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Pharmacology > Quiz 6 > Flashcards

Quiz 6 Flashcards

1
Q

Contraindication of captopril

A

Pregnancy: teratogonic
Salt substitues containing potassium
Potassium-sparing diuretics

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2
Q

Lorsatan side effects

A

dizziness, hypotension, electrolyte imbalance: Hyperkalemia
Fluid loss

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3
Q

Nursing interventions of losartan

A

Monitor electrolytes
Taper
Fall precautions
education on orthostatic hypotension

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4
Q

Which receptors does anti-adrenergics/sympatholytics include

A

Alpha 1 and beta 1 adrenergic blockers
Alpha 2 agonists

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5
Q

Side effects of beta adrenergic blockers

A

Hypotension, dizziness, fatigue, depression, sexual dysfunction, bradycardia

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6
Q

Side effects of Alpha 1 and beta 1 adrenergic blockers

A

Hypotension, bradycardia, dizziness,
Insomnia, sexual dysfunction
Nasal Congestion

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7
Q

Nursing interventions of beta-adrenergic blockers

A

VS
Tapering = rebound hypertension
Avoid OTC drugs without first checking with a health care provider

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8
Q

Nursing interventions for clonidine

A

Hypoactive bowel sounds
Take off old patch and rotate
Caution when standing up

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9
Q

Hydralazine, minoxidil
MOA

A

Direct-acting arteriolar vasodilatiors
Vasodilation of smooth muscles of blood vessels

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10
Q

Hydralazine side effects

A

Tachycardia (HR increases to compensate), palpitations, headache, dizziness, nasal congestion, edema, lupus-like symptoms
AKA Minoxidil

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11
Q

How can antihypertensives lower BP

A
  1. Decrease HR
  2. Dilate blood vessels
  3. Decrease fluid volume
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12
Q

Function of aldosterone

A

responsible for renal absorption of sodium & excretion of potassium

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13
Q

Adverse effects of captopril

A

Persistent cough: do not stop taking
Angioedema: life threatening, stop taking
Electrolyte imbalance
Hypotension
Hyperkalemia

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14
Q

MOA of captopril
What is it?

A

Vasodilation and fluid loss
ACE inhibitor

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15
Q

ACE vs ARBS

A

ACE inhibitors block the PRODUCTION of angio II, ARBs block the ACTIONS of angio II

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16
Q

MOA of losartan
What is it?

A

Vasodilation and fluid loss
ARBs (angiotensin receptor blockers)

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17
Q

Amlodipine MOA
What is it

A

Slow calcium channels in vascular smooth muscle
Causes vasodilation
Calcium channel blocker

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18
Q

Adverse effects of amlodipine

A

Flushing, headache, hypotension, peripheral edema

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19
Q

Nursing interventions of amlodipine

A

monitor VS
telemetry

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20
Q

What are anti-adrenergics/sympatholytics

A

Drugs that block the activation of adrenergic receptors

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21
Q

Types of beta-adrenergic blockers

A

Nonselective: inhibit beta 1 and beta 2 receptors
Cardioselective beta blockers: selective to beta 1

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22
Q

MOA of beta adrenergic blockers

A

Decreases heart rate by inhibiting beta 1 and beta 2 receptors

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23
Q

Nursing interventions for beta-adrenergic blockers

A

Hold for low BP
Hold if HR is lower than 60

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24
Q

Clonidine
Action
Administration type

A

Alpha 2 agonist
Stimulate alpha 2 receptors- cause vasodilation
PO and transdermal

