Pharmacology Study Guide 3

Pharmacology Study Guide 3 Final Exam Study Guide Digoxin discharge teaching, what must a client know how to do? ANTIDOTE = digoxin immune Fab (Digibind) **check apical pulse for a full minute before administering medication** -hold for heart rate below 60 bpm -does not affect blood pressure -encourage patient to eat high potassium diet -monitor for S/S of digoxin toxicity: N/V, vision changes (green halo vision), bradycardia, dysrhythmias, confusion educate patients to have digoxin levels checked (toxic level= 2ng/ml) How to monitor and interpret labs for potassium wasting diuretics. Normal potassium ranges. Nursing interventions, potassium rich foods *THIAZIDE DIURETIC promotes sodium, chloride, and water excretion (diuresis) Treats: HTN and peripheral edema does not treat immediate emergency diuresis First drug of choice for peripheral edema spares calcium= hypercalcemia affect glucose tolerance = hyperglycemia Only use in patients with NORMAL RENAL FUNCTION *LOOP DIURETICS act on loop on henle inhibit chloride transport of sodium into circulation sodium and water are lost along with potassium, calcium, and magnesium very potent can affect blood glucose and uric acid levels only prescribe if HCTZ treatment fails *FUROSEMIDE (LASIX) used to treat edema not used for hypertension Take potassium supplement with therapy Take in AM Daily weight (report gain 2 lbs. in 24 hours) BP and Heart rate Monitor lung sounds for fluid overload can be used IV for emergency pulmonary edema, and acute heart failure monitor electrolyte levels caution to CHANGE POSITION SLOWLY IV Administration: push SLOWLY! DO NOT EXCEED 20mg/min [administering too rapidly can cause hearing loss (Cranial nerve 8)] * NORMAL RANGES Potassium: 3.5-5 Sodium: 135-145 Actions of ACE inhibitors, think about chronotropic, inotropic etc. “PRIL” Medications Prevent angiotensin I (weak) from converting into angiotensin II (potent) and PREVENTS the release of aldosterone. Aldosterone promotes retention of sodium and water. RESULTS: prevent vasoconstriction Promotes diuresis of sodium and water this improves circulation and improves cardiac functions USES: HTN & HF * African American * Use combo therapy with diuretic to see results LISINOPRIL Side effects: dry cough, first dose hypotension, ANGIOEDEMA, hyperkalemia what meds should you not take with grapefruit juice-we did not cover this in depth, but calcium channel blockers should not be taken with grapefruit juice