Term
| The Autonomic Nervous System (ANS) includes the sympathetic nervous system & the parasympathetic nervous system. Which one increases the rate of impulses to the heart & which one decreases the rate of impulses to the heart? |
|
Definition
| Sympathetic = increases HR & Parasympathetic = decreases HR. |
|
|
Term
| Adrenergics stimulate the ________ nervous system and are also called adrenergic agonists. |
|
Definition
|
|
Term
| The sympathetic system & Adrenergic agonists are known for stimulating what response? |
|
Definition
| Fight or Flight function... allows the body to respond in a self-protective manner to dangerous situations. |
|
|
Term
| The sympathetic nervous system causes vasoconstriction or vasodilation? What effect does this have on BP & HR? |
|
Definition
| Sympathetic causes VASOCONSTRICTION of blood vessels & will INCREASE BLOOD PRESSURE, INCREASE HR (contractility). |
|
|
Term
| What affect does the sympathetic nervous system have on the bronchiole pathways? |
|
Definition
| Causes bronchodilation (widens bronchial pathways) |
|
|
Term
| What effect does the SNS have on the large intestine's GI motility? |
|
Definition
| DECREASES GI motility & Genitourinary motility |
|
|
Term
| The adrenergic agonists work on what receptors? |
|
Definition
| Alpha & Beta (all she mentioned), but there are also dopaminergic receptors that are adrenergic receptors. |
|
|
Term
| The SNS/Adrenergic Agonists may even cause pupils to ________ & cause your body (armpits) to _______. |
|
Definition
| Dilate (called Mydriasis), sweat (Diaphoresis) |
|
|
Term
| The SNS neurotransmitters that activate the adrenergic agonists are: _____________, _____________ and dopamine. |
|
Definition
| noripinephrine & epinephrine (they're catecholamines) |
|
|
Term
| CHOLINERGIC AGONISTS or CHOLINERGICS stimulate the __________________ nervous system. |
|
Definition
|
|
Term
| The parasympathetic & cholinergic drugs stimulate what response? |
|
Definition
|
|
Term
| Do cholinergics & the parasympathetic system cause vasodilation or vasoconstriction? What effect does this have on BP & HR? |
|
Definition
| Causes VASODILATION, DECREASEd HR, decreased BP |
|
|
Term
| What does the parasympathetic system & cholinergic drugs do to the bronchioles & the digestive system? |
|
Definition
| Causes vasoCONSTRICTION & causes increased GI & GU motility (promotes digestion). |
|
|
Term
| What does the parasympathetic nervous system & cholinergic drugs do to the pupils? |
|
Definition
| Causes contraction of the pupil (miosis) |
|
|
Term
| Drugs that block the sympathetic nervous system are adrenergic BLOCKERS. Thus you will have all the same as the _______________ nervous system. explain.... |
|
Definition
| Parasympathetic. Adrenergic Blocking Drugs will elicit Parasympathetic Nervous System activities in the body (vasodilation, decreased HR, decreased BP, bronchoconstriction, increased GI/GU motility, miosis) |
|
|
Term
| Drugs that block the Parasympathetic Nervous System are Cholinergic Blockers. Thus you will have all the same activities as in the ___________ Nervous System, explain... |
|
Definition
| Sympathetic. Cholinergic Blockers cause same effects as SNS. Like: vasoconstriction, increased BP, increased HR, decreased GI/GU motility, bronchodilation, mydriasis (pupil dilation), sweating.. |
|
|
Term
| What drug classes are included in Adrenergic Agents (effects SNS)? |
|
Definition
| Bronchodilators, Nasal Decongestants, Ophthalmic Decongestants, Vasoactive Agents |
|
|
Term
| What drug category does Albuterol go under? |
|
Definition
| Bronchodilators (Under Adrenergic Agonsists) |
|
|
Term
| Albuterol relaxes the _______ muscle in the bronchioles & is used for ________. |
|
Definition
|
|
Term
| AE of Albuterol include __________ HR and ___________. |
|
Definition
| increased HR & palpitations |
|
|
Term
| __________________ is a bronchodilator used for asthma & anaphylaxis (allergic rxns). |
|
Definition
| epinephrine (Adrenaline). Remember the "epi-pin" is something people carry for severe allergic reactions. |
|
|
Term
| Afrin & Sudafed are pseudoephedrines are ________ _____________. |
|
Definition
|
|
Term
| The AE of Afrin & Sudafed is _________ decongestion. What is recommended to prevent? |
|
Definition
| rebound decongestion, don't use longer then 3 days or nasal mucosa will get used to it. |
|
|
Term
| Opthalmic Decongestants work how? |
|
Definition
| Remember, opthalmic decongestants are under Adrenergics!! They are instilled into the eye, they stimulate adrenergic receptors in the eye on the small arterioles. This result is arteriolar vasoconstriction, which reduces conjunctival congestion & thus decreases redness in eye. Ex/ Visine |
|
|
Term
| Vasoactive adrenergics have effects primarily on what organ? They are used to support a failing ______ or to treat shock. |
|
Definition
| Vasoactive Adrenergics affect the HEART. They support a failing HEART and are used to treat SHOCK. |
|
|
Term
| What vasoactive drug increases contractility, and is given to treat shock & heart failure? |
|
Definition
|
|
Term
| What would you really need to monitor when giving a patient Dobutamine? |
|
Definition
| closely monitor vital signs and their ECG. |
|
|
Term
| Does Dobutamine increase or decrease the contractility of the heart? |
|
Definition
| increases contractility (why it's given for shock & HF! :) |
|
|
Term
| Adrenergic blocking drugs are divided into ____ blockers & _____ blockers. |
|
Definition
|
|
Term
| Where are most of the alpha-receptors located? |
|
Definition
| The ARTERIOLES, the GI & GU sphinters, the muscles of the eyes & skin. |
|
|
Term
| Where are most of the Beta-receptors located? |
|
Definition
|
|
Term
| What happens if we block the alpha receptors? peripheral vaso_______. |
|
Definition
|
|
Term
| What do we give Alpha-receptors for? |
|
Definition
| It is given to lower BP & this class is used for HTN because it causess peripheral vasodilation, but it also causes papillary constriction. So alpha receptors are also used for migraines & postpartum bleeding (causes vasoconstriction in the uterus). For all other areas it causes vasodilation though. |
|
|
Term
| There are Beta 1 & Beta 2 receptors. Beta 1 receptors are located in the _______ & Beta 2 receptors are located in the _____. |
|
Definition
| Beta 1 = heart, Beta 2 = lungs (you have 1 heart & 2 lungs that is how you keep this straight) |
|
|
Term
| When you block Beta 1 adrenergic receptors we know we are affecting the heart, but what happens specifically when these are blocked? |
