosine, work by slowing electrical conduction and are used for paroxysmal supraventricular tachycardia.
- Nursing implications for amiodarone include monitoring for GI upset, photosensitivity, and emphasizing the importance of eye protection.
- General contraindications for antidysrhythmics include drug allergy and certain heart conditions.
- Anticoagulants prevent clot formation and are indicated for conditions like MI, unstable angina, atrial fibrillation, and presence of indwelling devices.
- Warfarin is indicated for prevention of strokes, heart attacks, deep vein thrombosis, and pulmonary embolism.
- Unfractionated heparins, LMWHs, direct thrombin inhibitors, and factor Xa inhibitors are used for prevention and treatment of clot-related events.
Digoxin Toxicity and Antiarrhythmic Drugs: Mechanisms, Indications, and Adverse Effects
- Digoxin toxicity can lead to hyperkalemia and life-threatening cardiac dysrhythmias
- Life-threatening digoxin overdose is defined as more than 10 mg in adults and more than 4 mg in children
- Class 1a antiarrhythmic drugs, such as procainamide and quinidine, stabilize the membrane and depress phase 0 of the action potential
- Class 1a drugs are indicated for atrial fibrillation, premature atrial contractions, premature ventricular contractions, ventricular tachycardia, and Wolff-Parkinson-White syndrome
- Class 1b drugs, like lidocaine hydrochloride and phenytoin, act preferentially on ischemic myocardial tissue and are indicated for ventricular dysrhythmias
- Lidocaine solutions need to be used with extreme caution, and vials are labeled for cardiac or non-cardiac use
- Class 1c drugs, including flecainide acetate and propafenone hydrochloride, produce a more pronounced blockage of the sodium channel and significantly slow conduction in the heart
- Class 2 drugs, beta blockers, decrease heart rate and reduce myocardial contractility
- Sotalol has both class 2 and class 3 properties and is indicated for both supraventricular and ventricular dysrhythmias
- Class 3 drugs, such as amiodarone and dronedarone hydrochloride, increase the action potential duration by prolonging repolarization in phase 3
- Class 3 drugs are used for life-threatening ventricular tachycardia or fibrillation and atrial fibrillation or flutter resistant to other drugs
- Adverse effects of antiarrhythmic drugs include hypotension, dysrhythmia, dizziness, nausea, and visual disturbances
Test your knowledge of antidysrhythmic and coagulation modifier drugs with this quiz. From adverse effects to nursing implications, this quiz covers important information about these medications, including digoxin toxicity and antiarrhythmic drugs. Sharpen your understanding of mechanisms, indications, and adverse effects of these crucial drugs.
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