Cardiac Pharmacology PodQuiz for Nursing Students | Straight A Nursing

Understanding Cardiac Pharmacology PodQuizzes

• 💡 This episode is an "encore" of a popular PodQuiz from the Straight A Nursing podcast, designed to function like flashcards for your ears.
• 🎧 PodQuizzes offer an active and engaged way to study using auditory learning, allowing you to study while doing other tasks like exercising or folding laundry.
• 🎯 The goal is to review key concepts in cardiac pharmacology in an accessible, on-the-go format.

Key Cardiac Medications and Treatments

• ⚡ For persistent sinus bradycardia, epinephrine and dopamine infusions are used, with a pacemaker as a potential next step.
• 💊 Atropine (0.5 mg IV push) is the initial treatment for symptomatic bradycardia per ACLS guidelines.
• ❤️ Chronic atrial fibrillation management involves rate control medications (beta-blockers, calcium channel blockers, digoxin) and anticoagulants to prevent stroke.
• ⚡ Adenosine is used for supraventricular tachycardia (SVT) with initial and second doses of 6 mg and 12 mg IV, respectively.
• ⚡ Common medications for bradycardia include atropine, glycopyrolate, and epinephrine.
• ⚠️ Treatment for sinus tachycardia and asymptomatic sinus bradycardia focuses on addressing the underlying cause.
• ⚡ Amiodarone is commonly used for wide-complex ventricular tachycardia in non-unstable patients, with a 300 mg loading dose followed by 150 mg.
• ⚡ Magnesium is used to treat Torsades de Pointes.
• ⚡ ACLS treatment for asystole includes high-quality CPR and epinephrine.
• ⚡ Stable atrial tachycardia may be treated with IV beta-blockers, calcium channel blockers, or IV amiodarone.
• ⚡ Epinephrine increases cardiac excitability, heart rate, and is given as 1 mg of a 1:10,000 concentration in cardiac emergencies.
• ⚡ Dopamine increases both heart rate and contractility.
• ⚡ Adenosine can temporarily stop the heart (6-7 seconds) to restore sinus rhythm.

Diuretics and Vasodilators

• 💧 Loop and thiazide diuretics can lead to hypokalemia by increasing sodium concentration at the distal tubule, stimulating sodium-potassium exchange.
• 🩸 Trental (pentoxifylline) decreases blood viscosity to improve blood flow to extremities.
• 📈 Common IV anti-hypertensives for hypertensive crisis include nitroprusside, nicardipine, labetalol, and esmolol.
• 💊 For graft occlusion in peripheral artery disease, thrombolytic drugs, platelet inhibitors, or antiplatelet drugs are anticipated.
• 🩸 Riopro is a platelet inhibitor.
• 📉 Vasodilators decrease afterload, while venous vasodilators decrease preload.
• 🚫 To prevent nitrate tolerance, use the lowest effective dose and implement a drug holiday or discontinuous dosing.
• 📉 If a patient on nitroglycerin paste becomes hypotensive (e.g., BP 84/53), remove the paste and check for other applications.

ACE Inhibitors, ARBs, and Other Medications

• 🛡️ ACE inhibitors help prevent cardiac remodeling after a myocardial infarction.
• 🧬 ACE inhibitors disrupt the Renin-Angiotensin-Aldosterone System (RAAS) pathway.
• 🧬 The RAAS pathway involves renin, angiotensinogen, angiotensin I, and angiotensin II, which stimulates the release of ADH and aldosterone.
• 💊 ACE inhibitors typically end in the suffix "-pril".
• 🧬 Angiotensin Receptor Blockers (ARBs) also disrupt the RAAS pathway and end in the suffix "-sartan".
• 💧 Medications inhibiting sodium reabsorption in renal tubules lead to diuresis.
• 💧 Hydrochlorothiazide is a thiazide diuretic.
• 💧 Spironolactone is a potassium-sparing diuretic and an aldosterone inhibitor that inhibits remodeling.
• ⚠️ Monitor potassium levels closely in patients taking loop diuretics like furosemide.
• 📉 Beta-blockers (ending in "-olol") slow heart rate by slowing conduction across the AV node and decrease contractility.
• ⚠️ Patients with diabetes should use beta-blockers cautiously as they can mask hypoglycemia symptoms.
• ⚠️ Patients with COPD or asthma should use cardio-selective beta-blockers to avoid bronchospasm.
• 💖 Digoxin increases cardiac contractility and decreases heart rate; patients typically hold it if their heart rate is below 60 bpm.
• ⚠️ Digoxin toxicity signs include bradycardia, nausea, and visual disturbances (yellow halos).
• 🧪 The antidote for digoxin toxicity is Digibind.
• 💨 Morphine is sometimes given for pulmonary edema to cause bronchodilation, vasodilation, reduce air hunger, and calm the patient.
• 💖 Calcium channel blockers (ending in "-pine") dilate coronary arteries and common side effects include headache, nausea, and dizziness.
• 💥 A thrombolytic medication breaks up and dissolves clots.