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NUR 202 > 202-1 > Flashcards

202-1 Flashcards

1
Q

Classification of Captopril

A

ACE inhibitor

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2
Q

Mechanisms by which Captopril works:

A

1: inhibits change of Angiotensin I to Angiotensin II
2: Decreases aldosterone secretion (inc. sodium & water excretion)
3: Decreases peripheral vascular resistance

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3
Q

Common adverse effects of Captopril:

A

chronic cough

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4
Q

Serious adverse effects of Captopril:

A

neutropenia, fever, chest pain, hypotension, dysuria, photosensitivity, angioedema, hyperkalemia, hyponatremia, positive ANA titer

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5
Q

Pregnancy classification of Captopril:

A

D

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6
Q

Therapeutic class of Captopril

A

Antihypertensive

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7
Q

Pharmacotherapeutics for Captopril:

A

1: hypertension
2: malignant HTN when prompt titration of BP is needed
3: heart failure unresponsive to alternative treatment
4: left sided heart failure after an MI
5: diabetic nephropathy

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8
Q

Route of Captopril

A

PO

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9
Q

Onset of Captopril

A

15-60 min

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10
Q

Peak of Captopril

A

60-90 min

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11
Q

Duration of Captopril

A

6-12 hr

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12
Q

Captopril decreases ______ concentration in the blood

A

angiotensin II

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13
Q

Contraindications of Captopril

A

concurrent aliskiren use in diabetics or patients with renal impairments

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14
Q

Captopril may interact with:

A

ACE inhibitors: increased hypotension, renal impairment
allopurinol: incr. hypersensitivity reactions
antacids: decreases absorption
Digoxin: inc. digoxin levels
NSAIDS: additive effects
Alcohol: additive

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15
Q

Adverse reactions of Captopril:

A

Persistent nonproductive cough, angioedema, rash, hypotension, neutropenia, and dyspnea

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16
Q

____ decreases absorption of Captopril

A

food

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17
Q

What to watch for when patients are taking Captopril:

A

Assess blood reports for hyperkalemia, hyponatremia, and neutropenia, and assess urine for proteinuria.

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18
Q

Therapeutic class of Dextromethorphan

A

antitussive

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19
Q

Indications for Dextromethorphan

A

nonproductive cough

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20
Q

mechanism of action for dextromethorphan

A

affects the cough center in the medulla

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21
Q

onset of Dextromethorphan

A

~ 15-30 minutes

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22
Q

Duration of Dextromethorphan

A

5-6 hours

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23
Q

Dextromethorphan adverse effects:

A

toxicity, nausea, vomiting, drowsiness, dizziness, irritability

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24
Q

Use Dextromethorphan cautiously in:

A

patients with hepatic impairment, pregnant women

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25
Q

Contraindications of Dextromethorphan

A

chronic cough from emphysema or asthma

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26
Q

Drug-drug interactions with Dextromethorphan

A

other CNS depressants (increased sedation)
MAOIs (possible serotonin syndrome)
Alcohol (Additive effect)
Fluoxetine, quinidine

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27
Q

Food-drug interactions with Dextromethorphan

A 
grapefruit
Orange juice (increased risk of toxicity)
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28
Q

Important patient/family teaching for Dextromethorphan therapy

A

sedative effects, pregnancy

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29
Q

Classification of Guaifenesin

A

expectorant

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30
Q

indications for guaifenesin

A

cough with thick secretions and promoting productive cough

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31
Q

mechanism of action of guaifenesin

A

removes fluid and mucus from the URT by increasing volume & reducing adhesiveness and surface tension

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32
Q

onset of guaifenesin

A

30 mins

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33
Q

duration of guaifenesin

A

4-6 hours

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34
Q

peak of guaifenesin

A

unknown

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35
Q

contraindications of guaifenesin

A

hypersensitivity

36
Q

adverse effects of guaifenesin

A

dizziness, headache, nausea, vomiting, rash, urticaria

37
Q

Important patient/family teaching for guaifenesin

A

don’t take > 1 week

increase fluids to help thin secretions

38
Q

Classification of albuterol

A

selective beta-2 adrenergic agonist, bronchodilator, sympathomimetic

39
Q

indications of albuterol

A

prevents exercise induced asthma, treats bronschospasm

40
Q

mechanism of action of albuterol

A

attaches to beta-2 receptorson bronchial cell membranes. Converts ATP to cAMP (lowers Calcium levels-relaxes bronchial smooth muscle cells and inhibits histamine release

41
Q

onset of albuterol

A

5-15 mins

42
Q

peak of albuterol

A

50-55 mins

43
Q

duration of albuterol

A

2-6 hours

44
Q

contraindications of albuterol

A

hypersensitivity

45
Q

Use albuterol cautiously in

A

patients with cardiac disorders, diabetes, digitalis intoxication, HTN, hyperthyroidism, seizure hisotry

46
Q

Adverse effects of albuterol

A

anxiety, dizziness, drowsiness, angina, arrythmias, dry mouth,, diarrhea, bronschospasm, cough, dyspnea, paradixical bronschospasm, hypokalemia

47
Q

Drug-drug interations with albuterol

A 
beta blockers (inhibits)
digoxin (lowers)
MAOIs
Tricyclic antidepressants
potassium lowering drugs (hypokalemia)
Special considerations for albuterol
48
Q

administer during the second half of an inspiration, monitor serum potassium levels, drug tolerance may occur over time
Patient/family teaching for albuterol

A

teach inhaler use, shake and prep prior to use, wash mouth piece once a week, wait one minute between inhalations

49
Q

classifications of theophylline

A

xanthine derivative, bronchodilator

50
Q

indications for theophylline

A

reversible airway obstruction (as a loading dose/partial loading dose), maintenance of COPD and asthma

