Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Module 2 > Flashcards

Module 2 Flashcards

1
Q

What three major groups of drugs are used to maintain or restore circulation?

A

Anticoagulants, antiplatelets, and thrombolytics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is another name for an antiplatelet?

A

Antithrombotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does an anticoagulant do?

A

Prevent the formation of clots that inhibit circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does an antiplatelet do?

A

Prevent platelet aggregation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is platelet aggregation?

A

Clumping together of platelets to form a clot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is another name for a thrombolytic?

A

Clot bluster

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does a thrombolytic do?

A

Attack and dissolve blood clots that have already formed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Define thrombosis

A

Formation of a clot in an arterial or venous vessel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How does an arterial clot form?

A

Blood stasis, platelet aggregation on the blood vessel wall or blood coagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are arterial clots made of?

A

White (platelets that initiate the process —> fibrin formation) and red clots(trapping of red blood cells in fibrin mesh)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How are blood clots in the veins formed?

A

Platelet aggregation with fibrin that attaches to red blood cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is an embolus?

A

Where a blood clot is dislodged from the vessel wall (arterial or veinous) and moves through the bloodstream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How does a venous thrombus usually form?

A

Slow blood flow, and it can form rapidly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Oral and parenteral anticoagulants such as _________ and ___________ act primarily to prevent _____________ thrombosis

A

Warfarin, heparin, venous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What type of drug prevents arterial thrombosis?

A

Antiplatelet drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

T/F anticoagulants dissolve clots that are already formed

A

False- they prevent new clots form forming

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What type of patients may be put on anticoagulants?

A

Venous and arterial disorders that put them at high risk for clot formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are two venous problems?

A

Deep vein thrombosis (DVT) and pulmonary embolisms (PE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are some arterial problems?

A

Coronary thrombosis (Myocardial infarction (MI)) presence of artificial heart valves, and cerebral vascular accident (CVA/stroke)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How is heparin administered?

A

IV or SC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is heparin?

A

Natural substance in the liver that Prevents clot formation ; used for anticoagulant effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How does heparin prevent the clotting cascade?

A

Binds to antithrombin III, which inactivates thrombin . This inhibits the conversion of fibrinogen to fibrin, so the clot is prevented

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What tests are used to monitor Heparin therapy?

A

PTT and aPTT (partial thrombophlebitis time and activated partial thromboplastin time); used to detect clotting factor deficiencies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the anticoagulant antagonist for Heparin?

A

Protamine sulfate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is another name for aspirin?

A

ASA(acetylsalicylic acid) or salicilit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What instance you use chewable aspirin versus enteric coated?

A

Heart attack, chest pain- 324 mg baby aspirin, 4 tablets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What education should a nurse give when administered an NSAID?

A

Irritates stomach—> eat! Drink water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What type of drug is aspirin?

A

Antiplatelet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Adverse effects of aspirin?

A

GI irritation, hemorrhagic stroke, gastric bleeding (ulcer), thrombocytopenia , tinnitus, hearing loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Low dose of 81 mg of baby aspirin is taken for what?

A

Preventing MI or CVA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Side effects of clopidogrel

A

Bleeding, GI effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the four herbal supplements that interact with antiplatelets?

A

Ginseng, ginkgo,garlic, and ginger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is a sign that a nurse may expect if the patient has had too much aspirin?

A

Tinnitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Contraindications for antiplatelets?

A

Elective surgeries (bleeding risk!) stop at least 7 days prior Or active bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What should the nurse monitor for when a patient is on an Antiplatelet

A

Stroke: facial drooping, slurred speech, one sided weakness
Petichiae
Bruising
Melena (Black tarry stool)
Hematemesis
Hematuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Can aspirin and clopidogrel be taken together?

A

Yes, just assess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Normal platelet count?

A

150,000- 400,000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What kind of precautions should a patient be on when taking an antiplatelet?

A

Bleeding precations- soft toothbrush and electric razor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Adverse effects for anticoagulants?

