Cardiac Vascular Nursing Exam Pharmacology & Medications Flashcards

Which pharmacological property distinguishes low-molecular-weight heparins (LMWH) from unfractionated heparin (UFH) in clinical practice?

Answer: LMWH has predictable pharmacokinetics allowing weight-based dosing without routine aPTT monitoring

LMWH's consistent bioavailability and dose-response relationship allow fixed weight-based dosing with anti-Xa monitoring only in special populations, unlike UFH which requires frequent aPTT adjustments.

A patient with chronic atrial fibrillation receives dabigatran (Pradaxa). Which reversal agent is FDA-approved for urgent bleeding emergencies?

Answer: Idarucizumab (Praxbind)

Idarucizumab is a humanized monoclonal antibody fragment that binds dabigatran with high affinity, completely reversing its anticoagulant effect within minutes for emergencies.

Ranolazine is used as an antianginal agent through which mechanism that differs from nitrates and beta-blockers?

Answer: Inhibition of late sodium current reduces calcium overload in ischemic cardiomyocytes without affecting heart rate or blood pressure

Ranolazine blocks the late inward sodium current that causes calcium overload in ischemic cells, improving diastolic function and reducing angina without hemodynamic effects on heart rate or blood pressure.

Which patient assessment finding contraindicates the use of IV adenosine for SVT termination?

Answer: Severe reactive airway disease or asthma

Adenosine can trigger severe bronchospasm in asthmatic patients because adenosine receptors in bronchial smooth muscle mediate bronchoconstriction, making it contraindicated in reactive airway disease.

A nurse administers dobutamine to a patient in acute decompensated heart failure. Which hemodynamic response is expected?

Answer: Increased cardiac output and heart rate via beta-1 agonism with moderate reduction in systemic vascular resistance

Dobutamine's beta-1 receptor stimulation increases myocardial contractility and heart rate while its beta-2 effects moderately decrease systemic vascular resistance, improving cardiac output.

Which interaction between statins and which specific drug class requires monitoring for myopathy?

Answer: Concurrent use of statins with fibrates (especially gemfibrozil) significantly increases risk of rhabdomyolysis

Gemfibrozil inhibits statin glucuronidation, dramatically increasing statin plasma levels, which raises the risk of statin-induced myopathy and potentially fatal rhabdomyolysis.