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Pharm 1 Exam 2 > Perfusion > Flashcards

Perfusion Flashcards

1
Q

When a patient is first diagnosed with hypertension, what classification fo drugs does the physician use initially?

A

Diuretics

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2
Q

Hydrochlorothiazide (HCTZ) classification

A

Classification: Thiazide diuretic

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3
Q

Hydrochlorothiazide contraindications

A

Contraindications: Hypersensitivity to sulfonamides, anuria, electrolyte imbalance, dehydration.

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4
Q

Hydrochlorothiazide Uses/Action

A

Interferes with reabsorption of sodium.
Enhances excretion of Na, Cl, K+, Bicarbonate, and water.
Uses: Edema, CHF, Hepatic cirrhosis, hypertension.

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5
Q

Hydrochlorothiazide - Before giving the medication.

A

Check B/P
Check K+ levels

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6
Q

Hydrochlorothiazide - After giving the medication

A

Effectiveness: B/P begins to decrease in 3-4 days; max effects 3-4 wks

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7
Q

Hydrochlorothiazide interactions.

A

Corticosteroids > Hypokalemia
Insulin > Hypoglycemia

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8
Q

Hydrochlorothiazide side effects/adverse reactions.

A

Hyperglycemia
Hyperuricemia
Hypokalemia

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9
Q

Hydrochlorothiazide nursing interventions.

A

Allergic to sulfa drugs?
Give w/ food to reduce GI upset
Give in the A.M.
Weigh pt. Daily. Report 2 lb wt gain
Monitor glucose, electrolytes, BUN, Uric acid.
Monitor for hypotension, dizziness.
Monitor I & O; check for edema
Change positions slowly
Photosensitivity
Teach pt foods high in K+ and Mg

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10
Q

Joe complains that he feels week at times after taking the HCTZ. What are some possible causes of the weakness that could be associated with this drug?

A

Orthostatic hypotension
Hypokalemia

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11
Q

Alpha Adrenergic Blockers
Action, nursing considerations, drugs

A

Action: Block alpha 1 adrenergic receptors

Nursing considerations: Monitor B/P, can cause nasal vasodilation, GI disturbances, orthostatic hypotension, headache, syncope.

Drugs: Doxazosin mesylate (cardura), Prazosin HCL (Minipress)

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12
Q

Beta Adrenergic blockers

A

Action: Block Beta 1 - cause vasodilation; some block beta 2 (non-therapeutic), < HR, cardiac contractility.
Nursing considerations: Monitor B/P & HR, fatigue, Block beta 2 - Bronchoconstriction, wheezing, <myocardial contractility; heart failure, can lower blood sugar.

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13
Q

Central Acting Adrenergic Blockers

A

Action: Suppress sympathetic activity in medulla of brain; vasodilation
Nursing Considerations: Monitor B/P & HR, Impotence, urinary retention, edema, dry mouth.
Drugs: Clonidine HCL (Catapres)

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14
Q

Alpha 1 & Beta 1 Adrenergic Blockers

A

Action: Block Alpha 1 and Beta 1 receptors
Nursing Considerations: Monitor B/P and HR, Orthostatic hypotension, Fatigue
Drugs: Labetolol (Trandate), Cavedilol (Coreg)

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15
Q

Calcium Channel Blockers

A

Action: Inhibits CA ions into myocardial smooth muscles; vasodilation.
Nursing Considerations: Monitor B/P and HR, Avoid Grapefruit, < myocardial contractility.
Drugs: Amlodipine (Norvasc)

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16
Q

Angiotensin-Enzyme Converting Inhibitors (ACE Inhibitors)

A

Action: Blocks conversion of Angiotensin 1 to angiotensin 2 (angiotensin 2 most potent vasoconstrictor)
Nursing Considerations: Monitor B/P and HR, Angioedema, Tickling sensation in throat; dry cough, >K+, BUN, Creatinine, Check serum K+, avoid K+ supplements.

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17
Q

Angiotensin 2 Receptor Blockers (ARBs)

A

Action: Blocks vasoconstriction effect of Angiotensin 2 < release of aldosterone.
Nursing Considerations: Monitor B/P and HR, Angioedema, tickling sensation in throat; dry cough, > K+, BUN, Creatinine, check serum K+, avoid K+ supplements.

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18
Q

Atenolol (Tenormin) Classification

A

Antihypertensive: Beta Adrenergic Antagonist

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19
Q

Atenolol (Tenormin) contraindications

A

Bradycardia
CHF
Pregnancy

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20
Q

Atenolol (Tenormin) Uses/Action

A

Blocks Beta 1 selectively
Hypertension alone or in combination, stable angina pectorals, MI.

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21
Q

Atenolol (Tenormin) - Before giving this medication.

A

Check BP and HR

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22
Q

Atenolol (Tenormin) Interactions.

