NUR2474 PHARMACOLOGY EXAM 2 | QUESTIONS AND ANSWERS |
VERIFIED ANSWERS GRADED A+ | LATEST EXAM
How long do statins take to start working?
2-4 weeks to start seeing affects
What time of day should a patient take statins?
evening on an empty stomach is best
dietary restrictions with statins?
avoid grapefruit-can increase risk of rhabdomyolysis
What do we want our ratio for cholesterol to be
3:1 LDL: HDL
2:1 is more ideal, when it is 6:1 or 5:1 is when we start to medicate
how does cholestyramine work?
for elevated cholesterol.
It is a bile sequestrant (bile is made with cholesterol), so it binds to bile acids
and prevents them from being reabsorbed/reused and accelerates their excretion.
Therefore liver needs to make more using LDLs-the liver increases number of
LDL receptors, increasing the LDL uptake (which decreases LDL plasma
levels)
What other labs will be needed when taking statins/HMG-COA inhibitors
besides cholesterol and triglycerides, liver enzymes must me checked.
what can happen if patient takes cholestyramine without dilution?
it is like a cement and can lead to erosion in throat or GI tract.
must mix with 4 oz of fluid/soup/applesauce
8 oz is more ideal
how are colesevelam and cholestyramine different?
Cholestyramine can affect absorption of fat soluble vitamins. frequently causes
constipation, abdominal discomfort and bloating
,Colesevelam does not affect absorption of the fat-soluble vitamins, minimal
effects on other drugs, better tolerated. Can lower blood sugar-great for type 2
diabetes, but not type 1!
What drugs can be used for hyptertension?
ACE inhibitors
CCBs
Beta blockers
Diuretics
alpha blockers
ARBs
DRIs
What problems are caused by untreated HTN?
stroke, heart attack, plaque, kidney injury/problems, heart failure
how does plaque form
HTN causes fissures in arteries, macrophages enter that bind with LDLs,
platelets and debris adhere, plaque grows, impedes blood flow
How is dilutional hyponatremia different from diuretic induced
hyponatremia
Dilutional hyponatremia= too much water (diluted), so sodium is low
Diuretic induced hyponatremia= the diuretic causes sodium and water loss,
too much sodium has been lost. can also be dehydrated.
What can dehydration present like?
poor skin turgor, decreased blood pressure, tachycardia, increased thirst
What is a common side effect of furosemide (Lasix)
orthostatic hypotension
if a patient's potassium is 2.8 mEq/L, can furosemide be given?
NO! K+ normal range is 3.5-5, they are too low
furosemide is a loop diuretic-sodium, potassium and water will be excreted.
If a patient's potassium level is 5.7 mEq/L, which medication will the nurse
hold Furosemide or Spironolactone?
Spironolactone, it is a K+ sparing diuretic, their K+ is high
if a patient's potassium level is 5.3 mEq/L, can furosemide be given?
, Yes, their potassium level is elevated, furosemide will cause it to lower,
which is fine
What happens when a patient on furosemide has tinnitus?
can be a sign of ototoxicity. With furosemide, deafness is transient
with ethacrynic acid (another loop diuretic) hearing loss can be permanent
What labs will a patient taking hydrochlorothiazide need?
Creatinine clearance: can be hard on the kidneys. If the patient already has
kidney impairment, possibly suggest a different med
potassium: it can drop, so don't give it to patient if their K+ level is already low.
fix it before!
If a patient's potassium is 6.7 and is due for spironolactone, what should
you do?
hold the med.
potassium way too high-crisis situation. patient may need dialysis, insulin,
or kayexalate
what drug class is captopril (Capoten)
ACE inhibitor
What are some common side effects of captopril/ACE inhib.
dry, non-productive cough-if bad enough will need to switch to something
else (ARB).
Hypotension, especially after first dose
Hyperkalemia (because inhibits aldosterone)
rash, metalic taste, neutropenia can also occur
ANGIOEDEMA severe allergic reaction
What should we be worried about if patient is taking ACE inhibitor and
lithium
Can increase lithium toxicity! sodium and water will be depleted because
aldosterone is never released (salt water hormone) so lithium is more likely
to stay in body when salt is excreted
Nursing precautions when giving captopril or other ACE inhibitors
Start at a low dose and gradually increase
monitor and report angioedema
watch for cough
VERIFIED ANSWERS GRADED A+ | LATEST EXAM
How long do statins take to start working?
