N352 - Pharmacology Exam 4 (Cardiovascular
Drugs) With Complete Solutions
Lipid and cholesterol lowering drugs (general knowledge) - ANSWER - The liver
is responsible for lipid/cholesterol metabolism. These actions generally occur at
night.
- Cholesterol and lipid difficulties can be genetic, lifestyle, or both. Labs can
determine.
- The greater the amount of cholesterol circulating in the blood, the greater the
risk of cardiovascular disease.
- Circulating cholesterol bind to vessel walls, increasing plaque buildup as years
pass.
- Medications should be aimed at what type of cholesterol/lipids abnormality the
patient has.
What do HMG-CoA Reducatase Inhibitors (Statins) do? - ANSWER - most
efffective drugs for lowering LDL
- reduction of LDL cholesterol
- elevation of HDL cholesterol
- reduction of triglyceride levels
What are nonlipid beneficial cardiovascular actions of HMG-CoA Reductase
Inhibitors (Statins)? - ANSWER - Promote plaque stability
- Reduce the risk for cardiovascular (CV) events
- increased bone formation
What are the therapeutic uses of HMG-CoA Reducatase Inhibitors (Statins)? -
ANSWER - hypercholesterolemia
- primary and secondary prevention of CV events
- post-MI therapy
- Diabetes
- PVD/PAD
What are the adverse effects of HMG-CoA Reductase Inhibitors (Statins)? -
ANSWER - myopathy/rhabdomyolysis (muscle breakdown, muscle pain)
- hepatotoxicity
- hepatitis
What are the side effects of HMG-CoA Reducatase Inhibitors (Statins)? -
ANSWER - headache
- rash
,- GI disturbances: dyspepsia, gas
- Muscle and joint pain
- flushing
How do you determine for HMG-CoA Reducatase Inhibitors (statins) if muscle
pain developed by a patient is a side effect of the start of rhabdomyolysis? -
ANSWER Ask how severe the muscle and joint pain is...if severe stop the med
What are the nursing considerations for HMG-CoA Reductase Inhibitors
(Statins)? - ANSWER - teach dietary methods/lifestyle to reduce cholesterol/lipid
levels
- Monitor cholesterol profile (should be fasting lab)
- Monitor liver function tests
- Take with food, most effective if given in evening or at HS
- Avoid alcohol
Indications for Atorvastatin (Lipitor) - ANSWER - reduction of blood cholesterol
and lipids
- PO
Adverse effects of Atorvastatin (Lipitor) - ANSWER - dizziness
- bronchitis
- muscle and joint pain
- flushing
- pancreatitis
- elevated LFT's
Drug interactions of Atorvastatin (Lipitor) - ANSWER - Increase serum digoxin
levels
- increase warfarin effectiveness
- increase levels of anti-diabetic medication
Nursing Implications of Atorvastatin (Lipitor) - ANSWER - monitor LFT's and
serum cholesterol levels
- give at night or HS (don't have to but works better at night)
- avoid use with grapefruit juice
Other Medications for Antilipemic Effects - ANSWER - Bile Acid Sequestrants:
Cholestyramine (Questran) - decreases LBL through loss of bile acids
- Cholesterol Absorbing inhibitors: Ezetimibe (Zetia) - for dietary cholesterol,
given with meal to prevent dietary cholesterol from being absorbed from food
- Nicotonic Acid: Niacin (Vitamin B3) - decreases total cholesterol, take with
aspirin to decrease side effects, causes flushing
- Folic acid: Fenobibrate (Tricor) - decreases total cholesterol
, The patient is prescribed atorvastatin (Lipitor). The nurse will teach the patient
to take the medication at which time?
A. at any meal
B. at bedtime
C. 1 hour before breakfast
D. 2 hours after a meal - ANSWER B. at bedtime
The nurse will teach a patient who is prescribed niacin (Niacor) to prevent
flushing of the face by doing what?
A. Drinking a full glass of water after taking the medication
B. Taking 325 mg of aspirin 30 min. before each dose
C. Ingesting a meal before taking the medication
D. Increasing dietary fiber before and after each dose - ANSWER B. taking 325
mg of aspirin 30 min. before each dose
Action of Amiodarone (Cordarone) - ANSWER - prolongs myocardial action
potential
- blocks alpha and beta
- slows ventricular rate = slower heart rate
Indications for Amiodarone (Cordarone) - ANSWER - ventricular dysrhythmias
- very short half-life
Side effects of Amiodarone (Cordarone) - ANSWER - confusion
- fatigue
- bradycardia
- bluish discoloration of visible cartilage
Evaluation of effectiveness of Amiodarone (Cordarone) - ANSWER - decrease
HR
- Decrease ventricular dysrhythmia
Drug Interaction of Amiodarone (Cordarone) - ANSWER - Increases warfarin
effectiveness
- levaquin increase
- Dilantin increase
- Digoxin increase
Adverse effects of Amiodarone (Cordarone) - ANSWER - liver failure
- pulmonary fibrosis
Nursing Implications/Precautions of Amiodarone (Cardone) - ANSWER - annual
eye exams
- monitor for increase PT/INR
- monitor LFTs and PFTs
- monitor HR and BP
Drugs) With Complete Solutions
Lipid and cholesterol lowering drugs (general knowledge) - ANSWER - The liver
is responsible for lipid/cholesterol metabolism. These actions generally occur at
night.
