Pharm Exam #3 (Hypertension)

Question 1

Which calcium channel blocker can be given with a BP under 100 systolic?

Answer 1

nifedipine (only one that decreases BP)

Question 2

When should you hold beta blockers & calcium channel blockers?

Answer 2

when the heart rate is below 60 and the systolic blood pressure is below 100

Question 3

What is digoxin given for?

Answer 3

given for patients with systolic heart failure to create a more forceful contraction & decreases heart rate

Question 4

When giving digoxin what should you check for before administration?

Answer 4

check apical pulse for full 60 seconds (if heart rate less than 60, hold medication)

Question 5

What are symptoms of digoxin toxicity?

Answer 5

over 2.0 with symptoms of vision changes, nausea, and dizziness

Question 6

Who is at higher risk of digoxin toxicity?

Answer 6

older patients or patients with renal problems are at higher risk of digoxin toxicity

Question 7

Which low lab level increases risk of digoxin toxicity?

Answer 7

potassium below 3.5 increases risk of digoxin toxicity

Question 8

What symptom can be masked during beta blocker therapy?

Answer 8

hyperglycemia (bradycardia from beta blocker masks tachycardia from hyperglycemia)

Question 9

Nitroglycerin, nitroprusside, hydralazine, isosorbide, and minoxidil are examples of what type of medication?

Answer 9

vasodialators

Question 10

What should a patient avoid taking during vasodilator therapy?

Answer 10

a patient taking viagra (-afil) during vasodilator therapy can result in death

Question 11

When to stop nitroprusside therapy?

Answer 11

Systolic blood pressure is below 100 (or a drop by 30 mmHg)

Question 12

What are signs of low blood pressure during nitroprusside therapy?

Answer 12

lack of coordination
irritability
sweating
pallor

Question 13

What are normal side effects of nitroprusside? (Usually present after 1st dose)

Answer 13

headaches
orthostatic hypotension
hot flushing (facial redness)

Question 14

What is the #1 drug used for acute or worsening heart failure?

Answer 14

diuretics, which lowers blood pressure

Question 15

Which diuretics are K+ wasting?

Answer 15

furosemide and hydrochlorothiazide

Question 16

What is the first medication you should expect to give a patient with worsening crackles, new edema in legs, and rapid weight gain?

Answer 16

furosemide

Question 17

When to hold furosemide?

Answer 17

potassium less than 3.5

Question 18

What is the priority action for a patient with hypokalemia or hyperkalemia?

Answer 18

place on cardiac monitor

Question 19

What symptoms may indicate a potassium imbalance?

Answer 19

muscle ache, weakness, paresthesias

Question 20

How fast should potassium be given?

Answer 20

bag at rate of 1 hour or more (never push potassium IV)

Question 21

What are some patient teachings for diuretic therapy?

Answer 21

use sunblock
check weight daily
change positions slowly
take medication in the mornings
low sodium diet

Question 22

Angioedema and dry coughs are a symptom of which type of medications?

Answer 22

ACE inhibitors

Question 23

What should patients avoid while taking ACE and ARBs?

Answer 23

avoid pregnancy (teratogenic) & potassium rich foods

Question 24

Taking verapamil with grapefruit juice should be avoided because it causes what?

Answer 24

hypotension

Question 25

What are some adverse reactions to losartan therapy?

Answer 25

swelling of mouth, face, lips, tongue, and throat

Question 26

Headaches are a possible adverse effect of which drug?

Answer 26

nitroglycerin