Nurs 2514 CAD Pharmacology 100% SOLUTIONS GUARANTEE

Nurs 2514 CAD Pharmacology 100% SOLUTIONS GUARANTEE What are the two Lipid lowering agents? - ANSWER •HMG-CoA Reductase Inhibitors (Atorvastatin) •Bile-Acid Sequestrants (Colesevelam) _______ is a CCB (Ca Channel Blocker) - ANSWER Verapamil What are the different nitrates? - ANSWER Sublingual Nitroglycerin Isosorbide Dinitrate Morphine (learned in 2500) Clopidogrel is a __________________ - ANSWER Adenosine Diphosphate Receptor Antagonist What drug class is HMG -CoA reducatase inhibitor? - ANSWER Lipid lowering drug therapy -- often ends with "statin" •Lowers LDL (25%-60%) and total cholesterol •increases HDL (5-22%) True or False: Atorvastatin -Lipitor helps to lower the risk of heart failure, MI and sudden death - ANSWER True, there is a significant reduction of LDL in 2 weeks but effects might stop if the drug is stopped What is the MOA of Atorvastatin? - ANSWER - competitively inhibits of HMG CoA reductase so less HMG CoA = lowers the amount of cholesterol production - decreased cholesterol conc stimulates upregulation of LDL receptors + increase HDL to recruit LDL = increased uptake of LDL What is the indication of Atorvastatin? - ANSWER •hypercholesterolemia, (elevated LDL cholesterol levels) •1°and 2° prevention of cardiovascular (CV) events (even those with normal LDL) •diabetes What is the adverse effects of atorvastatin? - ANSWER •generally well tolerated Common: •headache, rash, memory loss, GI disturbance (usually transient) Severe/Uncommon: •Myopathy /Rhabdomyolysis (muscle disintegration) (mild 5-10%, rare myositsis- rhabdo) •Hepatotoxicity (0.5-2%) What are the nursing considerations of atorvastatin? - ANSWER •Dose should be given in evening because of cholesterol synthesis Common: •GI assessment (dyspepsia, cramps, flatulence, constipation, abd pain) •Monitor Liver (AST, ALT, Bilirubin) and Renal Function (Creatinine, BUN, Urea) Severe: - Monitor for hepatotoxicity - Monitor use of other lipid lowering medication •Observe for muscle pain (legs often) What drug class is Colesevelam? What is the effect in the body? - ANSWER bile acid sequestrant (Lipid lowering drug therapy) Effect: decrease in LDL ~20% after one month What is the MOA of colesevelam? - ANSWER creates a non-absorbable resin that binds to bile acid which promotes excretion + increases hepatocyte to LDL = increase uptake of LDL to create more bile to keep up with constant excretion in the feces What are the adverse effects of Colesevelam? - ANSWER Constipation, indigestion, nausea, muscle aches, What are the nursing considerations of Colesevelam? - ANSWER GI assessment for constipation, bloating, indigestion - If constipation occurs, try increasing dietary fiber + fluids or a mild laxative True or False: Colesevelam can be used together with statins - ANSWER True True or False: To increase perfusion, medications can be used to reduce cardiac workload + control pain associated with ischemia + prevent/dissolve blood clot - ANSWER True What is the MOA of Metoprolol? - ANSWER Cardioselective Beta-Blocker - Blocks Beta 1 in the heat which causes a reduction of heart rate and contractility of the heart, decreases renin secretion, decreases oxygen demand in the heart and decreases arterial pressure What are the indications of Metoprolol? - ANSWER Hypertension, Angina, Heart Failure, Cardiac Dysrhythmias, Myocardial Infarction What is the therapeutic effect of Metoprolol? - ANSWER • Lowers blood pressure in the large veins by slowing heart rate and widening vessels What are the adverse effects of Metoprolol? - ANSWER • Bradycardia, AV Heart Block, Heart Failure, Arrhythmias (sudden withdrawal) What are the nursing considerations of Metoprolol? - ANSWER • Assess heart rate prior to administration, hold medication if heart rate is low *Monitor for heart rate, chest pain, blood pressure, and palpitations • Monitor for early signs of heart failure (shortness of breath after mild exertion or lying flat, edema, weight gain, coughing at night) • Withdraw medication slowly (wean the drug), do not abruptly discontinue. (titrate dose down) True or False: Metoprolol should not be administered if patient has more than 1s