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Final pharm exam review
Pharm 2 things to know exam 3
Course
Pharmacology II (NUR 354)
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Arizona College of Nursing
Academic year: 2022/2023
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PHARM EXAM 3 REVIEW
Statins –
- Example ->Atorvastatin
- Used for hyperlipidemia
- Labs to check -> lipid panel
- What will make the doctor order it? LDL HDL triglycerides labs!!
- Once on statin, monitor labs every 3 to 6 months -> need to be educated to get labs checked frequently
- Once on them they are on them for life
- SE: rhabdo-> sign of muscle breakdown headache, fatigue
- Signs of rhabdo are dark urine and muscle cramping
- Any time a patient starts an anti-lipidemic medication, they need to report any major side effects such as rhabdo
- Cannot be on it if pregnant
- Educate about diet such as foods that are high cholesterol
- If a patient is old and confused and has dementia you cannot educate them therefore need to assess their ability to be educated, if they cannot need caregiver to remind them of things
- Can also be used to prevent MI and strokes
- Antilipidemic
- Hard on the liver should check liver labs
Bile acid sequestrants –
- Cholestyramine: used to excrete cholesterol through stool
- Main side effect is GI upset
- Administered PO -> mix powder with water, two hours before or 4 hours after meals
- If patient is on this medication in terms of coordinating care, who will you go to? -> dietician
Loop –
- Bumetanide (Bumex):
- Furosemide (Lasix): know Lasix is working if there is urine output
- Monitor urine output usually hourly, 30 ML per hour
- Do daily weights on these patients
Ace Inhibitors (ACEI)–
Lisinopril: used for hypertension or heart failure
SE: angioedema and dry cough
If have angioedema you will need to stop it
Monitor BP before
If hypotensive you will contact doctor and hold it
Pregnant woman can have it
Sign of low blood pressure and indicator of oxygenation-> cap refill
If patient with HF comes in on lisinopril to monitor improvement will check for? o Cap refill o Decreased edema o BP WNL o Oxygenation
If miss a dose of cardiac medication never double up just take it next time
Phosphodiesterase Enzyme Inhibitors –
- Milrinone: antidysrhythmic
- Only administered IV, will only get it at hospital never at home
- Monitor vital signs because can cause significant hypotension
Beta one adrenergic agonist, positive inotrope -
- Dobutamine: how does it work? It is a positive inotrope -> increases contractility of heart
- Check heart rate and BP
Cardiac glycoside -
- Digoxin: interacts with a lot of things
- Monitor potassium before you give it
- check apical pulse for one full minute on the skin if it is less than 60 you hold it and let DR know
- Has narrow therapeutic range -> digoxin toxicity
- Signs of digoxin toxicity: visual disturbances and halo, before halo will have anorexia, fatigue, N/V, won't want to eat
- Assess their heart rate
- Used for dysrhythmia, know it is working if patient has less occurrence of dysrhythmia
- How does it work -> improves heart contractility therefore improves cardiac output
Beta Blockers- Ex.
- Examples -> Metoprolol and Propranolol:
- What is special about propranolol? So many uses such as: o Hypertension o Prevention of MI o Anxiety
o Diet -> Educate them not to increase vitamin k they get from foods -> spinach, kale, broccoli o Main risk -> bleeding o What increases risk of bleeding -> ginger, garlic, ginkgo, chamomile, green tea, fever few o Antidote is vitamin k, will make it less potent o Education -> no NSAIDS, no OTC meds without talking to doctors
- – sub q administration: steps -> clean it, inject, push, leave bubble, pull out, teach patient not to massage, do not pull-on plunger
- Education for any blood thinner-> bleeding precautions: stool softeners, soft toothbrush, electric razor etc.
- Usually taken at the same time in the morning
Direct Thrombin Inhibitors -
- Argatroban: need to check APTT
Factor X inhibitors -
- Rivaroxaban:
- Apixaban: education for patient: o Reduce alcohol because not supposed to drink any alcohol with it o Report excessive bleeding o Can't take other anticoagulants with it such as aspirin -> would have to change to Tylenol instead
Antiplatelet blockers –
- Plavix: very few drug interactions don’t have to change a lot of other meds
- Main side effect: bruising
- Educate: stop taking before surgery
- Cannot crush or chew the pills
- Know other meds under this drug class:
Thrombolytics -
- Alteplase: busts out the clots, need to worry about bleeding
- Do not give it to anyone who is bleeding, especially not brain bleeding
Heart failure -
- Pt Education: o Dietary teaching specifically low sodium diet o Fluid restriction o medication compliance such as with diuretics
- Need to monitor potassium and sodium when on diuretics because will deplete both
- What do we give our patients that can put them in HF? Fluids -> crystalloids/ isotonic fluids
Nitro –
- What are its uses? o Angina o Decompensated HF
- side effects: headache and hypotension
- If come in and complain of severe headache explain to them, it is an expected side effect
How to increase cardiac output?
- Decrease afterload increases cardiac output
- If decrease afterload aka the pressure the heart must push out because more blood will be able to come out
- increase preload will also increase cardiac output
What do pretty much all anti dysrhythmics cause?
- Bradycardia
What medications are used for HF and HTN?
- Diuretics
- Ace inhibitors
- Hydralazine
Was this document helpful?
Final pharm exam review
Course: Pharmacology II (NUR 354)
409 Documents
Students shared 409 documents in this course
University: Arizona College of Nursing
Was this document helpful?
PHARM EXAM 3 REVIEW
Statins –
• Example ->Atorvastatin
• Used for hyperlipidemia
• Labs to check -> lipid panel
• What will make the doctor order it? LDL HDL triglycerides labs!!
• Once on statin, monitor labs every 3 to 6 months -> need to be educated to get labs
checked frequently
• Once on them they are on them for life
• SE: rhabdo-> sign of muscle breakdown headache, fatigue
• Signs of rhabdo are dark urine and muscle cramping
• Any time a patient starts an anti-lipidemic medication, they need to report any major
side effects such as rhabdo
• Cannot be on it if pregnant
• Educate about diet such as foods that are high cholesterol
• If a patient is old and confused and has dementia you cannot educate them therefore
need to assess their ability to be educated, if they cannot need caregiver to remind
them of things
• Can also be used to prevent MI and strokes
• Antilipidemic
• Hard on the liver should check liver labs
Bile acid sequestrants –
• Cholestyramine: used to excrete cholesterol through stool
• Main side effect is GI upset
• Administered PO -> mix powder with water, two hours before or 4 hours after meals
• If patient is on this medication in terms of coordinating care, who will you go to? ->
dietician
Loop –
• Bumetanide (Bumex):
• Furosemide (Lasix): know Lasix is working if there is urine output
• Monitor urine output usually hourly, 30 ML per hour
• Do daily weights on these patients
Ace Inhibitors (ACEI)–
• Lisinopril: used for hypertension or heart failure
• SE: angioedema and dry cough
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