A

Pallor, fatigue, pink urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What can anticoagulants be used for ______________________

A

Prophylactic treatment, A-fib, MI, CVA, artificial heart valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is the low molecular weight heparin?

A

Enoxaprin- prefilled syringe dependent on patient’s weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Do you aspirate a prefilled enoxaprin syringe?

A

No, the bubble stays in to seal it off after injection is given

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Heparin contraindications

A

Blood disorders, gastric ulcer, eye brain or gastric surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the pregnancy category for heparin?

A

C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

aPTT verified ______ to initiating and before any rate change (__________)

A

Prior; q4-6h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What three drug groups regulate heart contraction, heart rate, heart rhythm, and bloodflow to the myocardium?

A

Cardiac glycosides, antianginals, and antidysrhythmics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is ANP?

A

Atrial natriuretic peptide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What is another name for ANP?

A

ANH- atrial natriuretic hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What does ANP do?

A

Antagonist to renin and aldosterone- released during expansion of atrium-vasodilation and increased GFR—-> large volume of urine=decrease blood volume -decreased BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is BNP?

A

Brain natriuretic peptide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What can ANH be used for?

A

Confirm HF- heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What can BNP be used for?

A

Aid in diagnosis of HF-heart failure , helps differentiate dyspnea to HF rather than lung dysfunction; more sensitive test for HF than ANP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Normal value range for ANP?

A

20-77 pg/mL or ng/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Normal range value for BNP?

A

Desired=<100 pg/mL
Positive value= >100pg/mL
Heart failure= 400 pg/mL or greater

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

How many g of salt per day for a pt with HF?

A

2g/day (1 tsp)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Alcohol intake for HF pt?

A

1 drink/day or completely avoided - excessive alcohol can lead to cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What should a nurse restrict for a HF pt?

A

Sodium , fluids, sat fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

How does smoking affect a HF pt?

A

Deprives the heart of oxygen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What drug groups can be used to treat HF?

A

IN inotropic agents, vasodilators, diuretics, Beta blockers, ACE inhibitors, ARBS, CCBs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

How many actions does a cardiac glycoside have?

A

Three

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What are the three actions of a cardiac glycoside?

A

Positive inotropic, negative chronotropic, and negative dromotropic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What do the three actions of the cardiac glycosides do overall?

A

Increase the pumping ability of the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What does a positive inotropic cardiac glycoside do?

A

Increases myocardial contractility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What does a negative chronotropic cardiac glycoside do?

A

Decrease HR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What does a negative dromotropic cardiac glycoside do?

A

Decreases conduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What category does Digoxin fall under?

A

Cardiac glycoside

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What is the purpose of Digoxin?

A

Decrease cardiac workload, increase the contractility and Cardiac output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What are the indications to give a pt digoxin?

A

HF, A fib , A flutter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What routes can Digoxin be given?

A

IV, PO, IM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What reaction happens with a diuretic and digoxin?

A

Hypokalemia (from diuretic)= increased digoxin absorption= risk for toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What reaction occurs when digoxin is taken with an antacid?

A

Lower digoxin absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What are the lab interactions for Digoxin?

A

Hypokalemia, hypomagnesemia, and hypercalcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What is the normal potassium range?

A

3.5-5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

How can Digoxin toxicity affect the body?

A

Cardiotoxicity, GI effects, CNS effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What are the CNS effects for Digoxin toxicity?

A

Green yellow halos, diplopia, dysrhythmias, headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What is the therapeutic range for Digoxin?

A

0.5-2ng/mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What is the antidote for Digoxin?

A

Digoxin immune fab (given IV with continuous cardiac monitoring)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What is the first GI effect of Digoxin toxicity?

A

Anorexia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What must a nurse do prior to administering Digoxin to a patient?

A

Take their apical pulse for a full minute- hold if HR<60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

What are the S/S of HF?

A

Peripheral edema, SOB, activity intolerance, crackles, JVD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

When should a nurse get an EKG when a pt has monitored potassium levels?

A

<3.5—> STAT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

What should a nurse teach a client about when on Digoxin?

A

Assess HR—> report if <60 and hold med, eat potassium rich foods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

What foods are high in potassium?