|
Definition
| decreases the HR, decreases contractilty. This is why Beta 1 receptor drugs are perfect for heart attack patients. |
|
|
Term
| Beta 2 adrenergic receptors are located in the lungs.... and actually also in the smooth muscle of the blood vessels! What happens when these are blocked? |
|
Definition
| Blocking Beta 2 receptors causes bronchoconstriction in the lungs. There really isn't a reason we'd want to give a drug to do this. Beta 2 are also in the smooth muscle of blood vessels to dilate. We give Beta 2 blockers for HYPERTENSION. |
|
|
Term
| Blocking alpha adrenergic receptors will lead to what? |
|
Definition
| Well, w/o being blocked the alpha receptors helped the sympathetic nervous system, but now when they are blocked they mimic the parasympathetic nervous systems effects: Vasodilation, Decreased Blood Pressure and Constriction of the Pupil (Miosis). |
|
|
Term
| phentolamine (Regitine) & prazosin (Minipress) are key drugs in what category? |
|
Definition
| Alpha Blockers (Adrenergic blockers) |
|
|
Term
| Phentolamine is given to treat the extravasation of vasoconstricting intravenous drugs such as norepinephrine, epinephrine and dopamine (Vasoactive agents), which when given intravenously can leak out of the vein. What happens Phentolamine leaks out of a vein? What else is it used to treat? |
|
Definition
| If the IV tube is not correctly positioned Phentolamine can leak out. If it does onto surrounding tissue, the result is intense vasoconstriction, decreased blood flow, necrosis & potential loss of limb. When phentolamine is injected subcutaneously in a circular fashion around the extravasation site, it causes alpha adrenergic blockade & vasodilation, which in turn increases blood flow to the ischemic tissue & thus prevents damage. It is also give for real serious HTN. |
|
|
Term
| Prazosin (Minipress) is an alpha adrenergic blocking drug primarily used to treat ____ and to reduce: ______ obstruction in men with BPH? <--- what's that? |
|
Definition
| HTN, urinary. BPH = benign prostatic hypertrophy (enlarged prostate - happens often with aging) |
|
|
Term
| what class of drugs all end in 'olol'? |
|
Definition
|
|
Term
| A drug can be nonselective & affect Beta 1 & Beta 2 receptors. Of these 2 drugs, which one is a cardioselective Beta Blocker? metaprolol (Lopressor) or popanolol (Inderal)? |
|
Definition
| metaprolol (Lopressor): will affect cardiovascular & does NOT affect the bronchioles metaprolol (Lopressor) will decrease HR and decrease contractility of the heart. |
|
|
Term
| Cholinergic drugs stimulate the _____________ nervous system. |
|
Definition
|
|
Term
| What is the MOA of Cholinergic drugs? |
|
Definition
|
|
Term
| What effects happen from cholinergic drugs? Think PSNS (parasympathetic nervous system) |
|
Definition
| decreased HR, vasodilation, decreased BP, bronchi in lungs constrict & airways narrow, stimulates the intesting & bladder, increases GI motility and increased urinary frequency. Miosis (constriction of the pupil). |
|
|
Term
| We don't need to know direct acting or indirect acting r/t Cholinergics, but we do need to know that both cholinergics increase what? |
|
Definition
|
|
Term
| What are cholinergic drugs used to treat? |
|
Definition
| GLAUCOMA (done by reducing the intraocular pressure) or eye surg patients too, they're used to treat various GI & BLADDER DISORDERS (b/c cholinergics increase GI motility and emptying), MYASTHENIA GRAVIS (cholinergics stimulate muscle contractions), to treat ALZHEIMER'S DISEASE (stimulate muscarinic receptors) and also are used to treat EXCESSIVELY DRY MOUTH |
|
|
Term
| Why would bethanechol (Urecholine) be given? |
|
Definition
| It is given post-op to stimulate bladder & urinary excretion. bethanechol (Urecholine) treats urinary retention. |
|
|
Term
| What patients is donepezil (Aricept) given to? What does it increase? |
|
Definition
| Alzheimer's patients, increases ACh which Alzheimer's patients are depleted in, more ACh can help their cognitive functioning. |
|
|
Term
| Why would you give physostigmine (Antilirium)? What category is it in? |
|
Definition
| Cholinergic drug. Given to treat Myasthenia Gravis, increases ACh and improves muscle strength. With Myasthenia Gravis the ACh receptors are degraded & muscle contraction is impaired. Physostigmine (Antilirium) increases the amount of ACh present at the junction (doesn't affect the receptors) just increases chances to have a muscular contraction. |
|
|
Term
| Cholinergic drugs mimic the parasympathetic nervous system and are used for rest & digest. SLUDGE will help you remember Cholinergics. What is that? |
|
Definition
| Salivation, Lacrimation, Urination, Diarrhea, Gastrointestinal, Emesis. (not sure if G is right) |
|
|
Term
| Cholinergic blocking drugs block the action of the neurotransmtitter ____ at the muscarinic receptor sites in the PSNS. Blocking the PSNS allows the ________ nervous system to dominate. |
|
Definition
| ACh, sympathetic nervous system dominates in Cholinergic blockers |
|
|
Term
| Other names for Cholinergic blocking drugs are: |
|
Definition
| anticholinergics, parasympatholytics, and antimuscarinic drugs |
|
|
Term
| Cholinergic blocking drugs allow the _________ nervous system to dominate. |
|
Definition
|
|
Term
| Cholinergic blockers have the therapeutic effect of decreasing muscle rigidity and diminishing tremors. What disease do cholinergic blockers work as treatment for? |
|
Definition
| Cholinergic helps PARKINSON'S DISEASE and reduce EPS sd effects too. |
|
|
Term
| What medication would you give as life support for bradycardia? |
|
Definition
| Atropine - it is used on the unit if a pt's HR is really slow, like 30. Atropine can be given fast or slow & this changes its effects, but Rebecca had never seen it given slow. Usually given IV. Also Atropine is given pre-op to reduce secretions to aspirate on. Atropine is more potent then Scopalamine for this. |
|
|
Term
| What is the saying to remember Atropine OD? |
|
Definition
| "Hot as a hare (increased temperature), mad as a hatter (confused, delirious), red as a beet (flushed face), dry as a bone (decreased secretions, thirst)"... HOT, MAD, RED, DRY! |
|
|
Term
| What drug is used for IBS (irritable bowel syndrome)? |
|
Definition
|
|
Term
| Why would you give tolterodine (Detrol)? |
|
Definition
| overactive bladder, reduce urinary frequency & urgency, reduces GU |
|
|
Term
| Anticholinergics can help with: |
|
Definition
