Pharmacology Exam 3 Study Guide

Pharmacology Exam 3 Study Guide Cardiovascular A. Digoxin a. How does this medication work? Force of contraction in ventricles b. What is it used for? Manage Cardiac dysrhythmias . Slows and strengthens the heart. c. How do you know if the medication is working? What would you expect to see change in the patient? Decreased heart rate –Normal heart rate and sound closer to base line d. What category of medications does Digoxin belong in? antiarrhythmia e. What priorities are there prior to administering medication? Apical pulse (60 seconds), monitor digoxin level (symptoms of toxicity) Signs/symptoms f. What patient teaching needs to be included? Check pulse, sign/symptom toxicity, follow up with provider to check labs (bradycardia) 2 ng/ml g. When should this medication be held? Pulse 60. Signs of toxicity. Swallowing difficulty. h. What are signs of Digoxin Toxicity? Visual illusions, confusion, delirium, PVC’s, Cardiac Dysrhythmias, fast heart beat, irregular pulse, loss of appetite, n/v,diarrhea ANTIDOTE = digoxin immune Fab (Digibind) **check apical pulse for a full minute before administering medication -hold for heart rate below 60 bpm -does not affect blood pressure -encourage patient to eat high potassium diet ***monitor for S/S of digoxin toxicity: N/V vision changes(yellow/ green halo vision, bradycardia, dysrhythmias, confusion educate patients to have digoxin levels checked (toxic level= 2ng/ml) B. Diuretics a. What are the various reasons these medications are used? Hypertension, CHF, edema b. What lab values help to determine the need for these medications (think heart failure)? BNP 100 is good lab value. c. Thiazide diuretics i. Example: 1. HCTZ ii. What are the indications for use? Edema, CHF, hypertension iii. What needs to be monitored prior to administration of medication? Daily weight iv. What labs do we monitor to determine if the patient is in renal failure? Creatin, GFR v. What race responds well to this category of medication? African American vi. For the elderly, what precautions need to be taken? Fall risk, renal function, dehydration d. Loop Diuretics i. When is the best time to take these medications? Morning This study source was downloaded by from CourseH on :41:55 GMT -05:00 ii. What is an important way to monitor fluid retention (also can do this with thiazide diuretics)? Daily weight iii. Examples: 1. Furosemide (Lasix), Bumetanide, piretanide, torasemide a. What is a symptom that the patient should report immediately if experiencing while on this medication (or aspirin)? Tinnitus e. Potassium Sparing Diuretics i. What food substitute should be avoided with this group of medications? Sodium f. With many diuretics, potassium needs to be replaced. What are the normal levels of potassium? When should it be administered? Should you ever chew potassium tablets? Normal Potassium Levels 3.5-5.5 mEQ/L. Never chew or crush potassium tablets but may be dissolved. 2.5 is critical C. Calcium Channel Blockers a. What are they used for? Hypertension, cardiac arrhythmias, THEY ARE A VASODIALATOR b. Best to treat HTN in African Americans if HCTZ doesn’t work c. What patient education is important for this group of medications? Monitor bp, heart rate, rise slow. d. Side effects: Orthostatic hypotension, peripheral edema, increased fall risk, flushing e. What are examples of this category of medications? i. Nifedipine (Procardia) ii. Diltiazem D. Beta Blockers : Ends in LOL. Inderal (Propanolol) , Coreg (carvidilol) a. What are they used for? hypertension b. What needs to be monitored/checked prior to administration? Monitor BP, Pulse c. What do you need to teach your patient to check prior to taking medication at home? Monitor bp pulse and when to hold it . Hold is 60 bpm and SBP 90 d. When do you hold these medications? Systolic under 100 pulse under 60 e. What effect does wine have with this type of medication? Increase effect. Drops vital signs. f. Examples: i. Metoprolol (Lopressor) ii. Atenolol ( Tenormin) iii. Propanolol (Inderal) iv. Carvidilol (Coreg) ***Don’t stop abruptly----Can cause Hypertension E. ACE inhibitors (ALL END IN PRIL) Lisinopril (Zestril) a. What is the medication given for? Hypertension & HF b. How does it work? Blocks acetylcholine receptors, dilates vessels to lower bp. Prevents vasoconstriction Diuresis c. What is a common side effect of this group of meds that can be bothersome to patients? Persistent Dry cough. Adverse: angioedema (life threatening), Hypotension, orthohypo, hyperkalemia in diabetics, renal failure and with potassium-sparing diuretics. F. Nitroglycerin a. How does this medication work? Dialates blood vessels b. What different forms are available of this medication? Sublingual Tablets, ointment, patches This study source was downloaded by from CourseH on :41:55 GMT -05:00 c. When is an appropriate time to give this medication? Onset of chest pain d. What patient education is necessary in the use of this medication? Rotate sites for patch, 3 doses of sublingual every 5 minutes. e. What precautions should be advised? Don’t swallow, don’t stand up too fast. f. What side effects should the nurse educate the patient on prior to administering? What should the patient expect to experience? Nausea, light headed. g. What medication should NOT be given if a patient is using nitro? Erectile dysfunction 1. Can cause sudden drop in BP 2. Headache is common 3. Tabs should be protected from heat and light G. Statins a. What side effects need to be monitored for and the patient needs to be educated to report immediately if experiencing? Muscle pain, weakness (rhabdomyolysis). Life threatening muscle damage. b. What could these side effects lead to? H. Heparin a. What lab values are used to monitor normal levels? INR, Xa b. What is the antidote? Protamine Sulfate I. Coumadin a. What foods, meds, etc. can alter the effects of coumadin? Vitamin K, leafy greens, antibiotics, NSAIDS b. What is the antidote? Vitamin K c. Why might a patient be taking this medication? Afib, TIA, d. What lab value is used to monitor normal levels? What is a typical normal range we would expect?( 0.8-1.2 normal ) Coumadin (2-3) is therapeutic e. What are the various ways that could indicate the patient’s INR levels are off? Brusing, bleeding J. Plavix a. What is the indications for use? Antiplatelet b. What other medication should be used in combination with this one if the patient has a history of ulcers? PPI, c. When should this be stopped if a patient is having surgery? 7-10 days Respiratory A. Albuterol a. When is this indicated for use? Acute bronchospasm b. What is the expected outcome after use? Relief c. What are the expected side effects of the medication? Tachycardia, palpations B. Serevent a. Maintenance inhaler: Long acting b. What medication category does this fall into? Beta 2. C. Atrovent a. What can you do to help a patient manage the bitter taste that is common with this medication? Rinse mouth D. Duonebs a. Anticholinergic effects – what are they? Dries up mucous membranes E. Theophylline This study source was downloaded by from CourseH on :41:55 GMT -05:00 a. Why is this used? Emphysema b. What adverse effects might occur? c. What are signs of toxicity? Vomiting , abdominal pain, seizure,