Drug Functions

Question 1

Antacids

Answer 1

Neutralize gastric acids (Do NOT take with other oral drugs, take with other fluids, check Calcium levels if taking TUMS)

Question 2

Milk of Magnesia

Answer 2

Laxative Effect

Question 3

Aluminum Hydroxide

Answer 3

Constipating effect

Question 4

H2 Blockers

Answer 4

Reduce gastric acid production

(Take before meals or at bedtime; decrease intake of gastric irritants; increase intake of Vit. B12; raise head of bed; inform provider of bleeding)

Question 5

Protein pump inhibitor

Answer 5

Stop gastric Production

(Increase fluids/fiber/activity to prevent constipation; take 30 minutes before meals; decrease foods that cause gastric irritation; use short term; interact with dilantin (seizures), digoxin, anticoagulants, benzos due to liver metabolism.

Question 6

Benzodiazepines

Answer 6

Used to treat anxiety. Enhance soothing/inhibiting neurotransmitter GABA to depress CNS.

Abuse potential/ Controlled substances. Don’t mix with alcohol. Monitor BP and HR. Watch for orthostatic hypotension/ dizziness; don’t abruptly stop drug; decrease dose if liver or renal disease; don’t use if pregnant; no smoking or caffeine

Question 7

Anti-emetic

Answer 7

Treats nausea. Block neurotransmission of signals to the CTZ/ brain(vomiting center of brain) for nausea and vomiting.

Maintain hydration, oral care, patient safety, no driving NO alcohol, monitor BP, use non-pharmacologic methods

Question 8

Promethazine(Antiemetic)

Answer 8

Sedation, drowsiness, confusion, dry mouth, constipation, urinary retention, low BP

Question 9

Ondansetron(Antiemetic)

Answer 9

Drowsiness, headache, constipation, diarrhea

Question 10

Dimenhydrinate(Antiemetic)

Answer 10

Sedation, Dry mouth, blurry vision. Encourage to not drive.

Question 11

Anticoagulants

Answer 11

Inhibit blood clotting

Check bleeding, monitor platelet, let dentist know, limit high K food if using coumadin, consider herbs (start with G) that can interfere, fall precautions

Question 12

Heparin

Answer 12

Given SQ or IV NOT orally. Stops conversion of fibrinogen to fibrin. SLOW DOWN clot formation.
Monitor effect with aPTT(activated partial thromboplastin time) *time it takes blood to clot
25-40 seconds normal. 2X for therapeutic effects (60-80 seconds)

Question 13

Enoxaparin

Answer 13

Fractioned heparin. Given SQ.

No lab test, more predictable

Question 14

Warfarin

Answer 14

Stops liver synthesis of Vitamin K Factors 2,7,9,10. Given PO
Monitor effect with PT (Prothrombin time) and INR (International normalizing ratio)

PT: 12-15 sec. 2X normal for therapeutic effect
INR: 1.3-2 is normal. 2-3 if coumadin, 3-4 if artificial heart valve

Question 15

Perfusion formula for high BP

Answer 15

CO (usually 4-10 liters per minutes) X SVR (systemic vascular resistance/ tone of blood vessels) = BP

Question 16

CO

Answer 16

SV (70mL per beat) X HR (70 bpm)

Question 17

What drugs treat BP?

Answer 17

Ace Inhibitors, Beta Blockers, Calcium Channel Blockers, ARBs, Nitrates

Question 18

Beta Blockers

Answer 18

Decreases SNS effect on BP

Decrease HR and contractility of heart, decrease renin release —-> decrease BP

Check BP and HR; hold if too low; change positions slowly; watch glucose level if too low; watch for lethargy/depression/ heart failure

Question 19

Ace Inhibitors

Answer 19

Inhibit RAAS (renin angiotensin aldosterone mechanism), decrease formation of angiotensin II, and decreases release of aldosterone.

Causes vessel dilation. Also causes H20 and Na excretion—> decreased BP; causes K retention

Check B/P; hold if too low;check for dizziness/orthostasis ; monitor for cough and angioedema; monitor Vitamin K levels; decrease foods high in K

Question 20

Calcium Channel Blockers

Answer 20

Blocks calcium contractile effect on muscle. Causes vessel dilation and decreases myocardial contractility—-> decrease BP

Check BP, hold if too low; check for orthostasis; change positions slowly; watch for constipation, edema, heart failure, and cardia dysrhythmias

Question 21

ARBS

Answer 21

Block angiotensin II at angiotensin II receptors

Cause vessel dilation —-> decreases BP; causes K retention

Monitor BP; watch for orthostatic hypotension and dizziness; watch for first dose effect, fatigue, diarrhea, and increased Vitamin K

Question 22

Nitrates (nitroglycerin)

Answer 22

Vasodilation, relaxes vessel tone. Decreases BP.

Monitor BP. Do NOT mix with ED (erectile dysfunction) drugs or alcohol. Watch for headaches due to vessel dilation. Patient in reclining position on first dose

Question 23

What drugs increase urinary output?

Answer 23

Thiazides, Loops, and K Sparing

Question 24

Thiazides

Answer 24

Cause Na, H20, K, and Cl excretion from kidney

Monitor Urinary Output(30 mL/hr minimum output); maintain hydration; monitor weight, BP, and blood glucose; watch Na, Cl, K, Ca, levels. Patient may need K in diet

Give in AM with Food because urinary output will go up

Question 25

Loops

Answer 25

More potent than Thiazides. Bumex is more potent than Lasix. Cause Na, H20, K, and Cl loss from kidney.

Monitor Urinary output weight; I&(30mL/hr minimum); maintain hydration; , BP; watch for dizziness and electrolyte levels especially K., patient will likely need K supplement.

Give Lasix slowly IV to prevent oxotoxicity— tinnitus, hearing loss, vertigo, give in AM with food

Question 26

K sparing

Answer 26

Causes Na and H20 loss from the kidney, causes retention of K

Monitor BP, weight K levels; maintain hydration; check I&Os (30mL/hr minimum)

Given in AM with food

Question 27

What are the drugs for the heart?

Answer 27

Cardiac Glycoside

Question 28

Cardiac Glycoside

Answer 28

Inhibits Na/K-ATPase, more Ca available to promote cardiac muscle contractility

Stronger cardiac contraction; improved CO, blood flow, and tissue perfusion with oxygenated blood

Monitor HR- hold drug if HR <60bpm. Count Full minute of apical pulse
Check serum levels (therapeutic levels .8-2.0ng/mL, narrow TI drug with long half-life- may need peaks and troughs, in heart failure(therapeutic level is .5-1.0 ng/ml, toxic level if >2.2 ng/mL)

Due to long half life may need loading dose
Monitor for signs of toxicity-anorexia, blurry vision, bradycardia
Maintain good K intake in diet; if low K intake greater risk of digoxin toxicity
Monitor EKG and cardiac rhythm for dysrhythmias