NR 508 FINAL EXAM STUDY GUIDE LATEST VERSION Final study guide

NR 508 FINAL EXAM STUDY GUIDE LATEST VERSION Final study guide Cardiovascular management: 1. Know Initial treatment choices for HTN AceI- sartans Arbs- ipine, verapamil & diltazem Thiazide- iaside, chlorthalidone, imdapamide, metolazone calcium channel blocker 2. Know first line treatment options for HTN for African Americans without renal impairment. 3. First line option for HTN for anyone with chronic kidney disease Diuretics: 4. Types, Uses, Side effects Thiazides (HCTZ) Uses- HTN, CHF, edema, useful in decreases calcium stone formation Of label HCTZ- osteoporosis and diabetes AE- hypokalemia, hyperglycemia, arrhythmias, metabolic alkalosis, fatigue, postural Hypotension Loop diuretics(furosemide, torsemide, ethacrynic acid) *preferred diureticsfor renal Impairment Uses- CFH, HTN, nephrotic syndrome, cirrhosis, pulmonary edema AE-hypocalcemia, hyponatremia, hypokalemia, ototoxicity Carbonic anhydrase inhibitors (acetazolamide) *weak diuretic Uses- edema, epilepsy, glaucoma, mountain sickeness AE- toxic epidermal necrolysis, agranulocytosis, aplastic anemia, thrombocytopenia, metabolic acidosis Potassium-sparing (spironolactone, eplerenone) Uses- CHF (in combo with thiazides or ACE and loop), HTN AE-gynomastia, n/v, erectile dysfuction, electrolyte imbalance, metabolic acidosis **postdiuretic sodium retention- It is important for pts to adhere to a low sodium diet. As drug concentrations fall, there is a period of positive sodium balance ** If a pt has a sulfa allergy= take ethacrynic acid 5. Preferred diuretic with renal impairment6. Side effect of post diuretic sodium retention pg 374 Loop diuretics because they retain efficacy even with moderate renal insufficiency: such as furosemide, buetanide, torsemide, ethacrynic acid. Uses: Edematousstates(HF, cirrhosis, pulmonary edema, nephrotic syndrome), hypercalcemia Calcium channel blockers Thiazid