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Med Surg 210 > medications exam 2 > Flashcards

medications exam 2 Flashcards

(84 cards)

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1
Q

ezetimbibe (Zetia)

A

Cholesterol Absorption Inhibitor

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2
Q

inhibits the intetinal absorption of cholesterol; lowers LDL, raises HDL

A

cholesterol absorption inhibitor

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3
Q

side effects: infrequent, but may include headache and mild GI distress

A

cholesterol absorption inhibitor

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4
Q

nursing implication: may be combined with a statin- ezetimibe/simvastin; monitor AST and ALT

A

cholesterol absorption inhibitor

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5
Q

cholestyramine/ colestipol/ colesevelam

A

bile acid sequestrants

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6
Q

binds with bile acids in intestine, forming insoluble complex and excreted in feces. binding results in removal of LDL and cholesterol

A

bile acid sequestrants

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7
Q

side effects: unpleasant quality to taste, GI disturbances (indegestion, constipation, bloating)

A

bile acid sequestrants

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8
Q

nursing implications: interferes with the absorption of some drugs (Coumadin, thiazides, thyroid hormones, beta adrenergic blockers, digoxin, diuretcs, and some antibiotics). take before meals with plenty of fluids. mix powder with liquid throughly. take other medications 1 hour before, or 4 hours after, this medication

A

bile acid sequestrants

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9
Q

fenofibrate/ gemfibrozil

A

fibric acid derivatives

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10
Q

accelerates the elimination of VLDLs. increases production of apoproteins A-I and A-II. most effective in lowering triglycerides. also, increase in HDL- no effect on LDL

A

fibric acid derivatives

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11
Q

side effects: GI irritability (nausea, diarrhea). raises liver enzymes. may raise effects of antihyperglycemic drugs

A

fibric acid derivatives

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12
Q

nursing implications: should be used with caution when used with statins: raises risk of rhabdomyolysis, may increase risk of bleeding when used with warfarin, take with a meal

A

fibric acid derivatives

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13
Q

niacin, nicotinic acid

A

niacin

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14
Q

water soluble B vitamin that lowers LDL and triglyceride levels by interfering with their synthesis

A

niacin

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15
Q

side effects: severe flushing & pruritus in upper torso and face, GI complaints (nausea, vomiting, dyspepsia, and diarrhea), orthostatic hypotension, can raise homocysteine levels

A

niacin

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16
Q

nursing implications: instruct patient that flushing will occur within 20-30 minutes of taking drug and lasting 40-60 minutes/ after two weeks the SE should diminish/ ASA or NSAOD taken 30 minutes prior to administration may eliminate flushing

A

niacin

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17
Q

lovastatin/ pravastatin/ simvastin/ fluvastin/ atorvastin/ rosuvastatin/ pitavastatin

A

HMG-CoA reductase inhibitors

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18
Q

inhibits the synthesis of cholesterol in the liver by blocking hydroxymethylglutaryl coenzyme A reductase/ increase in hepatic LDL receptors; therefore, can remove more LDL from the blood. also, lowers VLDL and triglycerides. a small increase in HDL

A

HMG-CoA reductase inhibitors

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19
Q

side effects: liver damage and myopathy that can prgress to rhabdomyolysis (breakdown of skeletal muscle) also, may have rash and GI disturbances

A

HMG-CoA reductase inhibitors

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20
Q

nursing implications: monitor liver enzymes aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatine kinase enzymes are assessed if symptoms of myopathy occur. take with evening meal or at night; avoid grapefruit juice

A

HMG-CoA reductase inhibitors

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21
Q

ranolazine

A

sodium current inhibitor

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22
Q

exact mechanism of action is unknown/ to treat chronic angina in patients who have not achieved adequate control with other antianginal meds

A

sodium current inhibitor

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23
Q

side effects: dizziness, headache, constipation, nausea/ prolongs QT interval; therefore, should be used by patients who have not responded to other antianginal drugs

