NUR 146 - Unit 2 Meds REDONE

Question 1

Adenosine

Answer 1

• Class: Antiarrhythmic
• Indication: Supraventricular tachycardia (SVT)
• MOA: Slows conduction through the AV node, briefly stopping the heart to reset rhythm
• Adverse Effects: Flushing, chest discomfort, brief asystole, dyspnea
• Teaching/Considerations: Push rapidly IV with flush; very short half-life; transient asystole is expected

Question 2

Amiodarone HCL

Answer 2

• Class: Antiarrhythmic
• Indication: Life-threatening ventricular arrhythmias, atrial fibrillation
• MOA: Prolongs cardiac action potential and refractory period across all cardiac tissues
• Adverse Effects: Pulmonary toxicity, thyroid dysfunction, liver enzyme elevation, bradycardia
• Teaching/Considerations: Long half-life; monitor liver, lungs, and thyroid; avoid grapefruit juice

Question 3

Amlodipine, Diltiazem HCL, Verapamil

Answer 3

• Class: Calcium Channel Blockers (CCBs)
• Indication: Hypertension, angina, rate control in arrhythmias
• MOA: Blocks calcium channels in vascular smooth muscle and/or cardiac cells to reduce contraction and heart rate
• Adverse Effects: Peripheral edema, bradycardia, hypotension, dizziness
• Teaching/Considerations: Monitor BP and HR; avoid grapefruit juice (especially with verapamil); caution with beta blockers

Question 4

Apixaban, Rivaroxaban

Answer 4

• Class: Oral Anticoagulants (Factor Xa Inhibitors)
• Indication: Atrial fibrillation (stroke prevention), DVT/PE treatment and prevention
• MOA: Inhibits factor Xa, reducing thrombin generation and clot formation
• Adverse Effects: Bleeding
• Teaching/Considerations: No routine lab monitoring; monitor for bleeding; rivaroxaban should be taken with food

Question 5

Atorvastatin, Ezetimibe

Answer 5

• Class: Lipid-lowering agents (Statin + Cholesterol Absorption Inhibitor)
• Indication: Hyperlipidemia, cardiovascular risk reduction
• MOA: Atorvastatin inhibits HMG-CoA reductase; ezetimibe blocks intestinal cholesterol absorption
• Adverse Effects: Muscle pain, liver enzyme elevation, GI upset
• Teaching/Considerations: Take statins at night; monitor liver enzymes; avoid grapefruit juice

Question 6

Atropine

Answer 6

• Class: Anticholinergic
• Indication: Bradycardia, reversal of cholinergic toxicity
• MOA: Blocks parasympathetic stimulation by inhibiting acetylcholine at muscarinic receptors
• Adverse Effects: Dry mouth, tachycardia, blurred vision, urinary retention
• Teaching/Considerations: Monitor heart rate; encourage fluids and oral hygiene; contraindicated in glaucoma

Question 7

Carvedilol, Metoprolol Succinate, Propranolol HCL

Answer 7

• Class: Beta Blockers
• Indication: Hypertension, heart failure, angina, rate control
• MOA: Block beta-adrenergic receptors to decrease heart rate and myocardial contractility
• Adverse Effects: Bradycardia, fatigue, hypotension; bronchospasm with non-selective agents like propranolol
• Teaching/Considerations: Monitor HR and BP; do not stop abruptly; caution in asthma with propranolol

Question 8

Clopidogrel Bisulfate, Ticagrelor

Answer 8

• Class: Antiplatelet Agents
• Indication: Prevention of stroke/MI, especially after stents or ACS
• MOA: Inhibit platelet activation and aggregation via P2Y12 ADP receptor antagonism
• Adverse Effects: Bleeding, bruising; dyspnea (ticagrelor)
• Teaching/Considerations: Monitor for bleeding; may need to be held before surgery; ticagrelor often used with low-dose aspirin

Question 9

Dapagliflozin

Answer 9

• Class: SGLT2 Inhibitor
• Indication: Type 2 diabetes, heart failure with reduced ejection fraction (HFrEF)
• MOA: Increases urinary glucose excretion by blocking glucose reabsorption in renal tubules
• Adverse Effects: Genital infections, dehydration, UTI
• Teaching/Considerations: Maintain hydration; monitor for signs of infection; assess renal function