A

Fresh citrus fruits and vegetables, potatos, green leafy veggies and nuts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

What kind of medication are Nitrates?

A

Antianginal medications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

What is the most common antianginal medication?

A

Nitroglycerin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

What is the purpose of Nitroglycerin?

A

Decrease cardiac oxygen demand and vasodilation, decreasing preload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

What routes can nitroglycerin be given?

A

SL, ER cap, Topical, transdermal, IV(if IV- monitor VS frequently)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

What type of CP us nitroglycerin used for?

A

Acute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

What does alcohol, BP meds, vasodilators do to the effects of Nitroglycerin?

A

Increases the effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

What is a contra indicator for nitroglycerin?

A

PDE5 inhibitors- can cause fatal hypotension, soldenofil, tadialofil, and bardenofil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

What are the biggest side effects for nitroglycerin?

A

Headache and hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

What are some adverse effects for nitroglycerin?

A

Orthostatic hypotension, telex tachycardia, palpitations, dyspnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Nursing interventions for pt on nitroglycerin?

A

Pt move slowly, sit or lie down before taking it, sip of water before SL, acetaminophen for headache, educate to not abruptly stop med

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

How do diuretics work?

A

Block sodium and chloride, preventing water reabsorption= increased output; potassium wasting or sparing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

What is the purpose of a diuretic?

A

Lower BP and decrease edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

How does a diuretic affect kidney function?

A

Prevent sodium and water reabsorption in kidney tubles= increased urinate output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

What are the type of diuretics?

A

Thiazide, loop, potassium sparing, osmotic

98
Q

What are thiazides used for?

A

Essential HTN, HF, edema; slow onset

99
Q

What is the most common thiazide?

A

Hydrochlorothiazide (HCTZ)

100
Q

What are contraindications for HCTZ?

A

Renal failure, pregnancy, allergy to sulfonamides, anuria

101
Q

What are the lab interactions for thiazides?

A

Hypokalemia, hypomagnesemia, hyponatremia, hypercalcemia, hyperglycemia, hyperlipidemia, hyperuricemia

102
Q

What are the drug interactions for thiazides?

A

Digoxin and antihypertensives

103
Q

Side effects of thiazides?

A

Hypotension, phototoxic, dehydration, electrolyte changes, hyperglycemia, weakness, dizziness, diarrhea, constipation

104
Q

Nursing interventions for thiazides

A

S/S hypokalemia—> EKG, BP, calcium level, blood sugar, potassium supplements, output monitor, weight and fall risk

105
Q

How much fluid is retained when a retention pt gains 2.2 lbs?

A

1 liter

106
Q

Pt teaching for thiazides

A

Potassium rich goods, change positions slowly, take med in AM, Daily weight, sunblock, take with food

107
Q

Are loop diuretics potassium wasting or sparing?

A

Wasting

108
Q

What is the strongest Loop diuretic?

A

Furosemide (fast and furious)

109
Q

Are loop diuretics fast acting or slow acting?

A

Rapid action onset—> potent

110
Q

How long does it take IV loop diuretics to take effect?

A

5 minutes

111
Q

What are loop diuretics used for?

A

CHF, edema, HTN, acute renal failure, acute pulmonary edema, rapid mobilization of edema needed, hypertensive crisis

112
Q

What are the routes for loop diuretics?

A

IV, PO, IM

113
Q

Contraindications for loop diuretics?

A

Sulfamide or sulfa drug allergies, hypokalemia, or anuria (except for ethacrynic acid)

114
Q

What drug interactions happen with loop diuretics?

A

Digoxin (if hypokalemia from loop—> digoxin toxicity risk.. take potassium supplement to avoid Ototoxic drugs (loop can be ototoxic) and antihypertensives

115
Q

Lab interactions for loop diuretics?

A

Hypokalemia, hyponatremia, hypocalcemia, hypomagnesemia, hyperglycemia, hyperuricemia, BUN and creatinine increase, hyperlipidemia

116
Q

Side/adverse effects of loop diuretics?