- Cholesterol and lipid difficulties can be genetic, lifestyle, or both. Labs can
determine.
- The greater the amount of cholesterol circulating in the blood, the greater the
risk of cardiovascular disease.
- Circulating cholesterol bind to vessel walls, increasing plaque buildup as years
pass.
- Medications should be aimed at what type of cholesterol/lipids abnormality the
patient has.
What do HMG-CoA Reducatase Inhibitors (Statins) do? - ANSWER - most
efffective drugs for lowering LDL
- reduction of LDL cholesterol
- elevation of HDL cholesterol
- reduction of triglyceride levels
What are nonlipid beneficial cardiovascular actions of HMG-CoA Reductase
Inhibitors (Statins)? - ANSWER - Promote plaque stability
- Reduce the risk for cardiovascular (CV) events
- increased bone formation
What are the therapeutic uses of HMG-CoA Reducatase Inhibitors (Statins)? -
ANSWER - hypercholesterolemia
- primary and secondary prevention of CV events
- post-MI therapy
- Diabetes
- PVD/PAD
What are the adverse effects of HMG-CoA Reductase Inhibitors (Statins)? -
ANSWER - myopathy/rhabdomyolysis (muscle breakdown, muscle pain)
- hepatotoxicity
- hepatitis
What are the side effects of HMG-CoA Reducatase Inhibitors (Statins)? -
ANSWER - headache
- rash
,- GI disturbances: dyspepsia, gas
- Muscle and joint pain
- flushing
How do you determine for HMG-CoA Reducatase Inhibitors (statins) if muscle
pain developed by a patient is a side effect of the start of rhabdomyolysis? -
ANSWER Ask how severe the muscle and joint pain is...if severe stop the med
What are the nursing considerations for HMG-CoA Reductase Inhibitors
(Statins)? - ANSWER - teach dietary methods/lifestyle to reduce cholesterol/lipid
levels
- Monitor cholesterol profile (should be fasting lab)
- Monitor liver function tests
- Take with food, most effective if given in evening or at HS
- Avoid alcohol
Indications for Atorvastatin (Lipitor) - ANSWER - reduction of blood cholesterol
and lipids
- PO
Adverse effects of Atorvastatin (Lipitor) - ANSWER - dizziness
- bronchitis
- muscle and joint pain
- flushing
- pancreatitis
- elevated LFT's
Drug interactions of Atorvastatin (Lipitor) - ANSWER - Increase serum digoxin
levels
- increase warfarin effectiveness
- increase levels of anti-diabetic medication
Nursing Implications of Atorvastatin (Lipitor) - ANSWER - monitor LFT's and
serum cholesterol levels
- give at night or HS (don't have to but works better at night)
- avoid use with grapefruit juice
Other Medications for Antilipemic Effects - ANSWER - Bile Acid Sequestrants:
Cholestyramine (Questran) - decreases LBL through loss of bile acids
- Cholesterol Absorbing inhibitors: Ezetimibe (Zetia) - for dietary cholesterol,
given with meal to prevent dietary cholesterol from being absorbed from food
- Nicotonic Acid: Niacin (Vitamin B3) - decreases total cholesterol, take with
aspirin to decrease side effects, causes flushing
- Folic acid: Fenobibrate (Tricor) - decreases total cholesterol
, The patient is prescribed atorvastatin (Lipitor). The nurse will teach the patient
to take the medication at which time?
A. at any meal
B. at bedtime
C. 1 hour before breakfast
D. 2 hours after a meal - ANSWER B. at bedtime
The nurse will teach a patient who is prescribed niacin (Niacor) to prevent
flushing of the face by doing what?
A. Drinking a full glass of water after taking the medication
B. Taking 325 mg of aspirin 30 min. before each dose
C. Ingesting a meal before taking the medication
D. Increasing dietary fiber before and after each dose - ANSWER B. taking 325
mg of aspirin 30 min. before each dose
Action of Amiodarone (Cordarone) - ANSWER - prolongs myocardial action
potential
- blocks alpha and beta
- slows ventricular rate = slower heart rate
Indications for Amiodarone (Cordarone) - ANSWER - ventricular dysrhythmias
- very short half-life
Side effects of Amiodarone (Cordarone) - ANSWER - confusion
- fatigue
- bradycardia
- bluish discoloration of visible cartilage
Evaluation of effectiveness of Amiodarone (Cordarone) - ANSWER - decrease
HR
- Decrease ventricular dysrhythmia
Drug Interaction of Amiodarone (Cordarone) - ANSWER - Increases warfarin
effectiveness
- levaquin increase
- Dilantin increase
- Digoxin increase
Adverse effects of Amiodarone (Cordarone) - ANSWER - liver failure
- pulmonary fibrosis
Nursing Implications/Precautions of Amiodarone (Cardone) - ANSWER - annual
eye exams
- monitor for increase PT/INR
- monitor LFTs and PFTs
- monitor HR and BP