2-4 weeks to start seeing affects
What time of day should a patient take statins?
evening on an empty stomach is best
dietary restrictions with statins?
avoid grapefruit-can increase risk of rhabdomyolysis
What do we want our ratio for cholesterol to be
3:1 LDL: HDL
2:1 is more ideal, when it is 6:1 or 5:1 is when we start to medicate
how does cholestyramine work?
for elevated cholesterol.
It is a bile sequestrant (bile is made with cholesterol), so it binds to bile acids
and prevents them from being reabsorbed/reused and accelerates their excretion.
Therefore liver needs to make more using LDLs-the liver increases number of
LDL receptors, increasing the LDL uptake (which decreases LDL plasma
levels)
What other labs will be needed when taking statins/HMG-COA inhibitors
besides cholesterol and triglycerides, liver enzymes must me checked.
what can happen if patient takes cholestyramine without dilution?
it is like a cement and can lead to erosion in throat or GI tract.
must mix with 4 oz of fluid/soup/applesauce
8 oz is more ideal
how are colesevelam and cholestyramine different?
Cholestyramine can affect absorption of fat soluble vitamins. frequently causes
constipation, abdominal discomfort and bloating
,Colesevelam does not affect absorption of the fat-soluble vitamins, minimal
effects on other drugs, better tolerated. Can lower blood sugar-great for type 2
diabetes, but not type 1!
What drugs can be used for hyptertension?
ACE inhibitors
CCBs
Beta blockers
Diuretics
alpha blockers
ARBs
DRIs
What problems are caused by untreated HTN?
stroke, heart attack, plaque, kidney injury/problems, heart failure
how does plaque form
HTN causes fissures in arteries, macrophages enter that bind with LDLs,
platelets and debris adhere, plaque grows, impedes blood flow
How is dilutional hyponatremia different from diuretic induced
hyponatremia
Dilutional hyponatremia= too much water (diluted), so sodium is low
Diuretic induced hyponatremia= the diuretic causes sodium and water loss,
too much sodium has been lost. can also be dehydrated.
What can dehydration present like?
poor skin turgor, decreased blood pressure, tachycardia, increased thirst
What is a common side effect of furosemide (Lasix)
orthostatic hypotension
if a patient's potassium is 2.8 mEq/L, can furosemide be given?
NO! K+ normal range is 3.5-5, they are too low
furosemide is a loop diuretic-sodium, potassium and water will be excreted.
If a patient's potassium level is 5.7 mEq/L, which medication will the nurse
hold Furosemide or Spironolactone?
Spironolactone, it is a K+ sparing diuretic, their K+ is high
if a patient's potassium level is 5.3 mEq/L, can furosemide be given?
, Yes, their potassium level is elevated, furosemide will cause it to lower,
which is fine
What happens when a patient on furosemide has tinnitus?
can be a sign of ototoxicity. With furosemide, deafness is transient
with ethacrynic acid (another loop diuretic) hearing loss can be permanent
What labs will a patient taking hydrochlorothiazide need?
Creatinine clearance: can be hard on the kidneys. If the patient already has
kidney impairment, possibly suggest a different med
potassium: it can drop, so don't give it to patient if their K+ level is already low.
fix it before!
If a patient's potassium is 6.7 and is due for spironolactone, what should
you do?
hold the med.
potassium way too high-crisis situation. patient may need dialysis, insulin,
or kayexalate
what drug class is captopril (Capoten)
ACE inhibitor
What are some common side effects of captopril/ACE inhib.
dry, non-productive cough-if bad enough will need to switch to something
else (ARB).
Hypotension, especially after first dose
Hyperkalemia (because inhibits aldosterone)
rash, metalic taste, neutropenia can also occur
ANGIOEDEMA severe allergic reaction
What should we be worried about if patient is taking ACE inhibitor and
lithium
Can increase lithium toxicity! sodium and water will be depleted because
aldosterone is never released (salt water hormone) so lithium is more likely
to stay in body when salt is excreted
Nursing precautions when giving captopril or other ACE inhibitors
Start at a low dose and gradually increase
monitor and report angioedema
watch for cough