| Parkinson's Disease, Bradycardia, Pulmonary Dysfunction (bronchospasm), Irritable Bowel Syndrome, Reflec Neurogenic Bladder & Incontinence |
|
|
Term
| elderly patient taking anticholinergics should be reminded to: a.) avoid exposure to high temperatures b.) limit liquid intake to avoid fluid overload c.) begin an exercise program to avoid adverse effects d.) stop the medication if excessive mouth dryness occurs. |
|
Definition
| a.) elderly should avoid exposure to high temperatures if on antichoinergics b/c they decrease sweating & loss of normal heart-regulating mechanisms... possible heat stroke. |
|
|
Term
| Adverse Effects associated with the use of cholinergic blockers include: a.) Diaphoresis b.) Dry mouth c.) Diarrhea d.) Urinary Frequency |
|
Definition
|
|
Term
| A nurse administering a cholinergic blocking drug would expect to see which of the following effects in the patient? a.) Miosis b.) increased muscle rigidity c.) increased bronchial secretions d.) decreased GI motility & peristalsis |
|
Definition
| D.) cholinergic-blocking drugs cause DECREASED GI MOTILITY AND PERISTALSIS |
|
|
Term
| During the assessment of a pt about to to receive a cholinergic-blocking drug, the urs eshould determine whether the patient is taking any drugs that may potentiallt interact with the anticholinergic, including: a) Narcotics, such as morphine sulfate b) Antibiotics, such as penicillin c) Tricyclic Antidepressants, such as amitriptyline d) Anticonvulsants, such as phenobarbital |
|
Definition
| C) Tricyclic Antidepressants, such as amitriptyline |
|
|
Term
| The nurse caring for a patient who is receivig B-agonist drug therapy needs to be aware that these drugs cause: a) increased cardiac contractility b) decreased HR c) bronchoconstriction d) increased GI tract motility |
|
Definition
| a) increased cardiac contractility |
|
|
Term
| during a teaching session for a patient who is receving inhaled salmeterol, the nurse emphasizes that the drug is indicated for: a) rescue treatment of acute bronchospasms b) prevention of bronchospasm c) reduction of airway inflammation d) long-term treatment of sinus congestion |
|
Definition
| b) prevention of bronchospasm |
|
|
Term
| for a patient receiving a vasoactive drug such intravenous dopamine, which of the following actions by the nurse is most appropriate? a) monitor the gravity drip infusion closely and adjust as needed b) assess the pt's cardiac function by checking the radial pulse c) assess the iv site hourly to rule out infiltration d) administer the drug IV boluses according to the pt's BP |
|
Definition
| c) assess the iv site hourly to rule out infiltration |
|
|
Term
| A pt is receiving dobutamine for worsening of heart failure. vital signs yesterday were BP, 150/88; pulse rate 88 bpm; respiration rate 16. Vital signs now are BP 170/94, pulse rate 110, respirations 20. The pt is complaining of chest tightness. Which statement is most appropriate regarding the pt's symptoms? a) the changes in vitals are reflective of a therapeutic response to the drug. b) the pt most likely needs a dose of B-agonist to elevate the HR and help with the heart failure c) these changes reflect a need to switch to an oral form of dobutamine d) the presence of chest pain and the changes in vital signs need to be evaluated immediately by the nurse and physician. |
|
Definition
| d) the presence of chest pain & the changes in vitals need to be evaluated immediately by the nurse and physician |
|
|
Term
| When a drug is characterized as having a negative chronotropic effect, the nurse knows to expect: a)improved sinoatrial node firing b) Decreased HR c) decreased extopic beats d) increased force of cardiac contractions |
|
Definition
|
|
Term
| When a patient has experienced infiltration of a peripheral infusion of dopamine, the nurse knows that injecting the alpha-blocker phentolamine (Regitine) will result in: a) local vasoconstriction b) local vasodilation c) local analgesia d) local hypotension |
|
Definition
|
|
Term
| Which statement is most correct for a patient taking a B-Blocker? a)the drug may be discontinued w/o any time constraints b) postural hypotension is not a problem c)weaning off the medication is necessary to prevent rebound hypertension d) the patient should stop taking the medication at once if he or she gains 3-4 lbs. in a week |
|
Definition
| c) weaning off the med is necessary to prevent rebound hypertension |
|
|
Term
| The nurse is providing teaching for a patient who has a new prescription for B1-Blockers will keep in mind that these drugs may result in: a)tachycardia b) tachypnea c) bradycardia d) bradypnea |
|
Definition
|
|
Term
| A pt who has had a recent MI may be placed on which of the following drugs for its cardioprotective effects? a) metoprolol (Lopresor) b) esmolol (Brevibloc) c) prazosin (Minipress) d) phenooxybenazamine (Dibenzyline) |
|
Definition
|
|
Term
| Before initiating therapy with a nonselective B-blocker, the nurse should assess the patient for the presence of: a) HTN b) Liver disease c) Pancreatitis d) Chronic Bronchitis |
|
Definition
|
|
Term
| A pt is taking the direct-acting cholinergic drug betanechol (Urecholine) before meals. After 3 days, he calls his HC provider's office and complains of occasional N & V. What instruction is appropriate? |
|
Definition
| Take this med with meals to reduce GI upset |
|
|
Term
| The family of a pt who has recently been diagnoses with Alzheimer's disease is asking about the new drug prescribed to treat this disease. The pt's wife says, "I'm so excited that there are drugs that can cure this disease! I can't wait for him to start." What is appropriate for the nurse to say? |
|
Definition
| These drugs do not cure Alzheimer's disease. Let's talk about what the physician said to expect with this drug therapy. |
|
|
Term
| When giving intravenous cholinergic drugs, the nurse must watch for symptoms of a cholinergic crisis. WHich of the following is a symptom of this reaction? a) peripheral tingling b) hypotension c) hypertension d) tinnitus |
|
Definition
|
|
Term
| a patient took an accidental OD of a cholinergic drug while at home. He comes to the ER with severe ABD cramping and bloody diarrhea. The nurse expects that which drugs will be used to help this patient? a) Atropine b) Physostigmine c) Lidocaine d) Protamine sulfate |
|
Definition
|
|
Term
| Drugs that increase the force of myocardial contraction are called positive _________ drugs (such drugs have a beneficial role in treating a failing heart muscle). |
|
Definition
