Hesi Review Pharm - Pharmacology Hesi 2024

Digoxin (Lanoxin) - positive inotrope (increases force of contraction); negative chronotrope (decreases heart rate). How do you assess for this? - Always take apical pulse for one full minute Client with a long hx of daily digoxin and fourosemide (Lasix) use; creates a high risk for dig toxicity because - Lasix can cause hypokalemia, which can lead to dig toxicity What can happen when Digoxin is taken with Dronedarone (Multaq), which is another anti-dysrhythmic drug)? - Digoxin can increase in the blood level and further increase the effects What is the normal digoxin level? - 0.5-2 ng/mL Normal serum potassium level is - 3.5-5.0 mEq/L Low potassium or magnesium levels may increase risk for - Digoxin toxicity What are the signs and symptoms for digoxin toxcitiy? - anorexia, bradycardia, headache, dizziness, confusion, nausea, and visual disturbances such as blurred, yellow, or halo vision. When should you hold off on giving digoxin drug therapy? - if apical pulse is less than 60 What effects do Calcium channel blockers (-dipine; amlodipine (Norvasc), nifedipine (Procardia) cause - produce vasodialation and reflex tachycardia (lowers BP but increases HR) Verapamil and diltiazam produce - vasodialation and cardiosuppresssion (lowers BP and Lowers heart rate) Beta blockers have the drug ending - -OLOL such as atenolol, propanolol, esmolol, ect.) Beta 1 blocks receptors in the - heart Beta 2 blocks receptors in the - lungs A nurse should always check and before giving a beta blocker - AP Beta blockers can be non selective so be aware of any - respiratory conditions such as asthma, emphysema COPD, ect. and BP do not give if HR is below 60 never stop abruptly Why do you never stop taking a Beta BLocker abruptly - Must taper because angina or MI can orccur When would a nurse hold HTN medication Labetalol? - A patient with a low pulse rate. Side effect of Labetalol (beta blocker) is - weight gain / fluid retention montioring weight is one of the best indicators of loss/gain 1kg is equivalent to 1,000 mL It is important to assess when taking a beta blocker such as Labetalol - pulmonary is it OK to give nitroglycerin to a patient who is hypertensive? - Yes If an ICU patient on a nirto drip becomes hypotensive what immediate action should the nurse take? - titrate (decrease the rate) of the nitro drip. This drug is used for a rapid diuresis in emergencies to decrease pulmonary edema - Furosemide (Lasix) a loop diuretic Furosemide (Lasix) can cause - hypokalemia When taking furosemide (Lasix) a nurse should assess for what signs of hypokalemia? - muscle cramps and muscle weakness Hypotension F/E abnormalities dehydration Side effects with aminoglycosides (-mycin drugs) - dizziness head ache tinnitus N/V/D low potassium hyperglycemia ototoxicity