Pharm Exam 3: Cardio & Urinary

Question 1

What are the first line of drugs used to treat lipid disorders?

Answer 1

statins

Question 2

abnormal levels of lipoproteins (excess or not enough)

Answer 2

dyslipidemia

Question 3

the three types of lipids _____

Answer 3

triglycerides, steroids, and phospholipids

Question 4

Energy source

Account for 90% of total lipids in body

Answer 4

triglycerides

Question 5

Essential to building plasma membranes

Answer 5

phospholipids

Question 6

best known phospholipids are

Answer 6

lecithins

Question 7

transports cholesterol from liver to tissues and organs
Used to build plasma membranes and synthesize other steroids
Carries highest amount of cholesterol

Answer 7

LDL

Question 8

primary carrier of triglycerides in blood

becomes LDL through bodily processes

Answer 8

VLDL

Question 9

Manufactured in liver and small intestine

Reverse cholesterol transport
Assist in transport of cholesterol away from body tissues and back to liver

Answer 9

HDL

Question 10

Prototype drug: atorvastatin (Lipitor)
MoA:
Primary use:
adverse effects:

Answer 10

MoA: inhibits HMG-CoA reductase (less cholesterol biosynthesis)
Use: reduces serum-lipid levels
AE: muscle or joint pain

Question 11

Give the prototype drug for Bile-Acid Resins

Answer 11

cholestyramine (Questran)

Question 12

Prototype drug: cholestyramine (Questran)
MoA:
Primary use:
adverse effects:

Answer 12

Mechanism of action: bind with bile acids, increasing cholesterol excretion in stool
Primary use: to lower serum-lipid levels
Adverse effects: GI tract, such as bloating and constipation
***Can bind other drugs, increasing potential for drug–drug interactions

Question 13

Niacin for lipid lowering therapy

Answer 13

-Decreases VLDL levels
-Numerous adverse effects: flushing, hot flashes, nausea, excess gas, diarrhea; more serious effects:
hepatotoxicity and gout possible

Question 14

Fibric-Acid Agents used for what?

Answer 14

lipid lowering agent

Question 15

Fibric-Acid Agent prototype

Answer 15

gemfibrozil (Lopid)

Question 16

Prototype drug: gemfibrozil (Lopid)
MoA:
Primary use:
adverse effects:

Answer 16

Mechanism of action: unknown
Primary use: treating severe hypertriglyceridemia
Adverse effects: GI distress, watch for bleeding with patients on anticoagulants

Question 17

protype drug for class: Cholesterol Absorption Inhibitor

Answer 17

Ezetimibe (Zetia)

Question 18

nursing considerations for: statins

Answer 18

Monitor liver function tests

Do not use with pregnancy or breast-feeding

Watch for signs of GI upset

Question 19

role of renin

Answer 19

for blood-pressure regulation

Question 20

role of erythropoietin

Answer 20

to stimulate red blood-cell production

Question 21

role of calcitriol

Answer 21

active form of vitamin D for bone homeostasis

Question 22

diagnostic testing for renal failure

Answer 22

Urinalysis
Proteinuria
albuminuria

Serum creatinine

Diagnostic imaging
CT, MRI

Renal biopsy

Question 23

Largest, most commonly prescribed class of diuretics

Answer 23

thiazide diuretic

Question 24

Miscellaneous Diuretics

Answer 24

Carbonic Anhydrase Inhibitors

Question 25

Miscellaneous Diuretics—Osmotic Diuretics

Answer 25

Example: mannitol (Osmitrol) Mechanism of action: inhibits carbonic anhydrase Primary use: to reduce ICP due to cerebral edema

Question 26

Thiazide and Thiazide-like Diuretics pt. teaching

Answer 26

Use sunscreen to decrease photosensitivity Take potassium supplements, if ordered Consume potassium-rich foods, if ordered Report any tenderness or pain in joints

Question 27

Normal osmolality is

Answer 27

275–295 mOsm/kg

Question 28

this electrolyte is controlled by hormone aldosterone

Answer 28

Na+

Question 29

Movement of water from area of | low osmolality to areas of high osmolality

Answer 29

osmosis

Question 30

Water moves from interstitial space to plasma

Answer 30

Hypertonic intravenous fluid

Question 31

Water moves from plasma to interstitial space

Answer 31

Hypotonic intravenous fluid

Question 32

IV solutions with electrolytes

Answer 32

crystalloids

Question 33

Molecules too large to easily cross capillary membrane Stay in intravascular space Rapidly expand plasma volume Draw water from intracellular fluid and interstitial spaces into plasma Increase osmotic pressure

Answer 33

colloids

Question 34

Fluid Replacement Agent class. drug

Answer 34

colloids

Question 35

to raise oncotic pressure of blood; expands plasma volume within minutes of administration Primary use: as fluid replacement with hypovolemic shock from hemorrhage, surgery, severe burns

Answer 35

colloids--> dextran

Question 36

Positively or negatively charged inorganic molecules

Answer 36

electrolytes

Question 37

electrolyte: Essential for maintaining: osmolality water balance acid–base balance

Answer 37

Na+

Question 38

Acute hypernatremia treated with: (if hypovolemic) (if hypervolemic)

Answer 38

- hypotonic intravenous fluids | - diuretics

Question 39

Signs and symptoms: Thirst, fatigue, weakness, muscle twitching Convulsions, altered mental status, decreased level of consciousness (electrolyte imbalance)

Answer 39

hypernatremia

Question 40

what happens in the body as a result of hyponatremia?

Answer 40

Caused by excessive dilution of plasma | Excess antidiuretic hormone (ADH) secretion

Question 41

Early symptoms Nausea, vomiting, anorexia, abdominal cramping Later signs Altered neurologic function such as confusion, lethargy, convulsions, coma, muscle twitching, tremors

Answer 41

hyponatremia

Question 42

Hyponatremia caused by excessive dilution: Treat with Hyponatremia caused by sodium loss Treat with

Answer 42

1- loop diuretics to cause an isotonic diuresis 2-oral sodium chloride or intravenous fluids containing salt * Normal saline * Lactated Ringer's

Question 43

Symptoms of Hyperkalemia

Answer 43

dysrhythmias and heart block

Question 44

Hypokalemia:Caused by

Answer 44

High doses of loop diuretics Strenuous muscle activity Severe vomiting or diarrhea

Question 45

Symptoms of Hypokalemia

Answer 45

Muscle weakness, lethargy, anorexia, dysrhythmias, cardiac arrest

Question 46

symptoms of acidosis

Answer 46

Lethargy, confusion, coma | Deep, rapid respirations in attempt to blow off excess acid

Question 47

symptoms of alkalosis

Answer 47

Nervousness, hyperactive reflexes, convulsions Slow, shallow respirations in attempt to retain acid

Question 48

Can be used for hypertensive emergencies during labor and delivery Can lower blood pressure instantaneously Half-life of only 2 minutes

Answer 48

nitroprusside IV

Question 49

Blood backs up into veins Causes peripheral edema and organ engorgement

Answer 49

r. sided HF

Question 50

Blood backs up into lungs Cough and shortness of breath result

Answer 50

l. sided HF

Question 51

More fibers are stretched, more forcefully they will contract

Answer 51

Frank–Starling law

Question 52

Drug of choice for heart failure Enhance excretion of sodium and water Lowers peripheral resistance and reduces blood volume Increases cardiac output

Answer 52

ACE inhibitors

Question 53

basic conduction of heart, ECG

Answer 53

atrial depolarization(p), ventricular depolar(qrs)., ventricular repolarization (T)