|
|
Term
| Drugs that increase the rate at which the heart beats are called positive __________ drugs. |
|
Definition
|
|
Term
| These drugs have to do with how quickly electrical impulses travel through the AV node, bundle of HIS & purkinje fibers. Drugs that accelerate conduction are referred to as positive ____________ drugs. |
|
Definition
|
|
Term
| What are the 3 tropic effects of digoxin? |
|
Definition
| POSITIVE INOTROPIC (increases heart contraction) NEGATIVE CHRONOTROPIC (reduces the HR) and NEGATIVE DROMOTROPIC (decreases AV conduction through the heart) |
|
|
Term
| Digoxin helps _____ ______ because of its positive inotropic effects. The negative chronotropic & negative dromotropic effects will actually help with ______________ and abnormal ___________. |
|
Definition
| Heart Failure (you have decreased contractility with HF & Digoxin helps increase contractility). Tachycardia & Abnormal Dysrhythmias - Such, as Atrial Fibrilation. |
|
|
Term
| The big 2 things that Digoxin helps with are: |
|
Definition
| Heart Failure, Tachycardia |
|
|
Term
| What do we need to consider before giving Digoxin? |
|
Definition
| The patients HR b/c you will be affecting it. So, check the patients pulse or HR before giving Digoxin. |
|
|
Term
| Why do we need to memorize the blood levels of Digoxin? What should it be between? |
|
Definition
| Digoxin has a very narrow therapeutic index, blood levels need to be between 0.5-2.0. |
|
|
Term
| If someone is toxic and has too much Digoxin in their blood stream what are some of the signs? |
|
Definition
| Halo vision around lights, BRADYCARDIA, very nauseated & vomiting and can't eat anything. Often elderly patients come in & they're having N & V, visual disturbances and you get their blood levels drawn and sure enought they're digoxin toxic. They're above 2.0. |
|
|
Term
| How often is Digoxin taken a day? What time? Why? |
|
Definition
| ONCE a day. at 1:00. It is not given at 9:00 am b/c if they are having their blood levels drawn then that gives time to get their blood levels back. |
|
|
Term
| Who is prone to Digoxin toxicity? |
|
Definition
| ELDERLY people, people who are DEHYDRATED & people with HYPOKALEMIA (less then 3.5 K+ in blood) are prone to toxicity. |
|
|
Term
| Antianginal drugs are given to prevent _______. what is that again? |
|
Definition
| angina. This is chest pain d/t decreased blood flow to the myocardium. It affects people that have coronary artery disease. When fat & plaque build up in arteries it decreases blood flow to the myocardium. Antianginal drugs are given to help with that. |
|
|
Term
| What are the 3 classes of antianginal drugs? |
|
Definition
| 1. Nitrates 2. Beta-Blockers 3. Calcium Channel Blockers |
|
|
Term
| Nitrates work by causing vessel __________. |
|
Definition
| DILATION. Nitrates dilate arteries AND veins. The potent dilating effect on the myocardium is very beneficial for someone having angina. |
|
|
Term
| Why would you give a patient Isosorbide mononitrate (Imdur)? How is it given? |
|
Definition
| Angina. Imdur is a nitrate that would work by vasodilating. It is given by PILL. |
|
|
Term
| What category does Nitro-Bid & Nitrostat fall under? |
|
Definition
| Nitroglycerin (under antianginal drugs) |
|
|
Term
| How is Nitrostat taken? Is Nitrostat used to treat or prevent angina then? |
|
Definition
| Sublingually, to treat angina. When they feel pain they put the pill under their tongue where it is very vascular to cause the potent dilating effect on coronary arteries. Also dilates blood vessels in the brain so they will likely get a terrible headache too. |
|
|
Term
| Because of the potent dilating effect on arteries, what should you check as a nurse before giving nitroglycerins (Nitro-Bid or Nitrostat perhaps)? |
|
Definition
| you have gotta check their BLOOD PRESSURE. If it is low already, you are going to bottom them out. When the dilation occurs, the blood pressure drops. |
|
|
Term
| When teaching your patient, how often can Nitrostat be taken? |
|
Definition
| Every 5 minutes, up to a max of 3. If they still have chest pain after 3 then they should call 911 immediately. |
|
|
Term
| You should teach a patient taking nitroglycerin to do which one? a) take the med when they can't take the pain anymore b) chew the tablet c) keep a journal d) remember when they had their pain |
|
Definition
| c) keep a journal - best way of documenting how the pt feels, includes how many anginal episodes occur, what happens, charachter & intensity of the pain, frequency, precipitating and relieving factors. Take notes on how the medication is tolerated. |
|
|
Term
| What should you teach a patient taking aerosol nitroglycerin? |
|
Definition
| do not shake the canister before lingual spraying and avoid inhaling or swallowing the lingual aerosol until the drug is dispersed. |
|
|
Term
| Your patient taking nitroglycerin said he stopped taking his nitroglycerin b/c it burned under his tongue. What would you say? |
|
Definition
| They should expect burning or stinging once the med is placed under the tongue. If it does not burn, then the drug may have lost its potency & a new prescription must be obtained. Emphasize the med is only potent for 3-6 months & they'll need to always have a fresh supply on hand. |
|
|
Term
| What position would you advise a patient to be in when taking nitroglycerin? |
|
Definition
| To be seated or lying down when taking the medication to avoid falls secondary to a drop in blood pressure |
|
|
Term
| Where should patients keep their nitroglycerin meds? |
|
Definition
| away from moisture, light, heat, and coton filler and to keep the medication in original packaging (amber colored glass container). Keep the sublingual tablet under tongue until completely dissolved too (no eating or drinking to take the sting away). |
|
|
Term
| Nitro-Bid is another nitroglycerin that works by vasodilation to prevent angina. What route is it given? is to treat or prevent angina? |
|
Definition
| Patch (so dermally or topically) - given to PREVENT angina. It has a slow onset of action with a long duration. So, you would not use Nitro-Bid for someone who is in acute pain. |
|
|
Term
| Since Nitro-Bid has a slower onset then Nitrostat, does it still have AE? |
|
Definition
| Yes, you still need to inform & monitor the patient the first time they take the meds for the low BP & propable headache. Let them know it will get better, but their body just needs to adjust to it. |
|
|
Term
| How do Beta-Blockers prevent angina? |
|
