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NCLEX: Pharmacology > Cardiovascular Medications > Flashcards

Cardiovascular Medications Flashcards

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1
Q

Key side effects of direct renin inhibitor aliskiren (Tekturna) for hypertension

A

Hypotension, angioedema, GI upset

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2
Q

Captopril (Capoten) and lisinopril (Prinivil, Zestril) are examples of

A

ACE inhibitors

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3
Q

Key side effects of ACE inhibitors

A

Hypotension, Angioedema, Cough, Elevated potassium, rash, altered taste

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4
Q

Losartan (Cozaar) and valsartan (Diovan) are examples of

A

Angiotensin II Receptor Blockers (ARBs)

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5
Q

Key side effects of ARBs

A

Hypotension, dizziness, GI upset

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6
Q

Direct Renin Inhibitors, ACE inhibitors, and ARBs all carry a blackbox warning for

A

Fetal toxicity (do NOT use during pregnancy)

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7
Q

Patient education for ACE inhibitors and ARBs

A

Change positions slowly

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8
Q

ACE inhibitors and ARBs work on different parts of the RAAS system resulting in

A

Vasodilation

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9
Q

Eplerenone (Inspra) is an example of an

A

Aldosterone antagonist

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10
Q

Key side effect of eplerenone (Inspra)

A

Hyperkalemia (monitor potassium levels during therapy!)

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11
Q

Verapamil (Calan), nifedipine (Procardia, Adalat), and diltiazem (Cardizem) are examples of

A

Calcium channel blockers

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12
Q

Calcium channel blockers can be used to treat hypertension and

A

Angina

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13
Q

Calcium channel blockers work by blocking calcium channel in blood vessels and heart, leading to _________, _________ HR and BP

A

Vasodilation; decreased

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14
Q

Key side effects of calcium channel blockers

A

Peripheral edema, hypotension, bradycardia

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15
Q

Calcium channel blockers patient education

A

NO grapefruit juice

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16
Q

Clonidine (Catapres) is used for the treatment of hypertension by _________ sympathetic outflow to heart and blood vessels, resulting in _________ HR and BP

A

Decreasing; decreased

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17
Q

Key side effects of clonidine (Catapres) (HINT: 3 D’s)

A

Dizziness, Drowsiness, Dry mouth

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18
Q

Clonidine (Catapres) patient education

A

Suck on hard candy for dry mouth

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19
Q

Metoprolol (Lopressor) and atenolol (Tenormin) are examples of

A

Beta1 Blockers

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20
Q

Beta1 blockers _________ BP and HR

A

Decrease

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21
Q

Key side effects of Beta1 blockers

A

Bradycardia, hypotension, erectile dysfunction

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22
Q

Beta1 blockers blackbox warning

A

Abrupt discontinuation of these medications can cause angina and MI

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23
Q

Beta1 blockers patient education

A

Change positions slowly

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24
Q

Beta1 blockers nursing consideration

A

May mask the signs of hypoglycemia

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25
Q

Propranolol (Inderal), labetalol, and carvedilol (Coreg) are examples of

A

Non-selective beta blockers

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26
Q

Non-selective beta blockers work by blocking beta1 receptors in the _____ and beta2 receptors in the _____, by _________ BP and HR

A

Heart; lungs; decrease

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27
Q

Key side effects of nonselective beta blockers

A

Bronchospasm, hypotension, bradycardia, erectile dysfunction

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28
Q

Nonselective beta blockers nursing consideration

A

DO NOT use in patients with asthma due to side effect of bronchospasm

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29
Q

Nitroprusside (Nitropress) is a _________ indicated for hypertensive crisis

A

Vasodilator

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30
Q

Key side effects of nitroprusside (Nitropress)

A

Hypotension, cyanide and thiocyanate toxicity

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31
Q

Nitroprusside (Nitropress) blackbox warning

A

Severe hypotension

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32
Q

Nursing interventions for severe hypotension resulting from nitroprusside (Nitropress)

A

Elevate legs, decrease dose, increase fluids per facility protocol

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33
Q

Nitroglycerin, isosorbide mononitrate (Imdur), and isosorbide dinitrate are examples of

A

Antianginals

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34
Q

Side effects of antianginals

A

Orthostatic hypotension, headache, reflex tachycardia

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35
Q

How should sublingual nitroglycerin be stored?

A

In a cool/dark place

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36
Q

How should the nurse instruct the patient to take sublingual nitroglycerin for chest pain?

A

Take up to 3 tabs. Place 1st under tongue, wait 5 min. If no relief, call 911. Take 2nd tab, wait 5 min. If no relief, take 3rd.

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37
Q

Administration of topical nitroglycerin

A

Wear gloves, remove prior dose, rotate sites, place on hairless site

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38
Q

Cardiac glycoside indicated for HF, Afib, and Aflutter

A

Digoxin (Lanoxin)

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39
Q

How does digoxin (Lanoxin) work?

