Pharm Ch 22 24 25 Wb

Front 1

The antidysrhythmic drug lidocaine is used mainly to treat ...

Back 1

ventricular dysrhythmias

Front 2

When monitoring a patient who is taking quinidine, the nurse recognizes that the possible adverse effect of this drug is ...

Back 2

gastrointesinal upset

Front 3

When administering amiodarone, the nurse should monitor for what adverse side effect?

Back 3

pulmonmary toxicity

Front 4

A primary use of verapamil is to treat what condition?

Back 4

Recurrent paroxysmal supraventricular tachycardia (PSVT)

Front 5

A patient is experiencing a rapid dysrhythmia, and the nurse is preparing to administer adenosine. What is the correct administration technique for this drug?

Back 5

It should be given as a fast intravenous push.

Front 6

If a drug has a prodysrhythmic effect, then the nurse must monitor the patient for ...

Back 6

new dysrhythmias

Front 7

Sinoatrial node intrinsic rate

Back 7

60 to 100 beats/min

Front 8

Atrioventricular node intrinsic rate

Back 8

40 to 60 beats/min

Front 9

Purkinje fibers intrinsic rate

Back 9

40 or fewer beats/min

Front 10

Mr. Killian, who has been diagnosed with hypertension, is hospitalized after a myocardial infarction (MI). To reduce the risk of sudden cardiac death in Mr. Killian, the physician prescribes a drug from which class? Why?

Back 10

Class II antidysrhythmics, or β-blockers, are indicated because they have been shown to significantly reduce the incidence of sudden cardiac death after myocardial infarction.

Front 11

Mr. Killian, who has been diagnosed with hypertension, is hospitalized after a myocardial infarction (MI). To reduce the risk of sudden cardiac death in Mr. Killian, the physician prescribes a drug. How would a history of asthma in Mr. Killian affect the drug choice?

Back 11

If Mr. Killian had asthma, use of most of the class II drugs would be contraindicated. Noncardioselective β-blockers block not only the β₁-adrenergic receptors in the heart but also the β₂-adrenergic receptors in the lungs. As a result, preexisting asthma could be worsened.

Front 12

Mr. Needham has a life-threatening ventricular tachycardia that has been resistant to treatment, and the physician has now prescribed what she calls a "last resort" drug. To what drug is she referring, and why is it considered a drug of last resort?

Back 12

Amiodarone is considered a drug of last resort. Although it is very effective, amiodarone can penetrate and concentrate in the adipose tisue of any organ in the body, where it may have unwanted effects. It may cause either hypothyroidism or hyperthyroidism, corneal microdeposits, pulmonary toxicity, and even dysrhythmias. Amiodarone has a very long half-life, and the side effects may take months to subside.

Front 13

Mr. Maxwell is a 50yr old school teacher being treated with lidocaine after an MI. He is very upset and says that he hates injections; he wants to know why he can't just take a pill. What do you tell him?

Back 13

Lidocaine must be injected intramuscularly or intravenously; when lidocaine is taken orally, the liver converts most of it to inactive metabolites.

Front 14

Mr. Maxwell is a 50yr old school teacher being treated with lidocaine after an MI. If Mr. Maxwell has a history of cirrhosis, would the dosage of the lidocaine be affected?

Back 14

Lidocaine is extensively metabolized in the liver. For patients in liver failure or with a history of cirrhosis, a dosage reduction of 50% is recommended.

Front 15

Mrs. Inez calls the health clinic complaining of chest pain and dizziness. She says she cannot remember whether she took her quinidine yesterday and wants to know whether she should take two doses today, especially because she is feeling so bad. What do you tell Mrs. Inez?

Back 15

Mrs. Inez should NOT double up on her medication. The physician should be contacted about the missed dose and about Mrs. Inez's symptoms of chest pain and dizziness, which are adverse effects of the quinidine.

Front 16

Jack, age 39, is taking diltiazem as part of his treatment for occasional PSVT. He also has a history of seizures. How do calcium channel blockers such as diltiazem work?

Back 16

As their name implies, they work by inhibiting the slow-channel pathways, or the calcium-dependent channels. As a result, they depress phase 4 depolarization, slow sinoatrial and atrioventricular nodal conduction rates, and thus reduce the incidence of paroxysmal supraventricular tachycardia (PSVT).