Definition
| beta-blocker drugs decrease the HR, decrease contractility, and decrease BP... so if your patient is at risk for angina (has coronary heart disease) then doing these things allow the heart to not work so hard. |
|
|
Term
| How do Calcium Channel blocking drugs help angina? |
|
Definition
| work by blocking calcium channels in the smooth muscles of the coronary arteries. it causes VASODILATION. Also blocks the other arteries in the body. So, calcium channel blocks also have negative tropic effects and DECREASE myocardial contractility. Not a good thing for someone with HF, but is good for someone with angina. |
|
|
Term
| What do calcium channel blockers have a positive or a negative inotropic effect? what about chronotropic? dromotropic? |
|
Definition
| Negative inotropic effect (decreases contractility), negative chronotropic effect, negative dromotropic effect. So, calcium channel blockers are also used for dysrhythmias b/c of the negative chronotropic & negative dromotropic. |
|
|
Term
| What are some adverse effects of calcium channel clockers vasodilation? |
|
Definition
| headaches, lower BP, PULMONARY EDEMA (the decreased cardiac contractility puts the person at risk for pulmonary edema b/c blood gets backed up in lungs & increases fluid in lungs. It causes arterial dilation: so peripherally it increases capillary filtration pressure. Causes of edema: too much blood in the artery will cause blood to move from inside vessel walls out into the interstitial space.) |
|
|
Term
| Antihypertensive key drugs are: |
|
Definition
| adrenergic is CLONODINE (Catapres), ace inhibitor is CATOPRIL (Capoten), Ang II receptor blocker or antagonist is LOSARTAIN (Cozaar), and the direct acting vasodilator is HYDRALAZINE (Apresoline). |
|
|
Term
| Antihypertensives are medications used to treat ________. |
|
Definition
|
|
Term
| Clonidine (Catapres) is our adrenergic antihypertensive drug. Where & how does it work? |
|
Definition
| Central-acting... works in the brain to decrease BP |
|
|
Term
| Sd effects of clonidine (Catapres)? |
|
Definition
| sedation, drowsiness, dizziness. Assist to the bathroom or to stay sitting to avoid falls. Educate about operating heavy machinery & no driving. |
|
|
Term
| Captopril (Capoten) is our ___ ____________ antihypertensive. |
|
Definition
|
|
Term
| What is the ace inhibitor antihypertensive: Captropril (Capoten) mechanism of action? |
|
Definition
| inhibits the renin-angiotensin-aldosterone system (does not allow Na+ & Water resporption to happen which can raise BP). Ace Inhibitors help the heart by decreasing BP and decreasing SVR. They do so by preventing breakdown of vasodilating bradykinin and Substance P and prevent formation of Substance P. All this decreases afterload, or the resistance against which the left ventricle must pump to eject its volume of blood during contraction. The ACE inhibitors are beneficial in the treatment of heart failure b/c they prevent sodium & water resorption by inhibiting aldosterone secretion. This causes diuresis, which decreases BV and return to the heart. This decreases preload and required work of the heart. |
|
|
Term
| What are AE of Captopril (Capoten) the ace inhibitor antihypertensive? |
|
Definition
| Fatigue, Dizziness, Mood Changes, Headaches. A DRY NON-PRODUCTIVE COUGH, HYPERKALEMIA |
|
|
Term
| losartan (Cozaar) is an _______what?________________ receptor blocker, antihypertensive drug. |
|
Definition
| Angiotensin II receptor blocker = Cozaar |
|
|
Term
| The Ace inhibitor captopril (Capoten) works stopping the conversion of _____ to ____. |
|
Definition
|
|
Term
| Ace inhibitors block the breakdown of bradykinins and substance P, which accumulates and may cause adverse effects such as a ______. |
|
Definition
| cough (Captopril (Capoten) will cause a non-productive cough!) |
|
|
Term
| Ang II Receptor Blockers (ARBs) affect primarily vascular smooth muscle & the adrenal gland. They selectively block the binding receptors in the tissues, ARBs block vaso_____ and the secretion of _______. |
|
Definition
| constriction, aldosterone |
|
|
Term
| Ace Inhibitor captopril (Capoten) and Ang II Receptor Blocker or antagonist, losartan (Cozaar) appear to be equally effective for the treatment of ________. Both are well tolerated, but ARBs do not cause a _____. |
|
Definition
|
|
Term
| Most common AE of Ang II Receptor Blocker (ARBs) losartan (Cozaar) are what?? |
|
Definition
| upper respiratory infections & headaches. |
|
|
Term
| losarten (Cozaar)is beneficial in patients with ___________ and with ___________. |
|
Definition
| hypertension & with Heart Failure (more & more) |
|
|
Term
| Hydralazine (Apresoline) is the last antihypertensive that is a direct acting ________________. |
|
Definition
|
|
Term
| hydralazine (Apresoline) MOA is as a direct-acting vasodilator. Particularly its ability to cause _________ vasodilation. This results in a reduction of SVR causing a __________ effect. |
|
Definition
| peripheral vasodilation, reduces SVR, causes a hypotensive effect |
|
|
Term
| Diuretic drugs are going to __________ urinary output. |
|
Definition
|
|
Term
| Particularly for diuretics, but what is ALWAYS the best indicator for fluid volume? |
|
Definition
| it is ALWAYS weighing the patient, same time everyday on the same scale. 1 lb. is equivalent to 1 liter of fluid. |
|
|
Term
| When we give diuretics it is important to check ___________ levels before we give it. |
|
Definition
| Potassium (check this before giving Lasix b/c it's notorious for causing Hypokalemia) |
|
|
Term
| ANTIHYPERTENSIVE's Adrenergic Agents key drug is what? |
|
Definition
|
|
Term
| What type of an agent is clonidine (Catapres)? |
|
Definition
| centrally acting - it works on the brain |
|
|
Term
| An AE of adrenergic agent drug clonidine (Catapres) is sedation & drowsiness, why does this happen? |
|
Definition
|
|
Term
| Why does clonidine (Catapres) cause orthostatic hypotension? |
|
Definition
| A sudden drop in BP during changes in position |
|
|
Term
| What can clonidine (Catapres) have interactions with? |
|
Definition
| other CNS depressants - be careful with alcohol, benzodiazepines & opioids |
|
|
Term
| The ACE inhibitor drug captopril (Capoten) works by... |
|
Definition
| remember the RAAS? these drugs block the angiotensin converting enzyme (ACE), which ulitimately prevents vasoconstriction and aldosterone secretion. |
|
|
Term
| Ace Inhibitors "the pril" drug is captopril (Capoten) is used to treat: |
|
Definition
