311 Flashcards

(46 cards)

1
Q

if the creatine kinase level becomes elevated during statin​ therapy, what should happen?

A

the drug should be immediately discontinued.

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2
Q

What is the drug that’s mechanism of action interferes with HMG-CoA reductase, the critical enzyme in the biosynthesis of cholesterol.

A

Statins

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3
Q

What is the drug that’s mechanism of action decreases both VLDL and LDL levels

A

Niacin.

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4
Q

What is the drugs that’s mechanism of action blocks the absorption of cholesterol from the small intestine

A

Ezetimibe

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5
Q

What is the drug that’s mechanism of action binds bile acids, thus increasing the excretion of cholesterol in the stool

A

Bile acid sequestrants

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6
Q

Rare but serious adverse effects of statins

A

Severe myopathy and rhabdomyolisis

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7
Q

Patients taking statins could benefit from enhancing their diet with foods rich in CoQ10- like pork- why?

A

Statins reduce coQ10 synthesis

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8
Q

Lipid lowering drugs can deplete or diminish the absorption of what?

A

Fat soluble vitamins and folic acid

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9
Q

Gemfibrozil is contraindicated in patients with what

A

Chronic kidney disease

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10
Q

What drug is the only drug in a class called cholesterol absorption inhibitors and can block absorption of cholesterol which can cause the body to respond by creating more cholesterol?

A

Ezetimibe (Zetia)

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11
Q

Gemfibrozil (fibric acid derivative) is indicated for the treatment of what conditions

A

Hyper triglycerides and hypercholesterolemia
(It lowers VLDL with an increase in HDL)

NOT effective for lowering LDL

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12
Q

A patient has a triglyceride level of 450 mg/dL. Which drug should the nurse anticipate being prescribed for this patient

A

Fibric acid

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13
Q

Cholestyramine (Questran) can bind to other drugs. When should it be taken with a patient who also takes digoxin

A

2hours before or 4 hours after

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14
Q

If statins are having minimal impact and aren’t tolerated well by the patient, what drug would be the next choice

A

Gemfibrozil (lopid)

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15
Q

A patient is prescribed Gemfibrozil (Lopid). For which reason should the nurse expect the medication to be discontinued for this patient

A

Elevated low density lipoproteins (LDL)

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16
Q

Cholestyramine is contraindicated for what

A

Biliary obstruction

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17
Q

Triglycerides should be less than what number to be in normal range

A

Less than 150

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18
Q

What is the drug Atorvastatin (Lipitor)

A

Statin.
Side effects- myalgia, arthralagia, rhabdomyolisis (leads to renal failure!) elevated hepatic enzymes.

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19
Q

What do B-complex Vitam B do for lipid disorders and name the drug given

A

Decreases the VLDL into LDL, reduced triglycerides.
Niacin is what’s given
Side effects- flushing, nausea, diarrhea, hepatotoxicity, gout

20
Q

What do Fibric Acid Drugs do for lipid disorders

A

Activate the enzyme lipoprotein lipase, lower LDL, triglycerides and most effective lipid drug to increase HDL

Fenofibrate (Lofibra)
-administered with meals to decrease GI upset

21
Q

What do the kidney excrete that helps regulate bp

22
Q

What do kidneys excrete that stimulates red blood cell production

A

Erythropoietin hormone

23
Q

If a drug is bound to plasma proteins will it pass through the glomerulus and enter the filtrate or continue circulating in the blood.

A

Continue circulating. It’s too big

24
Q

Diuretic drugs and therapy for kidney failure

A

Diuretics: Loop/ thiazide/ potassium sparing.
Used for: HTN, AKI & CKD, heart failure, pulmonary edema.

Nurse teaching: monitor weight, HR, BP

25
Bumetanide (bumex) is what kind of drug
Loop diuretic. Most potent of them. It blocks the reabsorption of Na+ an Cl- in the nephron loop. Side effect: hypokalemia, hypotension Ototoxic
26
Ethacrynic acid (edecrin) is what kind of drug
Loop diuretic. Side effect: ototoxicity.
27
Chlorothiazide (Diuril) and hydrochlorothiazide (microzide) are what kind of drugs
Thiazide diuretics. Block Na+ reabsorption and increase k+ and water excretion. Side effect: hypokalemia (palpitations), hypotension, dehydration
28
Spironolactone (Aldactone) is what kind of drug?
Potassium sparing diuretic. Na+ & water excretion is increased & body retains more K. Side effect: hyperkalemia, no K supplements and limit K in diet. Reduces mortality in pt with CHF.
29
Furosemide and torsemide are what kind of drugs
Loop diuretic Furosemide (Lasix)- is the most popular and lasts 6 hrs.
30
Loop diuretics are mainly used for ….
Edema …..
31
Loop diuretic side effects.
Ototoxic. Decreased potassium and magnesium. Metabolic alkalosis (blood pH turning basic). Dehydration. (Fluid loss)
32
Potassium sparing diuretics can treat what and have what side effects
Tx: HTN, heart failure, edema. Side effects: elevated potassium levels; high levels can lead to gynecomastia
33
Thiazide and thiazide like diuretics work on what part of kidneys. Used for what?
Distal convoluted tubule. To prevent sodium from being reabsorbed. Used for HTN, Edema.
34
Thiazide diuretics side effects
Gout. Decreased sodium (hyponatremia) Decreased potassium (hypokalemia) Increased Uric acid (hyperuremia) Increased blood glucose (hyperglycemia)
35
OTC medications like NSAIDs, antacids, acetaminophen, and cough and flu, should be avoided with diuretics why?
All contain high levels of sodium.
36
If a patient is dehydrated and has a low BP. What do you give
Normal saline.
37
If a patient is dehydrated with a normal BP. What do you give.
0.45% NaCl
38
The drug Questran can take how long for effectiveness?
30 days or more.
39
Gemfibrozil is contraindicated in clients with what conditions
hepatic​ impairment, severe chronic kidney disease​ (CKD), pre-existing gallbladder​ disease, or those with prior hypersensitivity to the drug
40
Loop​ diuretics, compared with​ potassium-sparing diuretics, will result in what?
greatly increase urinary​ output, decrease​ edema, and promote the excretion of potassium.
41
A client is prescribed spironolactone​ (Aldactone). For which electrolyte imbalance should the nurse monitor this​ client?
Because spironolactone is a​ potassium-sparing diuretic, the client is at risk for cardiac dysrhythmias and hyperkalemia. The client is also at risk for hyponatremia and hypomagnesemia.
42
A client taking a diuretic develops gynecomastia. Which medication should the nurse suspect as causing this​ finding?
Spironolactone
43
client is taking hydrochlorothiazide​ (Microzide). Which effect should the nurse expect from concurrent use with a​ corticosteroid?
decreased serum potassium levels Hydrochlorothiazide and corticosteroids can both cause​ hypokalemia, and this likelihood is increased when the two medications are taken together
44
A client is prescribed a carbonic anhydrase inhibitor. Which response should the nurse expect after administering this​ medication?
minimal diuresis. The carbonic anhydrase inhibitors are rarely used as diuretics because they produce only a weak diuresis and can contribute to metabolic acidosis.
45
46
Normal levels for…. Na, K, Mg, Ca, creatinine
Na: 135-145 Ca: 8-10 K: 3.5-5.0 Mg: 1.5-2.5 Creatinine: 0.7-1.2