Aspirin
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Suppress platelet aggregation, prevent thrombosis in arteries.
Cyclooxygenase inhibitor - enzyme required by platelets to synthesize
Route - PO
Indications - stroke, TIAs, chronic stable angina, unstable angina, coronary
stenting, acute MI, previous MI, primary prevention of MI
Adverse effects - increased risk of GI bleeding & hemorrhagic stroke
A patient with a history of elevated triglycerides and LDL cholesterol begins taking
nicotinic acid [Niacin]. The patient reports uncomfortable flushing of the face, neck,
and ears when taking the drug. What will the nurse advise the patient?
A. "Ask your provider about taking an immediate-release form of the medication."
Incorrect
B. "Ask your provider about assessing your serum uric acid levels which may be
elevated."
,C. "You should stop taking the Niacin immediately since this is a serious adverse
effect."
D. "You should take 325 mg of aspirin a half hour before each dose of Niacin to
prevent this effect."
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D. Intense flushing of the face, neck, and ears occurs in practically all
patients taking nicotinic acid in pharmacologic doses. Patients should be
advised to take 325 mg of ASA 30 minutes prior to each dose to minimize
this effect or to use an extended-release form of the drug. Serum uric acid
levels may increase with Niacin use, but flushing does not indicate elevated
levels. This side effect is not serious and does not warrant discontinuation
of the drug.
ACE Inhibitor Drug Interactions
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Diuretics - may intensify first-dose hypotension
Antihypertensives (ARBs, duretics, vasodilators, Ca channel blockers) -
additive effects
Drugs that increase K levels - increased risk of hyperkalemia
Lithium - ACE inhibitors can increase serum levels causing toxicity
NSAIDs - can interfere with antihypertensive effects
Thiazide Diuretic Drug Interactions
Give this one a try later!
, Digoxin - increased risk of fatal dysrhythmias
Lithium - excretion suppressed, accumulation
A patient taking gemfibrozil [Lopid] and rosuvastatin [Crestor] concurrently begins to
complain of muscle aches, fatigue, and weakness. What should the nurse monitor?
A. For tendon tenderness
B. For a lupus-like syndrome
C. The patient's liver function test results
D. The patient's creatinine kinase levels
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D. Creatinine kinase levels are the best laboratory indicator of myopathy
and/or rhabdomyolysis, which may lead to renal failure
Niacin
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Prophylaxis of Atherosclerotic Cardiovascular disease
Decreased levels of LDL, VLDL & triglycerides, increased HDL
Route - oral
Contraindicated - active liver disease or severe or recurrent gout
Give ASA to stop flushing
Which plasma lipoprotein level is most concerning when considering the risk of
coronary atherosclerosis?
A. Elevated cholesterol
B. Elevated high-density lipoprotein
, C. Elevated low-density lipoprotein
D. Elevated very-low-density lipoprotein
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C. Elevated LDL levels make the greatest contribution to coronary
atherosclerosis with the probability of developing coronary heart disease
(CHD) directly related to the LDL level in the blood.
A patient has had blood pressures of 150/95 mm Hg and 148/90 mm Hg on two
separate office visits. The patient reports a blood pressure of 145/92 mm Hg taken in
an ambulatory setting. The patient's diagnostic tests are all normal. The nurse will
expect this patient's provider to order:
A. a beta blocker.
B. a loop diuretic and spironolactone.
C. a thiazide diuretic.
D. counseling on lifestyle changes.
Give this one a try later!
C. This patient has primary, or essential, hypertension as evidenced by
systolic pressure greater than 140 and diastolic pressure greater than 90,
along with normal tests ruling out another primary cause. Thiazide diuretics
are first-line drugs for hypertension
Anticoagulants
Give this one a try later!
Give this one a try later!
Suppress platelet aggregation, prevent thrombosis in arteries.
Cyclooxygenase inhibitor - enzyme required by platelets to synthesize
Route - PO
Indications - stroke, TIAs, chronic stable angina, unstable angina, coronary
stenting, acute MI, previous MI, primary prevention of MI
Adverse effects - increased risk of GI bleeding & hemorrhagic stroke
A patient with a history of elevated triglycerides and LDL cholesterol begins taking
nicotinic acid [Niacin]. The patient reports uncomfortable flushing of the face, neck,
and ears when taking the drug. What will the nurse advise the patient?
A. "Ask your provider about taking an immediate-release form of the medication."
Incorrect
B. "Ask your provider about assessing your serum uric acid levels which may be
elevated."
,C. "You should stop taking the Niacin immediately since this is a serious adverse
effect."
D. "You should take 325 mg of aspirin a half hour before each dose of Niacin to
prevent this effect."
Give this one a try later!
D. Intense flushing of the face, neck, and ears occurs in practically all
patients taking nicotinic acid in pharmacologic doses. Patients should be
advised to take 325 mg of ASA 30 minutes prior to each dose to minimize
this effect or to use an extended-release form of the drug. Serum uric acid
levels may increase with Niacin use, but flushing does not indicate elevated
levels. This side effect is not serious and does not warrant discontinuation
of the drug.
ACE Inhibitor Drug Interactions
Give this one a try later!
Diuretics - may intensify first-dose hypotension
Antihypertensives (ARBs, duretics, vasodilators, Ca channel blockers) -
additive effects
Drugs that increase K levels - increased risk of hyperkalemia
Lithium - ACE inhibitors can increase serum levels causing toxicity
NSAIDs - can interfere with antihypertensive effects
Thiazide Diuretic Drug Interactions
Give this one a try later!
, Digoxin - increased risk of fatal dysrhythmias
Lithium - excretion suppressed, accumulation
A patient taking gemfibrozil [Lopid] and rosuvastatin [Crestor] concurrently begins to
complain of muscle aches, fatigue, and weakness. What should the nurse monitor?
A. For tendon tenderness
B. For a lupus-like syndrome
C. The patient's liver function test results
D. The patient's creatinine kinase levels
Give this one a try later!
D. Creatinine kinase levels are the best laboratory indicator of myopathy
and/or rhabdomyolysis, which may lead to renal failure
Niacin
Give this one a try later!
Prophylaxis of Atherosclerotic Cardiovascular disease
Decreased levels of LDL, VLDL & triglycerides, increased HDL
Route - oral
Contraindicated - active liver disease or severe or recurrent gout
Give ASA to stop flushing
Which plasma lipoprotein level is most concerning when considering the risk of
coronary atherosclerosis?
A. Elevated cholesterol
B. Elevated high-density lipoprotein
, C. Elevated low-density lipoprotein
D. Elevated very-low-density lipoprotein
Give this one a try later!
C. Elevated LDL levels make the greatest contribution to coronary
atherosclerosis with the probability of developing coronary heart disease
(CHD) directly related to the LDL level in the blood.
A patient has had blood pressures of 150/95 mm Hg and 148/90 mm Hg on two
separate office visits. The patient reports a blood pressure of 145/92 mm Hg taken in
an ambulatory setting. The patient's diagnostic tests are all normal. The nurse will
expect this patient's provider to order:
A. a beta blocker.
B. a loop diuretic and spironolactone.
C. a thiazide diuretic.
D. counseling on lifestyle changes.
Give this one a try later!
C. This patient has primary, or essential, hypertension as evidenced by
systolic pressure greater than 140 and diastolic pressure greater than 90,
along with normal tests ruling out another primary cause. Thiazide diuretics
are first-line drugs for hypertension
Anticoagulants
Give this one a try later!