| HTN, stops progression of ventricular remodeling post MI (has a "cardioprotective effect"). It is the drug of choice for what population? diabetics |
|
|
Term
| Ace inhibitor drug captopril (Capoten) side/AE's is what? |
|
Definition
| persistent, non-productive cough is a classic side effect. Others? Fatigue, dizziness, mood changes and headaches, loss of taste, proteinuria, hyperkalemia, rash, pruritis, anemia, neutropenia, thrombocystosis and agranulocytosis. |
|
|
Term
| What drug interactions does ACE inhibitor drug captopril (Capoten) have? |
|
Definition
| LOTS of drug interactions, hyperkalemia may occur when ACE inhibitors are given with K+ sparing diuretics or K+ supplements. |
|
|
Term
| Ang II receptor blocker (ARB) drug is losartan (Cozaar) does not cause the classic cough like ACE inhibitors do, but what do they cause? |
|
Definition
| Upper respiratory infection and headache; occasionally-dizziness, inability to sleep, diarrhea, dyspnea, heartnurn, nasal congestion, back pain, and fatigue. |
|
|
Term
| What else may the Vasodilator class of drugs be used for? |
|
Definition
| Stopping unwanted hair growth in women |
|
|
Term
| You are preparing to administer hydralazine (Apresoline) to your elderly client. What is important to assess first? |
|
Definition
| Coronary artery disease and mitral valve dysfunction; history of childhood rheumatic fever |
|
|
Term
| Why assess respiratory status & K+ serum levels prior to giving captopril (Capoten)? |
|
Definition
| AE is HYPERKALEMIA; ACE inhibitors tend to promote K+ resorption in the kidney, although they also promote sodium excretion d/t their reductions of aldosterone excretion. rare AE is ANGIOEDEMA - (laryngeal swelling) a strong vascular reaction involving inflammation of submucosal tissues and can progress to anaphylaxis. |
|
|
Term
| Common AE of Ace inhibitors? |
|
Definition
| fatigue, dizziness, mood changes, headaches. a characteristic dry, nonproductive cough. |
|
|
Term
| Which of the following is of the most concern for the older adult patient taking antihypertensive drugs? a) dry mouth b) hypotension c) restlessness d) constipation |
|
Definition
|
|
Term
| When giving antihypertensive drugs, the nurse must consider giving the first dose at bedtime for which of the following classes of drugs? |
|
Definition
| alpha blockers such as prazosin (Minipress) should be given at bedtime |
|
|
Term
| A 56 y.o. man started taking antihypertensive drug therapy 3 months earlier and is in the office for a follow-up visit. While the nurse is taking his BP, he informs the nurse that he has had some problems with sexual intercourse. What is an appropriate response by the nurse? |
|
Definition
| The physician can work with you on changing the dose and/or drugs |
|
|
Term
| When a pt is being taught about the potential AE of an ACE inhibitor, which of the following should be mentioned as possibly occuring when this drug is taken to treat hypertension. a) Hypokalemia b) Nausea c) dry, nonproductive cough d) sedation |
|
Definition
| c) dry, nonproductive cough |
|
|
Term
| a patient has a new prescription for an adrenergic drug. During a review of the patient's list of current medications, which would cause concern about a possible interaction with this new prescription? a) benzodiazepine taken as needed for allergies b) multivitamin with iron taken daily c) oral anticoagulant taken daily d) an NSAID taken as needed for joint pain |
|
Definition
| a) benzodiazepine taken as needed for allergies. Adrenergics need to be careful of other CNS depressants like alcohol, opioids and benzodiazepines. |
|
|
Term
| An advantage of Loop Diuretics is they can work even if __________ clearance is low. (<25 mL/min; nl is 125 mL/min) |
|
Definition
|
|
Term
| Most commonly used loop diuretic? |
|
Definition
|
|
Term
| Loop diuretics MOA is potent _______ with loss of fluid. Which results in what? |
|
Definition
| diuresis, decreased return of blood to the heart or decreased filling pressures. |
|
|
Term
| What cardiovascular effects does loop diuretics like Lasix havee? |
|
Definition
| reduces BP, reduces pulmonary vascular resistance, reduces systemic vascular resistance, reduces ventral venous pressure, reduces left ventricular end-diastolic pressure |
|
|
Term
| Loop Diuretics like Lasix are indicated in the use of: |
|
Definition
| Edema with heart failure, hepatic (cirrhosis) and renal disease. HTN. and it will increase the renal excretion of calcium in patients with hypercalcemia. |
|
|
Term
| The major AE of loop diuretics like Lasix is what? other sd effects might be? |
|
Definition
| HYPOKALEMIA, CNS-dizziness, HA, tinnitus, blurred vision. GI- N&V, diarrhea. Hemetologic-agranulocytosis, thrombocytopenia, neutropenia. Metabolic-hyperglycemia, hyeruricemia. |
|
|
Term
| Because Lasix is such a common drug - it is really important to consider its interactions. What happens when it is given with ibuprofen (NSAID)? |
|
Definition
| Decreased diuretic activity |
|
|
Term
| Because Lasix is such a common drug - it is really important to consider its interactions. What happens when it is given with digoxin? |
|
Definition
| increased risk of digoxin toxicity (hypokalemia) |
|
|
Term
| What is the key drug in the osmotic diuretics class? |
|
Definition
| Mannitol : the osmotic diuretic of choice. Used commmonly in the early stages of renal failure. |
|
|
Term
| What is the osmotic diuretic Mannitol's MOA? It produces ____________ in the glomerular filtrate >>>> pulls fluid into tubules >>> resulting in diuresis. |
|
Definition
|
|
Term
| Osmotic diuretics like Mannitol are indicated for use in what patients? The early oliguric phase of _________________, increased intracranial pressure and cerebral edema. |
|
Definition
|
|
Term
| What are some significant undesirable effects of mannitol? Other less significant effects? |
|
Definition
| significant AE of mannitol: CONVULSIONS, THROMBOPHLEBITIS, and PULMONARY CONGESTION. Other less significant effects: headaches, chest pains, tachycardia, blurred vision, chills and fever. |
|
|
Term
| What is the key drug for potassium - sparing diuretics? |
|
Definition
| Spironolactone (Aldactone) |
|
|
Term
| What is the MOA of spironolactone (Aldactone)? |
|
Definition
| Binds to aldosterone receptors >>> blocks resorption of Na+ and water |
|
|
Term
| Potassium Sparing Diuretics like Spironolactone is indicated for use in: |
|
Definition
|
|
Term
| What F & E imbalance is the AE of spironolactone (Aldactone) K+ sparing diuretic? |
|
Definition
|
|
Term