A

Anticholinergics > absorption, insulin (hypoglycemia), NSAIDS.

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23
Q

Atenolol (Tenormin) Side effects/Adverse effects

A

Bradycardia, hypotension, CHF, Fatigue.

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24
Q

Atenolol (Tenormin) Nursing considerations.

A

Monitor BP and HR
Monitor blood glucose in diabetics
Orthostatic hypotension in early tx
Do not abruptly discontinue drug
Limit alcohol intake

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25
Clonidine (Catepres) classification
Antihypertensive - Central acting adrenergic blocker
26
Clonidine (Catepres) Contraindications
Coagulopathy.
27
Clonidine (Catepres) uses/action.
Stimulates alpha 2 -
28
Clonidine (Catapres) - Before giving this medication.
Check BP.
29
Clonidine (Catapres) - after giving the medication.
Closely monitor BP if beginning this drug. Weigh pt - may gain weight in first 3-4 days due to sodium and water retention.
30
Clonidine (Catapres) interactions.
Alcohol CNS depressants Tricyclic antidepressants MAO inhibitors Opiates bradycardia w/ Ca channel blockers, beta blockers
31
Clonidine (Catapres) side effects/adverse effects
Hypotension, dry mouth, constipation, drowsiness, sedation, impotence.
32
Clonidine (Catapres) Nursing interventions.
Monitor BP Monitor I&O Weigh daily Change positions slowly due to orthostatic hypotension Do not take OTC meds, alcohol or CNS depressants until discuss w/ HCP Avoid overheated or dehydration
33
Amlodipine (Norvasc) classification?
Antihypertensive - Calcium Chanel blocker
34
Amlodipine (Norvasc) Contraindications?
Pregnancy, coronary artery disease.
35
Amlodipine (Norvasc) Uses/action?
Selectively blocks Ca influx into myocardial muscle cell reducing vascular resistance; vasodilation. Uses: Hypertension, stable angina.
36
Amlodipine (Norvasc) - Before giving medication?
Check BP and HR.
37
Amlodipine (Norvasc) Interactions?
Many other Antihypertensive; adenosine, grapefruit; Herbs (ephedra, ma hung, melatonin, St. John’s wort).
38
Amlodipine (Norvasc) side effects/adverse effects?
Peripheral or facial edema, headache.
39
Amlodipine (Norvasc) nursing interventions?
Monitor BP and HR Check for peripheral or facial edema Orthostatic hypotension - change positions slowly Report SOB, palpitations, irregular heartbeat, nausea or constipation to HCP.
40
Benazepril (Lotensin) Classification?
Antihypertensive: renin angiotensin antagonist (ACE inhibitor)
41
Benazepril (Lotensin) contraindications?
Pregnancy, lactation.
42
Benazepril (Lotensin) uses/action?
Inhibits ACE, < angiotensin 2 (vasoconstrictor), < aldosterone Uses: Hypertension
43
Benazepril (Lotensin) - before giving medication?
Check BP
44
Benazepril (Lotensin) interactions?
K+ sparing diuretics.
45
Benazepril (Lotensin) side effects/adverse effects?
Headache
46
Benazepril (Lotensin) nursing interventions?
Assess BP Monitor serum potassium for hyperkalemia Do not use K+ supplements or salt substitute Report swelling of face, eyes, lips, tongue or difficulty breathing (angioedema)
47
Valsartan (Diovan) classification?
Antihypertensive; renin angiotensin antagonist (2)
48
Valsartan (Diovan) contraindications?
Heart failure Compromised renal function Dehydration History of ACE inhibitor-induced angioedema Pregnancy
49
Valsartan (Diovan) uses/action?
Action: Blocks angiotensin 2 receptors resulting in vasodilation < release of aldosterone Uses: Hypertension
50
Valsartan (Diovan) - before giving medication?
Check BP
51
Valsartan (Diovan) - after giving the medication?
Max effectiveness 2-4 weeks.
52
Valsartan (Diovan) interactions?
None
53
Valsartan (Diovan) side effects/adverse effects?
No common side effects.
54
Valsartan (Diovan) nursing interventions?
Give on empty stomach Monitor liver function studies, BUN & Creatinine, Potassium levels Assess for dizziness w/ position changes Do not give with K+ supplements
55
After taking the Valsartan for 2 years, Joe’s blood pressure on his last visit to his physician is 162/102. The physician prescribes atenolol in addition to Valsartan. Why would a physician prescribe two Antihypertensive drugs?
They work in different ways to lower the blood pressure.
56
When is the best time to give anti-hypertensives?
At bedtime.
57