Front 17

Jack, age 39, is taking diltiazem as part of his treatment for occasional PSVT. He also has a history of seizures. What therapeutic effects are expected?

Back 17

Prevention or reduction of supraventricular rhythms.

Front 18

Jack, age 39, is taking diltiazem as part of his treatment for occasional PSVT. He also has a history of seizures. Is there a possible concern with drug interactions?

Back 18

Taking phenytoin, an anticonvulsant, along with diltiazem may result in reduced effectiveness of the calcium channel blocker.

Front 19

Jack, age 39, is taking diltiazem as part of his treatment for occasional PSVT. He also has a history of seizures. After 4 months of therapy, Jack experiences dizziness, dyspnea, and a very rapid heart rate and is taken to the emergency department. He is diagnosed with sustained PSVT, and intravenous verapamil does not help. What do you think would be tried next?

Back 19

The physician may prescribe adenosine, which is useful for the treatment of PSVT that has failed to respond to verapamil.

Front 20

High blood pressure associated with disease such as renal, pulmonary, endocrine, and vascular diseases is known as _________ hypertension.

Back 20

Secondary

Front 21

Another term for Primary or Essential hypertension

Back 21

Idiopathic

Front 22

A common adverse effect of adrenergic drugs involving a sudden drop in blood pressure when patients change position is known as _________ hypotension

Back 22

Orthostatic

Front 23

These drugs are used in the management of hypertensive emergencies

Back 23

Vasodilators

Front 24

Another term for Primary or Idiopathic hypertension

Back 24

Essential

Front 25

Elevated systemic arterial pressure for which no cause can be found is known as ________ hypertension.

Back 25

Primary

Front 26

The primary effect of these drugs is to decrease plasma and extracellular fluid volumes.

Back 26

Diuretics

Front 27

Drugs that are often used as first-line drugs in the treatment of both heart failure and hypertension are known by the acronym _______ inhibitors

Back 27

ACE

Front 28

A 46 yr old man has been taking clonidine for 5 months. For the last 2 months, his blood pressure has been normal. During this office visit, he tells the nurse that he would like to stop taking the drug. The nurse's best response would be ...

Back 28

"This drug should not be stopped suddenly; let's talk to your doctor."

Front 29

When administering angiotensin-converting enzyme (ACE) inhibitors, the nurse keeps in mind that adverse effects include ...

Back 29

fatigue
headaches
a dry cough

Front 30

A patient with type 2 diabetes mellitus has developed hypertension. The nurse knows that the blood pressure goal for this patient would be ....

Back 30

less than 120/80 mm Hg

Front 31

A patient is being treated for a hypertensive emergency. The nurse expects what drug to be used?

Back 31

sodium nitroprusside

Front 32

A patient in her eighth month of pregnancy has preeclampsia. Her blood pressure is 210/100 mm Hg this morning. This type of hypertension is classified as what kind of hypertension?

Back 32

Secondary

Front 33

Potent diuretics that act along the ascending limb of the loop of Henle; furosemide is an example.

Back 33

Loop diuretics

Front 34

Abbreviation for the term that describes an index of how well the kidneys are functioning as filters.

Back 34

GFR

Front 35

A general term for drugs that accelerate the rate of urine formation.

Back 35

Diuretics

Front 36

The main structural unit of the kidney.

Back 36

Nephron

Front 37

A term for diuretics that cause the body to lose potassium.

Back 37

Kaliuretic diuretics

Front 38

Diuretics that result in the diuresis of sodium and water and the retention of potassium; spironolactone is an example.

Back 38

Potassium-sparing diuretics

Front 39

Diuretics that act on the distal convoluted tubule, where they inhibit sodium and water reabsorption; HCTZ is an example.

Back 39

Thiazides

Front 40

Abbreviations for a class of diuretics that inhibit the enzyme carbonic anhydrase; acetazolamide is an example.

Back 40

CAIs

Front 41

Drugs that induce diuresis by increasing the osmotic pressure of the glomerular filtrate, which results in a rapid diuresis; mannitol is an example.

Back 41

Osmotic diuretics

Front 42

An abnormal intraperitoneal accumulation of fluid.

Back 42

Ascites