Cardiac: Adverse/Drug/Allergic Reactions

Question 1

furoemide

Answer 1

• hypo: natremia + chloremia (low sodium and low chloride)
• hypotension: loss of volume and relaxation of venous (vein) smooth muscle
  ! - Hypokalemia: low potassium
• Hyperglycemia (need to add H2O to dilute sugar)
• Hyperuricemia (uric acid - gout)
• Pregnancy Cat. C
  ! Hearing Loss ! (kidney - ear relationship)
  – Permanent, develops quick, first sign tinnitus

Question 2

hydrochlorothiazide

Answer 2

• Watch for Sulfa allergy
• Hypo: natremia, chloremia, kalemia
• Hyper: glycemia, uricemia
  Impacts lipids, calsium and magnesium
• Pregnancy category B; enters breast milk

Question 3

mannitol

Answer 3

fluid/electrolyte imbalance, pulmonary edema, nausea, vomiting, peripheral edema, tachycardia, acidosis
contraindications: sucks fluid out of brain into blood vessels, give carefully to people if HF/renal failure

Question 4

spironolactone

Answer 4

Hyperkalemia, endocrine (hormones)
- Can lead to gynecomastia (larger breasts in men and lower testosterone levels)
Interacts with: Thiazide and loop diuretics and agents that raise potassium

Question 5

prazosin HCL

Answer 5

orthostatic hypotension, nausea, headache, drowsiness, nasal congestion, edema and weight gain

Question 6

-olol

Answer 6

Heart Block, heart failure, bradycardia, sinus arrest (sudden), hypotension, bronchospasm (in asthma patients)

Question 7

-pril

Answer 7

may have large first dose BP drop
fetal injury in pregnancy’s
cough: 1/6 get, not dangerous just annoying
Angioedema, hyperkalemia, rash and renal failure

Question 8

verapamil

Answer 8

constipation, not for use in elderly, blocks smooth muscle contraction
dizziness, facial flushing, headache
edema of ankles, overgrown gum tissue, bradycardia
GRAPEFRUIT JUICE

Question 9

diltiazen

Answer 9

less constipation, flushing, dizziness, edema in ankles
grapefruit juice!

Question 10

amlodipine

Answer 10

swollen ankles and headaches (similar to verapamil) no grapefruit juice

Question 11

digoxin

Answer 11

slows heart rate (can be !toxic), can cause dysrythmias, vomiting, diarrhea, headache, confusion
- Vision (HALO) around dark objects

Question 12

nitroglycerin

Answer 12

dilates everything, headache can be severe, vomiting common, orthostatic can tank, reflex tachycardia
do not take with HTN drugs
vomiting can be severe should have emesis basin ready
large interaction with erectile dysfunction medications, can intensify vasodilation

Question 13

gemfibrozil

Answer 13

rashes, GI, gallstones
Myopathy (muscle pain) + Hepatotoxic (liver, must check LFTs)

Question 14

-statin

Answer 14

Headache, avoid grapefruit juice, pregnancy category X, gi disturbance, possible -probable cataracts (know for final)
Rare: muscle break down (myopathy/rhabdomyolysis) and hepatotoxicity (liver - check LFTs every few months)

Question 15

heparins

Answer 15

hemorrhage (10%), hypersensitivity
(lovenox - low molecular) $1000 a month, does not pass placenta
DO not give for people w/ eye, brain, spinal cord or lumbar puncture surgeries

Question 16

warfarin

Answer 16

hemorrhage, MANY drug interactions (#3), do not use in pregnancy and lactation, onset 12 hr, peak 3-4 days, half life 2-5 days
vitamin k antidote

Question 17

dabigatran extexilate

Answer 17

gi issues, capsule form (no crush, if do huge risk for bleeding),
Must use manufacturer bottle, risk for absorbing moisture

Question 18

rivaroxaban + apixaban

Answer 18

bleeding not as easily reversed, fatal brain bleeds, easily bruised, heavy menstrual bleeding, blood in urine, GI bleeds
DO NOT TAKE WITH NSAIDS