Question 10

Dobutamine HCL, Dopamine HCL

Answer 10

• Class: Inotropes/Vasopressors
• Indication: Cardiogenic shock, heart failure, support BP and cardiac output
• MOA: Stimulate beta and/or alpha adrenergic receptors to increase heart contractility and vasoconstriction (dose-dependent for dopamine)
• Adverse Effects: Tachycardia, arrhythmias, extravasation risk (dopamine)
• Teaching/Considerations: Continuous cardiac monitoring; central line preferred; monitor closely for infiltration

Question 11

Isosorbide Mononitrate, nitroglycerin

Answer 11

• Class: Nitrates (Anti-anginal)
• Indication: Angina, chest pain
• MOA: Converts to nitric oxide → vasodilation → decreased myocardial oxygen demand
• Adverse Effects: Headache, hypotension, dizziness, flushing
• Teaching/Considerations: Avoid erectile dysfunction meds; tolerance can develop—use nitrate-free interval; store nitroglycerin properly

Question 12

Lisinopril, Losartan Potassium, Sacubitril/Valsartan

Answer 12

• Class: RAAS Inhibitors (ACE Inhibitor, ARB, ARNI)
• Indication: Hypertension, heart failure
• MOA: Inhibits RAAS: ACE blocks angiotensin I → II, ARBs block II at receptors, ARNIs also inhibit neprilysin to enhance natriuretic peptides
• Adverse Effects: Hyperkalemia, hypotension, renal impairment; cough and angioedema (ACE inhibitors)
• Teaching/Considerations: Monitor potassium and renal function; avoid potassium supplements; ARNIs require 36-hour washout if switching from ACE

Question 13

Digoxin

Answer 13

• Class: Cardiac Glycoside
• Indication: Heart failure, atrial fibrillation
• MOA: Inhibits Na⁺/K⁺ ATPase → increases intracellular calcium → increased contractility
• Adverse Effects: Bradycardia, nausea, visual disturbances, digoxin toxicity
• Teaching/Considerations: Monitor levels (narrow therapeutic range), check apical pulse before admin, signs of toxicity (yellow vision, confusion)

Question 14

Furosemide

Answer 14

• Class: Loop Diuretic
• Indication: Edema, hypertension, heart failure
• MOA: Inhibits sodium and chloride reabsorption in the loop of Henle
• Adverse Effects: Hypokalemia, hypotension, dehydration, ototoxicity
• Teaching/Considerations: Monitor electrolytes and BP; encourage potassium-rich foods; risk of dehydration

Question 15

Heparin, Enoxaparin

Answer 15

• Class: Anticoagulants (Heparins)
• Indication: DVT/PE prevention and treatment, MI, post-op VTE prophylaxis
• MOA: Inactivates thrombin and factor Xa (heparin), mostly Xa (enoxaparin)
• Adverse Effects: Bleeding, heparin-induced thrombocytopenia (HIT)
• Teaching/Considerations: Monitor aPTT (heparin); CBC/platelets; antidote = protamine sulfate; enoxaparin given subQ in abdomen

Question 16

Coumadin (Warfarin)

Answer 16

• Class: Anticoagulant (Vitamin K Antagonist)
• Indication: Atrial fibrillation, DVT/PE, prosthetic heart valves
• MOA: Inhibits synthesis of vitamin K-dependent clotting factors II, VII, IX, X
• Adverse Effects: Bleeding
• Teaching/Considerations: Monitor INR (2–3 goal); consistent vitamin K intake; multiple drug/food interactions; antidote = vitamin K

Question 17

Morphine

Answer 17

• Class: Opioid Analgesic
• Indication: Moderate to severe pain, acute MI (for chest pain relief)
• MOA: Binds to mu-opioid receptors in the CNS to block pain perception
• Adverse Effects: Respiratory depression, constipation, sedation, hypotension
• Teaching/Considerations: Monitor respiratory rate and sedation level; use fall precautions; naloxone is antidote

Question 18

Aspirin

Answer 18

• Class: Antiplatelet (NSAID)
• Indication: MI prevention/treatment, pain, inflammation
• MOA: Irreversibly inhibits COX-1 and COX-2 → inhibits platelet aggregation
• Adverse Effects: GI bleeding, ulcer, tinnitus (toxicity), bleeding risk
• Teaching/Considerations: Take with food; avoid with other anticoagulants/NSAIDs; not for children (Reye’s syndrome risk)