A

Increases the force of contractions and decreases HR

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40
Q

Key side effects of digoxin (Lanoxin)

A

Dysrhythmias, bradycardia, digoxin toxicity

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41
Q

S/S of digoxin toxicity

A

GI upset (vomiting), sudden fatigue/weakness, vision changes

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42
Q

Digoxin (Lanoxin) nursing consideration

A

Check pulse prior to administration. If pulse <60, hold the dose

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43
Q

Digoxin (Lanoxin) therapeutic range

A

0.5-2 ng/mL

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44
Q

_________ increases the risk of digoxin toxicity

A

Hypokalemia

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45
Q

Treatment for bradycardia associated with digoxin (Lanoxin) therapy

A

Atropine

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46
Q

Procainamide and lidocaine (Xylocaine) are examples of class ___ antidysrhythmics

A

I

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47
Q

Class I antidysrhythmics work by blocking _________ channels

A

Sodium

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48
Q

Key side effects of Class I antidysrhythmics

A

Hypotension, dysrhythmias, lupus, leukopenia, thrombocytopenia

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49
Q

Procainamide blackbox warning

A

May test positive for ANA (Antinuclear antibody) indicating autoimmune response

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50
Q

Procainamide therapeutic blood levels

A

4-8 mcg/mL

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51
Q

Propranolol (Inderal), metoprolol (Lopressor), and atenolol (Tenormin) are class ___ antidysrhythmics

A

II

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52
Q

Amiodarone (Nexterone, Pacerone) and sotalol are examples of class ___ antidysrhythmics

A

III

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53
Q

Class III antidysrhythmics block _________ channels

A

Potassium

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54
Q

Amiodarone (Nexterone, Pacerone) side effects

A

SEVERE: hypotension, bradycardia, pulmonary and liver toxicity, thyroid dysfunction

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55
Q

Amiodarone (Nexterone, Pacerone) blackbox warning

A

Cardiac, liver, and pulmonary toxicity

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56
Q

Amiodarone (Nexterone, Pacerone) patient education

A

NO grapefruit juice

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57
Q

Verapamil (Calan) and diltiazem (Cardizem) are examples of class ___ antidysrhythmics

A

IV

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58
Q

Class IV antidysrhythmics block _________ channels

A

Calcium

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59
Q

Adenosine (Adenocard, Adenoscan), digoxin, and magnesium sulfate are examples of class ___ antidysrhythmics

A

V

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60
Q

Adenosine (Adenocard, Adenoscan) side effects

A

Arrythmias, SOB, hypotension

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61
Q

Adenosine (Adenocard, Adenoscan) patient education

A

Change positions slowly

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62
Q

key anticholinergic/antimuscarinic drug used to treat sinus bradycardia, heart block, or to decrease secretions during surgery

A

Atropine

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63
Q

Atropine has _________ side effects

A

Anticholinergic

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64
Q

Route of administration for heparin

A

IV/Subcutaneous

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65
Q

Low molecular weight heparin, or enoxaparin (Lovenox) is only administered

A

Subcutaneously

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66
Q

T or F: heparin works to break up existing clots

A

FALSE! Heparin is an anticoagulant that PREVENTS new clots from forming

67
Q

Key side effects of heparin

A

Bleeding, heparin-induced thrombocytopenia (HIT), hypersensitivity

68
Q

What lab should be closely monitored in a patient taking heparin?

A

aPTT

69
Q

Baseline aPTT

A

30-40 seconds

70
Q

Therapeutic aPTT for a patient on heparin is ___-___ times the baseline

A

1.5-2

71
Q

Elevated aPPT carries a risk for _________, while an aPTT below baseline carries a risk for __________

A

Bleeding; blood clots

72
Q

Warfarin (Coumadin) is an example of an

A

Oral anticoagulant

73
Q

Key side effects of warfarin (Coumadin)

A

Bleeding, GI upset, hepatitis

74
Q

What labs should be monitored on a patient taking warfarin (Coumadin)?

A

PT/INR

75
Q

Therapeutic INR

A

2-3

76
Q

How long does it take for a patient on warfarin to obtain therapeutic levels?

A

3-5 days (this is why patients may be started on heparin first, along with warfarin)

77
Q

Normal PT range

A

11-13 seconds

78
Q

Normal PT for patient on warfarin

A

1.5-2x baseline PT

79
Q

Warfarin patient education

A

Maintain consistent intake of vitamin K (too much vitamin K may prohibit warfarin, while too little vitamin K can increase risk for bleeding)

80
Q

Rivaroxaban (Xarelto) and apixaban (Eliquis) are examples of

A

Factor Xa Inhibitor anticoagulants

81
Q

Key side effects of factor Xa inhibitors (anticoagulants)

A

Bleeding, elevated liver enzymes

82
Q

Factor Xa inhibitors blackbox warning

A

Abrupt discontinuation of these meds place patient at risk for thrombotic events

83
Q

What should the nurse monitor for patients on factor Xa inhibitors?

