Pharmacology Hesi 2023<\/p>\n\n\n\n
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<\/p>\n\n\n\n
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<\/p>\n\n\n\n
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<\/p>\n\n\n\n
What is the normal digoxin level?
0.5-2 ng\/mL<\/p>\n\n\n\n
Normal serum potassium level is
3.5-5.0 mEq\/L<\/p>\n\n\n\n
Low potassium or magnesium levels may increase risk for
Digoxin toxicity<\/p>\n\n\n\n
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.<\/p>\n\n\n\n
When should you hold off on giving digoxin drug therapy?
if apical pulse is less than 60<\/p>\n\n\n\n
What effects do Calcium channel blockers (-dipine; amlodipine (Norvasc), nifedipine (Procardia) cause
produce vasodialation and reflex tachycardia
(lowers BP but increases HR)<\/p>\n\n\n\n
Verapamil and diltiazam produce
vasodialation and cardiosuppresssion (lowers BP and Lowers heart rate)<\/p>\n\n\n\n
Beta blockers have the drug ending
-OLOL such as atenolol, propanolol, esmolol, ect.)<\/p>\n\n\n\n
Beta 1 blocks receptors in the
heart<\/p>\n\n\n\n
Beta 2 blocks receptors in the
lungs<\/p>\n\n\n\n
Beta blockers can be non selective so be aware of any
respiratory conditions such as asthma, emphysema COPD, ect.<\/p>\n\n\n\n
A nurse should always check _ and _<\/em><\/strong> before giving a beta blocker Why do you never stop taking a Beta BLocker abruptly When would a nurse hold HTN medication Labetalol? Side effect of Labetalol (beta blocker) is It is important to assess _<\/strong> when taking a beta blocker such as Labetalol is it OK to give nitroglycerin to a patient who is hypertensive? If an ICU patient on a nirto drip becomes hypotensive what immediate action should the nurse take? This drug is used for a rapid diuresis in emergencies to decrease pulmonary edema Furosemide (Lasix) can cause When taking furosemide (Lasix) a nurse should assess for what signs of hypokalemia? Side effects with aminoglycosides (-mycin drugs) Foods containing potassium It is important to use a large vein, such as AC (antecubital when administering __<\/em><\/strong> because it can irritate the vein It is important to notify the nurse immediately is burning at the IV site when giving potassium because this can result in Can potassium be given in a fast IV push? Which antihypertensives will raise potassium? Which antihypertensives will lower potassium? This drug can be administered via NG tube or as an enema to reduce severe serum potassium levels when life threatening values are seen To correct severe hyperkalemia administration of What are some potassium sparing diuretics that inhibit sodium and water reabsorption? What is important when teaching patients to take diuretics? ACEs and ARBs are often taken with other thiazide diuretics to treat\u2026 When taking an atorcastatin (Lipitor) the should increase whereas the _<\/strong><\/em><\/strong> and total cholesterol should decrease. An important patient teaching on diet when taking statin medications is
AP and BP
do not give if HR is below 60
never stop abruptly<\/p>\n\n\n\n
Must taper because angina or MI can orccur<\/p>\n\n\n\n
A patient with a low pulse rate.<\/p>\n\n\n\n
weight gain \/ fluid retention
montioring weight is one of the best indicators of loss\/gain
1kg is equivalent to 1,000 mL<\/p>\n\n\n\n
pulmonary<\/p>\n\n\n\n
Yes<\/p>\n\n\n\n
titrate (decrease the rate) of the nitro drip.<\/p>\n\n\n\n
Furosemide (Lasix) a loop diuretic<\/p>\n\n\n\n
hypokalemia<\/p>\n\n\n\n
muscle cramps and muscle weakness
Hypotension
F\/E abnormalities
dehydration<\/p>\n\n\n\n
dizziness
head ache
tinnitus
N\/V\/D
low potassium
hyperglycemia
ototoxicity<\/p>\n\n\n\n
dried fruits, fish, leafy veggies, squash, beans, meats, nuts, bananas, potatoes, dairy products<\/p>\n\n\n\n
potassium<\/p>\n\n\n\n
necrosis of the tissue<\/p>\n\n\n\n
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<\/p>\n\n\n\n
ACEs (-pril)
ARBs (-sartan)
and other renin inhibitors<\/p>\n\n\n\n
loop diuretics such as furosemide (-ide) and thiazides such as hydrochlorthiazide<\/p>\n\n\n\n
Sodium polystyrene sulfonate (Kayexalate)<\/p>\n\n\n\n
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<\/p>\n\n\n\n
Spionolactone (Aldactone), amiloride (Midamore), triamterene (Dyrenium)<\/p>\n\n\n\n
Take in the AM
avoid salt substitutes<\/p>\n\n\n\n
Edema, hypertension, and heart failure<\/p>\n\n\n\n
HDL increases
LDL decreases<\/p>\n\n\n\n
eating a diet low in animal fats and high in fiber<\/p>\n\n\n\n