Pharm Exam #3 (Hypertension) Flashcards
Which calcium channel blocker can be given with a BP under 100 systolic?
nifedipine (only one that decreases BP)
When should you hold beta blockers & calcium channel blockers?
when the heart rate is below 60 and the systolic blood pressure is below 100
What is digoxin given for?
given for patients with systolic heart failure to create a more forceful contraction & decreases heart rate
When giving digoxin what should you check for before administration?
check apical pulse for full 60 seconds (if heart rate less than 60, hold medication)
What are symptoms of digoxin toxicity?
over 2.0 with symptoms of vision changes, nausea, and dizziness
Who is at higher risk of digoxin toxicity?
older patients or patients with renal problems are at higher risk of digoxin toxicity
Which low lab level increases risk of digoxin toxicity?
potassium below 3.5 increases risk of digoxin toxicity
What symptom can be masked during beta blocker therapy?
hyperglycemia (bradycardia from beta blocker masks tachycardia from hyperglycemia)
Nitroglycerin, nitroprusside, hydralazine, isosorbide, and minoxidil are examples of what type of medication?
vasodialators
What should a patient avoid taking during vasodilator therapy?
a patient taking viagra (-afil) during vasodilator therapy can result in death
When to stop nitroprusside therapy?
Systolic blood pressure is below 100 (or a drop by 30 mmHg)
What are signs of low blood pressure during nitroprusside therapy?
lack of coordination
irritability
sweating
pallor
What are normal side effects of nitroprusside? (Usually present after 1st dose)
headaches
orthostatic hypotension
hot flushing (facial redness)
What is the #1 drug used for acute or worsening heart failure?
diuretics, which lowers blood pressure
Which diuretics are K+ wasting?
furosemide and hydrochlorothiazide
What is the first medication you should expect to give a patient with worsening crackles, new edema in legs, and rapid weight gain?
furosemide
When to hold furosemide?
potassium less than 3.5
What is the priority action for a patient with hypokalemia or hyperkalemia?
place on cardiac monitor
What symptoms may indicate a potassium imbalance?
muscle ache, weakness, paresthesias
How fast should potassium be given?
bag at rate of 1 hour or more (never push potassium IV)
What are some patient teachings for diuretic therapy?
use sunblock
check weight daily
change positions slowly
take medication in the mornings
low sodium diet
Angioedema and dry coughs are a symptom of which type of medications?
ACE inhibitors
What should patients avoid while taking ACE and ARBs?
avoid pregnancy (teratogenic) & potassium rich foods
Taking verapamil with grapefruit juice should be avoided because it causes what?
hypotension