A

sodium current inhibitor

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24
Q

nursing implications: monitor for prolonged QT interval

A

sodium current inhibitor

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25
captopril/ enalapril
angiotensin converting enzyme inhibitor
26
prevents conversion of angiotensin I to angiotensin II and decreases in preload and afterload and thus decreases the workload of the heart/ decreases endothelial dysfunction/ useful in HF, HTN, diabetes, and chronic kidney disease
angiotensin converting enzyme inhibitor
27
side effects: hyperkalemia, hypotension
angiotensin converting enzyme inhibitor
28
nursing implications: monitor BP, monitor potassium level
angiotensin converting enzyme inhibitor
29
diltiazem/ verapamil
calcium channel blockers
30
amlodipine/ felodipine/ nifedipine/ nicardipine
calcium channel blockers
31
decreases myocardial contractility and heart rate, lowers myocardial oxygen demand/ coronary vasodilation and raises myocardial oxygen supply. used to manage Prinzmetal's angina
diltiazem/verapamil (calcium channel blockers)
32
systemic vasodilation with decreased SVR and lowered myocardial workload
amlodipine/ felodipine/ nifedipine/ nicardipine (calcium channel blockers)
33
bradycardia or high degree of AV block, especially if used with a beta blocker. potentiates the action of digoxine by increasing serum digoxin levels during the first week of therapy. can precipitate HF in patients with compromised LV function--particularly if verapamil or diltiazem is used with a beta blocker
calcium channel blocker
34
vasodilation can cause: 1. peripheral edema 2. reflex tachycardia (can cause angina, but rare with amlodipine or slow released nifedipine)
calcium channel blocker
35
nursing implications: monitor BP and HR. monitor serum digoxin level. monitor for signs and symptoms of digitalis toxicity. teach patient signs and symptoms of digitalis toxicity. contstipation commone with verapamil -- especially in the elderly. instruct patient to not abruptly stop taking medication without medical supervision. do not administer with grapefruit juice
calcium channel blocker
36
aspirin/ clopidogrel/ prasugrel/ ticagrelor
antiplatelet therapy
37
inhibits cyclooxygenase (produces thromboxane A2, a potent platelet activator) should be administered as soons as ACS is suspected
aspirin
38
inhibits platelet aggregation, alternative for patient who cannot use aspirin
clopidogrel
39
side effects of ASA:
GI upset and bleeding/ ototoxicity
40
atenolol/ metoprolol/ nadolol/ propranolol
beta adrenergic blockers
41
inhibits sympathetic nervous stimulation of the heart; thus decreases myocardial contractility, HR, SVR, and BP all which decrease myocardial oxygen demand. preferred drugs for the management of chronic stable angina. have been shown to decrease morbidity and mortality in patients with CAD, especially MI
beta adrenergic blockers
42
side effects: bradycardia, hypotension, wheezing, GI complaints, weight gain, depression, sexual dysfunction/ may cause bronchoconstriction in paitnes with asthma or COPD, may mask signs and symptoms of hypoglycemia in diabetic patients
beta adrenergic blockers
43
nursing implications: monitor BP and HR. auscultate lung sounds. monitor for hypoglycemia in diabetic patients. instruct diabetic patients may not have normal s&s of hypoglycemia. may need to monitor glucose levels on a regular basis. instruct patient to not abruptly stop taking medication without medical supervision
beta adrenergic blockers
44
sublingual nitroglycerin/ translingual spray nitroglycerine
short acting nitrates
45
nitroglycerine ointment/ transdermal controlled released nitrates/ extended release buccal tablets/ isosorbide dinitrate/ isosorbide mononitrate
long acting nitrates
46
promotes peripheral vasodilation, decreasing preload and afterload and reduces the workload of the heart and therefore, lowers myocardial oxygen demand/ coronary artery vasodilation and raises myocardial oxygen supply
nitrates
47
side effects: hypotension, orthostatic hypotension, tachycardia, headache, dizziness, or flushing
nitrates
48
patients can be advised to take acetaminophen with to relieve headache
long acting nitrates
49
if chest pain is not relieved in five minutes, after one dose, activate EMS, patient may take one more while waiting, then, in five minutes one more== but not more than 3
nitrates
50
alsikiren
renin inhibitor
51
directly inhibits renin, thus lowering conversion of angiotensinogen to angiotensin I
renin inhibitor
52
side effects: rash, diarrhea, increased creatine kinase level, cough, hypotension, torsades de points, acute renal failure, angioedema
renin inhibitor
53
nursing implications: monitor for swelling of the face, lips, and tongue/ not to be used during prenancy
renin inhibitor
54
hydralazine/ minoxidil
vasodilators
55
highly selective for arterial rather than venous smooth muscle
