NUR 354 Exam 2 Questions And Answers Graded A+
What is the prototype cardiac glycoside? ANS Digoxin
What is digoxin's expected pharmacologic action (EPA)? ANS Causes calcium collection within heart
cells, increasing contractility. Also increases vagal tone, slowing the heart rate.
What are side effects of digoxin? ANS Dysrhythmias - especially AV block
Fatigue, visual changes such as halos around dark objects, blurring, or yellow tinge
What are signs of early digoxin toxicity? What is the antidote? ANS Signs: nausea, anorexia,
vomiting, fatigue
Antidote: Digoxin immune Fab (digibind)
What are contraindications for digoxin? ANS Uncontrolled ventricular dysrhythmia, heart rate <60,
AV block, severe heart disease
What are interactions with digoxin? ANS Diuretics increase the chance of hypokalemia, ginseng
raises digoxin levels, St. John's Wort lowers digoxin levels
What is the prototype inotropic sympathomimetic? ANS Dobutamine
What kind of patient receives dobutamine? Where is it administered? ANS Only very sick patients
with severe heart failure receive this drug (normally). It is administered only in a hospital via IV
What is the EPA of dobutamine? ANS Activation of B1-adrenergic receptors, increasing cardiac
contractility and output
What are side effects of dobutamine? ANS tachycardia, dysrhythmia, anginal pain (discontinue if
these appear)
What is a contraindication for dobutamine? ANS Idiopathic hypertrophic aortic stenosis
, What does dobutamine interact with? ANS In IV line - multiple incompatibilities (dedicated line)
MAOIs/TCAs and general anesthesia increase chance of dysrhythmia, Beta-blockers lower dobutamine
efficacy
What is the prototype phosphodiesterase inhibitor? ANS Milrinone
What is the EPA of milrinone? ANS Inhibits phosphodiesterase, leading to a buildup of cyclic AMP in
the heart = increased contractility and output
What are side effects of milrinone? ANS Ventricular dysrhythmia, hypokalemia, HTN, angina
What are contraindications for milrinone? ANS Aortic or pulmonary valve disorders
Use caution: renal impairment, history of arrhythmia, electrolytes imbalanced, abnormal digoxin levels
What interacts with milrinone? ANS No significant drug interactions. WILL form precipitate if mixed
with furosemide in IV line.
What suffix indicates that a medication is an ACE inhibitor? ANS -pril
e.g. captopril, lisinopril
What is the EPA of captopril? ANS Blocks ACE from producing angiotensin II = arteriolar
vasodilation and excretion of sodium and water (potassium retained)
What are side effects of captopril? ANS Severe hypotension (esp. on first dose), rash, metallic taste,
hyperkalemia, neutropenia
What is the prototype cardiac glycoside? ANS Digoxin
What is digoxin's expected pharmacologic action (EPA)? ANS Causes calcium collection within heart
cells, increasing contractility. Also increases vagal tone, slowing the heart rate.
What are side effects of digoxin? ANS Dysrhythmias - especially AV block
Fatigue, visual changes such as halos around dark objects, blurring, or yellow tinge
What are signs of early digoxin toxicity? What is the antidote? ANS Signs: nausea, anorexia,
vomiting, fatigue
Antidote: Digoxin immune Fab (digibind)
What are contraindications for digoxin? ANS Uncontrolled ventricular dysrhythmia, heart rate <60,
AV block, severe heart disease
What are interactions with digoxin? ANS Diuretics increase the chance of hypokalemia, ginseng
raises digoxin levels, St. John's Wort lowers digoxin levels
What is the prototype inotropic sympathomimetic? ANS Dobutamine
What kind of patient receives dobutamine? Where is it administered? ANS Only very sick patients
with severe heart failure receive this drug (normally). It is administered only in a hospital via IV
What is the EPA of dobutamine? ANS Activation of B1-adrenergic receptors, increasing cardiac
contractility and output
What are side effects of dobutamine? ANS tachycardia, dysrhythmia, anginal pain (discontinue if
these appear)
What is a contraindication for dobutamine? ANS Idiopathic hypertrophic aortic stenosis
, What does dobutamine interact with? ANS In IV line - multiple incompatibilities (dedicated line)
MAOIs/TCAs and general anesthesia increase chance of dysrhythmia, Beta-blockers lower dobutamine
efficacy
What is the prototype phosphodiesterase inhibitor? ANS Milrinone
What is the EPA of milrinone? ANS Inhibits phosphodiesterase, leading to a buildup of cyclic AMP in
the heart = increased contractility and output
What are side effects of milrinone? ANS Ventricular dysrhythmia, hypokalemia, HTN, angina
What are contraindications for milrinone? ANS Aortic or pulmonary valve disorders
Use caution: renal impairment, history of arrhythmia, electrolytes imbalanced, abnormal digoxin levels
What interacts with milrinone? ANS No significant drug interactions. WILL form precipitate if mixed
with furosemide in IV line.
What suffix indicates that a medication is an ACE inhibitor? ANS -pril
e.g. captopril, lisinopril
What is the EPA of captopril? ANS Blocks ACE from producing angiotensin II = arteriolar
vasodilation and excretion of sodium and water (potassium retained)
What are side effects of captopril? ANS Severe hypotension (esp. on first dose), rash, metallic taste,
hyperkalemia, neutropenia
