Final Exam: Medications

Question 1

PRILs: Rami, Perindo, Lisino

Answer 1

Therapeutic Class: Antihypertensive

Pharmacologic Class: ACE Inhibitor
Action: vasodilation, lower BP

Side Effects: drowsiness, dizziness, headache, persistent dry cough
Caution: risk of angioedema

Nursing Considerations: monitor for hypotension (hold SBP >90_, change position slow, fall risk, advocate for change in medication if patient has trouble with cough, metabolized by liver, excreted by kidneys

Question 2

SARTANs: Cande, Lo, Val

Answer 2

Therapeutic Class: antihypertensive

Pharmacologic Class: angiotensin II receptor blockers
Action: treat hypertension, lower BP

Side Effects: dizziness, headache
Caution:

Nursing Considerations: monitor for hypotension, may be appropriate for clients who cannot tolerate ACE inhibitors “PRILs”

Question 3

OLOLs: Metor, Carvedi

Answer 3

Therapeutic Class: antihypertensives & Anti Dysrhythmics

Pharmacologic Class: Beta-blockers
Action: decrease HR/cardiac contractility, lowers BP, treat dysrhythmias, HF, HTN, acute MI, CAD

Side Effects: dizziness, light-headedness, hypotension/ ortho hypo, bradycardia, dry mouth

Caution: may worsen CHF over time; therefore, contraindicated in late-stage

Nursing Considerations: Assess VS prior to admin (hold in HR <60. SBP >90), change position slowly, medication may mask hypoglycemic symptoms – monitor T1-T2 diabetes

Question 4

Amlodipine, Diltiazem

Answer 4

Therapeutic Class: antihypertensive & anti dysrhythmic

Pharmacologic Class: calcium channel blockers
Action: decreases HR/cardiac contractility, cause vasodilation, lowers BP

Side Effects: dizziness, light-headedness, hypotension/ortho hypo, bradycardia, peripheral edema, flushing, GI upset, constipation

Caution: avoid with CHF

Nursing Considerations: risk for hypotension (hold in HR <60. SBP >90), change position slowly, monitor I/O due to risk for edema, metabolized by liver, excreted by kidneys

Question 5

Digoxin, Digitalis

Answer 5

Therapeutic Class: anti dysrhythmic

Pharmacologic Class: cardiac glycoside
Action: treats dysrhythmias, improves myocardial contraction to increase CO and slows conduction to decrease HR

Side Effects: dizziness, fatigue, bradycardia, N/V/D, visual disturbances

Nursing Considerations: Monitor HR, hold HR <50, monitor for toxicity (GI upset, abnormal HR, Visual disturbances), risk for toxicity with impaired kidney function as med is eliminated by kidneys
- Blocks inotropes

Question 6

Nitroglycerine

Answer 6

Therapeutic Class: vasodilator (short-acting)

Pharmacologic Class: Nitrates
Action: decreases BP, decrease pre-load and afterload

Side Effects: dizziness, lightheadedness, headache, orthostatic hypotension, tachycardia, hypotension, flush

Caution: avoid sildenafil (viagara) = hypotension

Nursing Considerations: health teaching on use, monitor effects after use

Question 7

Furosemide (Lasix)

Answer 7

Therapeutic Class: antihypertensive

Pharmacologic Class: loop diuretic
Action: lower BP by reducing fluid volume

Side Effects: dehydration, dizziness, headache, hypotension/ortho hypo, electrolyte imbalance (hypoK, hypoNAT, hypoCA)
Caution:
Nursing Considerations: risk for hypotension, monitor lytes, daily wts, I/O, falls risk with older adults, monitor kidney function

Question 8

Hydrochlorothiazide

Answer 8

Therapeutic Class: antihypertensive
Pharmacologic Class: thiazide diuretic
Action: lower BP by reducing fluid volume

Side Effects: dehydration, dizziness, headache, hypotension/ortho hypo, electrolyte imbalance (hypoK, hypoNAT, hypoCA)

Caution: contraindicated with impaired kidney function

Nursing Considerations: risk for hypotension, monitor lytes, daily wts, I/O, falls risk for older adults, monitor kidney function

Question 9

Spironolactone

Answer 9

Therapeutic Class: Antihypertensives
Pharmacologic Class: potassium sparing diuretic.
Action: lower BP by reducing volume

Side Effects: dizziness, headache, hypotension/ ortho, electrolyte imbalances (hyperK), photosensitivity, N/V/D

Caution: contraindicated with later-stage kidney function

Nursing Considerations: Risk for hypotension, monitor lytes, daily wts, I/O, falls risk for older adults, monitor kidney function

Question 10

Acetylsalicylic Acid (ASA, Aspirin)

Answer 10

Therapeutic Class: Anti-inflammatory, antipyretic, analgesic & antiplatelet

Pharmacologic Class: NSAIDs
Action: decrease temp, inflammation, pain, and platelet aggregation

Side Effects: GI upset, bleeding

Nursing Considerations: health teaching on risk of bleeding

Question 11

Clopidogrel (Plavix, Ticagrelor)

Answer 11

Therapeutic Class: antiplatelet

Pharmacologic Class: adenosine diphosphate receptor antagonist
Action: decrease platelet aggregation

Side Effects: headache, nausea, bruising, GI upset, bleeding, heartburn

Nursing Considerations: health teaching on risk of bleeding, monitor PT/INR, hepatic activation

