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NUR 210 Exam 3 Study Guide
Principles of Pharmacology - Galen
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- Beta adrenergic blockers end in Answer -olol
- Alpha-adrenergic blockers end in Answer -sin
- Calcium Channel Blockers end in Answer -pine
- Angiotensin converting enzyme (ACE) Inhibitors end in Answer -pril
- Angiotensin II Receptor Blockers (ARBs) end in Answer -sartan or -tan
- Physiological risk factors for hypertension Answer -Excessive intake of saturated fat and simple carbohydrates -Alcohol: increases renin secretions
- Cultural responses to antihypertensive agents Answer -African Americans -Asian Americans
- Drugs that can be used as dual therapy along with a diuretic for African Americans Answer -Metropolol -Lisinopril
- Drugs that can be used as monotherapy in African Americans Answer -Prazosin -Nifidipine
-Acute heart failure -Bradycardia
- Metropolol (Beta-adrenergic blockers) Caution Answer -Diabetes -Asthma -Liver, kidney or thyroid dysfunction
- Metropolol (Beta-adrenergic blockers) Interactions Answer -Other drugs that lower heart rate or blood pressure -OTC cold medications -Alcohol -Anti-diabetic drugs -NSAIDS decrease effectiveness
- Prazosin (Alpha-adrenergic blockers) Action Answer Block the alpha-adrergic re- ceptors, resulting in vasodilation and decreased blood pressure
- Prazosin (Alpha-adrenergic blockers) Uses Answer -Hypertension
-Heart failure -Benign prostatic hypertrophy
- Prazosin (Alpha-adrenergic blockers) Side effects/adverse reactions Answer - -Dizzy, drowsy -Dry mouth -headache -Abdominal pain -Urinary incontinence -Orthostatic hypotension, hypotension -Palpitations
- Prazosin (Alpha-adrenergic blockers) Contraindications Answer -Renal Disease
(caution with angina)
- Prazosin (Alpha-adrenergic blockers) Interactions Answer -Other drugs that lower blood pressure -Alcohol -OTC cold medications
-In- hibits the production of angiotensin II (a strong vasoconstrictor) and aldosterone (holds water & Na, releases K)
-So by inhibiting angiotensin II the patient has inhibited vasoconstriction (results in vasodilation) and releases water and Na and holds K
- Lisinopril (Angiotensin-Converting Enzyme (ACE) Inhibitors) Uses Answer -Hy- pertension -Heart failure
- Lisinopril (Angiotensin-Converting Enzyme (ACE) Inhibitors) Side ef- fects/adverse reactions Answer -Constant irritating cough -headache -GI upset -Insomnia -Hyperkalemia -Tachycardia -Hypotension/orthostatic hypotension
- Lisinopril (Angiotensin-Converting Enzyme (ACE) Inhibitors) Contraindi- cations Answer -Pregnancy -Potassium-sparing diuretics such as spironolactone -Salt substitutes that contain potassium
- Valsartan (Angiotensin II Receptor Blockers (ARBs)) Interactions Answer -Other antihypertensives -Alcohol -aspirin can increase renal dysfunction/hyperkalemia -OTC cold medications
- Valsartan (Angiotensin II Receptor Blockers (ARBs)) Side effects/adverse reactions Answer -Does not cause the cough of ACE inhibitors -Dizzy, Drowsy, fatigue -Insomnia, headache -Orthostatic hypotension -Hyperkalemia -Hypoglycemia (rare) -Renal dysfunction
- Types of Diuretics Answer -Thiazide or Thiazide-like -Loop or High-ceiling -Osmotic -Potassium Sparing
- Diuretics that waste potassium Answer -Thiazide diuretics (Hydrochlorothiazide) -Loop diuretics (Furosemide)
- Diuretics that spare potassium Answer Spironolactone (potassium sparing diuretic)
- Hydrochlorothiazide (Thiazide Diuretics) Action Answer Action is in the Kidneys -Promotes Na, K, and Water excretion -Decreases Pre-Load and Cardiac Output -Acts on Arterioles causing Vasodilation
- Hydrochlorothiazide (Thiazide Diuretics) Uses Answer -Treat Hypertesion -Edema from Heart Failure -Hepatic Cirrhosis
