Pharmacology Hesi 2023, Pharm 01/2025
Digoxin (Lanoxin) - positive inotrope (increases force of contraction); negative chronotrope
(decreases heart rate). How do you assess this?
Always take apical pulse for one full minute
We have an expert-written solution to this problem!
Client with a long hx of daily digoxin and furosemide (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
antidysrhythmic drug)?
Digoxin can increase in the blood level and further increase the effects
We have an expert-written solution to this problem!
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
Beta blockers can be non selective so be aware of any
respiratory conditions such as asthma, emphysema COPD, ect.
A nurse should always check _____ and _____ before giving a beta blocker
AP 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
We have an expert-written solution to this problem!
Side effects with aminoglycosides (-mycin drugs)
dizziness
head ache
tinnitus
N/V/D
low potassium
hyperglycemia
ototoxicity
Foods containing potassium
dried fruits, fish, leafy veggies, squash, beans, meats, nuts, bananas, potatoes, dairy products
, It is important to use a large vein, such as AC (antecubital when administering __________
because it can irritate the vein
potassium
It is important to notify the nurse immediately is burning at the IV site when giving potassium
because this can result in
necrosis of the tissue
Can potassium be given in a fast IV push?
NO, always diluted
at a rate of 10 mEq/hr for peripheral
20 mEq/hr for central line
Requires an infusion pump
IV site should be assessed every hour
Which antihypertensives will raise potassium?
ACEs (-pril)
ARBs (-sartan)
and other renin inhibitors
Which antihypertensives will lower potassium?
loop diuretics such as furosemide (-ide) and thiazides such as hydrochlorthiazide
This drug can be administered via NG tube or as an enema to reduce severe serum potassium
levels when life threatening values are seen
Sodium polystyrene sulfonate (Kayexalate)
To correct severe hyperkalemia administration of
dextrose and insulin, sodium bicarbonate, and calcium gluconate or chloride are often required
followed by oral or rectal use of Kayexalate or even hemodialysis to eliminate the extra
potassium in the body
What are some potassium sparing diuretics that inhibit sodium and water reabsorption?
Spionolactone (Aldactone), amiloride (Midamore), triamterene (Dyrenium)
Digoxin (Lanoxin) - positive inotrope (increases force of contraction); negative chronotrope
(decreases heart rate). How do you assess this?
Always take apical pulse for one full minute
We have an expert-written solution to this problem!
Client with a long hx of daily digoxin and furosemide (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
antidysrhythmic drug)?
Digoxin can increase in the blood level and further increase the effects
We have an expert-written solution to this problem!
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
Beta blockers can be non selective so be aware of any
respiratory conditions such as asthma, emphysema COPD, ect.
A nurse should always check _____ and _____ before giving a beta blocker
AP 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
We have an expert-written solution to this problem!
Side effects with aminoglycosides (-mycin drugs)
dizziness
head ache
tinnitus
N/V/D
low potassium
hyperglycemia
ototoxicity
Foods containing potassium
dried fruits, fish, leafy veggies, squash, beans, meats, nuts, bananas, potatoes, dairy products
, It is important to use a large vein, such as AC (antecubital when administering __________
because it can irritate the vein
potassium
It is important to notify the nurse immediately is burning at the IV site when giving potassium
because this can result in
necrosis of the tissue
Can potassium be given in a fast IV push?
NO, always diluted
at a rate of 10 mEq/hr for peripheral
20 mEq/hr for central line
Requires an infusion pump
IV site should be assessed every hour
Which antihypertensives will raise potassium?
ACEs (-pril)
ARBs (-sartan)
and other renin inhibitors
Which antihypertensives will lower potassium?
loop diuretics such as furosemide (-ide) and thiazides such as hydrochlorthiazide
This drug can be administered via NG tube or as an enema to reduce severe serum potassium
levels when life threatening values are seen
Sodium polystyrene sulfonate (Kayexalate)
To correct severe hyperkalemia administration of
dextrose and insulin, sodium bicarbonate, and calcium gluconate or chloride are often required
followed by oral or rectal use of Kayexalate or even hemodialysis to eliminate the extra
potassium in the body
What are some potassium sparing diuretics that inhibit sodium and water reabsorption?
Spionolactone (Aldactone), amiloride (Midamore), triamterene (Dyrenium)
