VUSN pharm exam 3
Cholestyramine - statin
Action: reduces LDL
binds with bile salt in intestines --> bile acids + cholesterols are eliminated in feces
adverse effects: constipation, bloating, belching, esophageal irritation & obstruction
Fibric Acid Derivatives - gemfibrozil
use: reduces VLDL & triglycerides
action: inhibits breakdown of stored fats, uptake of fatty acids, triglyceride production
adverse effects: N/V, cholelithiasis, inc INR w/ warfarin, GI comp
Nicotinic Acid - niacin
use: reduces VLDL & LDL, triglycerides
action: inhibits release of free fatty acids, increased lipoprotein lipase activity
Side effects: flushing, itching, stimulation of prostaglandins, GI intolerance, myalgia
*take aspirin before morning dose
HMG - CoA reductase inhibitors - Rosuvastatin
action: inhibition of HMG-CoA reductase, reduces cholesterol synthesis & LDL
*nocturnal dosing
adverse effect: GI distress, rhabdomyolysis
*discontinue in cases of: muscle pain, weakness, fatigue, fever
monitor CK labs
interactions: grapefruit, pomegranates
beta blocker metoprolol - use: HTN, chest pain, post MI, dysthymias, HF
, action: block B1, <B2, decrease HR & contractility, decrease renin, decrease PVR
*negative chronotrope, isotrope
routes: PO, IR, SR, IV, ophthalmologic
contra: DM, chronic lung disease, HF on Dig, hyperthyroid, bradycardia, 2nd degree HB or greater, < 6yo
interact: other antihypertensives, digoxin (increase bradycardia), neuromuscular, blocking agents
Nurse Interventions (NI): orthostatic hypotnsn, monitor VS (BP, HR), edema
Client edu: do not discontinue abruptly, taper after 2 wks, check bp & hr, report edema, report new
chest pain
alpha adrenergic blocker - doxazosin
use: decrease BP, bph
action: alpha 1 blocker, decreases vasoconstriction (venous & arterial)
S.E.: reflex tachycardia, orthostatic hypotnsn
contra: liver disease, preg, low bp, children, EtOH, sildenafil
NI: check HR & ortho hypo, check bp, pulse
client edu: take at night, rise slowly, report dizziness/ syncope
ACE inhibitors / Angiotensin II blockers - Captopril / Losartin
use: HTN, AMI, LV fatigue
action: Captopril-- blocks angiotensin 1 to angiotensin 2, breakdown bradykinin
Losartin-- blocks receptor sit of angiotensin II to angiotensin
PO, IV
SE: hypotension, andioedema, dry hacking cough, HYPERKALEMIA, fetal harm, RENAL FAILURE
contra: pregnancy, previous run, hypotension
interact: K-SPARING DIURETICS, k supplement, other antihypertensive meds
NI: vs-BP monitor cough, facial swelling, labs-K, creatinine, discontinue if angioedema
Client Edu: VS, report cough, swelling, palpitations, chest pain, pregnancy
Calcium channel blockers - Niphedipine - Dihydropine
Cholestyramine - statin
Action: reduces LDL
binds with bile salt in intestines --> bile acids + cholesterols are eliminated in feces
adverse effects: constipation, bloating, belching, esophageal irritation & obstruction
Fibric Acid Derivatives - gemfibrozil
use: reduces VLDL & triglycerides
action: inhibits breakdown of stored fats, uptake of fatty acids, triglyceride production
adverse effects: N/V, cholelithiasis, inc INR w/ warfarin, GI comp
Nicotinic Acid - niacin
use: reduces VLDL & LDL, triglycerides
action: inhibits release of free fatty acids, increased lipoprotein lipase activity
Side effects: flushing, itching, stimulation of prostaglandins, GI intolerance, myalgia
*take aspirin before morning dose
HMG - CoA reductase inhibitors - Rosuvastatin
action: inhibition of HMG-CoA reductase, reduces cholesterol synthesis & LDL
*nocturnal dosing
adverse effect: GI distress, rhabdomyolysis
*discontinue in cases of: muscle pain, weakness, fatigue, fever
monitor CK labs
interactions: grapefruit, pomegranates
beta blocker metoprolol - use: HTN, chest pain, post MI, dysthymias, HF
, action: block B1, <B2, decrease HR & contractility, decrease renin, decrease PVR
*negative chronotrope, isotrope
routes: PO, IR, SR, IV, ophthalmologic
contra: DM, chronic lung disease, HF on Dig, hyperthyroid, bradycardia, 2nd degree HB or greater, < 6yo
interact: other antihypertensives, digoxin (increase bradycardia), neuromuscular, blocking agents
Nurse Interventions (NI): orthostatic hypotnsn, monitor VS (BP, HR), edema
Client edu: do not discontinue abruptly, taper after 2 wks, check bp & hr, report edema, report new
chest pain
alpha adrenergic blocker - doxazosin
use: decrease BP, bph
action: alpha 1 blocker, decreases vasoconstriction (venous & arterial)
S.E.: reflex tachycardia, orthostatic hypotnsn
contra: liver disease, preg, low bp, children, EtOH, sildenafil
NI: check HR & ortho hypo, check bp, pulse
client edu: take at night, rise slowly, report dizziness/ syncope
ACE inhibitors / Angiotensin II blockers - Captopril / Losartin
use: HTN, AMI, LV fatigue
action: Captopril-- blocks angiotensin 1 to angiotensin 2, breakdown bradykinin
Losartin-- blocks receptor sit of angiotensin II to angiotensin
PO, IV
SE: hypotension, andioedema, dry hacking cough, HYPERKALEMIA, fetal harm, RENAL FAILURE
contra: pregnancy, previous run, hypotension
interact: K-SPARING DIURETICS, k supplement, other antihypertensive meds
NI: vs-BP monitor cough, facial swelling, labs-K, creatinine, discontinue if angioedema
Client Edu: VS, report cough, swelling, palpitations, chest pain, pregnancy
Calcium channel blockers - Niphedipine - Dihydropine
