NUR 521 ADV PHARM EXAM 2 PROTOTYPE DRUGS with 564 excellently answered Questions.

NUR 521 ADV PHARM EXAM 2
PROTOTYPE DRUGS with 564
excellently answered Questions.
NUR 521 ADV PHARM EXAM 2
PROTOTYPE DRUGS with 564
excellently answered Questions.
Furosemide (Lasix) Class - ANSWER Loop diuretic



Furosemide (Lasix) MOA - ANSWER Acts in the thick segment of the ascending limb of the loop of Henle.
Blocks reabsorption of Na/ Cl, preventing reabsorption of H2O.

Produces profound diuresis



Furosemide (Lasix) use - ANSWER When rapid or massive mobilization of fluid is needed. Pulmonary
edema associated with CHF, Edema from heart, liver, or kidney that has not responded well to other
drugs, HTN



Furosemide (Lasix) caution - ANSWER CV disease, Renal impairment, DM, PMH of gout (can cause

a flare-up), Pregnancy, Ototoxic drugs, NSAIDS, antihypertensives



Furosemide (Lasix) Dosing/ Admin - ANSWER 20, 40, 80mg tabs; IV dose available; onset within

60min ; duration 6-8hrs; usual dosage 20-80mg (1-2 times/day); start at low dose and gradually increase



Why is Furosemide (Lasix) especially helpful for patients with renal impairment? - ANSWER because
diuresis can be produced even if there is a lack of renal blood flow and even when GFR is decreased



DI for Furosemide - ANSWER Digoxin (due to loss of K it can INC Digoxin levels and cause dysrhythmias),
Other Ototoxic Drugs (gentamycin) should be AVOIDED, K Sparing Diuretics (can negate the wasting
some and is sometimes combined w/ Furosemide), NSAIDS, Antihypertensive agents, Lithium

,NUR 521 ADV PHARM EXAM 2
PROTOTYPE DRUGS with 564
excellently answered Questions.
Furosemide AE - ANSWER Hyponatremia

Hypokalemia

Hypochloremia

Hypotension

Dehydration

Hyperglycemia

Hyperuricemia

INC LDL and TGs

DEC HDL

Ototoxicity**



Pt edu for furosemide - ANSWER Monitor BP; S/S of ortho hypotn (rise slowly to avoid), K rich foods, s/s
of dehydration



BBW for furosemide - ANSWER All loop diuretics can cause profound diuresis with water and electrolyte
depletion (hypokalemia s/s: constipation, palpitations, fatigue, muscle weakness, tingling, numbness)



Hydrochlorothiazide (Microzide) drug class - ANSWER Thiazide diuretic



Hydrochlorothiazide (Microzide) MOA - ANSWER Acts in the early segment of the distal convoluted
tubule.

Promotes urine production by blocking reabsorption of Na and Cl leading to water retention in the
nephron and increased urine flow.

More mild diuresis compared to Furosemide (Lasix)

Must have adequate GFR of at least 20mL/min

Steroid derivative

,NUR 521 ADV PHARM EXAM 2
PROTOTYPE DRUGS with 564
excellently answered Questions.
Hydrochlorothiazide (Microzide) Use - ANSWER HTN

Edema in CHF, Hepatic, or Renal disease



Hydrochlorothiazide (Microzide) Caution - ANSWER CV disease, Renal impairment, DM, PMH of gout
(can cause

a flare);

Meds: Digoxin, Lithium, Antihypertensive drugs



Hydrochlorothiazide (Microzide) Dosing/ Admin - ANSWER 12.5mg capsules; 12.5, 35, 50mg tablets;
onset- 2hrs;

peaks- 4-6 hrs ;duration 6-12 hrs; usual dose- 12.5-25mg/day. Start low and adjust carefully



Hydrochlorothiazide (Microzide) AE - ANSWER Low Na, K, Cl, Hypotension, Dehydration, Hyperglycemia,

Hyperuricemia (uric acid), INC in LDL/ Triglycerides, DEC in HDL, Skin photosensitivity



Hydrochlorothiazide (Microzide) DI - ANSWER Digoxin

Lithium

Antihypertensive drugs



Hydrochlorothiazide (Microzide) pt edu - ANSWER Daily wt., s/s of hypokalemia (constipation,
palpitations,

fatigue, muscle weakness, tingling, numbness)



Drug class for spironolactone (aldactone) - ANSWER Potassium Sparing Diuretic (Aldosterone
Antagonist)



MOA of Spironolactone (Aldactone) - ANSWER Acts in the late distal convoluted tubule and collecting
duct to block the actions of aldosterone.

, NUR 521 ADV PHARM EXAM 2
PROTOTYPE DRUGS with 564
excellently answered Questions.

Goal of spironolactone - ANSWER To treat hypertension (HTN) or edema and counteract potassium-
wasting drugs.



What are some uses of Spironolactone? - ANSWER Hypertension, edema, CHF, off-label for acne, hair
loss, hirsutism, hormone therapy for trans females.



What baseline data should be collected before administering Spironolactone? - ANSWER Vital signs (VS),
weight, and electrolytes.



What should be monitored while a patient is on Spironolactone? - ANSWER Vital signs, weight,
potassium level, and serum testosterone with trans treatment.



What are some adverse effects (AE) of Spironolactone? - ANSWER Hyperkalemia, gynecomastia,
menstrual irregularities, impotence, hirsutism, deep voice.



What is the dosing information for Spironolactone? - ANSWER Available in 25, 50, 100 mg tablets; onset
is 24-48 hours; duration is 48-72 hours; usual dose is 25-200 mg/day.



What drug interactions (DI) should be noted with Spironolactone? - ANSWER Can counteract potassium-
wasting drugs; caution with potassium supplements and potassium-sparing drugs (ACE-Is, ARBS, DRIs).



What patient education should be provided for Spironolactone? - ANSWER Inform about adverse effects
and restrict intake of potassium-rich foods.



What is the black box warning (BBW) for Spironolactone? - ANSWER Shown to cause tumors in rats;
avoid unnecessary use.



What is the class of Triamterene (Dyrenium)? - ANSWER Potassium Sparing Diuretic (Non-Aldosterone
Antagonist)