NURS 251 EXAM QUESTIONS WITH VERIFIED ANSWERS
monoclonal antibodies
Suffix ending 'mab'
Indications: treatment of cancer, RA, MS, and organ transplantation
Specifically target cancer cells and have minimal effect on healthy cells
Fewer AE's than traditional antineoplastic medications
CI: active TB and other infections
Different Types
Infliximab (Remicade) For RA, Crohn's
Natalizumab (Tysabri) For MS
· Adalimumab (Humira)
For RA
· Rituximab* (Rituxan)
For NHL
Associated with allergic response especially Ritux; premedicate with diphenhydramine
and acetaminophen
Diuretics
Anithypertensive
hydrocholrothiazide
first line therapy
MOA: decreases • plasma and ECF volumes. Results
- Decreased preload, cardiac output, and total peripheral resistance
Overall effect: Decreased workload of the heart and decreased BP.
directly affects vascular smooth muscle
CI: gout, know sensitivity to sulfa drugs, severely impaired kidney function, hx of
hyponatremia
AE: dry mouth, thirst, weakness, drowsiness, lethargy, muscle aches, muscular fatigue,
tachycardia, GI disturbances
,NI: monitor for signs of electrolyte imbalance, encourage intake of potassium-rich foods
(i.e. fruits), gerontologic: risk of postural hypotension significant due to volume
depletion; measure BP in three positions; caution patient to rise slowly
Adrenergics
Antihypertensive
Issues with orthostatic hypotension & first dose syncope (especially α blockers)
Asthma and glucose metabolism issues (hypoglycemia by preventing glycogenolysis)
with β blocker combo's (i.e. carvedilol)
Interact with CNS depressants (alcohol, benzodiazepines, and opioids)
Nonselective β blockers will have both heart β1 and respiratory β2 effects; β1
recommended for history of restrictive airway conditions
a1 blockers
adrenergic
Doxazosin mesylate
MOA: peripheral vasodilator acting directly on the blood vessel
CO: angina pectoris and coronary artery disease; induces tachycardia if not preceded
by admin of propranolol and a diuretic
AE: vomiting and diarrhea, urinary frequency, cardiovascular collapse (especially if
given with hydralazine without lowering the dose of the latter); drowsiness, lack of
energy, and weakness
a2 agonist
adrenergic
Clonidine
centrally acting; norepinephrine and blood pressure
MOA: acts through CNS through centrally mediated alpha-adrenergic stimulation in the
brain, producing blood pressure reduction
CO: severe coronary artery disease, pregnancy
AE dry mouth, drowsiness, headaches, fatigue, anorexia, malaise, vomiting, mild liver
function disturbance, sleepiness, constipation, impotence
NI: rebound or withdrawal hypertension common; monitor BP when discontinuing
medication
, Dual action α1 and β receptor blockers
adrenergic
nebivolol promoted as causing less sexual dysfunction than Clonidine
beta blockers
adrenergic
Metoprolol
• Reduce angiotensin mediated vasoconstriction
• Reduce aldosterone mediated fluid expansion
• Reduce peripheral vascular resistance
• Reduce heart rate through β1 blockade
MOA:
• Reduction of the heart rate through β1-receptor blockade
• Cause reduced secretion of renin
• Long-term use causes reduced peripheral vascular resistance.
• Block sympathetic nervous system (beta-adrenergic receptors) especially those to the
heart, producing a slower HR and lowered BP
CI: bronchial asthma, allergic rhinitis, right ventricular failure from pulmonary
hypertension, heart failure, depression, diabetes, dyslipidemia, heart block, peripheral
vascular disease, HR <60 bpm
AE: depression (insomnia, lassitude, weakness, and fatigue); light headedness and
occasional nausea, vomiting, epigastric distress
NI: avoid sudden discontinuation; check HR before administering; Geriatrics: risk of
toxicity with ¯ renal and liver function. Take BP in three positions, and observe for
hypotension
Dual-Action α1- and β-Receptor Blockers
Adrenergic
labetalol
• Dual antihypertensive effects of reduction in heart rate (β1-receptor blockade) and
vasodilation (α1-receptor blockade)
MOA: block alpha- and beta- adrenergic receptors; cause peripheral dilation and ¯
peripheral vascular resistance
monoclonal antibodies
Suffix ending 'mab'
Indications: treatment of cancer, RA, MS, and organ transplantation
Specifically target cancer cells and have minimal effect on healthy cells
Fewer AE's than traditional antineoplastic medications
CI: active TB and other infections
Different Types
Infliximab (Remicade) For RA, Crohn's
Natalizumab (Tysabri) For MS
· Adalimumab (Humira)
For RA
· Rituximab* (Rituxan)
For NHL
Associated with allergic response especially Ritux; premedicate with diphenhydramine
and acetaminophen
Diuretics
Anithypertensive
hydrocholrothiazide
first line therapy
MOA: decreases • plasma and ECF volumes. Results
- Decreased preload, cardiac output, and total peripheral resistance
Overall effect: Decreased workload of the heart and decreased BP.
