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| Questão | Responda |
| atorvastatin (Lipitor) pg. 167-169 | Class: Antilipemics, HMG-CoA reductase inhibitors Action: Inhibits HMG-CoA reductase Pregnancy Class: X Dose/Route: PO, 10, 20, 40, 80mg tablet Contraindications: Renal failure Adverse Effects: rhabdomyolysis, peripheral edema, flulike syndrome Drug Interactions: Cyclosporin, macrolides, verapamil Nursing Considerations: Watch for signs of myositis, warn pt to avoid alcohol. |
| gemfibrozil (Lopid) pg. 37, 676-677, 1498 | Class: Antilipemics, Fibric acid derivatives Action:Inhibits lipolysis, reduces triglyceride synthesis in the liver Pregnancy Class: C Dose/Route: PO, 600 mg tab Contraindications: Hypersensitivity Adverse Effects: leukopenia, thrombocytopenia, hypokalemia Nursing Considerations: Check CBC & LFT's first 12 months, instruct pt to take approx 30 min before breakfast & dinner, pt should inform PCP of fatty feces & muscle pain |
| cholestyramine (Questran) pg. 37, 319-320 | Class: Antilipemic, Bile aced sequestrant Action: binds bile acid preventing absorption Pregnancy Class: C Dose/Route: PO, 378 g Powder Contraindications: GI tract obstruction Adverse Effects: GI bleeding Nursing Considerations: Monitor cholesterol & triglycerides, monitor bowel habits, teach pt to always mix drug with milk, juice or water, take medicateion at mealtime |
| enoxaparin (Lovenox) pg. 510-513 | Class: Anticoagulant, Low-molecular-weight heparin Action: Accelerates formation of antithrombin III Pregnancy Class: B Dose/Route: IV, Sub Q Contraindications: prosthetic heart valves, hemorrhage, threatened abortion Adverse Effects: thrombocytopenia, hemorrhage BBW: epidural or spinal puncture may increase risk for spinal hematoma Nursing Considerations: Monitor VS, hematoma, hemorrhage, monitor pregnant women closely |
| Heparin pg. 697-700 | Class: Anticoagulants Action: Prevents conversion of fibrinogen to fibrin Pregnancy Class: C Dose/Route: I.V. Contraindications: After surgery, bleeding tendancies, women during menses & after child birth Adverse Effects: hemorrhage, prolonged clotting time, hyperkalemia, anaphylactoid reactions Drug Interactions: salicylates Nursing Considerations: Check order and vial carefully, check PTT 4-6 hours after dose, use protamine sulfate as an antagonist, monitor for signs of bleeding and bruising, avoid OTC drugs |
| warfarin (Coumadin) pg. 1467-1470, C32 | Class: Anticoagulants, Coumarin derivatives Action: Inhibits vitamin K dependent activation. Pregnancy Class: X Dose/Route: Injection, P.O. Contraindications: GI, GU or respiratory tract bleeding, avoid in diverticulitis & colitis Adverse Effects: hemorrhage, hepatits, anaphylactic reactions BBW: Major or fatal bleeding can occur Drug Interactions: amiodaronem steeroids, danazol, fibric acid, NSAIDs, salicylates, thyroid drugs, cranberry juice Nursing Considerations: Monitor INR, bleeing, gums, teach pt to use electric razor |
| clopidogrel (Plavix) pg. 359-360, C6 | Class: Antiplatelet drugs, platelet aggregation inhibitors Action: Inhibits binding of adenosine diphosphate to platelet receptor Pregnancy Class: B Dose/Route: P.O. Contraindications: use cautiously in pt at risk for increased bleeding Adverse Effects: fatal intracranial bleeding, hemorrhage, bronchospasm, Stevens-Johnson syndrome, toxic epidermal necrolysis, angioedema, anaphylaxis BBW: Drug effectiveness depends on drugs activation to matabolite- poor metabolizers should use alternate treatment Drug Interactions: salycilates Nursing Considerations: platelet aggregation take 5+ days to return to normal. may cause fatal thrombotic thrombocytopenic purpura |
| Aspirin pg. 2, 4, 54-55, 155-158 | Class: NSAIDs, Salicylates Action: Produce analgesia and exert anti-inflammatory effect Pregnancy Class: C, D if used full dose in 3rd trimester Dose/Route: Suppository, P.O. Contraindications: GI lesion, impaired renal function, oral and rectal OTC us of salicylates Adverse Effects: cerebral edema, coma, seizures, subdural or intracranial hemorrhage, arrhythmia, GI bleeding, pancreatits, antepartum and postpartum bleeding, leukopenia, thrombocytopenia, hepatits, hyperkalemia, metabolic acidosis, angio edema, Reye syndrome Drug Interactions: Heparin Nursing Considerations: monitor salicylate level, asses hematocrit, hemoglobin, PT, INR & renal function, advise low salt diet and to take with food, milk, antacid or large glass of water |