minoxidil
56
used as antihypertensive and to decrease afterload in patients with CHF
hydralazine
57
side effects: flushing, palpitations, reflex, tachycardia, angina, anxiety, headache, peripheral edema, hemolytic anemia, vasculitis
vasodilators
58
nursing implications: not useful for monotherapy and usually give with diuretic and BB
vasodilators
59
hydrochlorothiazide/ furosemide/ spironolactone/ triamteren/ eplerenone
diuretics
60
side effects: fluid and electrolyte imbalances/ hypotension/ ototoxicity with loop diuretics/ loop diuretics may raise LDL, triglycerides, glucose, and uric acid.
diuretics
61
amlodipine/ felodipine/ isradipine/ nicardipine/ nifedipine/ nisoldipine
dihydropyridines (CCB)
62
diltiazem/ verapamil
nondihydropyridines (CCB)
63
used to treat angina pectoris, dysrhythmias, and hypertension- blocks channels and inhibits Ca++ from entering cells and limiting muscular contraction and causing smooth muscle in arterioles to relax and loering peripheral resistance and lowering blood pressure
selective for blood vessels (CCB)
64
used to treat angina pectoris, dysrhythmias, and hypertension- blocks entry of calcium into cardiac myocytes and cells in the conduction system of the heart and results in negative inotropic, chronotropic, and dromotropic effects/ also relaxes coronary arteries
nonselective for both blood vessels and heart (CCB)
65
side effects: nonselective and bradyarrhythmias and conduction disturbances; can worsen heart failure; constipation; ankle edema; possible esophageal reflux or urinary retention
calcium channel blockers
66
nursing implications: monitor BP, pulse, EKG, for chest pain / grapefruit juice increases absorption of these drugs from the GI tract, causing greater than expected effects from the doses
calcium channel blockers
67
carvedilol/ labetalol/ nadolo/ pindolol/ propranolol
nonselective beta blockers
68
acebutolol/ atenolol/ betaxolol/ bisoprolol/ metoprolol
selective beta blockers
69
side effects: fatigue, sleeop disturbance, male sexual dysfunction/ may cause hyperkalemia, bradycardia, hypotension
beta blockers
70
nursing implications: monitor BP, HR, orthostatic hypotension/ may cause bronchoconstriction in astham patients/ may mask hypoglycemia in diabetic patients/ monitor carefully in HF- two that are usually used carvedilol and metoprolol/ teach patients to avoid abrupt withdrawal
beta blockers
71
reserpine
anti adrenergic (peripherally acting)
72
increased risk for orthstatic hypotension in elderly
anti adrenergic (peripherally acting)
73
depletes peripheral norepinephrine through an interaction with storage vesicles n sympathetic nerve endings and produces a fall in peripheral vascular resistance with little or no change in cardiac output
reserpine
74
doxazosin/ prazosin/ terazosin
alpha 1 adrenergic receptor antagonists
75
monitor BP, HR & orthostatic hypotension/ monitor urinary status, reduces resistance to the outflow of urine in bening prostatic hyperplasia
anti adrenergic (peripherally acting)
76
blocks the vasoconstrictor actions of norepinephrine, epinephrine at postsynaptic alpha 1 adrenergic receptors and causes vasodilation, lowers peripheral vascular resistance, and a fall in venous return/ decreases contractions in smooth muscle of the prostatic capsule and decreases urinary urgency
``` anti adrenergic (peripherally acting) alpha 1 adrenergic receptor antagonists ```
77
clonidine/ methyldopa
alpha 2 adrenergic agonists (centrally acting)
78
enters the brain and inhibits sympathetic outflow by activating receptors in the vasomotor center and leading to decreased systemic blood pressure; lowers peripheral vascular resistance, heart rate, and cardiac output
alpha 2 adrenergic agonists (centrally acting)
79
side effects: sedation/ dry mouth/ bradycardia, orthostatic hypotension, sleep disturbances, male sexual dysfunction
alpha 2 adrenergic agonists (centrally acting)
80
nursing implications: monitor BP, HR, orthostatic hypotension/ teach to avoid abrupt discontinuation and rebound withdrawal syndrome may occur and marked increase in BP, HR, anxiety, sweating
alpha 2 adrenergic agonists (centrally acting)
81
candesartan/ losartan/ valsartan/ irbesartan/ olmesartan/ telmisartan/ eprosartan/ tasosartan
ARB -angiotensin II receptor blockers
82
blocks receptors for angiotensin II in arteriolar smooth muscle and the adrenal gland and decreases blood pressure and increases UOP via blockage of aldosterone
ARB -angiotensin II receptor blockers
83
side effects: similar to ACE inihibitors/ persistent cough appears not to be as common/ postural hypotension/ should not be given during pregnancy/ risk for angioedema
ARB -angiotensin II receptor blockers
84
nursing implications: monitor BP, UOP, K+ levels, may cause hyperkalemia
ARB -angiotensin II receptor blockers

Med Surg 210 (6 decks)

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