- Hydrochlorothiazide (Thiazide Diuretics) Side effects/adverse reactions Answer -
- Furosemide (Loop diuretics) Uses Answer -Treat fluid retention caused by heart failure -Renal dysfunction -Cirrhosis -Hypertension -Pulmonary Edema
- Furosemide (Loop diuretics) Side effects/adverse reactions Answer -GI distress
-Fluid and electrolyte imbalances -Hypotension, orthostatic hypotension -Photosensitivity -Hyperglycemia -Hearing Loss (when IV pushing too fast)
- Furosemide (Loop diuretics) Contraindications Answer -Severe electrolyte imbal- ance -Hypovolemia -Allergy to sulfa drugs
(Caution : Heart Failure and Diabetes)
- Furosemide (Loop diuretics) Interactions Answer -Anticoagulants (Increased Bleed- ing) -Steroids (Increased K Loss) Digoxin if Hypokalemia is present
- K Wasting Diuretic Lab Abnormalities (serum chemistry abnormalities with K wasting diuretics) Answer -Hypokalemia -Hypomagnesemia -Hypochloremia -Hyponatremia -Hyperglycemia
*Hypocalcemia in Loop Diuretics *Hypercalcemia in Thiazide Diuretics
- Mannitol (Osmotic Diuretics) Action Answer Causes water, chloride, potassium, and water to be excreted through the kidneys
- Mannitol (Osmotic Diuretics) Uses Answer -Prevent Kidney Failure
- Decrease Intracranial Pressure (ICP) -Decrease Intraocular Pressure (IOP) -Usually used in an Emergency situation
-Hyperkalemia
- Spironolactone (Potassium-Sparring Diuretics) Contraindications Answer -Severe Kidney/Renal Disease -Hyperkalemia
- Spironolactone (Potassium-Sparring Diuretics) Interactions Answer -Potassium supplements -ACE Inhibitors and Angiotensin II Receptor blockes
- Antitubercular Drugs - Drug combinations Single-drug and multi drug therapy Answer Single drug Not used as it is ineffective
Multidrug Decreases bacterial resistance to drug and treatment duration decreased
- Antitubercular Drugs - Treatment regimen is divided into Answer 2 phases
- Antitubercular Drugs - Phase 1 Answer *Isoniazid *Rifampin -More effective than second-line -Less toxic than second-line
Duration Approximately 2 months
- Antitubercular Drugs - Phase 2 Answer -Less effective -More Toxic Duration Approximately 4 to 7 months
-Diabetic retinopathy
- Isoniazid & Rifampin (Antitiburcular Drugs) Interactions Answer -Alcohol -Antacids
- Isoniazid & Rifampin (Antitiburcular Drugs) Interventions/Teaching Answer -Ad- minister Isoniazid 1 hour before meals or 2 hours after meals -Must follow complete regimen -Collect sputum in early morning -Check liver enzymes, kidney function -Need frequent eye examinations -Report numbness, tingling, burning -Take pyridoxine (vitamin B6) to help prevent peripheral neuropathy -Teach sun precautions, to avoid antacids -Teach rifampin can turn urine, feces, saliva, sputum, sweat, and tears red-orange. Contact lenses and clothes can be stained
- Antihistamines Answer -Diphenhydramine (first generation) -Loratadine (second generation) non-sedating
- Diphenhydramine (Antihistamine) first generation Action Answer Blocks hista- mine, which decreases allergic response
- Diphenhydramine (Antihistamine) first generation Uses Answer Treat allergic rhini- tis, itching (allergic reaction), prevent motion sickness, sleep aid, antitussive
- Diphenhydramine (Antihistamine) first generation Side effects Answer -Anticholin- ergic (Drowsiness, dry mouth, decreased secretions, dizziness, blurred vision, uri- nary retention, constipation) -Photosensitivity -Excitability in children
- Diphenhydramine (Antihistamine) first generation Contraindications Answer - -Acute asthma attack -Severe liver disease
(Caution : narrow angle glaucoma, BPH, urinary retention, pregnancy)
- Diphenhydramine (Antihistamine) first generation Interactions Answer Other CNS depressants
- Loratadine (Antihistamine) second generation/non-sedating
