Tuesday, October 7, 2008

pharmacology GRM week #8 (brief)

Week 8-Chapter 22
1. What is it that results in disturbances in cardiac rhythm?
a. abnormally functioning cardiac cells
2. What is the term for spontaneous electrical excitability found in cardiac cells?
a. automaticity
3. What are the three main ions involved that move across the cell membrane causing cardiac electrical activity?
a. calcium, sodium, and potassium
4. What mechanism maintains the polarized distribution of ions in the myocardium?
a. sodium-potassium adenosine triphosphatase (ATPase) pump
5. How are antidysrhythmic drugs categorized?
a. Class 1, 1a, 1b, 1c, class II, class III, class IV
6. In general, how do antidysrhythmic drugs work?
a. affect the resting membrane potential (RMP) and sodium channels, in turn influencing the rate of impulse conduction
7. Be able to recognize from the pictures on pages 335 – 337 and defined on page 338, the following dysrhythmias:
a. atrial fibrillation: supraventricular dysrhythmia characterized by rapid atrial contractions that only incompletely pump blood into the ventricles
-rapid, ineffective atrial contractions: QRS complex separated by squiggly lines


b. ventricular tachycardia: rapid heartbeat from impulses originating in ventricles
-photo of sustained VT: uniform mounds

c. ventricular fibrillation: worsened ventricular tachycardia which can be fatal if not reversed
-rapid, ineffective ventricular contraction: small, irregular, bumpy hills

*photos from learntheecg.com
8. What are the therapeutic responses to antidysrhythmic drugs that the nurse should see in the patient?
a. improved cardiac output, decreased chest discomfort, decreased fatigue, improved vital signs, skin color, and urinary output
Week 8-Chapter 24
1. List all of the drug categories that are used to lower the blood pressure in those with hypertension.
a. Loop diuretics, potassium sparing diuretics, beta blockers, ACE inhibitors, alpha 1 antagonists, ARBs, CCBs and vasodilators
2. In Figure 24-1 on page 369, be familiar with the values that represent normal as well as the different classifications of hypertension. Know columns 1, 2 & 3 of the table.
BP Classification: SBP (mm Hg) / DBP (mm Hg)
a. normal: less than 120/less than 80
b. prehypertension: 120-139/80-89
c. stage 1 hypertension: 140-159/90-99
d. stage 2 hypertension: 160 or higher/100 or higher
3. Know Figure 24-3 on page 372 you need to know only the classes of antihypertensives, not the drugs that represent each class. Essentially, what I want you to know is where each anti-hypertensive class works in the body.
a. centrally-acting alpha 2-receptor agonists: vasomotor center
b. centrally and peripherally acting allergenic neuron blocker: vasomotor center and sympathetic ganglion --> blood vessel
c. peripherally acting alpha 1-receptor antagonists: blood vessel
d. direct-acting arteriolar dilators: blood vessel
e. direct-acting arteriolar and venous dilator: blood vessel
f. diuretics: kidney
g. angiotensin II receptor blockers (ARBs): angiotensin II
h. angiotensin-converting enzyme (ACE) inhibitors: angiotensin-converting enzyme
i: beta-adrenergic blocking drugs: heart
Week 8-Chapter 25
1. What do diuretics remove from the body?
a. sodium and water
2. What are the mechanisms that make diuretics hypotensive drugs?
a. direct arteriolar dilation which decreases peripheral vascular resistance
b. reduce extracellular fluid volume, plasma volume, and cardiac output
3. What is the main problem with diuretic use?
a. excessive fluid and electrolyte loss
4. How are diuretics classified?
a. carbonic anhydrase inhibitors, loop diuretics, osmotic diuretics, potassium-sparing diuretics, and thiazide and thiazide-like diuretics
5. List the diuretic subclasses according to their potency in the order of most potent to least potent.
a. loop diuretics, osmotic, thiazide-like diuretics, thiazides, and potassium sparing
6. Fill in the blanks. The more sodium and water diuretics inhibit from resorption, the greater the amount of diuresis.
7. What are the beneficial hemodynamic effects of loop diuretics?
a. reduction of preload and central venous pressures
8. What are the cardiovascular effects of loop diuretics?
a. reduces blood pressure, pulumonary vascular resistance, systemic vascular resistance, central venous pressure, and left ventricular end-diastolic pressure
9. What are the electrolyte losses associated with diuretic administration?
a. loss of sodium, potassium and some calcium
10. How do osmotic diuretics work?
a. produces osmotic pressure in the glomerular filtrate which pulls fluid (mostly water) into renal tubules from surrounding tissue
b. inhibits tubular resorption of water and solutes producing rapid diuresis
11. How does spironolactone lead to diuresis?
a. competitively binds to aldosterone receptors thus blocking the resorption of sodium and water induced by aldosterone secretion
12. How do thiazide diuretics work?
a. inhibit resorption of sodium, potassium, and chloride resulting in osmotic loss

1 comment:

May-Ann said...

Here are my slightly different answers:

Chapter 22
5. How are antidysrhythmic drugs categorized?
-according to where and how they affect cardiac cells
6. In general, how do antidysrhythmic drugs work?
-in general, by correcting, to varying degrees and by various mechanisms, abrnomal cardiac electrophysiological function.