A

Hypokalemia, hypotension, phototoxic, dehydration, tinnitus/ ototoxicity (IV route if pushed too quickly)

117
Q

Nursing interventions- loop diuretic

A

Sulfa allergies? S/S hypokalemia, BG, postassium supplements, urine output, weight

118
Q

Pt teaching for loop diuretics

A

Change positions slowly, eat potassium rich foods, take in AM, S/S hypokalemia, hypomagnesemia, and hypocalcemia , take with food, wear sunscreen, avoid foods high in sodium, daily weight, and BP log (if for HTN)

119
Q

What drug interactions happen with potassium sparing diuretics?

A

Any drug that can increase potassium (K supp and ACE inhibitors), salt substitutes (made with k) and thiazide and loop diuretics (rxn bc k intention diff- wasting vs sparing and incrased dehydration with multiple diuretics)

120
Q

Contraindications for potassium sparing diuretics

A

Hyperkalemia, kidney failure, 1st trimester pregnancy

121
Q

Side/adverse effects for potassium sparing diuretics

A

Hyperkalemia, dizziness, androgen effects, gynecomastia, diarrhea, increased risk of gastric bleeding,tumor prone, headache, and abd cramping

122
Q

Potassium sparing interventions

A

Hyperkalemia, monitor for N/V diarrhea, paresthesia, tachycardia, oliguria, abd cramps; watch k levels, k rich foods, long half life, avoid salt substitutes and k supplements, avoid fruit juices

123
Q

What should you remember about diuretics?

A

Check BP before giving, dehydration bc inc output, output should be min 30mL/hr, take in AM no later than 2 pm (urinate frequently, at night= safety risk), daily weights

124
Q

How can you check for dehydration?

A

Assess mucous membranes, skin turgor, and VS

125
Q

If a pt has a potassium level of 3.5 and the nurse is to give them a loop diuretic, what does the patient need along with the medication?

A

Potassium

126
Q

What type of drug is mannitol

A

Osmotic

127
Q

What is the purpose of mannitol?

A

Acute renal failure, increased ICP or IOP, kidney protection for susplatin (chemo)

128
Q

Side effects of osmotics

A

Edema, fluid and electrolyte imbalances, heart failure, N/V, headache, hypotension, tachycardia, pulmonary edema, renal failure

129
Q

What should be cautioned for osmotics?

A

If patient has a heart disease or failure

130
Q

Nursing interventions for osmotics

A

S/S HF, monitor VS, EKG, I&O, RFTs, Electrolytes, in-line filter for IV administration

131
Q

What should the nurse teach the pt when on mannitol?

A

S/S HF (JVD/ peripheral edema, SOB, fluid retention, activity intolerance)

132
Q

How is BP classified?

A

JNC 8

133
Q

What is stage 1 hypertension?

A

SVP 130-139 and DVP 80-89

134
Q

What is stage 2 hypertension?

A

SVP greater than equal to 140 and DVP greater than or equal to 90

135
Q

BP target for those <60 yo

A

140/90

136
Q

BP target for those > 60 yo

A

150/90

137
Q

BP target for those with CKD

A

<140/90

138
Q

Initial tx for nonblack pt including DM

A

Thiazides, calcium channel blockers, ACE inhibitors, ARBS

139
Q

initial tx for black patients

A

Thiazides or calcium channel blockers

140
Q

Tx for those with CKD and HTN

A

ACE or ARB S or add on therapy , if target not reached in one month, increase dose or add a second med

141
Q

What are the two types of HTN?

A

Primary (essential) HTN and secondary HTN

142
Q

What is the difference between primary and secondary HTN?

A

Primary is chronic and progressive with tx but no cure, and it results from an unidentifiable cause. Secondary is a result of a primary cause identifiable, tx for cause and can be cured, renal and endocrine disorders most common cause

143
Q

What are the risk factors for primary (essential) HTN?

A

Obesity, race, age, family Hx, smoking, stress, high cholesterol, DM, and alcohol use

144
Q

What is the first recommendation for HTN Tx?

