What to watch for when taking drugs

Question 1

What to watch for when taking Calcium Channel Blocker’s (CCB’s)

Answer 1

Heart Rate:
Check for bradycardia (slow heart rate) or tachycardia (fast heart rate), especially with non-dihydropyridines like verapamil and diltiazem.

Cardiac Assessment
Electrocardiogram (ECG): Monitor for changes in cardiac rhythm, particularly if the patient is at risk for arrhythmias.
Signs of Heart Failure: Assess for symptoms such as shortness of breath, edema, and weight gain, which may indicate worsening heart failure.

Fluid Status
Edema: Check for peripheral edema, a common side effect, especially with dihydropyridines like amlodipine and nifedipine.
Weight: Monitor daily weights to detect fluid retention.

Medication Side Effects
Gastrointestinal Symptoms: Assess for constipation (common with verapamil) and nausea.
Flushing and Headaches: Common with dihydropyridines.
Gingival Hyperplasia: Overgrowth of gum tissue can occur, particularly with long-term use of dihydropyridines.

Patient Education
Compliance: Ensure the patient understands the importance of taking the medication as prescribed.
Lifestyle Modifications: Encourage dietary changes, regular exercise, and smoking cessation to enhance the effectiveness of the medication.
Orthostatic Hypotension: Educate the patient to rise slowly from sitting or lying positions to prevent dizziness and falls.

Laboratory Monitoring
Liver Function Tests (LFTs): Periodically assess liver function, as some CCBs are metabolized by the liver.
Renal Function: Check kidney function, particularly if the patient has underlying kidney disease.

Drug Interactions
Other Medications: Review all medications the patient is taking to assess for potential drug interactions, particularly with other antihypertensives, digoxin, or beta-blockers.
Symptoms of Overdose
Severe Hypotension
Bradycardia
Dizziness or Syncope
Regular follow-ups and communication between the patient and healthcare provider are essential to manage therapy effectively and to address any issues promptly.

Question 2

What about dopamine vs Dobutamine

Answer 2

Dopamine can be given in cases of low kidney perfusion.
Dobutamine can be given during hypertension because it effects B2 alot

Question 3

Diuretics and what to watch for

Answer 3

1. Always check potassium as it will allow you to differentiate
2. Then check the rest of the electrolytes to differentiate as listed in the picture