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202-1 Flashcards

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1
Q

Classification of Captopril

A

ACE inhibitor

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2
Q

Mechanisms by which Captopril works:

A

1: inhibits change of Angiotensin I to Angiotensin II
2: Decreases aldosterone secretion (inc. sodium & water excretion)
3: Decreases peripheral vascular resistance

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3
Q

Common adverse effects of Captopril:

A

chronic cough

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4
Q

Serious adverse effects of Captopril:

A

neutropenia, fever, chest pain, hypotension, dysuria, photosensitivity, angioedema, hyperkalemia, hyponatremia, positive ANA titer

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5
Q

Pregnancy classification of Captopril:

A

D

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6
Q

Therapeutic class of Captopril

A

Antihypertensive

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7
Q

Pharmacotherapeutics for Captopril:

A

1: hypertension
2: malignant HTN when prompt titration of BP is needed
3: heart failure unresponsive to alternative treatment
4: left sided heart failure after an MI
5: diabetic nephropathy

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8
Q

Route of Captopril

A

PO

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9
Q

Onset of Captopril

A

15-60 min

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10
Q

Peak of Captopril

A

60-90 min

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11
Q

Duration of Captopril

A

6-12 hr

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12
Q

Captopril decreases ______ concentration in the blood

A

angiotensin II

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13
Q

Contraindications of Captopril

A

concurrent aliskiren use in diabetics or patients with renal impairments

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14
Q

Captopril may interact with:

A

ACE inhibitors: increased hypotension, renal impairment
allopurinol: incr. hypersensitivity reactions
antacids: decreases absorption
Digoxin: inc. digoxin levels
NSAIDS: additive effects
Alcohol: additive

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15
Q

Adverse reactions of Captopril:

A

Persistent nonproductive cough, angioedema, rash, hypotension, neutropenia, and dyspnea

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16
Q

____ decreases absorption of Captopril

A

food

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17
Q

What to watch for when patients are taking Captopril:

A

Assess blood reports for hyperkalemia, hyponatremia, and neutropenia, and assess urine for proteinuria.

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18
Q

Therapeutic class of Dextromethorphan

A

antitussive

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19
Q

Indications for Dextromethorphan

A

nonproductive cough

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20
Q

mechanism of action for dextromethorphan

A

affects the cough center in the medulla

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21
Q

onset of Dextromethorphan

A

~ 15-30 minutes

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22
Q

Duration of Dextromethorphan

A

5-6 hours

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23
Q

Dextromethorphan adverse effects:

A

toxicity, nausea, vomiting, drowsiness, dizziness, irritability

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24
Q

Use Dextromethorphan cautiously in:

A

patients with hepatic impairment, pregnant women

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25
Contraindications of Dextromethorphan
chronic cough from emphysema or asthma
26
Drug-drug interactions with Dextromethorphan
other CNS depressants (increased sedation) MAOIs (possible serotonin syndrome) Alcohol (Additive effect) Fluoxetine, quinidine
27
Food-drug interactions with Dextromethorphan
``` grapefruit Orange juice (increased risk of toxicity) ```
28
Important patient/family teaching for Dextromethorphan therapy
sedative effects, pregnancy
29
Classification of Guaifenesin
expectorant
30
indications for guaifenesin
cough with thick secretions and promoting productive cough
31
mechanism of action of guaifenesin
removes fluid and mucus from the URT by increasing volume & reducing adhesiveness and surface tension
32
onset of guaifenesin
30 mins
33
duration of guaifenesin
4-6 hours
34
peak of guaifenesin
unknown
35
contraindications of guaifenesin
hypersensitivity
36
adverse effects of guaifenesin
dizziness, headache, nausea, vomiting, rash, urticaria
37
Important patient/family teaching for guaifenesin
don't take > 1 week | increase fluids to help thin secretions
38
Classification of albuterol
selective beta-2 adrenergic agonist, bronchodilator, sympathomimetic
39
indications of albuterol
prevents exercise induced asthma, treats bronschospasm
40
mechanism of action of albuterol
attaches to beta-2 receptorson bronchial cell membranes. Converts ATP to cAMP (lowers Calcium levels-relaxes bronchial smooth muscle cells and inhibits histamine release
41
onset of albuterol
5-15 mins
42
peak of albuterol
50-55 mins
43
duration of albuterol
2-6 hours
44
contraindications of albuterol
hypersensitivity
45
Use albuterol cautiously in
patients with cardiac disorders, diabetes, digitalis intoxication, HTN, hyperthyroidism, seizure hisotry
46
Adverse effects of albuterol
anxiety, dizziness, drowsiness, angina, arrythmias, dry mouth,, diarrhea, bronschospasm, cough, dyspnea, paradixical bronschospasm, hypokalemia
47
Drug-drug interations with albuterol
``` beta blockers (inhibits) digoxin (lowers) MAOIs Tricyclic antidepressants potassium lowering drugs (hypokalemia) Special considerations for albuterol ```
48
administer during the second half of an inspiration, monitor serum potassium levels, drug tolerance may occur over time Patient/family teaching for albuterol
teach inhaler use, shake and prep prior to use, wash mouth piece once a week, wait one minute between inhalations
49
classifications of theophylline
xanthine derivative, bronchodilator
50
indications for theophylline
reversible airway obstruction (as a loading dose/partial loading dose), maintenance of COPD and asthma
51
mechanism of action of theophylline
inhibits phosphodiesterase enzymes, causing bronschodilation, calcium translocation, antagonizes prostaglandins
52
contraindications of theophylline
hypersensitivity, peptic ulcer disease, uncontrolled seizure disorder
53
use theophylline cautiously in
elderly, adults with cardiac decompensation, or hepatic impairment, acute pulmonary edema
54
Adverse effects of theophylline
agitation, anxiety, headache, insomnia, hypotension, tachycardia, hyperglycemia, hypercalcemia
55
Drug-drug interactions with theophylline
don't mix with any additives, don't infuse with Hetastarch, allopurinol, oral contraceptives, metropolol, benzos, ephedrine, alcohol (increased blood theophylline levels), smoking (decrease theophylline effectiveness)
56
Diet interactions with theophylline
high carb, low protein diet (decreased theophylline elimination) low carb, high protein diet (increased theophylline elimination)
57
special considerations of theophylline
drug doesn't bind well to body fat, monitor blood theophylline levels, assess HR and rhythm
58
Patient/family teaching theophylline
capsules may be opened and mixed with food, take with a glass of water on an empty stomach unless GI distress occurs, incorporate lifestyle changes
59
last resort drug in COPD patients
theophylline
60
classification of hydrochlorothiazide
diuretic
61
indications for hydrochlorothiazide
edema from CHF, HTN, hepatic or renal disease, secondary to drug use
62
MOA of hydrochlorothiazide
increases sodium and water excretion by inhibiting sodium and chloride reabsorption in distal segment of the nephron
63
onset of hydrochlorothiazide
2 hours
64
peak of hydrochlorothiazide
4-6 hours
65
duration of hydrochlorothiazide
6-12 hours
66
contraindications of hydrochlorothiazide
severe renal disease, anuria ( > 250 mL/day), hepatic coma
67
use hydrochlorothiazide cautiously in:
patients with renal disease, lupus erythematosus, liver disease, fluid/electrolyte imbalances, diabetes, gout, elevated cholesterol/triglycerides
68
adverse effects of hydrochlorothiazide
dizziness, headache, orthostatic hypotension, pancreatitis, renal failure, aplastic anemia, fluid/electrolyte loss, thrombocytopenia, hypokalemia, hyponatremia, hypochloremia, hypercalcemia
69
Drug-drug interactions with hydrochlorothiazide
dofetilide (severe cardiac arrythmias) high sodium foods acetaminophen anticoagulants
70
special considerations in hydrochlorothiazide therapy
monitor BP, weight loss, serum electrolyte levels
71
important patient/family teaching in hydrochlorothiazide therapy
take in morning so diuresis doesn't affect sleep, avoid high sodium diets
72
classification of digoxin
digitalis glycoside, antiarrythmic, cardiotonic
73
indications of digoxin
HF, atrial flutter, Afib, paroxysmal atrial tachycardia with rapid digitalization
74
MOA of digoxin
increases force and velocity of myocardial contraction (increases inotropic effects), decreases conduction rate, increases ERP of the AV node
75
contraindications of digoxin
hypersensitivity, hypersensitive carotid sinus syndrome, presence/history of digitalis toxicity or idiosyncratic reaction to digoxin, Vfib, tachycardia, patients with restrictive cardiomyopathy, constrictive pericarditis, amyloid heart disease, idiopathic hypertrophic subaortic stenosis
76
use digoxin cautiously in
elderly debilitated or patients with pacemakers, beri-beri heart disease
77
adverse effects of digoxin
weakness, confusion, drowsiness, arrythmias, heart block, abdominal discomfort, dizziness, nausea, vomiting, electrolyte imbalances
78
drug-drug interactions with digoxin
antacids (decreases absorption) | high fiber foods (decreases absorption)
79
special considerations for digoxin therapy
once diluted, giver immediately; monitor ECG and patient's serum potassium levels
80
classification of nitroglycerin
nitrate, antianginal, antihypertensive, vasodilator
81
indications for nitroglycerin
angina, manage HTN or heart failure
82
MOA of nitroglycerin
interacts with nitrate receptors in vascular smooth muscle cell membranes (forces calcium out of muscle cells) reduces pre- & afterload dilates coronary arteries
83
contraindications of nitroglycerin
MI, acute closure glaucoma, hypovolemia, increased intracranial pressure, orthostatic hypotension, pericardial temponade, severe anemia
84
use nitroglycerin cautiously in
elderly patients
85
adverse effects of nitroglycerin
agitation, anxiety, dizziness, arrythmias, hypotension, abdominal pain, dysuria, arthralgia, bronchitis, contact dermatitis, flushing of the face/neck, headache
86
drug-drug interactions with nitroglycerine
acetylcholine, norepinephrine, heparin (decreases anticoagulant effects), vasodilators, phosphodiesterase inhibitors, sympathomimetics (dec. antianginal, Inc. hypotension), alcohol (inc. orthostatic hypotension)
87
special considerations for nitroglycerin therapy
plan nitroglycerin free-time for 10 hours per day check LOC and vitals keep out of light don't shake

NUR 202 (3 decks)

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