| What other AE does spironolactone have? |
|
Definition
| CNS=dizziness, headache GI=cramps, nausea, vomiting, diarrhea Other=urinary frequency, weakness, hyperkalemia |
|
|
Term
| If you're on a potassium sparing diuretic like spirolactone, giving ACE inhibitors or K+ supplements can result in _____________. |
|
Definition
|
|
Term
| Thiazides is a category within Diuretics. What is the key drug? |
|
Definition
|
|
Term
| What is the MOA of thiazides? It works best with what? |
|
Definition
| Inhibit the resportion of Na+, K+, Cl- >>> result in: osmotic water loss. Direct relaxation of arterioles >>> reduces afterload. Works best with adequate creatinine clearance (> 50 mL/min) |
|
|
Term
| Thiazides like hydrochlorothiazide are indicated when? |
|
Definition
| for edema, hypercalcuria, disabetes insioidus, HTN |
|
|
Term
| What are the electrolyte & metabolic disturbances associated with hydrochlorthiazide? |
|
Definition
| These are mainly reduced potassium levels and elevated levels of calcium, lipids, glucose and uric acid. So, hypokalemia, glycosuria, hyperglycemia, hyperuricemia, hypochloremic alkalosis. |
|
|
Term
| What drugs will interact with hydrocholorthiazide? |
|
Definition
| corticosteroids, digitalis, and oral hypoglycemics |
|
|
Term
| What 3 things must the nurse assess when giving a thiazide like hydrochlorothiazide? |
|
Definition
1. Baseline fluid volume status (taken with vital signs, weight, and intake & output measurements. 2. Postural blood pressures (so lying down, sitting & standing) should be assessed before and during drug therapy b/c of diuretic-induced fluid volume loss. This volume loss may lead to postural hypotension or a drop in BP (20 mm Hg or more) upon standing
3. Skin turgor, status of moisture levels of mucous membranes, and capillary refill are also important to assess with diuretic therapy. |
|
|
Term
| List things you will want to do when giving hydrochlorothiazide? |
|
Definition
| BP, pulse rate, I & O, and daily weights should be measured when on diuretic therapy. EKG or heart monitor b/c diuretics can cause cardiac irreularity. Fluid loss can lead to constipation so you can prevent this will diet changes or use of naturally occuring bulk formers like Metamucil, take hydrochlorothiazide with food to prevent GI upset, look for signs & symptoms of hyperkalemia: N & V, diarrhea, abd cramping and report immediately. |
|
|
Term
| Patient teaching tips for diuretics: what should they eat? What should they supplement with? How should they change positions? should fluids be forced? how can constipation be prevented? Why do you keep a journal? |
|
Definition
| Need to eat potassium rich foods if on K+ sparing diuretics (like bananas, oranges, dates, raisins, plums, fresh vegs) whole grains, meat, Potassium supplement might be necessary if below 3, change positions slowly, forcing fluids may be dnecessary, prevent constipation by increasing fiber, keep a journal noting weight & how they feel. |
|
|
Term
| Pt's on diuretics should be taught about the S & S of hypokalemia. What are they? What climates do diuretic drug pts need to avoid? |
|
Definition
| weakness, leg cramps, other cramping. Avoid excessively hot climates, fever and the use of saunas or hot tubs. The heat further increases further loss of potassium and sodium through sweat. Excessive sweating, vomiting or fluid loss with be exacerbated on diuretics. |
|
|
Term
| What do diuretics do to DM patients? |
|
Definition
| Diuretics may cause an elevation in blood glucose & DM pt's need to monitor it closely. |
|
|
Term
| hydrochlorothiazide is the prototypical thiazide diuretic. What is it prescribed in? What related effects need to be monitored with thiazides? |
|
Definition
| hepatic cirrhosis, edema and heart failure. hypokalemia, hypercalcemia, hyperlipidemia, hyperglycemia and hyperuricemia. |
|
|
Term
| AE which nurse should monitor in patients taking loop and/or thiazide diuretics is metabolic _________. Also, drowsiness, lethargy, tachycardia, hypotension, leg cramps, restlessness, decreased mental alertness. |
|
Definition
|
|
Term
| Key point for antidysrhythmics... The key point: Any abnormality in cardiac automaticity or impulse conduction will result in some type of _________. Then, an __________ agent will be prescribed! |
|
Definition
| dysrhythmia, antidysrhythmic |
|
|
Term
| What are the 2 antidysrhythmic drugs? |
|
Definition
| lidocaine (Xylocaine) and amiodarone (Cordarone) |
|
|
Term
| lidocaine (Xylocaine) is used ONLY to treat ______________. |
|
Definition
| ventricular tachycardia (VT) - rapid heart rate that originates out of the ventricle. |
|
|
Term
| What is the only drug route for Lidocaine? |
|
Definition
| always given IV.. it works really fast & it is usually given in an emergency situation |
|
|
Term
| If a guy comes into the ER with decreased CO and his BP is real low. You do an ECG & his QRS is really fast. What drug would you use? What are its side effects? |
|
Definition
| Lidocaine b/c it is going to react very quickly. Sd effects are hypotension, can cause bradycardia, lots of CNS effects: confusion, convulsions, some tremors. |
|
|
Term
| Amiodarone (Cordarone) is given for what heart dysrhythmia? |
|
Definition
| supraventricular and ventricular tachycardia (VT & VT). So rapid heart beats that originate above the ventricular (such as atrial fibrillation). |
|
|
Term
| Amiodarone (Cordarone) is aviailable in what drug routes? |
|
Definition
| Oral, injectable & IV routes |
|
|
Term
| What kind of half life does Amiodarone (Cordarone) have? |
|
Definition
| very, very long... like 15-100 days |
|
|
Term
| What are the sd effects of Amiodarone (Cordarone)? |
|
Definition
| Can effect the thyroid (can get hypo or hyperthyroidism), can get visual disturbances (microcorneal deposits in the eye), gives a blue/gray color to their skin & is worse with sun, pulmonary fibrosis (scarring of the lungs). B/c of the pulmonary fibrosis risk the patient needs to have their pulmonary function tested & then monitored every 6 months when on Amiodarone (Cordarone). |
|
|
Term
| warfarin sodium (coumadin), enoxaparin (Lovenox) and Heparin are all ____________. |
|
Definition
|
|
Term
| Aspirin & clopidogrel (Plavix) are _________. |
|
Definition
|
|
Term
| streptokinase (Streptase) is a _____________ ________. |
|
Definition
| thrombolytic agent. Which means it is going to break down clots. |
|
|
Term
| Anticoagulants and antiplatelets are used to ____________ clots and thrombolytic agents are used to _______ ______ clots. |