A

Liver function, Hgb, Hct

84
Q

Clopidogrel (Plavix) and abciximab are examples of

A

Antiplatelets

85
Q

Side effects of abciximab

A

Bleeding, hypotension, dysrhythmias

86
Q

Side effects of clopidogrel (Plavix)

A

Bleeding, GI upset, rash

87
Q

Abciximab nursing considerations

A

Monitor EKG and vitals

88
Q

Argatroban and dabigatran (Pradaxa) are examples of

A

Thrombin inhibitors

89
Q

Key side effects of argatroban

A

Bleeding, hypotension

90
Q

Key side effects of dabigatran (Pradaxa)

A

Bleeding, GI upset, angioedema

91
Q

Aminocaproic acid (Amicar) is indicated for hemorrhage and carries a risk for

A

Hypercoagulation (assess for thromboembolism)

92
Q

Alteplase (Activase, tPA), streptokinase (Streptase), and reteplase (Retavase) are examples of

A

Thrombolytics

93
Q

Key side effect of thrombolytic medications

A

Bleeding

94
Q

Thrombolytics medications are contraindicated in

A
  • patients who have had a hemorrhagic stroke
  • internal bleeding
  • recent trauma/surgery
  • severe hypertension
95
Q

Thrombolytics are indicated for ischemic strokes and should be administered within ___ hours of symptoms

A

3

96
Q

Thrombolytic nursing considerations

A

Limit venipunctures and IM injections

97
Q

Medication used to increase production of RBCs for the treatment of anemia related to chronic kidney disease, HIV, chemotherapy

A

Epoetin Alfa (Epogen)

98
Q

Key side effects of epoetin alfa (Epogen)

A

Hypertension, increased risk of DVT, stroke, MI, and seizures

99
Q

A patient receiving epoetin alfa (Epogen) should also be taking

A

Iron

100
Q

Medication that increases production of neutrophils to decrease risk of infection in neutropenic patients (r/t chemotherapy)

A

Filgastrim (Neupogen)

101
Q

Side effects of Filgastrim (Neupogen)

A

Bone pain, leukocytosis (high WBCC), splenomegaly (enlarged spleen)

102
Q

Vasopressor indicated for severe allergic reactions, anaphylaxis, and advanced cardiac support

A

Epinephrine (Adrenalin, EpiPen)

103
Q

Epinephrine works by stimulating alpha 1 sites (causing __________), beta 1 receptors (causing _________ HR), and beta 2 receptors (causing _________)

A

Vasoconstriction; increased; bronchodilation

104
Q

Side effects of epinephrine

A

Hypertension, dysrhythmias, angina, nervousness, tremor

105
Q

T or F: when given for shock, hypovolemia should be corrected FIRST before using vasopressors

A

True

106
Q

Vasopressors used for shock and severe hypotension

A

Norepinephrine (Levophed)

107
Q

Side effects of norepinephrine (Levophed)

A

Hypertension, dysrhythmias

108
Q

Vasopressors indicated for shock, sepsis, HF, and renal failure

A

Dopamine (Intropin)

109
Q

Dopamine (Intropin) stimulates alpha 1 receptors (causing _________), beta 1 receptors (causing increased ___ and ___), and dopaminergic receptors (causing increased __________)

A

Vasoconstriction; CO, HR; renal perfusion

110
Q

Side effects of dopamine (Intropin)

A

Dysrhythmias, angina

111
Q

Norepinephrine (Levophed) stimulates alpha 1 sites (causing _________) and beta 1 receptors (increasing _________).

A

Vasoconstriction; cardiac output

112
Q

Medication indicated for cardiogenic shock and HF by stimulating beta 1 receptors (causing increased CO) without much effect on HR and BP

A

Dobutamine (Dobutrex)

113
Q

Dobutamine (Dobutrex) side effects

A

Hypertension, dysrhythmias, angina

114
Q

Colloid (volume expander) indicated for shock, hemorrhage, and burns

A

Albumin

115
Q

Albumin works by

A

Maintaining osmotic pressure in plasma by drawing fluid from extravascular space to intravascular space

116
Q

Albumin side effects

A

Fluid overload, pulmonary edema, hypertension

117
Q

Albumin is contraindicated for what patients?

A

HF patients

118
Q

Atorvastatin (Lipitor) and simvastatin (Zocor) are indicated for

A

Hypercholesterolemia, prevention of coronary heart disease

119
Q

How do -statins work?

A

Decreased production of LDL, increase production of HDL

120
Q

-statin side effects

A

Hepatotoxicity, muscle pain, rhabdomyolysis, GI upset

121
Q

Why should -statins be administered with evening meal?

