1533 Pharm Flashcards
Beta blockers
“olol”s decrease force of heart contractions and cardiac output (decrease BP). RX for angina, HTN, heart disease, arrhythmias, to lower risk of repeat MI.
SE: Hypotension, bradycardia, GI disturbances, lethargy/drowsiness, depression, CHF, bronchospasm and mask sxs of hypoglycemia and prolongs effect of insulin (caution with diabetic, asthma or COPD pts)
Allergic rxn: respiratory distress
Increases risk dig tox
all hypertensive drugs monitor and teach
Monitor: HR, BP, ECG, and daily weight
Do not stop abruptly, avoid hot tubs- vasodilation plus meds= syncope
Thiazide diuretic
“thiazide”s increase excretion of everything except ammonia. Tx for edema and HTN.
Monitor for adverse effects: electrolyte imbal (especially hypokalemia- muscle aches & leg cramps), pancreatitis, blood disorders, hyperglycemia and dehydration.
take in morning, increase risk of dig tox. diet high in K and low in Na. Can decrease urine output in DI
Loop diuretic
Furosimide. For more serious edema or HTN when thiazide not working, most potent, more adverse effects. Increase risk of tox with dig and Li. take with food or milk for GI upset. Contains SULFA
ACE Inhibitor
A”pril”s vasodilation and H2O/Na secretion for HTN, impaired renal fxn w/ DM, HF.
Monitor for first dose hypotension (2hrs), and WBCs
Avoid NSAIDs and take on empty stomach
SE: Dizziness, ortho hypo, GI distress, **Nonproductive cough, H/A.
Notify: Fever, Leukopenia, Hypotension, tachycardia, swelling, rash, decrease tase
Angiotensin 2 receptor blocker
Losartan.
Calcium channel blocker
VND. Decrease conductivity and contractility and dilate vessels- reduce O2 demand.
SE: hypotension, bradycardia, peripheral edema, H/A, abdml discomfort, flushing, dizziness.
Monitor BP and Apical pulse before giving
not with grapefruit juice or alcohol
Meds for severe preeclampsia
HTN- vasodilator hydralaine
Mag sulfate to reduce seizure risk
norm SE mag sulfate: warmth, flush, sweat, burning at IV site.
Toxic SE: All v/s decrease, slurred speech, muscle weakness- give calcium gluconate (antidote)
Insulin general
throw away bottle when insulin level with bottom of label and/or having less success with controlling sugar. use up to 4 weeks at room temp. no heat/ sun/freeze. store extra in fridge. B Blockers mask sxs of hypoglycemia and prolong effect of insulin. loss of k (like with diuretic) potentiates hyperglycemia.
Dawn phenom
sugar is high at dawn because insufficient insulin through night- increase insulin at bedtime.
symogyi phenom
glucose high in morning because too much insulin caused hypoglycemia overnight and body produced glucagon. eat a snack at bedtime and poss reduce bedtime insulin.
metforman
1st line drug for type 1. increase insulin sensitivity while decrease liver production of glucose and intestinal absorption of glucose. not for kidney or liver disease, HF, alcoholic, IV contrast (iodine)- acute kidney injury,
levothyroxin
synthetic preparation of T4 which is needed to convert to t3. used for hypothyroidism. take in the morning, 30-60 minutes before breakfast.
SE: tachycardia, angina, tremors and can intensify warfarin effects