| valsartan (Diovan) pg 1440-1441 | Class: Antihypertensives, Angiotensin II receptor antagonist Action: block binding of angiotensin II to receptor sites in vascular smooth muscle Pregnancy Class: D Dose/Route: P.O. Contraindications: renal/hepatic disease Adverse Effects: neutropenia, angioedema BBW: Drugs acting on renin-angiotensin system can cause injury & death to fetus Nursing Considerations: Monitor for hypotension, serum BUN |
| epoietin alfa (Epogen) pg. 523-256 | Class: Colony stimulating factors, Recombinant human erythropietins Action: Mimics effects of erythropoietin, enhancing RBC production Pregnancy Class: C Dose/Route: Injection Contraindications: Use cautiously in BF women Adverse Effects: hypokalemia BBW: Chronic renal disease increases risk of death, cancers have risk of tumor growth & shortened survival, increase risk of DVT Nursing Considerations: evaluate iron, b12 and folic acid levels, monitor B/P, diet restrictions, monitor hemoglobin twice weakly |
| neupogen (Filgrastim) pg. 612-613 | Class: Colony stimulating factors, Hematopoietics Action: binds cell receptors to stimulate end- cell function of neutrophils Pregnancy Class: C Dose/Route: Injection Contraindications: caution in BF women Adverse Effects: MI, arrhythmia, thrombocytopenia, neutropenic fever Drug Interactions: chemotheraputic drugs, lithium Nursing Considerations: Obtain CBC & platelet count prior to therapy & 2-3 x weekly, advise pt to report LUQ pain |
| Nitroglycerin pg. 27-28, 36-37, 1016-1019 | Class: Vasodilator, Nitrates Action: reduces cardiac oxygen demand by decreasing preload and afterload Pregnancy Class: C Dose/Route: Aerosol, P.O, Injection, Transdermal Contraindications: early MI, Hypotension Adverse Effects: Headache, S.L. burning Drug Interactions: Alteplase, sildenafil, tadalafil, vardenafil Nursing Considerations: Closely monitor V.s, pt should take regularly as prescribed and have accessible, teach pt to take S.L form at first sign of attack and again 5 minutes later if symptoms persist for a total of 3 times. |
| Isordil pg. 792-794 | Class: Antianginal, Nitrate Action: reduce cardiac oxygen demand by decreasing preload and afterload Pregnancy Class: C, B for mononitrate Dose/Route: P.O. Contraindications: cautiously in pt with blood volume depletion or hypotension Adverse Effects: headache, orthostatic hypotension, S.L. burning Drug Interactions: Sildenafil, tadalafil, vardenafil Nursing Considerations: monitor VS, caution pt to take regularly as prescribed, store in cool place in tightly sealed container away from light |
| amplodipine (Norvasc) pg. 124-125, C3 | Class- Anti-hypertensive, Calcium channel blocker Action: prohibits movement of calcium in myocardium. Pregnancy Category: C Indication: Hypertension & stable angina Available Form: PO Adverse Effects: Dizziness, Palpitations, Abdominal pain Considerations: Take B/P prior to medication administration, monitor B/P frequently. Do not abruptly stop medication, taper dosage. |
| Captopril pg. 25-26, 36-37, 264-266, 1496 | Class: Antihypertensive, ACE inhibitor Action: Prevents conversion of A I to A II (vasoconstrictor) Pregnancy Class: C, D in 2nd & 3rd trimester Dose/Route: P.O. Contraindications: Use caution in renal function impairment Adverse Effects: leukopenia, agranulocytosis, thrombocytopenia, pancytopenia, angioedema BBW: Use during pregnancy can cause injury & death to fetus Drug Interactions: Capsaicin Nursing Considerations: Assess for angioedema, monitor WBC in renal or vascular disease pts, have pt take drug 1 hr prior to meals, monitor for signs of infection, Promptly report swelling of face, lips or mouth |
| lisinoprol (Prinivil) pg. 859-861, C17 | Class: Antihypertensive, ACE inhibitor Action: Decreases production of AII Pregnancy Class: D Dose/Route: P.O. Contraindications: Caution in impaired renal function pt & those at risk for hyperkalemia & hypotension Adverse Effects: hyperkalemia, angioedema BBW: Use during pregnancy causes injury or death to fetus Nursing Considerations: Monitor VS, monitor WBC every 2 weeks for first 3 months, teach to dangle, DO NOT USE salt substitutes |