A

Because cholesterol is synthesized at night

122
Q

Nursing considerations for patients on -statins

A

Monitor liver function and CK levels (rhabdo)

123
Q

Patient education for -statins

A

Avoid alcohol; NO grapefruit juice

124
Q

Colesevelam (Welchol) and cholestyramine (Questran) are examples of

A

Bile acid sequestrants for hypercholesterolemia

125
Q

Side effects of bile acid sequestrants

A

GI upset, constipation

126
Q

Patient education for administration of bile acid sequestrants

A
  • increase fiber and fluid intake (to combat constipating effects)
  • take with food and full glass of water
127
Q

Bile acid sequestrants can interfere with absorption of

A

Fat-soluble vitamins (A, D, E, K)

128
Q

Water-soluble vitamin indicated for treatment of hypercholesterolemia

A

Niacin (B3)

129
Q

Side effects of niacin (B3)

A

Flushing of face, pruritis, hepatotoxicity, hyperglycemia

130
Q

Niacin (B3) nursing consideration

A

Use cautiously in patients with diabetes due to risk for hyperglycemia

131
Q

Vitamin indicated for megaloblastic and macrocytic anemia, and prevention of neural tube defects during pregnancy

A

Folic acid (Folate, vitamin B9)

132
Q

How does folic acid work?

A

Stimulates production of RBCs, WBCs, and platelets

133
Q

Folic acid side effects

A

Rash, change in urine color (more intensely yellow)

134
Q

Vitamin indicated for pernicious anemia

A

Cyanocobalamin (B12)

135
Q

Route of administration for B12 for treatment of pernicious anemia

A

Nasal spray (for malabsorption d/t lack of intrinsic factor)

136
Q

Cyanocobalamin (B12) side effects

A

Hypokalemia, hypersensitivity, GI upset

137
Q

Higher doses of folic acid can mask a _____ deficiency, leading to deterioration in cognitive function

A

B12

138
Q

Vegetarians are at high risk for ___ and ___ deficiency

A

B9; B12

139
Q

Oral iron supplement indicated for iron deficiency anemia

A

Ferrous sulfate

140
Q

Side effects of ferrous sulfate

A

Constipation, teeth staining (drink with straw!), dark green/black stools (harmless)

141
Q

IV/IM iron supplement indicated for iron deficiency anemia

A

Iron dextran

142
Q

Iron dextran side effects

A

Staining at IV site, hypotension, flushing

143
Q

__________ increases absorption of iron

A

Vitamin C

144
Q

Iron supplement administration patient education

A
  • take on empty stomach (1 hour before or 2 hours after meals)
  • increase fiber and fluid intake to prevent constipation
145
Q

If giving IM iron dextran, use _________ method

A

Z-track

146
Q

Calcium carbonate and citrate are indicated for

A

Hypocalcemia and prevention of post-menopausal osteoporosis

147
Q

Medication used for emergency treatment of hyperkalemia and hypermagnesemia

A

Calcium gluconate

148
Q

_________ is an essential electrolyte needed for bone/teeth formation, nerve and muscle function, and clotting

A

Calcium

149
Q

Side effects of calcium supplements

A

Constipation, arrythmias, bradycardia

150
Q

Supplement indicated for hypokalemia

A

Potassium chloride

151
Q

Key electrolyte needed for maintenance of intracellular fluid, nerve function, and regulation of muscle and heart contractions

A

Potassium

152
Q

Side effects of potassium chloride

A

Arrythmias, weakness

153
Q

IV potassium side effects

A

Irritation at site (patient can request for K+ to be administered with lidocaine to minimize burning)

154
Q

PO potassium side effects

A

GI upset (BIG horse pill or powder mixed into water — does not taste good!)

155
Q

Alkalinizing agent indicated for metabolic acidosis or PUD that works by promoting acid-base balance and neutralizing stomach acid

A

Sodium bicarbonate

156
Q

Sodium bicarbonate side effects

A

Metabolic alkalosis

157
Q

Agent indicated for hyperkalemia

A

Kayexalate

158
Q

Kayexalate side effects

A

Constipation, fecal impaction, N/V, hypokalemia

159
Q

Supplements indicated for hypomagnesemia, preterm labor, and torsades de pointes

A

Magnesium supplements such as magnesium chloride, magnesium gluconate, magnesium oxide

160
Q

Essential electrolyte for nerve and muscle function, bone formation, biochemical reactions, and slowing uterine contractions

A

Magnesium

161
Q

Side effect of magnesium supplements

A

Diarrhea

162
Q

S/S of magnesium toxicity

A

Decreased DTRs, UO < 30 mL/hr, respiratory depression, hypotension

163
Q

Treatment for magnesium toxicity

A

Calcium gluconate

NCLEX: Pharmacology (11 decks)

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