Page | 1
PHARM EXAM 1 STUDY GUIDE CH. 8, 14,
16, 17 QUESTIONS WITH DETAILED
VERIFIED ANSWERS
Positive Inotropic Drug Ans: Increases contractility and the ability of the
heart to pump
Negative Inotropic Drug Ans: Decreases contractility and ability of the
heart
Thiazides Ans: Increases urine output by preventing water, sodium,
potassium and chloride from going through the walls of the nephron to be
reabsorbed back into the blood
Examples:
- chlorothiazide (Duiril)
- hydrochlorothiazide (Esidrix, Ezide, Hydrodiuril, Oretic, Zide)
- Most commonly used diuretic and often are the first line in the
management of HIGH BP
- Over long term, this diuretic also act to dilate the smooth muscles in
the arterioles, the smallest vessels in the arterial system
- Approved for use during pregnancy and may be used in low doses for
breast-feeding mothers without adverse effects on the infant
- High doses of diuretics for breast-feeding women may suppress
lactation
Nursing Interventions:
- Weigh the patient daily while he/she is taking diuretics to monitor
trends and prevent dehydration
, Page | 2
- Monitor I&O to make sure patient achieves fluid balance
- Monitor potassium levels to assess that they are within normal levels
because these drugs can reduce potassium levels
- Monitor patients BMP to check for abnormal electrolytes, BUN, and/or
creatinine. These lab test can indicate fluid and electrolyte imbalance or
kidney problems
- Report potassium levels below normal to HCP because low potassium
levels can have serious effects on muscles and breathing.
- Inform the HCP if your patient has a history of gout because this
diuretic can cause a flare-up
- If patient has Diabetes, monitor his/her glucose level carefully because
diuretics can cause elevated blood sugar
- HOLD diuretics if patients have a BP less than 90/60 mm Hg because
this can be a symptom of dehydration or other adverse effects
Loop Diuretics Ans: Drugs that increase urine output by blocking active
transport of chloride, sodium and potassium in the thick ascending loop
of Henle
Ex. bumetanide (Bumex), furosemide (Delone, Lasix)
*Has a half life of 6 hrs (laSIX)
- Widely considered the MOST powerful of diuretics
- Can result in significant decreases in fluid volume and increase in urine
output
Uses:
- HF
- Pulmonary Edema
, Page | 3
- Cirrhosis of the liver with ascites
**Potassium is one of the major electrolytes that can be LOST after the
administration of this diuretic drug
Nursing Interventions:
- Side effects are more severe with this type of diuretic than an other
diuretic drug
- Watch for symptoms of low potassium including dry mouth, increased
thirst, muscle cramps, fatigue, weakness and mood changes
- Remind patient to stand up slowly to avoid orthostatic hypotension
- Notify HCP if patient reports decreased hearing or ringing in the ears
because this diuretic can be ototoxic
- Monitor blood glucose in patients with diabetes because these drugs can
cause hyperglycemia
- Check and record urine output
- Urination typically occurs within 1 hr, so inform the patient that he/she
will need to be close to a bathroom to avoid urinary urgency or
incontinence
Potassium-Sparring Diuretics Ans: Increases the excretion of water and
sodium, leading to increased urine output WITHOUT the loss of potassium
Ex. amiloride (Midamor), spironolactone (Aldactone), triamterene
(Dyrenium)
- Acts by slowing down the sodium pump in the collecting duct of the
nephron so that more sodium and water are excreted as urine
- This drug does NOT waste potassium, which often happens with thiazide
and loop diuretics
Nursing Interventions:
, Page | 4
- Monitor potassium levels because higher than normal blood potassium
levels can occur with these drugs
- Report potassium levels greater than 5.0 mEq/L or 5.0 mol/L to the HCP
because high potassium levels can cause dangerous cardiac problems
- Teach patients signs of high potassium levels, including confusion,
irregular heartbeat, nervousness, numbness or tingling in the hands or
feet, unusual fatigue and heavy feeling of the legs
- Teach patients to stand up slowly to avoid orthostatic hypotension
because these drugs decrease fluid volume and decrease BP
- Teach patient to avoid foods high in potassium to prevent hyperkalemia
- Remind patients to avoid salt substitutes because they are often high in
potassium
Heparin Ans: Anticoagulant (Indirect Thrombin Inhibitors)
Actions:
- Decreases clot formation by increasing the amount and action of a
protein called antithrombin III
Uses:
- Used to prevent new clot formation or to stop existing clots from
growing in size
Antidote:
- protamine sulfate
Expected Side Effects:
- Can cause easy bleeding/bruising, pain, redness, warmth, irritation or
skin changes where the drug was injected
- Foot itching or bluish-colored skin