| nifedipine (Procardia) pg. 27-28, 36-37, 44, 1007-1009 | Class: Antihypertensive, Calcium channel blocker Action: Inhibits calcium ion influx across cardiac muscle Pregnancy Class: C Dose/Route: P.O. Contraindications: caution in HF, hypotension & elderly Adverse Effects: coughing, headache, pruritis Drug Interactions: Grapefruit juice Nursing Considerations: Monitor VS, protect medication from direct light & moisture |
| Clonidine pg. 356-359 | Class- Antihypertensive, Centrally acting alpha agonist Action: Induce smooth contraction and vasoconstriction Pregnancy Class: C Indication: Hypertension, ADHA, Ulcerative colitis, Opiate dependence, Smoking cessation Available Form: PO, Injection, Epidural, Transdermal patch (rotate site) Adverse Effects: bradycardia, severe rebound hypertension, sedation, dry mouth impotence BBW: Epidual injection form containing 500 mcg/mL must be diluted in normal saline to yield 100 mcg/mL Contraindications: Beta-blockers- cause life threatening hypertension Considerations: Take B/P prior to medication administration, monitor B/P frequently. Taper drug to prevent severe rebound high blood pressure. |
| digoxin (Lanoxin) pg. 1,-2, 4, 52-53, 446-450, 1498 | Class: Inotropes, Cardiac glycosides Action: Inhibits adenosin triphosphatasem strengthens myocardial contraction Pregnancy Class: C Dose/Route: PO, IV Contraindications: Wolff Parkinson White syndrome, Acute MI Adverse Effects: arrhythias, heart block Drug Interactions: Amiodarone, diuretics, Antibiotics Nursing Considerations: Monitor for arrhythmia, monitor for theraputic level (0.8-2 ng/mL), monitor potassium, report pulse <60 or >110 |
| diltiazem (Cardizem) pg. 450-452, C8 | Class: Antihypertensive, Calcium channel blocker Action: Inhibits calcium influx across cardiac smooth muscle Pregnancy Class: C Dose/Route: PO, IV Contraindications: Use of IV in A fib or flutter pts, caution in elderly Adverse Effects: arrhythmia, AV block, bradycardia, heart failure, acute hepatic injury Nursing Considerations: Monitor BP & HR, HR <60 or systolic BP <90 with hold drug & notify prescriber |
| lopressor (Metroprolol) pg. 937-939, C19 | Class- Antihypertensive, Selective beta-adrenergic blocker Action: blocks renin secretion, reduces heart O2 demand and increases oxygen carrying capacity of blood. Pregnancy Class: C Indication: Hypertension, Angina, Heart failure, Cardiac risk reduction for surgery Available Form: PO, IV Adverse Effects: Bradycardia, Heart Failure, AV block BBW: Do not stop drug suddenly- may cause exacerbation of angina or MI Contraindication: Bradycardia, Heart failure, Diabetes, Respiratory or Hepatic Disease Considerations: Check APICAL pulse prior to administration, hold if <60. Monitor BP frequently, Tell PT to warn providers about drug use prior to procedures/sx. Instruct PT to alert provider of shortness of breath Effects on Lab test results: May increase alkaline phosphatase, LDH & uric acid levels |
| propanolol (Inderal) pg. 1193-1196, C24 | Class: Antihypertensive, non-selective beta blocker Action: Depresses renin secretion and prevents vasodilation Pregnancy Class:C, D 2nd & 3rd trimester Dose/Route: PO Contraindications: caution in renal impairment, DM & elderly Adverse Effects: bradycardia, heart failure, intensification of AV block, agranulocytosis, bronchospasm BBW: Abruptly stopping drug may cause exacerbation of angina or MI Drug Interactions: Cimetidine, propafenon, quinidine Nursing Considerations:drug masks s/s or shock and hypoglycemia, monitor black pts for therapeutic effects |
| ferrous fumarate (Iron) pg. 604-606 | Class: Iron supplement, Hematinics Action: provides elemental iron Pregnancy Class: A Dose/Route: PO Contraindications: repeated blood transfusions Adverse Effects: GI irritation BBW: can cause fatal poisoning in children Nursing Considerations: Take with juice, do not crush, report constipation |
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