|
Definition
|
|
Term
| What are coagulation modifying agents prescribed for? |
|
Definition
| A formation of thrombosis is primarily the cause of the infarction. It can be used to prevent DVT, can be used to prevent an ischemic stroke (would NOT be given for hemoregic stroke then), used for atrial fibrillation (it's quivering and every once in a while it fires, blood hangs out there & it is very common to get a stroke from this). They are put on Coumadin to keep them from forming a clot. |
|
|
Term
| Coagulation modifying agents cause what AE? |
|
Definition
| extra bleeding in gums when they floss, Sub Q Heparinor Lovenox will have bruised bellies b/c it's given in the abdomen, all put patients at risk for excessive bruising though, pt's need to be aware if blood in urine or in their stool. Bloody stools will most often be black btw. (if it's up high it's black, if it is bright red then it's down low in intestine - less common). |
|
|
Term
| When patients are on Coumadin & Heparin the nurse needs to pay close attention to what their patients clotting times are. With warfarin (Coumadin) we look at lab values of prothrombonin time or International Normalized Ratio (INR). We want our patients clotting times when on COUMADIN to be ____ times the control. |
|
Definition
|
|
Term
| If a normal persons blood clots at 12 seconds, then a patient on Coumadin should clot in about _____ seconds. |
|
Definition
| 18 seconds (this is about 1.5 times the control). |
|
|
Term
| What is the route of warfarnin (Coumadin)? |
|
Definition
| It is only available for oral use. It is the most common PO anticoagulant. |
|
|
Term
| Why was INR developed? What is a healthy INR range? |
|
Definition
| International Normalized Ratio (INR) made blood level variance all of the world on the same levels. We want 2.0-3.0. If you had a patient with an atrial fibrillation, the INR is checked & they have a 2.4 that is good. If they have a 4.5 that is bad & they're at risk for bleeding out. Do NOT stick them with a needle! |
|
|
Term
| When patients are on Heparin we measure ______. |
|
Definition
| partial thromboplastin time (PTT) |
|
|
Term
| If you are on Heparin, you want the partial thromboplastin time (PTT) to be ____-____ times the control. |
|
Definition
|
|
Term
| The control takes 25 seconds to clot. How long should the patient on Heparin take to clot? |
|
Definition
| Between 1.5 - 2.5 times. 37 seconds-50 seconds. |
|
|
Term
| What if the control takes 25 seconds to clot. The Heparin patient takes 80 seconds to clot! Would you slow down or speed up the rate of Heparin? |
|
Definition
| you would SLOW down or decrease the rate of Heparin. (maybe just stop it) |
|
|
Term
| What lab value do you follow for streptokinase? |
|
Definition
|
|
Term
| All drugs in the Antilipemics category end in "__________." |
|
Definition
|
|
Term
| The nurse is teaching a patient about self-administration of Lovenox. What would you include in the teaching session? a) teach family member to give drug in arm b) drug is given in the folds of your abdomen, but at least 2 inches away from your naval c) this drugs needs to be taken at the same time every day with water d) be sure to massage the injection site thoroughly |
|
Definition
| b) Lovenox is given in the folds of abdomen, at least 2 inches from the naval |
|
|
Term
| How does atrovastatin (Lipitor) work? |
|
Definition
| It blocks an enzyme that is necessary for the production of cholesterol. In a nutshell, it stops the production of cholesterol. |
|
|
Term
| What are the sd effects when on atrovastatin (Lipitor)? |
|
Definition
| Since it stops production of cholesterol in the liver - we play close attention to liver function tests. They would not be able to consume alcohol if on Lipitor. Also effects anticoagulants. It increases clotting time with Lipitor. If they're on Lipitor with Coumadin then they are at a doubly increased risk for bleeding. |
|
|
Term
| How does Cholestyramine (Questran) work? |
|
Definition
| It is a bile acid sequestrant. It works by binding with bile acids that are necessary for the absorption of cholesterol. In a nutshell, it PREVENTS absorption of cholesterol. (It also decreases the absorption of fat soluble vitamins) |
|
|
Term
| What form do you take cholestyramine (Questran) in? When should you take it? What does it cause? |
|
Definition
| Questran is a powder that goes in juice & they drink. It is usually due at meal times. Since it works in the GI tract, Questran will cause belching, bloating and heartburn with it. |
|
|
Term
| How does niacin (Nicobid, Vitamin B3) is a unique lipid lowering drug, it is also a vitamin. how does it work? |
|
Definition
| not really sure how they work, the MOA of niacin is unknown |
|
|
Term
| niacin (Nicobid, Vitamin B3) can cause what AE? |
|
Definition
|
|
Term
| gemfibrozil (Lopid) is a _____ ______ __________. |
|
Definition
|
|
Term
| How does gemfibrozil (Lopid) work? |
|
Definition
| activates lipolipase. It BREAKS DOWN CHOLESTEROL, that's how it works. We look at their LDL which we want to be low. Look at the HDL which we want to be high b/c that is what takes cholesterol back to the liver. So, gemfibrozil (Lopid) may have effects on triglycerides, lower LDL's & raise HDL's. |
|
|
Term
| Unfortunately, gemfibrozil (Lopid) is associated with a higher incidence of ______________ & probably increases ____________. |
|
Definition
| gallstones (cholelithiasis) & incrases bleeding time. |
|
|
Term
| An antilipemic is a drug that decreases _______ levels. |
|
Definition
|
|
Term
| What antilipemics decrease LDLs? |
|
Definition
| all of them decrease LDLs |
|
|
Term
| what antilipemics increase HDLs? |
|
Definition
| all of them increase HDLs |
|
|
Term
| What antilipemics decrease triglycerides? |
|
Definition
| All decrease triglycerides except Questran the bile acid sequestrant. |
|
|
Term
| If you had a patient that had high triglycerides, what antilipemic would you avoid? |
|
Definition
| cholestyramine (Questran), the bile acid sequestrant |
|
|
Term
| What is Simvastatin ( Zocor )? |
|
Definition
| It is a HMG-CoA Reductase Inhibitors, commonly referred to as "statins." (our other key drug in this category is atrovastatin ( Lipitor ). They are considered a first-line therapy for the treatment of high cholesterol. HMG-CoA Reductase is a chemical made in our bodies that helps the liver produce cholesterol. Statins get in the way of that process, thus reducing the amount and frequency of cholesterol being produced. |
|
|
