Pharmacology Test 2 Flashcards

Front 1

• Antilipemics and drug-food interactions

Back 1

Grapefruit juice results in sustained levels of unmetabolized statin drug, increasing the risk for major drug toxicity: ie rhabdomyolysis.

Front 2

• Nursing implications for HMG-CoA reductase inhibitors

Back 2

Monitor for muscle pain and possible myopathy

Front 3

time frame for response to statin drugs

Back 3

it may take several weeks to see a change in cholesterol levels with statins

Front 4

adverse effects of fibric acid derivatives

Back 4

Abdominal discomfort, diarrhea, nausea; blurred vision, headache; increased risk of gallstones; prolonged prothrombin time; liver studies may show increased function

Front 5

recommended analgesic for pt on coumadin

Back 5

paracetamol/codeine combinations are least likely to upset warfarin control
NSAIDs

Front 6

herbals to avoid with coumadin

Back 6

capsicum pepper, garlic, ginger, gingko, ginseng, feverfew

Front 7

correct administration of heparin

Back 7

subcutaneously or via IV

Front 8

antidote for coumadin

Back 8

vitamin k

Front 9

use of persantine

Back 9

Dipyridamole (Persantine) can be used with warfarin to prevent postoperative thromboembolic complications
Also for diagnosis of cardiac disease when they can’t exercise

Front 10

reason for use of coumadin with heparin

Back 10

Initially the pt will be given heparin to achieve therapeutic effects
Coumadin is started after therapeutic effects from the heparin because it takes 4-5 days for Coumadin to have a therapeutic anticoagulation level.

Front 11

use of fresh frozen plasma

Back 11

increase clotting factor levels in pts with demonstrated deficiency (coagulation disorders)

Front 12

correct administration of potassium IV

Back 12

must always be given diluted

Front 13

contraindications to potassium supplements

Back 13

Any known allergy to a specific drug product, hyperkalemia from any cause, severe renal disease, acute dehydration, untreated addison’s disease, severe hemolytic disease, and conditions involving extensive tissue breakdown

Front 14

action of loop diuretics

Back 14

block the chloride pump in the ascending loop of henle, causing reabsorption of sodium and chloride

Front 15

teaching for a pt taking a diuretic

Back 15

Instruct pt to take meds in the morning as much as possible to avoid interference with sleep patterns, to maintain proper nutritional and fluid volume status; to eat more potassium rich foods when taking any but the potassium sparing drugs; how to monitor for digitalis toxicity; diabetic pts who are taking thiazide and/or loop diuretics should be told to monitor blood glucose and watch for elevated levels; teach to change positions slowly; encourage to keep a log of their daily weight

Front 16

side effects of aldactone

Back 16

headache, fatigue, cramps, nausea, vomiting, diarrhea, urinary frequency, weakness, hyperkalemia

Front 17

initial diuretic used for hypertension

Back 17

low dose thiazide

Front 18

interventions to minimize adverse reactions to nicotinic acid

Back 18

Small doses of aspirin or nonsteroidal anti-inflammatory drugs may be taken 30 minutes before niacin to minimize the cutaneous flushing
Start pts on a low initial dosage and increase it gradually and have patients take the drug with meals

Front 19

antihypertensive agent with renal-protective effects

Back 19

ACE inhibitor: enalapril and captopril

Front 20

medication used to treat eclampsia

Back 20

magnesium sulfate

Front 21

teaching regarding antihypertensive medications

Back 21

Pt will begin…
Taking drug therapy as soon as possible after prescription given
Initiate lifestyle changes to decrease blood pressure
Take medication every day even if feeling perfectly fine
State that blood pressure therapy is life-long
Report any sexual dysfunction (impotence) to the physician promptly so that other options can be explored

Front 22

nursing diagnoses associated with antihypertensives

Back 22

Deficient knowledge related to new prescribed drug regimen and lack of familiarity with medications and lifestyle changes.
-Noncompliance with drug therapy related to lack of familiarity with or acceptance of the disease process
-Sexual dysfunction related to adverse effects of some antihypertensive drugs
-Risk for injury related to adverse effects of the antihypertensive drug such as dizziness, orthostatic hypotension, and syncope
-acute pain related to headache as an adverse effect of drug therapy
-ineffective tissue perfusion r/t the impact of the disease process or possible severe hypotensive adverse effects of drug therapy
-Excess fluid volume r/t adverse effects of edema
-Imbalanced nutrition, less than body requirements, related to the drug’s adverse effects
-constipation related to adverse effects of antihypertensive drugs
-risk for injury r/t possible CNS adverse effects such as paresthesia, sedation, tremors, weakness and seizures
-risk for injury to mucous membranes r/t the adverse effects of the medication and decreased saliva
-disturbed body image r/t adverse effects of antihypertensives.

Front 23

arterial blood pressure

Back 23

cardiac output and vascular resistance determine regulation of arterial blood pressure

Front 24

recommended antihypertensive for a pt with liver dysfunction

Back 24

captopril and lisinopril

Front 25

correct administration of topical nitroglycerin

Back 25

Nitroglycerin ointment in a tube is measured carefully on clean, ruled application paper before it is applied to the skin. Unit-dose packages should not be measured. Do not massage nitroglycerin ointment into the skin. Apply the measured amount onto a clean, dry site and then secure the application paper with a transparent dressing or a strip of tape. Always remove the old medication before applying a new dose.