directly affects vascular smooth muscle
CI: gout, know sensitivity to sulfa drugs, severely impaired kidney function, hx of
hyponatremia
AE: dry mouth, thirst, weakness, drowsiness, lethargy, muscle aches, muscular fatigue,
tachycardia, GI disturbances
,NI: monitor for signs of electrolyte imbalance, encourage intake of potassium-rich foods
(i.e. fruits), gerontologic: risk of postural hypotension significant due to volume
depletion; measure BP in three positions; caution patient to rise slowly
Adrenergics
Antihypertensive
Issues with orthostatic hypotension & first dose syncope (especially α blockers)
Asthma and glucose metabolism issues (hypoglycemia by preventing glycogenolysis)
with β blocker combo's (i.e. carvedilol)
Interact with CNS depressants (alcohol, benzodiazepines, and opioids)
Nonselective β blockers will have both heart β1 and respiratory β2 effects; β1
recommended for history of restrictive airway conditions
a1 blockers
adrenergic
Doxazosin mesylate
MOA: peripheral vasodilator acting directly on the blood vessel
CO: angina pectoris and coronary artery disease; induces tachycardia if not preceded
by admin of propranolol and a diuretic
AE: vomiting and diarrhea, urinary frequency, cardiovascular collapse (especially if
given with hydralazine without lowering the dose of the latter); drowsiness, lack of
energy, and weakness
a2 agonist
adrenergic
Clonidine
centrally acting; norepinephrine and blood pressure
MOA: acts through CNS through centrally mediated alpha-adrenergic stimulation in the
brain, producing blood pressure reduction
CO: severe coronary artery disease, pregnancy
AE dry mouth, drowsiness, headaches, fatigue, anorexia, malaise, vomiting, mild liver
function disturbance, sleepiness, constipation, impotence
NI: rebound or withdrawal hypertension common; monitor BP when discontinuing
medication
, Dual action α1 and β receptor blockers
adrenergic
nebivolol promoted as causing less sexual dysfunction than Clonidine
beta blockers
adrenergic
Metoprolol
• Reduce angiotensin mediated vasoconstriction
• Reduce aldosterone mediated fluid expansion
• Reduce peripheral vascular resistance
• Reduce heart rate through β1 blockade
MOA:
• Reduction of the heart rate through β1-receptor blockade
• Cause reduced secretion of renin
• Long-term use causes reduced peripheral vascular resistance.
• Block sympathetic nervous system (beta-adrenergic receptors) especially those to the
heart, producing a slower HR and lowered BP
CI: bronchial asthma, allergic rhinitis, right ventricular failure from pulmonary
hypertension, heart failure, depression, diabetes, dyslipidemia, heart block, peripheral
vascular disease, HR <60 bpm
AE: depression (insomnia, lassitude, weakness, and fatigue); light headedness and
occasional nausea, vomiting, epigastric distress
NI: avoid sudden discontinuation; check HR before administering; Geriatrics: risk of
toxicity with ¯ renal and liver function. Take BP in three positions, and observe for
hypotension
Dual-Action α1- and β-Receptor Blockers
Adrenergic
labetalol
• Dual antihypertensive effects of reduction in heart rate (β1-receptor blockade) and
vasodilation (α1-receptor blockade)
MOA: block alpha- and beta- adrenergic receptors; cause peripheral dilation and ¯
peripheral vascular resistance