A

Lifestyle modifications: weight loss, stress reduction, sodium restriction, DASH eating plan,alcohol restriction, increase exercise, and smoking cessation

145
Q

Can a beta blocker be used with another antihypertensive or diuretic?

A

Yes

146
Q

What are the selective beta blockers?

A

Metoprolol, atenolol, bisoprolol, acebutolol, and betaxolol

147
Q

What are the nonselective beta blockers?

A

Propranolol, carvedilol

148
Q

What do beta blocker cause?

A

Bradycardia, hypotension, decreased contractility, mask hypoglycemia , insomnia, fatigue, depression, nightmares, ED

149
Q

How do Asian Americans differ for Caucasians on beta blockers

A

They are more hypersensitive, so a lower dose is needed

150
Q

How do black African Americans differ from Caucasians on beta blockers

A

Not initial tx/ mono therapy (they have decreased renin HTN) and Caucasian’s have increased renin HTN

151
Q

What do Nonselective beta blockers cause?

A

Bronchoconstriction and hypoglycemia

152
Q

What are contraindications to give a nonselective beta blocker?

A

Those with DM and respiratory disorders

153
Q

What are the nursing interventions for beta blockers?

A

VS monitor. Taper dos (causes rebound HTN, angina, possible MI if abruptly stopped), orthostatic hypotension- safety and dizziness=fall risk, depression=safety and educate, labs= kidney and liver function tests (BUN creatinine liver enzymes) and blood glucose monitoring , decrease Na in diet and report S/S of depression

154
Q

What are two central acting alpha agonists?

A

Clonidine and methyldopa

155
Q

What to clonidine and methyldopa do?

A

Stimulate alpha 2 receptors, decrease epi/norepi release= vasodilation and decrease CO

156
Q

Side effects of methyldopa and clonidine

A

Hypotension, bradycardia, anticholinergic effects, peripheral edema

157
Q

Can methyldopa and clonidine be stopped abruptly?

A

No, must be tapered, or rebound HTN

158
Q

Which central acting alpha 2 agonist can be administered as a transdermal patch?

A

Clonidine, replace on new site very 7 days

159
Q

Which central acting alpha 2 agonist can be given during pregnancy?

A

Methyldopa

160
Q

What are the contraindications for central acting alpha 2 agonists?

A

Liver dysfunction

161
Q

What type of drug is prazosin, terazosin, doxazosin, and tamsulosin?

A

Alpha 1 blockers

162
Q

What does prazosin do?

A

Lower BP and edema- vasodilation, hypotension= dizziness, headache, nausea

163
Q

What do direct acting vasodilators do?

A

Vasodilate arteries and increases blood flow to brain and kidneys; retains water and sodium

164
Q

What are hydralazine and minoxidil used for?

A

Moderate- severe HTN

165
Q

Side effects/adverse effects of direct acting vasodilators

A

Orthostatic hypotension dizziness, headache, parenthesia, reflex tachycardia, palpitations, angina, nasal congestion, atresia, N/V/D

166
Q

What is Nitroprusside?

A

Fastest acting antihypertensive available; emergencies; titration depends on BP (monitor whole time)

167
Q

Nitroprusside Side/adverse effects

A

Brady/tachycardia, restlessness, palpitations, hypotension

168
Q

What type of drug is an ACE inhibitor?

A

Antihypertensive

169
Q

What is the suffix for ACE inhibitors?

A

-pril

170
Q

How do ACE inhibitors work?

A

RAAS, blocks aldosterone release , decreases BP w/ little to no change in CO

171
Q

Do ACE inhibitors affect blood glucose levels?

A

No

172
Q

T/F: ACE inhibitors can be used to treat neuropathy patients

A

T, it preserves renal function

173
Q

What other drugs can ACE inhibitors be used with?

A

Antihypertensives like thiazines (diuretic) and Beta blockers

174
Q

What is used as the primary treatment for black patients?

A

Diuretics like thiazine

175
Q

What are some major warnings for ACE inhibitors?

