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43 Cards in this Set

  • Front
  • Back
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?
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.”
What is the antidote for severe Digitalis toxicity
digoxin immune Fab (Digibind).
Tabe 21-2 on pg 349
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?
notify the physician for a pulse below 60 beats per minute
What would be a contraindication for patients taking ACE inhibitors
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
What are the common side effects of Angiotension-converting enzyme (ACE)
part 1
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
What are the common side effects of Angiotension-converting enzyme (ACE)
part 2
loss of
taste, proteinuria, hyperkalemia, rash, pruritus, anemia, neutropenia, thrombocytosis,
and agranulocytosis
What are some of the therapeutic uses or indications for Calcium
Channel Blockers?
HTN, angina, supraventricular tachycardia, atrial fib & flutter (short term),
migraines, Raynaud's disease
What are common side effects of Calcium Channel Blockers
Hypotension, palpitations, tachycardia or bradycardia, heart failure, Constipation, nausea, Dermatitis, dyspnea, rash, fllushing, peripheral edema, wheezing
What are the drug effects of Angiotension-converting enzyme inhibitors like Captopril
Decreases blood pressure and decreases systemic vascular resistance (SVR); Prevents sodium and water resorption, inhibits aldosterone secretion and inhibits
potassium resorption
What is the
mechanism of action of Angiotensin II Receptor Blockers (ARBs) like Cozaar?
ARBs act by blocking the binding of AII to type 1 AII receptors (AT 1 receptors).
[Page 407]
What are examples of other Angiotensin II Receptor Blockers (ARBs)?
Eprosartan (Teveten), Valsartan (Diovan),
Irbesartan (Avapro), Losartan (Cozaar), Candesartan (Atacand), Olmesartan (Benicar), Telmisartan (Micardis). [Page 407]
What are signs of a hypersensitive reaction to an ACE inhibitor?
Angioedema (laryngeal swelling) pg 405
Mouth sores, fever, swelling of the hands or feet, palpations, or irregular heartbeats, and chests pain. pg 415
What are 4 examples of drugs that are Beta-Blockers?
Atenolol, metoprolol, nadolol, propanolol
What medical conditions would Beta-Blockers worsen?
Asthma, Systolic Heart Failure, Depression, Diabetes Mellitus, COPD, Peripheral
Vascular Disease
side effects of antidysrhythmic agents such as quinidine are:
nausea, vomiting, blurred vision, dizziness, headache,
and dysrhthmic effects.
how should quinidine sulfate extended-release
tablets be taken?
should not be crushed or chewed when ingesting.This medicine should be taken as directed/not exceed 4 g/day.
A patient has been started on therapy with lidocaine. What side effects will the nurse monitor in this patient?
nausea, vomiting, diarrhea/ blurred vision/dizziness and headache/dysrhythmis effect
What is the MOA of the thrombolytics
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.
What are their drug effects and therapeutic uses of the thrombolytics
They stimulate the firbronolytic system to lyse the preformed clots and their action is limited solely to the fibrinolytic system.
Indications for thrombolytics
Acute MI, arterial thrombosis, DVT, occlusion of shunts or catheters or
What is the MOA of desmopressin part 1
Desmopressing increases the resorption of water by the collecting ducts in the
kidneys, resulting in increased urine osmolality and decreased urinary flow.
What is the MOA of desmopressin part 2
Causes dose dependent increase in the concentration of plasma factor VIII, along with an increase in the plasma concentration of tissue plasminogen activator.
What is the MOA of desmopressin part 3
Overall effects of this is
increased platelet aggregation and clot formation.
What action is recommended to help reduce the tolerance that often develops with
transdermal nitroglycerin therapy
provide a regular nitrate-free period (usually overnight) which allow certain enzyme pathways to replenish
What is the reason for her receiving two anticoagulants such as warfarin and coumadin
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
how long does it take for the full theraputic effects of oral anticoagulants to take place?
4-5 days after the first dose
what should be done when a person prescribed nitroglycerin suffers from acute anginal attack
take one
sublingual tablet ASAP, lie down and remain calm and rest
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?
call emergency
How should sub lingual nitro tabs be taken?
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.
what does it mean if sublingual nitro tabs burn when placed under the tongue?
If the pill causes a burning
sensation under the tongue the drug is still potent
what type of drug isdigoxin?
This drug is a cardiac glycoside
how does digoxin work? part 1
it improves myocardial
contractility. It accomplishes this by inhibiting the sodium pump, thus increasing sodium
and calcium.
part 2
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
how does one know if digoxin is working?
decrease in pul. edema/ pul. hypertension/ r-sided vent. failure/ decrease in atrial flutters and fibrillation.
What is the mechanism of action of Desmopressin part 1
increase resorption of water by the collecting ducts in the kidneys, resulting in increased urine osmolality and a decreased urinary flow
What is the mechanism of action of Desmopressin part 2
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
What are examples of HMG-CoA Reductase inhibitors
lovastatin, pravastatin, simvastatin, atorvastatin, cerivastatin, and fluvastatin
What are the drug effects of HMG-CoA Reductase inhibitors
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
What should the nurse monitor for side effects in HMG-CoA Reductase inhibitors
GI-constipation, heartburn, nausea, belching, bloating
other-bleeding, headache, tinnitus, burnt odor of urine
What are some therapeutic uses of ACE inhibitors part 1
They are antihypertensives and adjunctive agents for treatment of heart failure.
They also have a nephro protective effect on kidneys.
What are some therapeutic uses of ACE inhibitors part 2
They decrease plasma volume and filling pressures (preload).They decrease SVR which means a decreased afterload.
What are 6 examples of drugs that are ACE inhibitors
captopril (Capoten), benazepril (Lotesin), enalapril (Vasotec), fosinopril (Monopril),
lisinopril (Prinivil, Zestril), moexipril (Univasc)
What side effects will the nurse monitor for lidocaine
CNS toxicity (twitch, convulsion, confusion), respiratory depression,
hypotension, bradycardia, dysrhythmia,nausea,vomiting, dizziness,headache, blurred vision