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Questions and Answers

What is the primary mechanism of action of Ezetimibe?

Enhances renal excretion of cholesterol

Inhibits absorption of cholesterol in the small intestine (correct)

Inhibits cholesterol synthesis in the liver

Increases secretion of bile acids

What is a common side effect of Alirocumab?

Increased heart rate

Nausea and vomiting

Flu-like symptoms (correct)

Severe headaches

Which of the following medications is an example of an ACE inhibitor?

Lisinopril (correct)

Metoprolol

Losartan

Amlodipine

What is a contraindication for using Carvedilol?

Asthma Signup and view all the answers

What should be checked prior to administering a beta blocker and a glycoside?

BP and HR Signup and view all the answers

Which condition can cause Digoxin toxicity symptoms?

Hypokalemia Signup and view all the answers

What is a expected effect of Furosemide in heart failure management?

Removal of excess fluid Signup and view all the answers

What is a key nursing consideration when administering Milrinone?

Place patient on a cardiac monitor Signup and view all the answers

What are the common signs associated with right-sided heart failure?

Fluid retention Signup and view all the answers

Which condition is most commonly associated with left-sided heart failure?

Coronary artery disease Signup and view all the answers

What does preload refer to in the context of heart function?

The pressure in the heart before contraction Signup and view all the answers

What is the main mechanism of action for statins?

Inhibit HMG-CoA reductase Signup and view all the answers

What serious complication should be reported when taking statins?

Rhabdomyolysis Signup and view all the answers

What is the primary purpose of cholestyramine?

Limit bile acid reabsorption Signup and view all the answers

How long before or after medications should cholestyramine be taken?

2 hours before or 4 hours after Signup and view all the answers

What does gemfibrozil primarily help with?

Break down triglyceride particles Signup and view all the answers

What is the primary use of Ezetimibe?

To lower cholesterol Signup and view all the answers

Which of the following is a common side effect of Alirocumab?

Flu-like symptoms Signup and view all the answers

What condition is Carvedilol contraindicated in?

Asthma Signup and view all the answers

What should be monitored when administering Milrinone?

Blood pressure and heart rate Signup and view all the answers

What effect do Beta Blockers have on heart function?

Decrease blood pressure and slow heart rate Signup and view all the answers

How is Alirocumab administered?

Subcutaneously Signup and view all the answers

What type of drug is Digoxin classified as?

Cardiac glycoside Signup and view all the answers

Which symptoms may indicate Digoxin toxicity?

Nausea and vomiting Signup and view all the answers

What is a mechanism of action of ACE inhibitors?

Inhibit the conversion of angiotensin I to II Signup and view all the answers

What potential side effect could be associated with the use of Hydralazine and Isosorbide?

Reflex tachycardia Signup and view all the answers

What condition is most commonly associated with right-sided heart failure?

Fluid retention Signup and view all the answers

What is the primary cause of left-sided heart failure?

Coronary artery disease Signup and view all the answers

What is the effect of gemfibrozil on HDL and VLDL levels?

Increases HDL and reduces VLDL Signup and view all the answers

Which of the following is a common complication of statin use?

Rhabdomyolysis Signup and view all the answers

What does cholestyramine do in the gastrointestinal tract?

Binds to bile acids Signup and view all the answers

When should cholestyramine be administered in relation to other medications?

2 hours before or 4 hours after Signup and view all the answers

What is the mechanism of action of statins?

Inhibit HMG-CoA reductase Signup and view all the answers

What indicates a need to report potential statin complications?

Rust-colored urine Signup and view all the answers

What is the main effect of preload in the heart?

Involves the volume of blood in the ventricles Signup and view all the answers

What is the primary use of gemfibrozil?

Break down triglycerides Signup and view all the answers

What is a potential complication when taking gemfibrozil?

Gallstones Signup and view all the answers

Which medication requires evaluation of the apical pulse prior to administration?

Digoxin Signup and view all the answers

What is the primary action of alirocumab?

Binds to LDL receptors Signup and view all the answers

Which of the following medications should be given with food to prevent heartburn?

Gemfibrozil Signup and view all the answers

What is a significant adverse effect associated with amiodarone?

Pulmonary toxicity Signup and view all the answers

Which statement is true regarding rivaroxaban?

Antidote is andexanet alfa Signup and view all the answers

What must clients be educated about when taking metoprolol?

They should not drive until they know how it affects them Signup and view all the answers

What is the recommended route of administration for milrinone?

Intravenous Signup and view all the answers

What is the recommended dietary approach for clients suffering from heart failure?

Low sodium and monitoring fluid intake Signup and view all the answers

Which adverse effect is associated with atorvastatin?

Severe muscle pain and weakness Signup and view all the answers

What is the primary goal of anti-cholesterol drugs?