A

Black box warnings: pregnancy contraindicated(decreases placental blood flow) and angioedema a serious adverse effect

176
Q

Side/ adverse effects of ACE inhibitors

A

A-angioedema (a/e)
C- cough (dry, irritated=s/e)
E- elevated potassium (hyperkalemia-a/e)

177
Q

What should a nurse do if a patient has a cough on an ACE inhibitor?

A

If cough= tolerable, can continue med, but if intolerable, notify provider and switch to ARB

178
Q

Nursing interventions for ACE inhibitors?

A

Call provider if SVP<100, monitor VS, I&O, angioedma, and labs (liver and renal function tests, CBC, glucose levels)
Teach to taper dose, avoid potassium high foods, how to take BP at home, and avoid during pregnancy

179
Q

What is an ARB?

A

Angiotensin II receptor blockers (ARBs)

180
Q

What is the suffix for ARBs?

A

-sartan

181
Q

What are ARBs used for?

A

Similar to ACE inhibitor, no cough, less risks, contraindicated in pregnancy; decrease BP by inhibiting the release of renin

182
Q

Who are ARBs less effective on?

A

Black patients

183
Q

What is Valsartan?

A

An ARB

184
Q

What do calcium channel blockers do?

A

Block the calcium channels in smooth muscle causing vasodilation, effective in black patients

185
Q

What is the suffix for calcium channel blockers?

A

-di, -pine, -mil, -dial (except diltiazem)

186
Q

Side/adverse effects of calcium channel blockers

A

Edema (hands, feet, ankles), hypotension,bradycardia, reflex tachycardia, CHF, flushing, palpitations

187
Q

Nursing interventions for Calcium channel blockers

A

Monitor VS, EKG, I&O, daily weight, labs, edema and flushing?
Pt teaching- taper dose, report CP or SOB
Drug reactions= statins, grape fruit juice (increase calcium blockers)

188
Q

What is considered a hypertensive emergency?

A

DBP greater than 120mm Hg, all drugs given IV, hydralazine IV for hypertensive crisis

189
Q

What are some things to remember for antihypertensives?

A

-Always check VS before giving BP meds
-MUST be tapered
-OTC meds and herbs interact with BP meds
-ALL BP meds cause some degree of dizziness and hypotension
-Most BP meds cause sexual dysfunction

190
Q

What can ACE inhibitors cause?

A

Cough, hyperkalemia, 1st dose HTN, angioedema

191
Q

What should a nurse not administer with an ACE inhibitor?

A

Potassium sparing diuretics (ACE inhibitors cause hyperkalemia)

192
Q

T/F: ARBs cause angioedema and cough

A

False, cause angioedema but not cough

193
Q

What can a nurse assess for when a patient is on calcium channel blockers?

A

Peripheral edema

194
Q

What condition do Beta blockers mask?

A

S/s of hypoglycemia

195
Q

What is cholesterol?

A

Substance made by liver in the sleep that is required for synthesis of some hormones and is in the cell membranes

196
Q

What deactivated enzyme is responsible for lowering cholesterol levels?

A

HMG-CoA reductase

197
Q

What are the first interventions for lowering a patients cholesterol?

A

Diet- cholesterol no more than 30% caloric intake, decrease sat fat and cholesterol, exercise, and smoking cessation

198
Q

What is the maximum of cholesterol per day?

A

300 mg/day

199
Q

T/F: drugs are able to effectively lower cholesterol by themselves

A

False, drugs alone does not produce effective results

200
Q

What drugs lower cholesterol?

A

Statins

201
Q

What is another name for statins?

A

HMG-CoA re-educated inhibitors

202
Q

Statins should be taken _________.

A

Indefinitely, cholesterol levels will resume to previous levels without medications

203
Q

What is the normal HDL level?

A

> 45 mg/dL

204
Q

What is the normal range for LDL levels?

A

<130 mg/dL

205
Q

What are statins used for?

A

Hypercholesterolemia treatment

206
Q

What are the baseline labs tested before administration and throughout therapy for patients on statins?

A

Cholesterol, HDL, LDL, Triglyceride, Liver function, kidney function, creatinine kinase, homocysteine, CRP, eye exam

207
Q

What is the normal cholesterol range?

