NURS 617 Exam 1 Pharm concepts Latest

NURS 617 Exam 1 Pharm concepts Latest Update - 125 Questions and 100% Verified Correct Answers Guaranteed A+ Approved by the Professor

• Can be given IV for acute or critically ill
• Rapid onset of action, immediate when given IV
• Short duration of action which results in rapid recovery from adverse effects
• Easy conversion to other nitrates, if necessary for long term nitrate therapy
• Very useful in those with acute CHF in association with ischemic heart disease or MI -

CORRECT ANSWER: Advantages of Nitroglycerin in treatment of heart failure

• Headache and Dizziness
• can cause hypotension and tachycardia
• Tolerance can develop - CORRECT ANSWER: Disadvantages of nitroglycerin in acute

congestive heart failure

• headaches that should become less likely with continuous use, usually accompanied

by facial flushing

• Tolerance and physical dependence can occur and can be decreased by incorporating

"drug holidays"

• Hypotension and tachycardia at higher doses.
• Occasionally provoke angina

- Withdraw slowly - CORRECT ANSWER: Disadvantages of Nitrates in treatment of

angina

• Highly toxic drug with very low therapeutic index
• GI adverse effects including anorexia, nausea and vomiting
• Bradycardia and arrhythmias are common
• Requires close observation of serum potassium because hypocalcemia increases the

risk of toxicity. 1 / 3

• Use with St. John's wort may decrease plasma digoxin levels.

- Has not been shown to improve mortality - CORRECT ANSWER: Disadvantages of

Digoxin

• Hypotension
• Contraindicated in pregnancy
• Very expensive
• May cause some skeletal muscle cramping
• Some references report a persistent nocturnal cough in some patients though the

mechanism is unclear .

- headache and diarrhea are occasionally reported. - CORRECT ANSWER:

Disadvantages of ARBs (sartans)

• Nitrates
• ACE inhibitors
• Beta Blockers
• CCB
• Antithrombotic drugs

- Statins - CORRECT ANSWER: What categories of drugs are used to treat Angina

• Possible bradycardia and CHF
• Orthostatic hypotension
• Can cause a variety of arrhythmias (especially likely with verapamil and nifedipine)
• Constipation
• May worsen GERD symptoms
• More expensive
• Other than some limited studies with nifedipine, these are generally not safe in

pregnancy - CORRECT ANSWER: Disadvantages of Calcium Channel Blockers

• Reflex tachycardia 2 / 3

• Sodium and water retention and edema
• Frequently requires concomitant use of Beta blockers and diuretics

- Not useful as mono therapy - CORRECT ANSWER: Disadvantages of Direct acting

vasodilators

• Selective alpha 1 receptor blockers and CCBs due to orthostatic hypotension risk
• CCB due to constipation
• Exercise caution with Beta blockers and CCBs due to risk of CHF
• Diuretics since older adults already have contracted blood volume (may have to use

lower than normal dose to begin therapy) - CORRECT ANSWER: Which

antihypertensives should be avoided in older adults?

• Those with bilateral renal stenosis
• Those with history of angioedema
• Pregnant patients - CORRECT ANSWER: ACE inhibitors are contraindicated in what

patients?

• tinnitus
• confusion
• hyper-reflexia
• metabolic acidosis
• arrhythmias
• hypotension

- death - CORRECT ANSWER: What are signs of Thiocyanate poisoning?

-May lower BP too much especially when being used with diuretics -May produce severe hyperkalemia especially in those with renal insufficiency -Angioedema -May cause an increase in renal insufficiency -Persistent nocturnal cough

• / 3