Question 12

Apixaban, Dabigatran, rivaroxaban

Answer 12

Therapeutic Class: oral anticoagulants
Pharmacologic Class: factor Xa inhibitors
Action: inhibit clotting

Side Effects: bruising, bleeding gums, nose bleeding, heavy menses, blood in urine/stool

Caution: risk for stroke

Nursing Considerations: monitor for PT/INR, health teaching on risks of bleeding

Question 13

Statins: Atorvastatin, rosuvastatin

Answer 13

Therapeutic Class: antihyperlipidemic
Pharmacologic Class: HMG – CoA reductase inhibitors
Action: decrease LDL/triglycerides

Side Effects: Headache, dizziness, GI upset, insomnia, MUSCLE PAIN

Nursing Considerations: monitor lipids (**fasting), hepatoxic

Question 14

Valproic Acid (epival)

Answer 14

Therapeutic Class: anticonvulsant
Pharmacologic Class:
Action: treats seizure disorders

Side Effects: abdo pain, constipation, increased appetite, N/V/D, dizziness, double vision, drowsiness, weight gain, rash

Nursing Considerations: tale same time every day, don’t stop abruptly, interact with other seizure meds (phenytoin and carbamazepine), routinely monitor blood levels, monitor liver, white blood cells/platelets

Question 15

Carbamazepine (Tegretol)

Answer 15

Therapeutic Class: anticonvulsant
Pharmacologic Class:
Action: treats partial seizure disorders – ineffective for myoclonic/absent

Side Effects: dizziness, blurred vision, confusion, constipation, drowsiness, nausea

Nursing Considerations: take same time every day, don’t stop abruptly, interacts with other seizure meds (phenytoin and valproic acid), monitor blood levels routinely, toxicity: rash/liver symptoms

Question 16

Phenytoin (Dilantin)

Answer 16

Therapeutic Class: anticonvulsant
Pharmacologic Class:
Action: treats partial seizure disorders – ineffective for absent/myoclonic

Side Effects: headache, constipation, NV, drowsiness/fatigue, gum swelling, nervousness, sleep disturbances, increased hair growth, depression, decrease HR/BP

Caution: suicidal ideation, skin rashes (Stevens-Johnson)

Nursing Considerations: Teach 1-hour pre meal or 2 hours post meal, take at same time daily, oral care (gingival hyperplasia), don’t stop abruptly, interacts with other meds – carbamazepine, valproic acid, and oral contraceptives, toxicity therapeutic range is 10-20; ataxia, tremors, slurred speech; monitor blood levels

Question 17

Lorazepam

Answer 17

Therapeutic Class: anticonvulsant
Pharmacologic Class:
Action: treats seizure disorders, slows CNS

Side Effects: dizziness, confusion, drowsiness, NV, agitation, hyperactivity

Nursing Considerations: expect to notice effect in 5-10 mins of admin, for sublingual admin DO NOT force mouth open – place between lip or inside cheek (massage until dissolved), move with client while admin, do not restrain

Question 18

Midazolam (versed)

Answer 18

Therapeutic Class: anticonvulsant
Pharmacologic Class:
Action: treats seizure disorders, slows CNS

Side Effects: Dizziness, confusion, drowsiness, fatigue

Caution: avoid in clients with glaucoma

Nursing Considerations: expect to notice effect in 5-10 mins of admin, for sublingual admin DO NOT force mouth open – place between lip or inside cheek (massage until dissolved), move with client while admin, do not restrain

Question 19

Spironolactone

Answer 19

Therapeutic Class: Antihypertensive, diuretic
Pharmacologic Class: potassium sparing diuretic
Action: lower BP by reducing fluid volume

Side Effects: dizziness, headache, hypotension, ortho hypotension, electrolyte imbalance (hyperK), photosensitivity, nausea, vomiting, diarrhea

Caution: contraindicated with impaired kidney function

Nursing Considerations: risk for hypotension, monitor lytes, daily wts, I/O, falls risk with older adults, monitor kidney function

Question 20

Norfloxacin

Answer 20

Therapeutic Class: antibiotic
Pharmacologic Class: fluoroquinolone
Action: treats infection

Side Effects: headache, nausea
Caution:
Nursing Considerations: take drug at same time daily

Question 21

Vitamin K (phytonadione)

Answer 21

Therapeutic Class: vitamin
Pharmacologic Class:
Action: supports liver in generating clotting factors

Side Effects: decreased appetite

Caution: avoid with anticoagulants, NSAIDs and ASA

Nursing Considerations: in acute bleed, admin via IV; for routine management, admin orally with bile salts to increase uptake

Question 22

Rifaximin (Zaxine)

Answer 22

Therapeutic Class: antibiotic
Pharmacologic Class: rifamycin
Action: breaks down bacteria in the colon to prevent ammonia production

Side Effects: dizziness. This med is not absorbed well so few side effects

Nursing Considerations: assess mental status during therapy for S&S of hepatoceph

Question 23

Lactulose

Answer 23

Therapeutic Class: laxative
Pharmacologic Class: sugar
Action: promotes elimination by pulling water into colon, removes ammonia from GI by drawing into colon

Side Effects: bloating, cramping, diarrhea

Nursing Considerations: may experience loose stools or increased stools/day

Question 24

Opioids (hydromorphone, morphine)

Answer 24

Therapeutic Class: analgesics
Pharmacologic Class: opiates
Action: treats pain

Side Effects: drowsiness, pruritis, N&V, constipation

Nursing Considerations: monitor resp rate, increased risk of overdose with older age, existing renal/hepatic dysfunction