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25
Adverse reactions to clonidine
Decreased peristalsis Decreased acid production
26
Nursing interventions for minoxidil
Seizure precautions, monitor weight, telemetry AKA hydralazine
27
What is variant (prinzmetal, vasospatic) angina?
occurs during rest
28
MOA nitroglycerin
Causes vasodilation & < O2 demand. > oxygen supply Decrease preload and afterload
29
Action of atenelol
Decreases HR=Decrease in O2 demand Block the action of epinephrine and norepinephrine
30
Function of coronary artery
Perfuse the heart (supply oxygen to the heart)
31
What is coronary artery disease
plaque buildup
32
Why can coronary artery disease lead to myocardial infarction (acute coronary syndrome)
Chest pain due to lack of O2 to the heart
33
What is classic angina (stable)
Occurs with predictable stress or exertion Ex walking up stairs
34
What is unstable angina (preinfarction)
Coronary atherosclerotic disease unpredictable regarding stress/exertion and intensity
35
Side effects of nitroglycerin
Headache, hypotension, and flushing
36
Routes of administration nitroglycerin
sublingual, IV, oral, topical
37
Routes of administration Nitro-Bid
Sublingual, IV
38
3x5 rule
take 3 tabs 5 min apart. Take 1 tab, let it absorb and wait 5 min if pain goes away you can stop, but if pain remains repeat after 3 tabs they might be having a heart attack
39
Long-acting nitrates
Isosorbide (Imdur)- BID Transderm-Nitro (nitroglycerin) 12 on, 12 off (put it on when going out and take it off when at home)
40
Long-acting nitrates caution
do no abruptly discontinue Taper-chest pain can come back = heart attack/spasms
41
Discontinuing of beta-blockers
tapering take daily
42
Nifedipine action
Relax coronary and peripheral arteries Take every day for prevention
43
Nifedipine adverse effects
relax tachycardia
44
Classic angina pectoris suggested steps for treatment
Step 1: Nitrates Step 2: + beta blockers Step 3: + calcium blockers Step 4: coronary artery bypass graft
45
Variant angina pectoris suggested steps for treatment
Step 1: nitrates/calcium blockers Step 2 + clacium blockers Step 3: coronary artery bypass graft
46
Causes of heart failure
Heart muscle weakens and enlarges Compensatory mechanisms fail Loses ability to pump blood adequately Lungs and periphery become congested
47
Nonpharmacologic treatment of heart failure
Limit salt and saturated fat intake. Limit or avoid alcohol intake; stop smoking. Perform mild exercise.
48
Positive inotropic
Increases myocardial contractility = strength
49
Side effects of digoxin
Bradycardia, cardiac dysrhythmias, anorexia, N/V/D, headache, blurred or yellow vision
50
Phosphodiesterase inhbitors MOA
Positive inotropic effects Vasodilation: decrease stress of the heart
51
Administration considerations of phosphodiesterase inhibitors
Only given IV for acute exacerbations decrease HR and BP
52
Pathophysiology of heart failure
High preload (volume) = > stretching of heart High afterload (pressure) = > pressure on heart
53
Laboratory tests-Diagnosis Heart failure
Atrial natriuretic peptide (ANP): natural diuretic Brain natriuretic peptide (BNP): natural diuretic
54
MOA digitalis/digoxin
Positive inotropic Negative chronotropic Negative dromotropic Increases stroke volume = > cardiac ouptut
55
Negative chronotropic
Slowing/decreasing heart rate (how many times it contracts in a minute)
56
Negative dromotropic
Decreases conduction. How fast nerve signals gets to the heart
57
Therapeutic range of digoxin
Heart failure: 0.5-0.8ng/ml (narrow range)
58
Digitalis toxicity side effects
slow -irregular pulse confusion headache delirium Green vision halos around dark objects NVD >2 ng/mL
59
Antidote of digoxin
digoxin immune FAB
60
How does hypokalemia affect the heart
Causes increases sensitivity to digoxin = digoxin toxicity
61
drug interactions of digoxin: antacids
Decrease digitalis absorption, causing increased excretion
62
Drug interactions of digoxin: glucocorticoids
Cause hypokalemia
63
Other agents used to treat heart failure
Beta blockers: decrease heart rate Diuretics ACE inhibitors
64
A patient is ordered to receive digoxin to treat congestive heart failure. The nurse is most concerned about which assessment finding? A. Heart rate 56 beats/min B. BP 138/90 mm Hg C. RR 21 breaths/min D. 1+ pitting edema of the lower extremities
A.Heart rate 56 beats/min
65
A nurse is preparing to administer digoxin to a patient. Which laboratory result is the nurse most concerned about? A. Sodium 140 mEq/L B. Potassium 3.0 mEq/L C. Digitalis level 1.8 ng/mL D. BNP 200 pg/mL
B. Potassium 3.0 mEq/L
66
A nurse is administering digoxin, 0.125 mg, to a patient. Which nursing interventions will the nurse implement? (Select all that apply.) A. Checking the apical pulse rate before administration. B. Monitoring the patient's serum digoxin level. C. Instructing patient to report pulse rate less than 60. D. Advising patient to avoid foods high in potassium. E. Always giving an antacid with digoxin to reduce GI distress.
Checking the apical pulse rate before admin Monitoring the pt's serum digoxin level Instructing pt to report pulse rate < than 60
67
MOA of medication of dysrhythmias
Blocks adrenergic sitmulation of the heart < myocardial excitability and strength < conduction velocity in cardiac tissue > recovery time of myocardium Suppresses automaticity
68
Adverse effects of antidysrhythmics
Cardiac dysrhthmias, chest pain, bradycardia, hypotension: dizziness, lightheadedness, CNS changes (weakness, dizziness)
69
Nursing interventions for dysrhythmias
VS ECG abnormal patterns Education: side effects and what to warn to provider Avoid alcohol, caffeine, and tobacco
70
MOA of sodium channel blocker
Decrease automaticity Slow conduction velocity Prolong refractory period (reduces influx of sodium into cells = slower, regular heart rhythm)
71
MOA beta-adrenergic blockers
< HR & BP and < fluid < blood glucose, < peristalsis and acid, and < RR (blocks impulse that may cause irregular heart rhythm, slows speed of impulses, increase recovery, prevent spontaneous action potentials)
72
MOA of potassium channel blockers
Prolong action potential duration Prolong repolarization (prolong relaxation stage of action potential)
73
MOA of calcium channel blockers
Slow conduction velocity (slows down the speed of an electrical impulse) Prolong refractory period (prolong recovery phase, phase after a neuron has fired action potential)
74
What is hemodynamic shock
Severe hypotension that leads to a decreased perfusion
75
Drugs that can be used to treat shock
Dopamine, epinephrine Increases contractility and heart rate thus increasing blood pressure

Pharmacology (10 decks)

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