PHARM EXAM 1 STUDY GUIDE CH. 8, 14,
16, 17 QUESTIONS WITH DETAILED
VERIFIED ANSWERS
Positive Inotropic Drug Ans: Increases contractility and the ability of the
heart to pump
Negative Inotropic Drug Ans: Decreases contractility and ability of the
heart
Thiazides Ans: Increases urine output by preventing water, sodium,
potassium and chloride from going through the walls of the nephron to be
reabsorbed back into the blood
Examples:
- chlorothiazide (Duiril)
- hydrochlorothiazide (Esidrix, Ezide, Hydrodiuril, Oretic, Zide)
- Most commonly used diuretic and often are the first line in the
management of HIGH BP
- Over long term, this diuretic also act to dilate the smooth muscles in
the arterioles, the smallest vessels in the arterial system
- Approved for use during pregnancy and may be used in low doses for
breast-feeding mothers without adverse effects on the infant
- High doses of diuretics for breast-feeding women may suppress
lactation
Nursing Interventions:
- Weigh the patient daily while he/she is taking diuretics to monitor
trends and prevent dehydration
, Page | 2
- Monitor I&O to make sure patient achieves fluid balance
- Monitor potassium levels to assess that they are within normal levels
because these drugs can reduce potassium levels
- Monitor patients BMP to check for abnormal electrolytes, BUN, and/or
creatinine. These lab test can indicate fluid and electrolyte imbalance or
kidney problems
- Report potassium levels below normal to HCP because low potassium
levels can have serious effects on muscles and breathing.
- Inform the HCP if your patient has a history of gout because this
diuretic can cause a flare-up
- If patient has Diabetes, monitor his/her glucose level carefully because
diuretics can cause elevated blood sugar
- HOLD diuretics if patients have a BP less than 90/60 mm Hg because
this can be a symptom of dehydration or other adverse effects
Loop Diuretics Ans: Drugs that increase urine output by blocking active
transport of chloride, sodium and potassium in the thick ascending loop
of Henle
Ex. bumetanide (Bumex), furosemide (Delone, Lasix)
*Has a half life of 6 hrs (laSIX)
- Widely considered the MOST powerful of diuretics
- Can result in significant decreases in fluid volume and increase in urine
output
Uses:
- HF
- Pulmonary Edema
, Page | 3
- Cirrhosis of the liver with ascites
**Potassium is one of the major electrolytes that can be LOST after the
administration of this diuretic drug
Nursing Interventions:
- Side effects are more severe with this type of diuretic than an other
diuretic drug
- Watch for symptoms of low potassium including dry mouth, increased
thirst, muscle cramps, fatigue, weakness and mood changes
- Remind patient to stand up slowly to avoid orthostatic hypotension
- Notify HCP if patient reports decreased hearing or ringing in the ears
because this diuretic can be ototoxic
- Monitor blood glucose in patients with diabetes because these drugs can
cause hyperglycemia
- Check and record urine output
- Urination typically occurs within 1 hr, so inform the patient that he/she
will need to be close to a bathroom to avoid urinary urgency or
incontinence
Potassium-Sparring Diuretics Ans: Increases the excretion of water and
sodium, leading to increased urine output WITHOUT the loss of potassium
Ex. amiloride (Midamor), spironolactone (Aldactone), triamterene
(Dyrenium)
- Acts by slowing down the sodium pump in the collecting duct of the
nephron so that more sodium and water are excreted as urine
- This drug does NOT waste potassium, which often happens with thiazide
and loop diuretics
Nursing Interventions:
, Page | 4
- Monitor potassium levels because higher than normal blood potassium
levels can occur with these drugs
- Report potassium levels greater than 5.0 mEq/L or 5.0 mol/L to the HCP
because high potassium levels can cause dangerous cardiac problems
- Teach patients signs of high potassium levels, including confusion,
irregular heartbeat, nervousness, numbness or tingling in the hands or
feet, unusual fatigue and heavy feeling of the legs
- Teach patients to stand up slowly to avoid orthostatic hypotension
because these drugs decrease fluid volume and decrease BP
- Teach patient to avoid foods high in potassium to prevent hyperkalemia
- Remind patients to avoid salt substitutes because they are often high in
potassium
Heparin Ans: Anticoagulant (Indirect Thrombin Inhibitors)
Actions:
- Decreases clot formation by increasing the amount and action of a
protein called antithrombin III
Uses:
- Used to prevent new clot formation or to stop existing clots from
growing in size
Antidote:
- protamine sulfate
Expected Side Effects:
- Can cause easy bleeding/bruising, pain, redness, warmth, irritation or
skin changes where the drug was injected
- Foot itching or bluish-colored skin
