Pharmacology Test 2 Part A

Front 1

A 45 year old female is taking oral Digoxin and complains of
constipation. She asks the nurse if she may eat bran for constipation. How
should the nurse respond?

Back 1

Digoxin may be administered with meals but not with foods high in fiber
because the fiber will bind to the digitalis, which will make less drug available
for absorption.”

Front 2

What is the antidote for severe Digitalis toxicity

Back 2

digoxin immune Fab (Digibind).
Tabe 21-2 on pg 349

Front 3

75 year old male is admited with congestive heart failure. His cardiologist
prescribes Lanoxin (Digoxin) PO 0.125 mg daily. The nurse takes his pulse and finds that his pulse is 55. What should the nurse do?

Back 3

notify the physician for a pulse below 60 beats per minute

Front 4

What would be a contraindication for patients taking ACE inhibitors

Back 4

known drug allergy, esp a previous reaction of angioedema (laryngeal swelling) with an ACE inhibitor. a baseline potassium of 5.0 mEq/L or greater because these drugs can promote hyperkalemia

Front 5

What are the common side effects of Angiotension-converting enzyme (ACE)
inhibitors?
part 1

Back 5

fatigue, dizziness, mood changes, and headaches. A characteristic dry, nonproductive cough is reversible with discontinuation
of the therapy. A first dose hypotension effect: significant decline in BP

Front 6

What are the common side effects of Angiotension-converting enzyme (ACE)
inhibitors?
part 2

Back 6

loss of
taste, proteinuria, hyperkalemia, rash, pruritus, anemia, neutropenia, thrombocytosis,
and agranulocytosis

Front 7

What are some of the therapeutic uses or indications for Calcium
Channel Blockers?

Back 7

HTN, angina, supraventricular tachycardia, atrial fib & flutter (short term),
migraines, Raynaud's disease

Front 8

What are common side effects of Calcium Channel Blockers

Back 8

Hypotension, palpitations, tachycardia or bradycardia, heart failure, Constipation, nausea, Dermatitis, dyspnea, rash, fllushing, peripheral edema, wheezing

Front 9

What are the drug effects of Angiotension-converting enzyme inhibitors like Captopril

Back 9

Decreases blood pressure and decreases systemic vascular resistance (SVR); Prevents sodium and water resorption, inhibits aldosterone secretion and inhibits
potassium resorption

Front 10

What is the
mechanism of action of Angiotensin II Receptor Blockers (ARBs) like Cozaar?

Back 10

ARBs act by blocking the binding of AII to type 1 AII receptors (AT 1 receptors).
[Page 407]

Front 11

What are examples of other Angiotensin II Receptor Blockers (ARBs)?

Back 11

Eprosartan (Teveten), Valsartan (Diovan),
Irbesartan (Avapro), Losartan (Cozaar), Candesartan (Atacand), Olmesartan (Benicar), Telmisartan (Micardis). [Page 407]

Front 12

What are signs of a hypersensitive reaction to an ACE inhibitor?

Back 12

Angioedema (laryngeal swelling) pg 405
Mouth sores, fever, swelling of the hands or feet, palpations, or irregular heartbeats, and chests pain. pg 415

Front 13

What are 4 examples of drugs that are Beta-Blockers?

Back 13

Atenolol, metoprolol, nadolol, propanolol

Front 14

What medical conditions would Beta-Blockers worsen?

Back 14

Asthma, Systolic Heart Failure, Depression, Diabetes Mellitus, COPD, Peripheral
Vascular Disease

Front 15

side effects of antidysrhythmic agents such as quinidine are:

Back 15

nausea, vomiting, blurred vision, dizziness, headache,
and dysrhthmic effects.

Front 16

how should quinidine sulfate extended-release
tablets be taken?

Back 16

should not be crushed or chewed when ingesting.This medicine should be taken as directed/not exceed 4 g/day.

Front 17

A patient has been started on therapy with lidocaine. What side effects will the nurse monitor in this patient?

Back 17

nausea, vomiting, diarrhea/ blurred vision/dizziness and headache/dysrhythmis effect

Front 18

What is the MOA of the thrombolytics

Back 18

They can activate the fibrolytic system to break down a clot in the blood vessel.They accomplish this by activating the conversion of plasminogen to plasmin, which breaks down the thrombus.(Plasmin is a proteolytic enzyme, meaning it breaks down clots.) These drugs work by mimicking the body's own process of clot destruction.

Front 19

What are their drug effects and therapeutic uses of the thrombolytics

Back 19

They stimulate the firbronolytic system to lyse the preformed clots and their action is limited solely to the fibrinolytic system.

