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NCLEX Pharm Review Propanolol atenolol and metoprolol, What are these, what do we watch for Beta blockers- will decresea BP and HR Avoid with asthma patients, monitor for bronchoconstriction/spasm Will mask hypoglycemia in type 1 diabetics Will mask tachycardia in hypovolemia Clonidine, prazosin, and terrazosin- what are they, what do they work on, what must you watch and how do they work?These are alpha 1 blockers for HTN (some BPH) Works on Smooth muscle and is centrally acting Watch for dizziness and sedation Used a patch and changed once weekly Verapamil, dilitiazem, amlodipine, and nifedipine- What are they for/are they, how do they work and a s/e Calcium channel blockers of influx calcium Will keep vasculature relaxed, decreses SA, AV node conduction For antihypertension and antidysrhythmias Monitor for edema and hypotension verapamil- can have constipation Enalapril, lisinopril, and captopril, How does it work and side effects?Blocks angiotension converting enzyme in renin angiotensin loop S/E- dry cough, angioedema(SERIOUS LIFE THREATENING) MOnitor renal function
Losartan, Valsartan, and Irbesartan- what does it do, what should you moitor and S/E Blocks angiotensin II receptors in the renin angiotensin loop
Monitor potassium level: may ↑ esp. w/K+
Monitor renal function
Angioedema: (dyspnea, facial swelling)
What are diuretics used for, what should you monitor?Used for both antihypertensive effects & control of edema Monitor electrolytes; for dehydration; orthostatic hypotension (especially with alcohol & CNS drugs); digoxin/lithium toxicity risk increases; hyperglycemia risk (monitor especially with diabetes mellitus) Use cautiously with renal impairment What is a thiazide diuretic?hydrochlorothiazide Furosemide, bumetanide- what are they and what do you monitor?Loop Diuretics Monitor for hypotension, ototoxicity & potassium depletion.Check for sulfa allergy Spironolactone- what is it used for a a major S/ E K sparing diuretic Used for edema Monitor for hyperkalemia
What is mannitol used for, how and what do you monitor?Used for increased ICP/ARF Given intravenously w/filter Monitor for confusion Monitor IV site What is sodium polystyrene sulfonate for?treats hyperkalemia What are Ca channel blockers and beta used for?Antidysrythmics Digoxin- what is it used for, therapeutic level, S?S of toxicity, instrucitons when giving, things to monitor and antidote?
Indications: CHF, A-Fib, PAT
Therapeutic level: 0.5 – 2 ng/ml
S & S of toxicity: abdominal pain, anorexia, nausea, vomiting, visual
disturbances, & bradycardia
Take apical heart rate: Hold for pulse <60or >100
Monitor K+: ↓ K+ precipitates dig toxicity
Antidote: digoxin immune fab (Digibind)
What are nitrates given for, what do they do, what is the dosage, S/E?
Indications: Angina, MI (given IV), CHF
Lowers BP, improves blood flow to myocardium,
Usual adult dose for acute anginal episode:
- tab SL Q 5 min times 3
If no relief , transport to ED Monitor for hypotension, HA & rebound tachycardia due to vasodilation
How often is nitro replaced?Q6months What is heparin used for, normal dose, therapeutic level, S/E, labs to monitor and antidote
Indications: PE, MI, CVA, DVT
Prevents thrombus formation
Usual adult dose: 5,000 units subq Q 8-12 hours
Therapeutic blood levels: generally 1.5-2.5 times normal control level
Adverse effects: bleeding, anemia, thrombocytopenia
Monitor aPTT or PTT and hematocrit
Antidote: protamine sulfate
What is enoxaparin used for, and why is it better than heparin?
enoxaparin (Lovenox): low molecular weight heparin
Similar to heparin, longer half-life, less thrombocytopenia What is warfarin for, therapeutic levels, adverse effects, lab to view, and antidote?
Indications: Venous thrombus, PE, MI, A-fib, Prosthetic valve replacement
Therapeutic blood levels: INR between 1.5-2 (DVT); 2-3 (A-fib); 2.5-3.5 (Prosthetic valve)
Adverse effects: bleeding
Monitor protime (PT) and INR
Antidote: vitamin K
atorvastatin, simvastatin, and lovastatin- What do they do, what must you check and avoid, and then monitor?lipid lowering agents
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