Joe has blood drawn for cholesterol levels on his last visit. The results were: Total cholesterol……………… 362 mg/dl LDL………………………………….. 154 mg/dl HDL…………………………………. 32 mg/dl Interpret these results.
Total cholesterol should be below 200 mg/dl. LDLs are high - should be below 100 mg/dl. HDLs are low - should be above 40 mg/dl.
58
What are the 3 anti-lipemics?
Statins, Bile acid sequestrants, cholesterol absorption inhibitors.
59
Statins Classification, Action, Dugs, Side effects?
Classification: Anti-lipemic Action: Decrease cholesterol synthesis in liver Drugs: Atorvastatin (Lipitor), Pravastatin (Pravchol), Rosuvastsatin (Crestor), Simvastatin (Zocor) Side effects: No common; watch for muscle pain, hyperglycemia in diabetics.
60
Bile acid sequestrants Classification, action, drugs, side effects?
Classification: anti-lipemic Action: Bind w/ bile acids secreting cholesterol in the stool Drugs: Choestyramine (Questran) Side effects: None common; gas, bloating, nausea, constipation.
61
Cholesterol absorption inhibitors Classification, action, drugs, side effects?
Classification: Anti-lipemic Action: Absorbs cholesterol in the intestines Drugs: Ezetimibe (Zetia) Side effects: None common; diarrhea.
62
Atorvastatin (Lipitor) classification?
Anti-lipemic - statin
63
Atorvastatin (Lipitor) contraindications?
Liver disease, myopathy, renal failure, uncontrolled seizures, pregnancy.
64
Atorvastatin (Lipitor) uses/action?
Inhibits hepatic production of cholesterol Uses: reduction of cholesterol.
65
Atorvastatin (Lipitor) interactions?
Digoxin, erythromycin, macrolide antibiotics, anole anti fungal, GRAPEFRUIT, oral contraceptives.
66
Atorvastatin (Lipitor) Side effects/adverse effects?
No common side effects GI distress.
67
Atorvastatin (Lipitor) nursing interventions?
Continued assessment for muscle pain May increase blood glucose Monitor liver function tests Minimize alcohol intake Give with food
68
What side effect of Atorvastatin (Lipitor) should a nurse report immediately?
Muscle pain.
69
Enoxaparin (Lovenox) classification?
Anticoagulant - low molecular weight heparin
70
Enoxaparin (Lovenox) contraindications?
Active bleeding, thrombocytopenia, low platelet count, ITP (immune thrombocytopenia)
71
Enoxaparin (Lovenox) uses/action?
Inactivates factor Xa & thrombin Uses: prevent DVT, treat DVT & pulmonary embolism, post MI
72
Enoxaparin (Lovenox) - before giving medication?
Assess for bleeding Check platelet count - hold if <100,000
73
Enoxaparin (Lovenox) - after giving medication?
Assess for bleeding.
74
Enoxaparin (Lovenox) interactions?
Aspirin Warfarin NSAIDS Herbs (Garlic, Ginger, ginkgo, feverfew > bleeding risk)
75
Enoxaparin (Lovenox) side effects/ adverse effects?
Hemorrhage
76
Enoxaparin (Lovenox) nursing interventions?
Ongoing assessment for bleeding Administer deep SQ in lower abdomen, pinch skin and inject into skin fold. Rotate sites. Antidote: Protamine sulfate No need to monitor lab work Lower risk of bleeding than with heparin Bleeding precautions.
77
Rivoroxaban (Xarelto) classification?
Anticoagulant - selective Xa factor inhibitor
78
Rivaroxaban (Xarelto) contraindications?
Bleeding Renal or hepatic disease
79
Rivaroxaban (Xarelto) uses/ action?
Factor Xa inhibitor Uses: Prevention or tx of DVT or PE, non-vascular atrial fibrillation.
80
Rivaroxaban (xarelto) - before/after giving medication?
Before: Assess for bleeding. After: Monitor for bleeding.
81
Rivaroxaban (xarelto) interactions?
Clopidogrel, Herbs (St. John’s wort), OTC meds?
82
Rivaroxaban (Xarelto) side/adverse effects?
Hemorrhage Elevated GGT (sign of liver disease or damage to bile ducts)
83
RIvaroxaban (xarelto) nursing interventions?
Ongoing assessment for bleeding Monitor VS, for neurological impairment, muscle weakness Monitor LFTs, kidney function, Hgb & Hct CHeck with HCP before using aspirin, NSAIDS, herbal products Take w/ evening meal Andtidote: Adexxa
84
Acetazolamide (Diamox) classification?
Diuretic Carbonic anhydrase inhibitor
85
Acetazolamide (Diamox) uses/action?
To inhibit formation of carbonic acid Use: to decrease intraocular fluid pressure in patients with open-angle glaucoma
86
Acetazolamide (Diamox) side/adverse effects?
Sulfa allergy Fluid and electrolyte imbalance.

Pharm 1 Exam 2 (4 decks)

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