A

150-200

208
Q

What is the normal triglyceride range?

A

40-150

209
Q

What are the liver function tests?

A

ALT and AST

210
Q

Kidney function tests

A

Creatinine, BUN, GFR

211
Q

What does creatine kinase (CK) show?

A

Increase levels =Presence of cardiac disease, CVA, or Alzheimers

212
Q

What does CRP show?

A

Increase level= tissue injury and inflammation

213
Q

Why does a patient on statins need to get an eye exam yearly?

A

Check for cataracts

214
Q

What route are statins given?

A

Oral

215
Q

When does a statin need to be taken?

A

At night before bed

216
Q

What is the pregnancy category for a statin?

A

X

217
Q

What are the contraindications for statins?

A

Liver disease, breast feeding, or pregnancy

218
Q

What are the side/ adverse effects of statins?

A

Gi issues, myopathy, hepatotoxicity, rhabdomyolysis, diplopia; d/c if myalgia or myopathy

219
Q

What are the signs a nurse should look for in a patient for rhabdomyolysis on a statin?

A

Tea/brown colored urine, myalgia, myopathy, and elevated creatinine kinase

220
Q

Nursing interventions and teaching for patients on statins

A

Liver function tests, S/S hepatotoxicity, CK level (myalgia), alcohol (avoid), eye exam (cataracts?), grapefruit juice (inc drug concentration), report muscle pain (myalgia), take before bed (liver makes cholesterol in sleep),take with food to decrease GI upset

221
Q

S/S of hepatotoxicity

A

Abd pain, jaundice, Decrease GFR, high CK level

222
Q

What is Nicotinic Acid?

A

Vitamin B3

223
Q

What is another name for Nicotinic acid?

A

Niacin

224
Q

When would a patient need Niacin?

A

If triglyceride level is >500

225
Q

What is the dosing for Nicotinic Acid?

A

1,500-3,000mg qid/tid or ER tab 1,000-2,000 mg H.S.

226
Q

What are the side effects of Niacin?

A

Peripheral vasodilation= flushing in face, ears, neck, chest and GI effects; dizziness, syncope, hypotension (with higher doses)

227
Q

What can be taken to help the flushing side effects of Vitamin B3?

A

325 mg of aspirin

228
Q

How can a patient avoid GI effects from Nicotinic acid?

A

Take it with food!

229
Q

What is the route for Niacin?

A

Oral

230
Q

Lipid Lowering drugs are what category?

A

Bile acid-binding resins (cholestyramine, colesevelam, and colestipol)

231
Q

How do Bile-binding resins work?

A

They bind negatively charged acids in the SI; they are not absorbed and metabolized - they are excreted into feces.
Body compensates for reduction in bile-acids by converting cholesterol to bile acids which lowers cholesterol levels

232
Q

How do Bile acid-binding resins lower cholesterol?

A

Use bile acid in stomach to bind to them and be excreted and convert cholesterol into bile acids to compensate for loss of bile acids.

233
Q

Bile Acid Sequestrants are adjunct to what drugs?

A

Statins

234
Q

What routes can Bile Acid Sequestrants be taken?

A

Powders PO in water and juice and PO pill

235
Q

What are cholestyramine and colestipol?

A

Powders mixed with juice and water that are Bile Acid Sequestrants

236
Q

What is colesevelam?

A

PO med taken with food and water with no other medications at the Same time

237
Q

Colestipol pill must be taken……

A

30 min before a meal

238
Q

What are the side and adverse effects of Bile Acid Sequestrants?

A

Flatulence, constipation, abd fullness, diarrhea, and prevents absorption of fat soluble vitamins and other medications

239
Q

What are the nursing interventions for Bile Acid Sequestrants?

A

Increase fiber and fluids to prevent consitpation, laxatives can be used as well, mix the powders well and swallow pills and capsules whole-cannot be crushed or chewed, give fat soluble- vitamin supplements and all other medications four hours before BAS administration

240
Q
A

Pharmacology (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions