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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
Q

Clonidine (Catepres) classification

A

Antihypertensive - Central acting adrenergic blocker

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26
Q

Clonidine (Catepres) Contraindications

A

Coagulopathy.

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27
Q

Clonidine (Catepres) uses/action.

A

Stimulates alpha 2 - <BP and HR
Uses: Hypertension, severe pain, ADHD.

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28
Q

Clonidine (Catapres) - Before giving this medication.

A

Check BP.

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29
Q

Clonidine (Catapres) - after giving the medication.

A

Closely monitor BP if beginning this drug.
Weigh pt - may gain weight in first 3-4 days due to sodium and water retention.

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30
Q

Clonidine (Catapres) interactions.

A

Alcohol
CNS depressants
Tricyclic antidepressants
MAO inhibitors
Opiates <BP> bradycardia w/ Ca channel blockers, beta blockers</BP>

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31
Q

Clonidine (Catapres) side effects/adverse effects

A

Hypotension, dry mouth, constipation, drowsiness, sedation, impotence.

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32
Q

Clonidine (Catapres) Nursing interventions.

A

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

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33
Q

Amlodipine (Norvasc) classification?

A

Antihypertensive - Calcium Chanel blocker

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34
Q

Amlodipine (Norvasc) Contraindications?

A

Pregnancy, coronary artery disease.

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35
Q

Amlodipine (Norvasc) Uses/action?

A

Selectively blocks Ca influx into myocardial muscle cell reducing vascular resistance; vasodilation.
Uses: Hypertension, stable angina.

36
Q

Amlodipine (Norvasc) - Before giving medication?

A

Check BP and HR.

37
Q

Amlodipine (Norvasc) Interactions?

A

Many other Antihypertensive; adenosine, grapefruit; Herbs (ephedra, ma hung, melatonin, St. John’s wort).

38
Q

Amlodipine (Norvasc) side effects/adverse effects?

A

Peripheral or facial edema, headache.

39
Q

Amlodipine (Norvasc) nursing interventions?

A

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
Q

Benazepril (Lotensin) Classification?

A

Antihypertensive: renin angiotensin antagonist (ACE inhibitor)

41
Q

Benazepril (Lotensin) contraindications?

A

Pregnancy, lactation.

42
Q

Benazepril (Lotensin) uses/action?

A

Inhibits ACE, < angiotensin 2 (vasoconstrictor), < aldosterone
Uses: Hypertension

43
Q

Benazepril (Lotensin) - before giving medication?

A

Check BP

44
Q

Benazepril (Lotensin) interactions?

A

K+ sparing diuretics.

45
Q

Benazepril (Lotensin) side effects/adverse effects?

A

Headache

46
Q

Benazepril (Lotensin) nursing interventions?

A

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
Q

Valsartan (Diovan) classification?

A

Antihypertensive; renin angiotensin antagonist (2)

48
Q

Valsartan (Diovan) contraindications?

A

Heart failure
Compromised renal function
Dehydration
History of ACE inhibitor-induced angioedema
Pregnancy

49
Q

Valsartan (Diovan) uses/action?

A

Action: Blocks angiotensin 2 receptors resulting in vasodilation
< release of aldosterone
Uses: Hypertension

50
Q

Valsartan (Diovan) - before giving medication?

A

Check BP

51
Q

Valsartan (Diovan) - after giving the medication?

A

Max effectiveness 2-4 weeks.

52
Q

Valsartan (Diovan) interactions?

A

None

53
Q

Valsartan (Diovan) side effects/adverse effects?

A

No common side effects.

54
Q

Valsartan (Diovan) nursing interventions?

A

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
Q

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?

A

They work in different ways to lower the blood pressure.

56
Q

When is the best time to give anti-hypertensives?

A

At bedtime.

57
Q

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.

A

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
Q

What are the 3 anti-lipemics?

A

Statins, Bile acid sequestrants, cholesterol absorption inhibitors.

59
Q

Statins
Classification, Action, Dugs, Side effects?

A

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
Q

Bile acid sequestrants
Classification, action, drugs, side effects?

A

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
Q

Cholesterol absorption inhibitors
Classification, action, drugs, side effects?

A

Classification: Anti-lipemic
Action: Absorbs cholesterol in the intestines
Drugs: Ezetimibe (Zetia)
Side effects: None common; diarrhea.

62
Q

Atorvastatin (Lipitor) classification?

A

Anti-lipemic - statin

63
Q

Atorvastatin (Lipitor) contraindications?

A

Liver disease, myopathy, renal failure, uncontrolled seizures, pregnancy.

64
Q

Atorvastatin (Lipitor) uses/action?

A

Inhibits hepatic production of cholesterol
Uses: reduction of cholesterol.

65
Q

Atorvastatin (Lipitor) interactions?

A

Digoxin, erythromycin, macrolide antibiotics, anole anti fungal, GRAPEFRUIT, oral contraceptives.

66
Q

Atorvastatin (Lipitor) Side effects/adverse effects?

A

No common side effects
GI distress.

67
Q

Atorvastatin (Lipitor) nursing interventions?

A

Continued assessment for muscle pain
May increase blood glucose
Monitor liver function tests
Minimize alcohol intake
Give with food

68
Q

What side effect of Atorvastatin (Lipitor) should a nurse report immediately?

A

Muscle pain.

69
Q

Enoxaparin (Lovenox) classification?

A

Anticoagulant - low molecular weight heparin

70
Q

Enoxaparin (Lovenox) contraindications?

A

Active bleeding, thrombocytopenia, low platelet count, ITP (immune thrombocytopenia)

71
Q

Enoxaparin (Lovenox) uses/action?

A

Inactivates factor Xa & thrombin
Uses: prevent DVT, treat DVT & pulmonary embolism, post MI

72
Q

Enoxaparin (Lovenox) - before giving medication?

A

Assess for bleeding
Check platelet count - hold if <100,000

73
Q

Enoxaparin (Lovenox) - after giving medication?

A

Assess for bleeding.

74
Q

Enoxaparin (Lovenox) interactions?

A

Aspirin
Warfarin
NSAIDS
Herbs (Garlic, Ginger, ginkgo, feverfew > bleeding risk)

75
Q

Enoxaparin (Lovenox) side effects/ adverse effects?

A

Hemorrhage

76
Q

Enoxaparin (Lovenox) nursing interventions?

A

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
Q

Rivoroxaban (Xarelto) classification?

A

Anticoagulant - selective Xa factor inhibitor

78
Q

Rivaroxaban (Xarelto) contraindications?

A

Bleeding
Renal or hepatic disease

79
Q

Rivaroxaban (Xarelto) uses/ action?

A

Factor Xa inhibitor
Uses: Prevention or tx of DVT or PE, non-vascular atrial fibrillation.

80
Q

Rivaroxaban (xarelto) - before/after giving medication?

A

Before: Assess for bleeding.
After: Monitor for bleeding.

81
Q

Rivaroxaban (xarelto) interactions?

A

Clopidogrel, Herbs (St. John’s wort), OTC meds?

82
Q

Rivaroxaban (Xarelto) side/adverse effects?

A

Hemorrhage
Elevated GGT (sign of liver disease or damage to bile ducts)

83
Q

RIvaroxaban (xarelto) nursing interventions?

A

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
Q

Acetazolamide (Diamox) classification?

A

Diuretic
Carbonic anhydrase inhibitor

85
Q

Acetazolamide (Diamox) uses/action?

A

To inhibit formation of carbonic acid
Use: to decrease intraocular fluid pressure in patients with open-angle glaucoma

86
Q

Acetazolamide (Diamox) side/adverse effects?

A

Sulfa allergy
Fluid and electrolyte imbalance.

Pharm 1 Exam 2 (4 decks)

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