Front 20

Indications for thrombolytics

Back 20

Acute MI, arterial thrombosis, DVT, occlusion of shunts or catheters or
PE.

Front 21

What is the MOA of desmopressin part 1

Back 21

Desmopressing increases the resorption of water by the collecting ducts in the
kidneys, resulting in increased urine osmolality and decreased urinary flow.

Front 22

What is the MOA of desmopressin part 2

Back 22

Causes dose dependent increase in the concentration of plasma factor VIII, along with an increase in the plasma concentration of tissue plasminogen activator.

Front 23

What is the MOA of desmopressin part 3

Back 23

Overall effects of this is
increased platelet aggregation and clot formation.

Front 24

What action is recommended to help reduce the tolerance that often develops with
transdermal nitroglycerin therapy

Back 24

provide a regular nitrate-free period (usually overnight) which allow certain enzyme pathways to replenish

Front 25

What is the reason for her receiving two anticoagulants such as warfarin and coumadin

Back 25

Coumadin is taken orally and is absorbed much slower than heparin which is given Sub Q
or IV. So heparin is used while waiting for the full anticoagulant effect of warfarin to take place

Front 26

how long does it take for the full theraputic effects of oral anticoagulants to take place?

Back 26

4-5 days after the first dose

Front 27

what should be done when a person prescribed nitroglycerin suffers from acute anginal attack

Back 27

take one
sublingual tablet ASAP, lie down and remain calm and rest

Front 28

If there is no relief from an acute anginal attack once 3 sublingual nitro tabs are taken after 15 minutes, what should the person do?

Back 28

call emergency

Front 29

How should sub lingual nitro tabs be taken?

Back 29

Never chew or swallow the pills b/c it interferes with the action and effectiveness of the drug. The tablet should be placed under the tongue and allowed to dissolved.

Front 30

what does it mean if sublingual nitro tabs burn when placed under the tongue?

Back 30

If the pill causes a burning
sensation under the tongue the drug is still potent

Front 31

what type of drug isdigoxin?

Back 31

This drug is a cardiac glycoside

Front 32

how does digoxin work? part 1

Back 32

it improves myocardial
contractility. It accomplishes this by inhibiting the sodium pump, thus increasing sodium
and calcium.

Front 33

part 2

Back 33

also has the capability of changing the electrical conduction properties of the heart by decreasing velocity of electrical conduction/ prolong the refractory period in the conduction system

Front 34

how does one know if digoxin is working?

Back 34

decrease in pul. edema/ pul. hypertension/ r-sided vent. failure/ decrease in atrial flutters and fibrillation.

Front 35

What is the mechanism of action of Desmopressin part 1

Back 35

increase resorption of water by the collecting ducts in the kidneys, resulting in increased urine osmolality and a decreased urinary flow
rate.

Front 36

What is the mechanism of action of Desmopressin part 2

Back 36

causes a dose-dependent increase in the concentration of plasma factor VIII (von Willebrand factor), and an increase in the plasma concentration of tissue plasminogen activator

Front 37

What are examples of HMG-CoA Reductase inhibitors

Back 37

lovastatin, pravastatin, simvastatin, atorvastatin, cerivastatin, and fluvastatin

Front 38

What are the drug effects of HMG-CoA Reductase inhibitors

Back 38

these statins inhibit HMG-CoA reductase, which is the rate-limiting enzyme in the reactions needed to make cholesterol, and therefore decrease cholesterol production in the liver

Front 39

What should the nurse monitor for side effects in HMG-CoA Reductase inhibitors

Back 39

GI-constipation, heartburn, nausea, belching, bloating
other-bleeding, headache, tinnitus, burnt odor of urine

Front 40

What are some therapeutic uses of ACE inhibitors part 1

Back 40

They are antihypertensives and adjunctive agents for treatment of heart failure.
They also have a nephro protective effect on kidneys.

Front 41

What are some therapeutic uses of ACE inhibitors part 2

Back 41

They decrease plasma volume and filling pressures (preload).They decrease SVR which means a decreased afterload.

Front 42

What are 6 examples of drugs that are ACE inhibitors

Back 42

captopril (Capoten), benazepril (Lotesin), enalapril (Vasotec), fosinopril (Monopril),
lisinopril (Prinivil, Zestril), moexipril (Univasc)

Front 43

What side effects will the nurse monitor for lidocaine

Back 43

CNS toxicity (twitch, convulsion, confusion), respiratory depression,
hypotension, bradycardia, dysrhythmia,nausea,vomiting, dizziness,headache, blurred vision