Lower LDL levels Signup and view all the answers

What is a crucial instruction for a nurse administering Furosemide?

Push slowly to avoid hearing loss Signup and view all the answers

What should be monitored before administering statin medications?

Lipid profile and liver enzymes Signup and view all the answers

Which medication is known to block the production of LDL cholesterol?

PCSK9 inhibitors Signup and view all the answers

What is a potential complication of IV crystalloid administration?

Fluid overload leading to heart failure Signup and view all the answers

What should clients newly diagnosed with hyperlipidemia be educated about regarding medication?

Lifestyle changes may reduce the need for medication Signup and view all the answers

Study Notes

Heart Failure (HF)

Right-sided HF is characterized by dependent edema, vein distention, and fluid retention. This condition arises from left ventricular dysfunction, such as a myocardial infarction (MI), hypertension, coronary artery disease (CAD), or cardiomyopathy. Blood backs up into the left atrium and pulmonary veins, causing pulmonary congestion.
Left-sided HF (more common) is due to blood backing up into the left atrium and pulmonary veins, leading to pulmonary congestion. This condition occurs from problems like MI, hypertension, CAD, or cardiomyopathy.
Preload: The precontraction pressure in the heart as the volume of blood builds up.
Afterload: The resistance to blood ejection from the ventricle.
Statins work by inhibiting HMG-CoA reductase, reducing low-density lipoprotein (LDL) production in the liver. Common side effects include hepatotoxicity, rhabdomyolysis, and muscle aches.
Cholestyramine binds bile acids, limiting their reabsorption in the gastrointestinal tract. This action reduces serum cholesterol and LDL. It must be taken with 60-80 ml of liquid.
Gemfibrozil breaks down triglycerides (TG) particles, increasing high-density lipoprotein (HDL) and reducing very-low-density lipoprotein (VLDL). Potential side effects are gallstones, gastrointestinal distress, and liver function issues.
Ezetimibe inhibits cholesterol absorption in the small intestine, lowering cholesterol levels. Potential side effects include elevations in liver enzymes and GI issues.
Alirocumab is an example of a PCSK9 inhibitor. It reduces LDL by binding to the low-density lipoprotein (LDL) receptors in the liver. Given subcutaneously. Possible adverse events include flu-like symptoms.
ACE-I Inhibitors (Captopril, Lisinopril, Enalapril) and ARBs (Losartan) reduce blood pressure by reducing afterload and preload, which helps improve cardiac output. Potential side effects include dizziness, orthostatic hypotension, and cough.
Diuretics (such as Furosemide, Thiazides, Spironolactone) help remove excess fluid, a key aspect in managing HF.
Beta-blockers (Metoprolol, Carvedilol) slow heart rate and decrease blood pressure. Carvedilol is contraindicated with severe asthma or bronchospastic issues.
Digoxin increases heart contractions and force, which lowers heart rate. Potential adverse effects include visual disturbances, nausea, vomiting. Check heart rate and blood pressure before administering with other heart medications. Digoxin toxicity includes visual halos and anorexia.
Vasodilators such as Hydralazine and Isosorbide help relax blood vessels, reducing blood pressure. Milrinone is typically given intravenously for acute HF management. Adverse effects of milrinone include dysrhythmias.
Dysrhythmias: Irregular heartbeats. Monitor ECG and assess vitals

Other Medications

Procainamide and Lidocaine: Sodium channel blockers used to treat ventricular arrhythmias. Procainamide has a black box warning for bone marrow suppression. Lidocaine can cause toxicity such as confusion and fever.
Amiodarone: Antiarrhythmic drug. Possible side effects include pulmonary toxicity, bradycardia, and hypotension
Calcium Channel Blockers: (Diltiazem, Verapamil) slow AV node conduction, decrease contractility, and are used to treat hypertension, angina, and certain types of cardiac arrhythmias. These drugs are typically given to lower heart rate and slow conduction through AV node.
Adenosine: Decreases contractility and conduction through AV node. This medication is given intravenously and can be used to manage supraventricular tachycardia (SVT).
Digoxin: Digitalis glycoside used to treat HF by increasing heart contractility.
Anticoagulants: Heparin, Enoxaparin, Warfarin, Dabigatran, and Rivaroxaban. Used to prevent blood clots such as deep vein thrombosis (DVT) and pulmonary embolism (PE).
Antiplatelets: Aspirin, Clopidogrel, Eptifibatide, and Tirofiban prevent platelet aggregation, preventing clot formation.
Thrombolytics: Alteplase, Reteplase, Streptokinase, and Tenecteplase dissolve or break down clots.
Hemostatics: Desmopressin(DDAVP). Prevents or stops bleeding.

Nursing Considerations

Monitor weight, input/output, and oxygen saturation (SpO2).

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