51
Q

mechanism of action of theophylline

A

inhibits phosphodiesterase enzymes, causing bronschodilation, calcium translocation, antagonizes prostaglandins

52
Q

contraindications of theophylline

A

hypersensitivity, peptic ulcer disease, uncontrolled seizure disorder

53
Q

use theophylline cautiously in

A

elderly, adults with cardiac decompensation, or hepatic impairment, acute pulmonary edema

54
Q

Adverse effects of theophylline

A

agitation, anxiety, headache, insomnia, hypotension, tachycardia, hyperglycemia, hypercalcemia

55
Q

Drug-drug interactions with theophylline

A

don’t mix with any additives, don’t infuse with Hetastarch, allopurinol, oral contraceptives, metropolol, benzos, ephedrine, alcohol (increased blood theophylline levels), smoking (decrease theophylline effectiveness)

56
Q

Diet interactions with theophylline

A

high carb, low protein diet (decreased theophylline elimination)
low carb, high protein diet (increased theophylline elimination)

57
Q

special considerations of theophylline

A

drug doesn’t bind well to body fat, monitor blood theophylline levels, assess HR and rhythm

58
Q

Patient/family teaching theophylline

A

capsules may be opened and mixed with food, take with a glass of water on an empty stomach unless GI distress occurs, incorporate lifestyle changes

59
Q

last resort drug in COPD patients

A

theophylline

60
Q

classification of hydrochlorothiazide

A

diuretic

61
Q

indications for hydrochlorothiazide

A

edema from CHF, HTN, hepatic or renal disease, secondary to drug use

62
Q

MOA of hydrochlorothiazide

A

increases sodium and water excretion by inhibiting sodium and chloride reabsorption in distal segment of the nephron

63
Q

onset of hydrochlorothiazide

A

2 hours

64
Q

peak of hydrochlorothiazide

A

4-6 hours

65
Q

duration of hydrochlorothiazide

A

6-12 hours

66
Q

contraindications of hydrochlorothiazide

A

severe renal disease, anuria ( > 250 mL/day), hepatic coma

67
Q

use hydrochlorothiazide cautiously in:

A

patients with renal disease, lupus erythematosus, liver disease, fluid/electrolyte imbalances, diabetes, gout, elevated cholesterol/triglycerides

68
Q

adverse effects of hydrochlorothiazide

A

dizziness, headache, orthostatic hypotension, pancreatitis, renal failure, aplastic anemia, fluid/electrolyte loss, thrombocytopenia, hypokalemia, hyponatremia, hypochloremia, hypercalcemia

69
Q

Drug-drug interactions with hydrochlorothiazide

A

dofetilide (severe cardiac arrythmias)
high sodium foods
acetaminophen
anticoagulants

70
Q

special considerations in hydrochlorothiazide therapy

A

monitor BP, weight loss, serum electrolyte levels

71
Q

important patient/family teaching in hydrochlorothiazide therapy

A

take in morning so diuresis doesn’t affect sleep, avoid high sodium diets

72
Q

classification of digoxin

A

digitalis glycoside, antiarrythmic, cardiotonic

73
Q

indications of digoxin

A

HF, atrial flutter, Afib, paroxysmal atrial tachycardia with rapid digitalization

74
Q

MOA of digoxin

A

increases force and velocity of myocardial contraction (increases inotropic effects), decreases conduction rate, increases ERP of the AV node

75
Q

contraindications of digoxin

A

hypersensitivity, hypersensitive carotid sinus syndrome, presence/history of digitalis toxicity or idiosyncratic reaction to digoxin, Vfib, tachycardia, patients with restrictive cardiomyopathy, constrictive pericarditis, amyloid heart disease, idiopathic hypertrophic subaortic stenosis

76
Q

use digoxin cautiously in

A

elderly debilitated or patients with pacemakers, beri-beri heart disease

77
Q

adverse effects of digoxin

A

weakness, confusion, drowsiness, arrythmias, heart block, abdominal discomfort, dizziness, nausea, vomiting, electrolyte imbalances

78
Q

drug-drug interactions with digoxin

A

antacids (decreases absorption)

high fiber foods (decreases absorption)

79
Q

special considerations for digoxin therapy

A

once diluted, giver immediately; monitor ECG and patient’s serum potassium levels

80
Q

classification of nitroglycerin

A

nitrate, antianginal, antihypertensive, vasodilator

81
Q

indications for nitroglycerin

A

angina, manage HTN or heart failure

82
Q

MOA of nitroglycerin

A

interacts with nitrate receptors in vascular smooth muscle cell membranes (forces calcium out of muscle cells) reduces pre- & afterload dilates coronary arteries

83
Q

contraindications of nitroglycerin

A

MI, acute closure glaucoma, hypovolemia, increased intracranial pressure, orthostatic hypotension, pericardial temponade, severe anemia

84
Q

use nitroglycerin cautiously in

A

elderly patients

85
Q

adverse effects of nitroglycerin

A

agitation, anxiety, dizziness, arrythmias, hypotension, abdominal pain, dysuria, arthralgia, bronchitis, contact dermatitis, flushing of the face/neck, headache

86
Q

drug-drug interactions with nitroglycerine

A

acetylcholine, norepinephrine, heparin (decreases anticoagulant effects), vasodilators, phosphodiesterase inhibitors, sympathomimetics (dec. antianginal, Inc. hypotension), alcohol (inc. orthostatic hypotension)

87
Q

special considerations for nitroglycerin therapy

A

plan nitroglycerin free-time for 10 hours per day
check LOC and vitals
keep out of light
don’t shake

NUR 202 (3 decks)

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