Front 26

antidysrhythmics nursing assessment

Back 26

Obtain a thorough drug and medical history
n Measure baseline BP, P, I&O, and cardiac rhythm
n Measure serum potassium levels before initiating therapy
n Assess for conditions that may be contraindications for use of specific drugs
n Assess for potential drug interactions
n Instruct patients regarding dosing schedules and adverse effects to report to physician
n During therapy, monitor cardiac rhythm, heart rate, BP, general well-being, skin color, temperature, heart and lung sounds
n Assess plasma drug levels as indicated
n Monitor for toxic effects

Front 27

lidocaine side effects

Back 27

CNS toxicities such as twitching, convulsions and confusion
Respiratory depression or arrest
Hypotension, bradycardia and dysrhythmias

Front 28

teaching regarding quinidine sulfate ER

Back 28

do not crush pill.
may experience cinchonism: tinnitus, loss of hearing, slight blurring of vision, and GI upset

Front 29

adverse effects of procainamide

Back 29

Ventricular dysrhythmias and blood disorders.
Can cause Lupus erythematosus-like syndrome with long-term therapy
GI effects but are less intense than those produced by quinidine
Fever, leucopenia, maculopapular rash, urticaria, pruritus, flushing and torsades de pointes resulting from prolongation of the QT interval

Front 30

drug interactions with digoxin

Back 30

Thiazide Diuretics increase the risk of dig toxicity

o Bile acid sequestrants

o HMG-CoA inhibitors

-Alpha agonists

Front 31

treatment of overdose of ergotamine tartrate

Back 31

Pt’s stomach should be emptied immediately, either by inducing emesis or by gastric lavage.
Activated charcoal should be administered to bind to the drug and remove it from the stomach and the circulation. First dose should be given with a cathartic such as sorbitol.
Blood pressure support and anticonvulsants can also be implemented if needed.

Front 32

normal dig levels

Back 32

0.5-2.0 ng/mL

Front 33

conditions that predispose a pt to digoxin toxicity

Back 33

Use of cardiac pacemaker
Hepatic dysfunction
Hypokalemia
Hypercalcemia
Atrioventricular block
Dysrhythmias
Hypothyroid, respiratory or renal disease
Advanced age
Ventricular fibrillation

Front 34

adverse effects of anticholinergic drugs

Back 34

Blurred vision, mydriasis, cycloplegia, photophobia, palpitations and bradycardia, dry mouth and altered taste perception, urinary hesitancy and retention, decreased sweating and predisposition to heat prostration

Front 35

teaching regarding anticholinergic drugs

Back 35

Teach pt to limit physical exertion and avoid high temperatures and strenuous exercise, the importance of adequate fluid and salt intake, teach pt advantages of synthetic derivatives of the drugs (fewer adverse effects)

Front 36

advantages to synthetic versions of drugs

Back 36

fewer adverse effects

Front 37

antidote for anticholinergic drugs

Back 37

physostigmine

Front 38

teaching regarding cholinergic drugs to pts with myasthenia gravis

Back 38

encourage pts with myasthenia gravis to take meds 30 minutes before eating to helpt improve chewing and swallowing

Front 39

therapeutic effects of cholinergic drugs

Back 39

Often called parasympathetic drugs because their action mimics that of the PSNS so they increase the activity of acetylcholine receptor sites throughout the body
Since they are not limited to a specific site, cholinergics are associated with many undesirable effects

Front 40

use of direct-acting cholinergic drugs

Back 40

Occupy receptor sites for Ach on the membranes of the effector cells of the prostaganglionic cholinergic nerves
Cause increased stimulation of the cholinergic receptor

Front 41

beta blocker teaching

Back 41

Change positions slowly to prevent or minimize postural hypotension
Avoid alcohol ingestion and hazardous activities until blood levels become stable
-They may decrease in their tolerance for exercise; dizziness and fainting may occur with increased activity. Notify the physician if these problems occur.
-should report weight gain of more than 2 pounds in 1 day or 5 pounds in a week; edema of the feet or ankles; shortness of breath; excessive fatigue or weakness; syncope or dizziness.

Front 42

treatment of diastolic dysfunction heart failure

Back 42

carvedilol (coreg)

Front 43

medication given to pt that is post-MI

Back 43

beta-adrenergic blocking agents

Front 44

adrenergic drugs stimulate this type of receptors

Back 44

adrenergic receptor: alpha or beta receptors

Front 45

teaching regarding salmeterol

Back 45

used for prevention of bronchospasms NOT for acute symptoms

Front 46

teaching regarding pseudoephedrine

Back 46

excessive use can cause a "rebound effect" characterized b y greater congestion

Front 47

inotropic effect

Back 47

heart rate increases: a positive inotropic effect
stimulate the beta-receptors in the sympathetic nervous system, increase calcium flow into them myocardial cells and causing increased contraction

Front 48

normal sodium levels

Back 48

135-145

Front 49

normal chloride levels

Back 49

96-106

Front 50

normal potassium levels

Back 50

3.5-5

Front 51

normal levels of calcium

Back 51

8.5-10

Front 52

normal levels of magnesium

Back 52

1.8-2.5

Front 53

normal levels of phosphate

Back 53

: 85% is found in bones. Should form a 1:2 ratio with calcium. Drinking lots of soda (which contains phosphorus) can leach calcium from the bones.