HSC1149 - Pharmacology for Nurse

Beschreibung

Exam 3 Review Q&A's
Kimberly Marie'M
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Kimberly Marie'M
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Frage Antworten
Concerning side effects of Omega 3 Fatty Acids Increased LDL
What is given to decrease cutaneous flushing? Small doses of aspirin or NSAIDs may be taken 30 minutes before niacin to minimize cutaneous flushing
Why treat with Anticoagulants? 1. To prevent strokes in patients with a.fib 2. To treat thrombosis in myocardial infarction (MI) 3. To prevent or treat a deep vein thombosis (DVT) or a pulmonary embolism (PE)
Why treat increased cholesterol? Because it increases risk of CHD(Coronary Heart Disease)
Good Lipoprotein HDL (High-density lipoprotein)
Bad Lipoproteins VLDL (Very-low-density lipoprotein) LDL (Low-density lipoprotein)
LDL Goal <100 is optimal
HDL Goal (Women/Men) Women: ≥ 40 Men: ≥ 50
Mechanism of Action of Statins 1. Inhibit HMG-CoA reductase, which is used by the liver to produce cholesterol 2. Lower the rate of cholesterol production
Side effects of Statins 1. Mild, transient GI disturbances 2. Rash 3. Headache 4. Myopathy (muscle pain) 5. Elevations in liver enzymes or liver disease Rhabdomyolysis (=breakdown of muscle)
Main adverse effect of anticoagulants Bleeding
Unfractionated Heparin mechanism of action Binds to antithrombin and increases its potency
Enoxaparin (Lovenox) & Dalteparin (Fragmin) Class? Low Molecular Weight Heparin (LMWH)
Antidote for Unfractionated Heparin (UFH) Protamine Sulfate
Vitamin K dependent clotting factors II, VII, IX, X (“SN0T”)
Antidote for Warfarin (Coumadin) Vitamin K
Drug interactions for Coumadin 1. Amiodarone (Cordarone®) 2. Levofloxacin (Levaquin®) 3. Ciprofloxacin(Cipro®) 3. Sulfamethoxazole/Trimethoprim 4. (Bactrim®) 5. Metronidazole (Flagyl®) 6. Fluconazole (Diflucan®)
Dabigatran (Pradaxa) Dose 150 mg PO BID or 75 mg PO BID
Advantages of NOAC’s (New OralAnticoagulants) 1. Do not have to monitor INR (finger stick) 2. Start working immediately (warfarin takes 5 days) 3. No interactions with food
What do active platelets release? 1. Thromboxane A2 2. Adenosine Diphosphate (ADP)
Aggrenox is a combination of what two drugs? Aspirin 25mg + Dipyridamole 200mg
Brilinta is recommended for what disease? Why is use an issue? 1. Recommended1st Line to prevent/treat MI 2. Expense is an issue
Max Alteplase Dose 90mg
Thrombolytics treat what? Only used to treat thrombotic events, never used for prophylaxis
Unfractionated Loading/Maintenance Heparin Doses for PE Loading Dose - 80 units/kg (in test question pt is 70kg = dose of 5,600 unit) Maintenance Dose - 18 units/kg (in test question pt is 90kg = dose of 1,620 units)
What contributes to BP? 1. CO = cardiac output 2. SVR = systemic vascular resistance
Typical cutoff that defines Hypertension Systolic <120 Diastolic < 80
Nonpharmaceutical treatments for HTN 1. Diet & Exercise 2. Reduce sodium intake 3. Limit alcohol consumption 4. Smoking cessation
Clonidine (Catapres) side effects 1. Dizziness 2. Drowsiness
Generic Name for Cardura Doxazosin
One method to combat orthostatic HTN Go from lying to sitting position slowly
Generic Name for Inderal Propranolol
Beta-Blockers to avoid in Asthma/COPD Nonselective
Lisinoprol Drug Class Angiotensin-Converting Enzyme (ACE) Inhibitor
ACE Inhibitors (“prils”) side effect Cough
Mechanism of action of Calcium Channel Blockers (CCB’s) Cause smooth muscle relaxation by blocking the binding of calcium to its receptors, preventing muscle contraction
Norvasc Drug Class Calcium-Channel Blockers (CCB’s)
Cardizem indicated for what disease? Hypertension
Spironolactone side effect Increases serum K+
Hydralazine Drug Class Vasodilator
Stable angina is also called ______________ Classic or Effort Angina
Goal of Antianginal treatment To increase blood flow to ischemic heart muscle & decrease myocardial oxygen demand
Nitroglycerin - when do you call 911? Call 911 after giving ONE dose
Nitroglycerin Side Effect Headache
Mechanism of action of Calcium Channel Blockers (CCB’s) 1. Relaxes of coronary vascular smooth muscle 2. Cause peripheral arterial vasodilation 3. Reduce myocardial contractility - 3. Negative inotropic action Result: decreased myocardial oxygen demand
For patients on Antianginal Meds – nurse should perform the following (TEST ANSWER = ALL OF THE ABOVE) 1. Before administering, perform a complete health history to determine presence of conditions that may be contraindications for use or call for cautious use 2. Obtain baseline VS, including respiratory patterns and rate 3. Assess for drug interactions 4. Patients should not take any medications, including OTC medications, without checking with the physician 5. Teach patients to change positions slowly to avoid postural BP changes Keep records of anginal attacks including - precipitating factors, number of pills taken, and therapeutic effects
Difference between hypertensive emergency vs. hypertensive urgency depends on presence of symptoms [Questions on test will be (True/False)] Presence of symptoms = hypertensive emergency [Organ damage is apparent in hypertensive emergency – TRUE] No symptoms = hypertensive urgency [Organ damage is apparent in hypertensive urgency – FALSE]
Trick question?? Rocephin: 1. Is not renally eliminated (eliminates hepatically) 2. Can be given IM or IV - TRUE 3. Useless against pseudomonas - TRUE
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