NUR 635 Advanced Pharmacology Midterm Review (Guaranteed Pass)

Pt on heparin in hospital setting. Why start coumadin 2 days before dc? Because coumadin needs a couple days before it starts working. Angina: bc pts dev tolerance to long-acting nitroglycerine w/i 1 day. How to prevent? Pts must have 8hrs with no nitroglycerine every days. Hint: At night, remove nitro patch bc no risk of exertional angina Underlying cause of angina coronary disease, athlerosclerosis Why do we give aspirin in pts w/atherosclerosis? Aspirin is an antiplatelet.. Prevents the existing plaques from getting bigger. Prevents plaque rupture. Cardio protective, prevents stroke, MI, CVA What is prescribed for angina pts w/DM? ACE inhibitors to protect the kidneys and nerves SE of high doses of aspirin? Tinnitus: ringing ears Pt education regarding Plavix(clopidogrel bisulfate)? Anti-platelet med. S/sx bleeding: blood in stool or vomit, excessive bruising, abd pain uterine bld, back pain, petichae. Interactions with EVERYTHING: OTC, herbals, supplements Pts on coumadin? What are we watching for? INR to check therapeutic levels. Half life is long. Check 12hrs after taking. What can be caused if pt started on heparin? day4, ordering blood work to check platelet count to observe for THROMBOCYTOPENIA coumadin and childbearing aged females Interactions with oral contraceptives- must have a back up method during time you're taking coumadin Pregnancy considerations and coumadin Need to monitor anti-Xa levels biggest food group interaction with coumadin Grapefruit, green leafy veggies. Why? high in vitamin K which counteracts warfarin Short duration: rapid acting insulin indication, MOA, usage Given w/meals Provide bs control between meals at night Can use in conjunction w/intermediate or long-acting agent lispro, aspart, gluulocene Short duration: short acting insulin indication, MOA, usage Before meals to control postprandial hyperglycemia Infused SQ via pump humulin/regular intermediate(humalin/novalin) duration insulin indication, MOA, usage BS control between meals and during the night Only one suitable for mixing w/short actings basal coverage Long duration: Insulin glargine U100 up to 24hrs, once daily subq dosing, basal coverage for DM1 or Dm2 Neostigmine is a medication uesd to tx what disease/disorder? Myastenia Gravis: AI disorder, antibodies destroy communication btw nerves and muscles. S/S weak skeletal muscles, voluntary muscles, dysphagia, ptosis Myasthenia gravis is an AI disorder that may cause what s/s? difficulty swallowing Medication must cross _____________ to affect CNS BBB Goal in Parkinson's tx is to restore ________________ in brain dopamine MCSE of dopaminergics sleep attacks, hallucinations, confusion Med appropriate to treat acute psychosis? Haloperidol ASE of first-generation antipsychotic(FGA) medications such as haloperidol, chlorpromazine: diff speaking, chewing tardive dyskinesia Med to help manage panic attacks? SSRI Cholinesterase inhibitors are used in tx of what conditon? Alzheimer's disease. MOA block normal breakdown of acetylocholine which increases their levels and duration of action in the CNS and PNS (neuromuscular junction). Also used in tx of myasthenia gravis Ex: neostigmine, donepezil, galantamine, rivastigmine What are some diseases/disorders/conditions are anticonvulsants used to treat other than seizure disorders? migraine HA prevention, bipolar DO, epilepsy Examples: carbamazepine(Tegretol), gabapentin(Neurontin), phenobarbital, topiramate(Topamax) Anti-seizure med used for prophylactic tx of migraines topiramate Anti-seizure med that is also an anti-arrhythmic phenytoin(Dilantin) Anti-seizure med w/black box warning for blood dyscrasias and serious derm rxns carbamazepine(Tegretol) First-line agent for early onset migraine NSAIDs Hallucinations may occur if __________ is stopped abruptly baclofen atomoxetine(Straterra), clonidine, and guanfacine are used in tx of which DO? ADHD initial intervention for infrequent migraine HA HA diary Meds that may cause QT prolongation methadone, tricyclic antidepressants, amiodarone CI for a triptan includes htn, CAD, MAOI use. Triptans used to ease migraine symptoms by calming overactive nerves in the brain and vasoconstriction of blood vessels in the brain What to give for hives and wheezing r/t pb? epinephrine IM Beta blockers have been used to treat _____________, _________, ____________ post MI, HTN, HF Drug route for 100% bioavailability IV Chronic renal failure will affect ___________ element of pharmacokinetics excretion Adrenergic antagonists or alpha blockers cause ____________________ vasodilation in addition to lowering BP, alpha blockers are used in tx of ________ BPH symptoms of BPH urinary frequency and urgency, nocturia, hesitancy and difficulty continuing to urinate, reduced force and size of urinary stream ("weak" stream), sensation of incomplete bladder emptying, straining to begin urination, post-void dribbling or leaking, hematuria, enlarged prostate Common side effect of ACE inhibitors dry cough Angina is a pain caused by _________________ cardiac ischemia All pts with angina should receive what drug for prophylaxis of a myocardial infarction? aspirin- antiplatelet lifestyle modifications to reduce cardiac risk include Wt loss (at least 10lbs), stop smoking, daily exercise Pt w/ heart failure, angina w/walking and slight limitation of activity is what class? Class II pt is taking hydrochlorothiazide(HCTZ) for HTN. What lab is most impt to monitor? K, for hypokalemia. Hypokalemia can result in abnormal heart rhythms, cramp and twitch muscles. HCTZ, thiazide diuretic, removes excess salt and water cardiac remodeling in HF Worsens HF. The wall of the left ventricle thickens and enlarges in an attempt to compensate for the increased workload. class of medication in pts post MI to prevent cardiac remodeling ACE inhibitors. ACE inhibitors are known to increase tissue bradykinin accumulation. Bradykinin has antigrowth effects and reduces vasomotor tone. When tx hyperlipidemia, calculation ____________ risk will help to determine tx. ASCVD risk, Atherosclerotic cardiovascular d