Pharmacology NRTC
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| Digoxin is contraindicated when | HR<60BPM
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| Digoxin is used for what 2 heart abnormalities | Heart failure, arrhythmias... afib
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| This electrolyte imbalance increases the effect of digoxin | Hypokalemia
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| Normal potassium level | 3.5-5.0
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| Normal digoxin level | 0.5-2.0
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| Classic s/s of digoxin toxicity | Visual disturbances... Halos around objects
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| Digoxins action | Increased contractility.... Positive inotrope
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| Digoxins anecdote | Digibind
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| Nitrates action | Vasodilation
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| Nitrates are used for what | Angina
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| Side effects of nitrates | headache hypotension dizziness and syncope
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| Nitroglycerin comes in what form | Sublingual transdermal patch extended release tablet and trans lingual spray
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| How is nitroglycerin stored | Dark glass bottle not childproof
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| Client should feel this when nitro is put under the tongue | A tingle or burning sensation
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| How is nitro taken for angina | Can take one tablet under the tongue every 5 minutes for a total of 3 doses
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| What signs and symptoms may the client have after taking nitro | Headache dizziness syncope client can take Tylenol or aspirin for headache
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| When discontinuing A nitro patch what is the procedure | Taper down over several weeks
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| What is important to know about IV nitroglycerin | Must use specialMust use special tubing
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| What is the action of beta blockers | Block epinephrine and cause peripheral vasodilation
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| Beta blockers are used for what heart conditions | hypertension some tachy arrhythmias and angina
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| What are the side effects of beta blockers | Bradycardia hypotension erectile dysfunction
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| What can beta blockers mask the signs of that is important for diabetics to know | Hypoglycemia client should do more finger stick blood sugar tests
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| What do all clients need to know before taking beta blockers | Check apical pulse do not take if less than 60 beats per minute
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| What can occur if beta blockers are stopped abruptly | Rebound hypertension
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| Beta blockers may cause this type of dysfunction | Sexual
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| What are important teaching topics for clients taking CCBs | Take BP and pulse and watch for orthostatic hypotension and edema
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| name one centrally acting alpha agonist | Clonidine
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| What can happen if clonidine is stopped suddenly | rebound hypertension
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| What is the action of ACE inhibitors | Blacks the production of angiotensin ll vasoconstrictor and blocks release of aldosterone
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| What side effects of ACE inhibitors should be reported to the PCP | Persistent dry cough
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| What diuretic can cause ototoxicity when administered too fast with IV infusion | Lasix furosemide
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| What group of diuretics is commonly combined with ACE inhibitors | Thiazide diuretics
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| What is a common electrolyte imbalance with thiazide diuretics | Hypokalemia
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| Thiazides are contraindicated in what patients | Renal failure patients ...unlike loop diuretics
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| What must a nurse monitor for in patients taking thiazides | Vs wait I / O's E-Lites especially K+
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| What are signs of hypokalemia to teach patients | Muscle weakness leg cramps dysrhythmias
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| Loop diuretics are more potent than thiazides why are they not prescribed as often | Less effective as an anti hypertensive
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| What drug do loop diuretics have a major interaction with | Digoxin can cause digoxin toxicity because of hypokalemia
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| clients should take diuretics at what time of the day | Early morning to prevent nocturia
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| What is important to teach about potassium sparing diuretics | Monitor potassium levels periodically, do not take potassium supplements or salt substitutes
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| Potassium sparing diuretics should not be taken with what class of heart medications? | ACE inhibitors both can cause hyperkalemia
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| What do platelet inhibitors do,? | Inhibit aggregation of platelets, decrease clotting
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| What are the side effects of platelet inhibitors | Uncontrolled bleeding
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| Do platelet inhibitors affect existing clots | No effect on thrombi
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| What platelet inhibitor is commonly given after an acute MI | Aspirin
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| When are anticoagulants used | After MI, PE, DVT and ischaemic CVA
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| Name a common LMWH | Enoxaparin, lovenox
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| What are some advantages to LMWH | No need to monitor PTT
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| What is the antidote for heparin | Protamine sulfate
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| What is the antidote for coumadin, warfarin | Vitamin K
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| What lab is monitored for heparin | aPTT
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| What labs do we monitor for coumadin, warfarin | PT / INR
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| What should INR be | 2.0- 3.0
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| Plan teaching for clients taking anticoagulants? | Tell dentist, use soft toothbrush, use electric razor, Cary Medical ID, do not smoke, do not take aspirin, do not take herbs, may interact with anti- coagulant, avoid EtOH
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| If clients experience bleeding when taking anticoagulants what do they need to do? | Apply firm, direct pressure for 5 - 10 minutes
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| If you are taking an anticoagulant what food must you avoid | green leafy vegetables, high in vitamin K
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| What do thrombolytics do | Directly break up blood clots
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| What drugs must be avoided when taking thrombolytics | NSAIDs
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| Total cholesterol level goal | <200
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| triglyceride level goal | <150
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| LDL goal | <130
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| HDL goal | >40
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| What are serious side effects of statins | Elevation of liver enzymes and rhabdomylosis
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| How long does it take for full therapeutic effects of statins | 2 - 4 weeks
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| When taking statins what food must be avoided | Grapefruit, leads to statin toxicity
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| What lab values are to be expected while on statins | Liver function studies, LFTs, lipid profile
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| Gemfibrozil may increase the risk of what | Gallstones
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| What is a potential side effect of niacin that is not well tolerated | Flushing
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| Important patient teaching in regards to all cholesterol lowering medications includes | Take 1 hr before or 4-6 hrs after meals to avoid interference with absorption
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Created by:
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