FNP EXAM DRUGS QUESTIONS WITH CORRECT ANSWERS GRADED TO PASS

Warfarin sodium (Coumadin): monitor what? - INR Digoxin (Lanoxin): monitor what? - Dig level, EKG, electrolytes (potassium, magnesium, calcium) Theophylline: monitor what? - Monitor blood levels Carbamazepine (Tegretol) and phenytoin (Dilantin): monitor what? - Monitor blood levels Lithium: monitor what? - Blood levels, TSH (risk of hypothyroidism) What antibiotic interacts with warfarin (Coumadin)? - Sulfa drugs: Bactrim (trimethoprim-sulfamethoxazole) elevates INR increasing risk for bleeding First pass metabolism drugs can not be given by which route? - Oral Name Drugs that act as inhibitors slow drug clearance and increase drug concentration - Macrolides, antifungals, cimetidine, citaprolam Macrolides - Erythromycin Clarithromycin Pediazole Azithromycin Antifungals - Ketoconazole Fluconazole Cimetidine - Tagamet Citaprolam - Celexa Cardiac Glycosides (class) Name of drug? - Digoxin (lanolin) Treats A Fib Not first line for HR control in a fib S/s of dig toxicity, treatmeht - Initially: GI (anorexia, n/v, abdominal pain) Others sx: arrhythmias, confusion, visual changes (yellowish green tinged color vision, scotomas) Treatment of severe dig toxicity - Digoxin-binding antibodies (Digibind) Therapeutic Digoxin range - 0.5-2.0 ng/mL Labs to check for suspected dig toxicity - Digoxin level, electrolytes (potassium, magnesium, calcium), creatinine, serial EKGs Normal potassium - 3.5-5.0 Critical: 2.5, 6.5 Decreases emboli, used to treat a fib, stroke, pulmonary emboli - Warfarin sodium(Coumadin) Target INR for pt with a fib on warfarin - 2.0-3.0 What if INR is too high? - If no s/s of bleeding, Hold warfarin for 1-2 doses, recheck every 2-3 days, may need to add a small dose of vitamin K, avoid vit K foods After INR stabilized, check monthly Foods high in vit K - Green leafy, cabbage, mayonnaise, canola oil, soybean oil S/s of bleeding on warfarin - Petechiae Bleeding gums Bruising Dark stools List thiazide diuretics - HCTZ 12.5-25mg po daily Chlorthalidone 12.5-25 Indapamide (Lozol) Adverse effects of thiazide diuretics - Hyperglycemia (caution DM) Elevates triglycerides and LDL Elevates uric acid Hypokalemia (muscle weakness, arrhythmias) Name potassium sparing diuretics - Triamterene (Dyrenium) Amiloride (Midamor) Potassium sparing black box warning - Hyperkalemia Avoid salt with k+ Avoid with severe renal disease Caution with ACE/ARB Name loop diuretics - Furosemide (Lasix) Bumetanide (bumex) **extremely potent, can lead to profound diuresis Adverse effects of loop diuretics (furosemide, bumetanide) - Electrolytes (decreases) Hypovolemia Hypotension (dizziness, lightheadedness) Pancreatitis (jaundice, rash) Ototoxicity What do loop diuretics treat? - Edema from heart failure, cirrhosis, renal disease, hypertension Name aldosterone antagonists - Spironolactone (aldactone) Treats:hirsuitism, HTN, severe heart failure Adverse effects of spironolactone - Galactorrhea, hyperkalemia Black box: increases risk of tumors First line drug post MI - Beta blockers "lol" What are beta blockers used for? - HTN, post MI, angina, arrhythmias, migraine prophylaxis